Propecia’s Effective Years

Dear Dr. Rassman.

I write today about a nagging issue concerning propecia. I started it just a couple of weeks ago, with no side effects so far, but my worry is this that I read around the web, about propecia eventually losing its effectiveness after five years. I thought it would work by diminishing A-5-Reductase and therefore it would reduce DHT as well. Why would it lose its effectiveness? Or is this just a rumor? I wouldn’t mind having to take it for the rest of my life as long as I can keep my hair with it. Of course I plan to get a transplant eventually to recover some thinning areas in case it can’t fix it, in addition to some other treatments available today. If it’s only going to work for five years, what’s the point of taking it? Wouldn’t it be better to blow it all in a transplant? Or is there the chance to keep most of my mane by simply taking Propecia?

Thanks, and keep up the great work.

You should approach the question as Propecia not losing effectiveness, but having limitations and possibly not managing all of the hair loss to your satisfaction. Propecia will not restore your hair back to when you were a teenager. Even hair transplant surgery will not do that. Propecia slows down the male pattern hair loss process. The 5 years is not a magic number, but it does reflect the published 5 year study by Merck, the makers of Propecia. Patients not taking Propecia had a much greater rate of hair loss in the five years that the process was studied. If your question is based on pure monetary economics, you are correct in stating that hair transplant is the only permanent solution, but a solution to what? I often tell young men not to transplant if the drug holds off the hair loss and the hair loss does not bother them a great deal. I make my living doing hair transplants, yet I tell more people to take Propecia than suggest hair transplants, because I am honest… and honesty is the best policy. But if your question is based on hair economics, Propecia with a hair transplant (in some people) will maximize your hair density and give you a better cosmetic result. Just be careful who you talk to. When someone wants to push you to a hair transplant, take your time and remember: Let the buyer beware.