Dr. Rassman,

I really can’t think of any other industry – medical or professional – that has a preeminent member so willing to directly interact with the general public. You do a great service (and a excellent technical execution of it with your website) and I wanted to start off by thanking you for your contribution. Imagine a world that had this sort of “hands-on” information from the most knowledgeable people available on other life and business topics.

Just a quick note – I recently turned 30 and marked my 6th year with Propecia. I’ve never had a single side effect, and I wanted to highlight your point about the internet being filled with the loud minority that have problems. Us folks with happy results tend to keep quiet and go about our business. I was certain when I started I would be bald by now, but happy to report a full head of hair – it really does dramatically stop the speed of genetic MPB. Good thing smart Doc’s like you are not afraid to stick up for it.

Cheers!

I’m glad the medication has been successful in maintaining your hair and I’m also pleased that you enjoy the site. I really appreciate emails like yours (we all like a pat on the back once in a while), so thank you for your kind words.

Hi Dr.Rass . I have been under OCD treatment for the past 11 years. I am undergoing SSRIs (Es-Citalopram oxalate) Would you recommend Finasteride in my case.

Shall I try topical minoxidil will it in any way interacts with my OCD medication.

I can’t recommend finasteride to you, since I do not know if you’re even a candidate and it is a prescription medication. Talk to your doctor about a prescription and you can learn his/her thoughts on it. As for minoxidil, that is over-the-counter so you can use it without my input (read up on it and use your best judgment). You shouldn’t have any interaction problems with your OCD meds and minoxidil, but without knowing which medications you’re taking I can’t say for sure.

There have been some reports of some mood / behavioral changes with Propecia, although these changes are very infrequent and it needs to be studied further. That is why you need to have a good relationship with your doctor.

hey doctor, it seems everywhere (mainly hair loss forums) i read it’s saying that propecia is meant to just maintain hair and that any regrowth is an added bonus. But propecia’s website says in their 2 year study that 66% of men had visible regrowth. 2/3 sounds like the majority of people should regrow hair. furthermore the 5 year study says that almost 50% regrew hair. could u shed some light on this as nearly every forum i visit states that hair regrowth with propecia should not be expected.

I have seen substantial growth from Propecia, and even a complete regrowth in the frontal area once or twice in my years in practice. Regrowth in the crown is much more common and expected in men under 30 years old.

As for forums vs scientific data, well… let’s put it this way. If you got great growth, are you going to spend time on a message board letting everyone know? Probably not. But if you didn’t get the results you expected, you’ll be more likely willing to spend the time to warn people. So when it seems like a lot of posts say the same thing, its because it can be easily skewed.

Dr. my hair loss started when I was 23. At that point I started researching my options. I’m now 27. My hair loss has progressed at slow pace (thank god). I tried propecia based on my research, a lot of which came from your blog. Right around the 3rd month I really felt like the loss at least stopped where it was at and if I would have kept taking it possibly could have had some regrowth. I was deployed to Iraq at this time. When I came back I came into your office for a consult. Where I saw Dr. Pak. My hair loss was determined to be I beleive the 4a pattern. (can’t remember for sure)

Anyway to get to the point. someone had pointed out to me that that my chest was getting kinda big. I definitly had some breast enlargement which I ended up having reduced by lipo suction. (Very happy with the results by the way incase anyone else has this issue) I’m not sure if the enlargement came from propecia or a combination of bad diet and heavy heavy drinking. My question is whats your opinion on me trying propecia again? and when there is enlargement from taking propecia is it fat deposits as mine obviously was or is it actual breast tissue like a female would have? As this could possibly answer where my enlargement came from propecia or something else. I am not sure how fast I got the enlargment. It could have been very gradual which is why i didn’t notice myself or maybe sudden when I was taking the propecia. I would really love to stop my hair loss. what do you think I should do?

Thank you very much for your time!

I would try the Propecia again and follow closely what happens. While it is possible you experienced gynecomastia from the medication, a poor diet with weight gain could also cause the same symptoms. I wouldn’t be able to determine if it was just the medication, just your weight gain / poor diet, or a combination of everything. I believe the medication (as rare as the side effect is) would cause the mammary glands to enlarge. This is mostly composed of fat, so it’s difficult to visually distinguish if the enlargement was caused by diet or medication. That’s one of the reasons I’m skeptical about a lot of the reports I’ve read on various forums. People might be seeing it, but it doesn’t necessarily mean it was Propecia.

Coincidences happen all the time. At least you recognize that. I’m glad your liposuction was successful, and if you’re in the LA area and would like to come in again, we can get a good baseline on your chest size before restarting the medication.