What Percent of Patients Get Transplants and Skip Propecia?
Hi Drs. Rassman, et al., and thanks for your great site. I was wondering what percentage of patients in your practice elect to have hair transplant surgery as the sole treatment option for male pattern baldness and forgo Propecia. And, of those who do not use finasteride, how do their results compare long range with those who do? Is the difference significant? I plan a hair transplant procedure this year but have decided against using Propecia due to the controversy surrounding its side effects.
Thanks again!
Controversy surrounding Propecia’s side effects are nothing more than circumstantial and hearsay. I realize most of you reading BaldingBlog are smart or savvy enough to use the Internet to conduct your research and form opinions. What some people seem to be missing though is that the Internet is not the source of medical information for self assessment, treatment, and management. I am not your doctor, but if you have concerns with medications (such a Propecia) talk with your doctor and get the real facts.
I will say again that in my 10+ years of prescribing and managing thousands of patients on Propecia (including my sons), I have yet to see the exaggerated side effects that I read on the Internet. I recommend it to almost all my male patients that have hair transplant surgery to preserve the existing hair as well as minimizing the shock loss that occurs in a limited number of patients. While I have not documented the exact numbers, I would say that in my practice well over 75% of my patients who have surgery take Propecia (finasteride). There are patients who do elect not to take Propecia and that is perfectly OK as well.
In general, I feel most patients who continue to take Propecia seem happier in the long run, because the hair loss has been arrested. It may be my perception, but those who do not take Propecia tend to come back for another hair transplant surgery as they lose more of their existing hair faster… and hey, that is fine by me. It is my practice to give my patients all the information they need (on surgery and medication) and come up with the Master Plan in managing their own hair loss. The ultimate decision is left to the patient themselves.
Young men (those under 30), in particular, are in a rapid mode for their hair loss. On the other hand, men over 50 are not prone to the acceleration of hair loss seen with the young man. Those men between 30-50 years old are somewhere in between the two groups. There are tests that we do routinely to advise men what to expect with their hair loss and when to expect it. It is so important to develop a Master Plan, bond with your doctor who you should visit and follow with yearly examinations, as the tests we now use (bulk assessment, miniaturization studies) clearly define just how progressive the hair loss will be and how effective we are at controlling it. Using Propecia (finasteride) does require, in my opinion, that these tests get done to allow you to follow the Master Plan and change it accordingly.
It is circumstantial. I don’t get why you think there is some great conspiracy on my part. I posted this and allow comments to let the readers of this site get all viewpoints. If I wanted to brush it under the rug, I’d simply not post about it. You should look up malpractice law before accusing me of such. I’m not your doctor. The views on this site are my opinion, which is based on peer-reviewed studies and FDA approval. I don’t base a lot of opinion on what anonymous commenters say across the web.
I don’t think there is some conspiracy on your part. However, by using your authoritative podium to call the thousands of anecdotal reports circumstantial and hearsay you are sweeping their significance under the rug. It would be much more appropriate for you to not mention the issue at all if you are just going to use your instincts to dismiss them.
Like I said, I feel this is an important point to bring up because anxious patients will look to you for your expert opinion on matters like this and the tone you use in your blog posts, at the very least, creates the impression that you think very little of these voluminous reports.
Many of the reports are anonymous and unverified. This is circumstantial and hearsay. I’ve yet to see any case of permanent side effects that doesn’t start with “one guy on the web said…”
Patients should always do their own research and talk to their own prescribing doctor. I’m really having a tough time understanding why you don’t get that. I’m not prescribing anything via the web and the visitors to this site aren’t my patients.
“The Traish review article cites a single case without supporting documentation or a full case history.”
Jason, do you care to respond to this point that Dr Rassman makes? Or will you just inform us to go to that anonymous website again?