The crown of the scalp is often more finasteride responsive than the frontal area of the scalp. In this man in 3 months he has clear growth beginning. If he added minoxidil it might get better faster
2020-08-05 03:06:022020-07-31 14:10:043 months on finasteride (photo)
Dr. Rassman’s Comments: There is some good reading here for those interested in finasteride and the many finding of things that go wrong with this drug. One of the referenced article reflect a single case study and show DNA damage to sperm. From any single case study, one can’t conclude that the finding is attributed to finasteride as discussed by the authors. Another article address high grade prostate cancer risks with finasteride and found nothing to suggest that it is a cause and effect. Still, these articles are not authoritative and do not stand alone.
This is a follow up from
https://www.reddit.com/r/tressless/comments/f4hnuy/my_trip_to_the_derm/
Once again I am not a medical professional or giving advice.
Basically I’m in my late 20s and have had some thinning and recession, this has gotten worse despite several years of using minoxodil 5% with good compliance. I also use Ketoconazole 2% shampoo (usually daily). I think they both help, but it’s hard to prove.
So I’m looking into propecia/finasteride. I have the pills with a derm. prescribing 5mg stating that the higher dose is more effective than 1 mg.
I saw a urologist the other day about sexual and in particular fertility concerns prior to using finasteride. Honestly the fertility worries me more because I would like to have children down the road but fertility problems aren’t always known until one attempts to conceive. I feel that if one gets noticeable (like erectile dysfunction) side effects, discontinuing the drug is likely to lead to a recovery whereas keeping on the drug for years seems more likely to impair recovery. The Dr. seemed open and candid about side effects overall and discussed both sexual and psychiatric side effects. He stated that the causation of effects was hard to determine given the number of different reported effects and how many things could cause them. He seemed to think that for how often the drug is prescribed side effects aren’t super clear. He stated that fertility effects were “usually” reversible. He also felt that 5mg was too much and referred me to another derm. (who he said takes finasteride himself).
It says right on the finasteride pamphlet that fertility might be effected. I’ve read some studies that have shown a reduction in sperm parameters in some men, typically reversible. This one is probably best https://academic.oup.com/jcem/article/92/5/1659/2598215 , it states that;
” Some individuals (approximately 5% of the subjects on active treatment) demonstrated greater sensitivity to the effects of 5?-reductase inhibition, with decreases in total sperm count to less than 10% of their baseline values during treatment. “
and
“Partial to nearly complete recovery was observed during the follow-up period for total sperm count and semen volume. Of particular note, approximately 5% of individuals on active treatment showed dramatic declines in total sperm count during treatment, although they demonstrated recovery in the follow-up period. The overall impact of these findings on fertility is currently unknown. “
But even that doesn’t tell the whole story. In particular sperm can be visually (by microscope) OK but have damage to the DNA “fragmentation” that causes the cell the either self-destruct “apoptosis” (although I would think this happens early in spermatogenesis), lead to a miscarriages as the human body effectively aborts a fetus with problems, or result in a child carrying/with a mutation. The sperm (or mother through mechanisms I don’t understand well) can sometimes fix the fragmented DNA. I believe this fixing ability deteriorates with age.
DNA fragmentation is associated with older fathers and I believe is why they are associated with offspring with disorders like autism, Down syndrome, and schizophrenia. A high rate of DNA fragmentation is associated with overall difficulty in conceiving and there are at least a couple of case studies of men who discontinued finasteride and had fragmentation levels improve dramatically.
(Articles below)
So, my opinion is that finasteride might effect fertility and this effect is likely reversible. I do feel however that there is a real risk. If I’m one of the 5% with a huge drop in fertility and I take the drug for I dunno 10 years, maybe it’s not so reversible, or some of the less detectable factors don’t fully reverse. It seems odd to me that fertility isn’t a bigger concern with this drug when prescribed to young men.
https://link.springer.com/article/10.1007%2Fs11255-012-0315-9
Herein, we present an unusual case of secondary infertility after prolonged use of low-dose finasteride for androgenetic alopecia in a 40-year-old man. We detected sperm DNA damage in the patient. Despite such a long-term use, we observed that impairment in semen parameters and sperm DNA fragmentation index regressed after the drug was discontinued. Consequently, pregnancy occurred and resulted in live birth.
https://www.ncbi.nlm.nih.gov/pubmed/21292254
To report a case of low-dose finasteride-induced secondary infertility with associated elevated sperm DNA fragmentation index (DFI) and otherwise normal semen parameters.
Case report.
University hospital.
A 48-year-old man on low-dose finasteride and his 37-year-old wife with normal menses and normal gynecologic exam.
Determination of sperm DFI and discontinuation of low-dose finasteride.
Sperm DFI.
The sperm DFI done a year earlier was 30%. This value was unchanged when repeated 2 months later. The patient was advised to stop finasteride. Three months after discontinuing the finasteride, the DFI decreased to 21% and subsequent DFI after another 3 months improved to 16.5%. To date, there is still no documented full-term pregnancy or live birth.
The significant reduction in DFI within 3 months of finasteride cessation and continued improvement suggests a causal link between finasteride and sperm DNA damage. We hypothesize that low-dose finasteride may exert a negative influence on sperm DNA integrity, resulting in increased pregnancy losses. We suggest that in infertile men using finasteride, sperm DFI should be measured in addition to semen parameters, and a trial of discontinuation of finasteride may be warranted.
Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
2021-09-08 01:32:472021-09-05 12:18:09Information on finasteride by Reddit poster
I am a 51 year old female who had a complete hysterectomy 10 years ago. My scalp has been itching ever since and I find hair on my pillow every morning. Fortunately, I also began with very thick hair. The itching is intense. I was diagnosed with a fragrance allergy, but using fragrance free products (everything) does not help at all. Dandruff shampoo made no difference. Prescription shampoo did not help. I hate to think I will have this condition for the rest of my life. I’ve tried cutting back on my hormone replacement hoping it would help, but it didn’t.
If I examined your scalp I might make sense of what you are telling me here, but there’s not much help I can offer you without seeing you and knowing more about your history. Just note that scratching your scalp harshly will eventually cause hair loss from traction alopecia.
Since treating a fragrance allergy didn’t resolve the itchy scalp, you should go back to your dermatologist for a follow-up. It’s possible the HRT is leading to the scalp itch, but this is something you should also be discussing with your doctor.
2011-08-12 12:46:142011-08-09 15:11:22Intense Scalp Itch After Hysterectomy a Decade Ago
I love doing Scalp Micropigmentation (SMP) because at times, the results are instantaneously amazing as it was today. Leave aside some mild pink color to the area of the scar that was just treated (it will be gone tomorrow), he was blown away by the disappearance of his scar from two hair transplant procedures in the past and the apparent fill-in of his crown with just the SMP pigments. Scarring like his is unusual and occurs in only a few patients who have stretchable skin (with high elastin collagen). He said his crown looked as good as if he has another hair transplant today with instant growth.
2019-10-08 14:04:422019-10-08 14:27:56In just one day we repaired this man’s surgical scar and filled in a very thin crown area
The drug melatonin, a potent antioxidant and growth modulator, was identified as a promising candidate for the topical treatment of hair loss. The study was conducted in 2003 at the Forenap Centre Hospitalier in Rouffach, France. The drug was found to be well tolerated. Approximately 80% of people found that it reduced hair loss during the short 90 day trial. The study concluded that there was a positive effect of melatonin on hair growth in patients with AGA. The authors recommended more studies have to be done to confirm the benefits for both short and long term hair loss treatment. The drug melatonin may behave similar to a topical drug which was marketed by a French pharmaceutical company which was known as a “morning after” abortion pill (as it was/is known and marketed some 20 years ago) and no longer on the market. A topical form of melatonin is commercialized in Spain (a topical solution called Lambdapil solution) but according to a colleague there, it is weak and no better than minoxidil.
2015-01-22 07:21:282015-01-20 11:21:54Interesting Topical Medication For Hair Loss
2019-12-16 04:00:292019-10-26 13:03:25Is 19 Too Young to Start Finasteride? I Started Puberty Fairly Late.
Creatine may accelerate genetic hair loss but with conventional treatments and cessation of the creatine, it could be reversed.
