Question regarding catch-up hair loss and propecia. I have been on propecia for 4 years now and have not seen an affect of balding. Im a 27 year old male with no sign of hairloss as of right now. I started taking it because my mothers father was bald as well as her brother. I had no signs of hair loss. Right now Im about to attend a school for work (military) that does not allow prescriptions. My question is how long do most people have before they see severe catch-up hair loss?

I don’t know why you would take a prescription hair loss treatment if you didn’t have signs of hair loss — or I guess the better question would be, why would a doctor prescribe it to you? Finasteride should not be used as a preventive medication; it should only be taken once hair loss is evident. Since you started taking the medication with no hair loss present, I don’t know if you do have genetic hair loss that Propecia protected you from, or if the hair loss gene skipped you altogether.

If you have genetic male patterned hair loss, and have been slowing or stopping the problem with finasteride/Propecia, you may very well have “catch-up” hair loss and see the impact in 1-4 months.

Hello and thank you for all these answers and clarifying a lot of myths on balding!

My father, his brother and their dad are bald and I started balding in my early 20s. A quick visit to a dermatologist made me start 1/4 Proscar which I did for 6 years. By then end of that period I become increasingly worried that some depression symptoms, lack of motivation, memory and concentration were being caused by it. No major sexual problems… I stopped it over 1.5years ago.

Some people think stopping finasteride may not have any consequences… that’s very naive i think, specially if you took it for a long time. The major changes I’ve noticed were: increased body hair (beard, arms, back and legs mainly), more easy to gain muscle, but my belly suddenly also started accumulating fat way more easily, body smells are all of a sudden way more intense, my constant 4-5 colds/ throat “virus” per year reduced a lot (not been sick at all this past year…), erections are more potent (horny way more often), skin aging seems to have accelerated, hair is falling and receding fast! Many of these are consequences of a male hormone back into a high level i think. Depression, memory improvements? … very hard to tell!

Question: Have you heard of any of these depression/ mental problems? Some people claim nasty sexual sides, is it likely that i will develop those if i restart 1/4 proscar for some more years? I mean, given i had no major sides (apart from the elusive mental problems which doctors never believed) can i assume proscar is safe for me?

Also, may i ask what are the current guidelines for having a HT at an early balding stage? Could i just assume that balding is occurring and do half transplant now which lasts some years and do the rest in say… 10years time or so?

Many thanks in advance for your advice and for this blog!

I appreciate your problems, but you need to see a doctor to surround them. I’ve never heard of anyone having their body smells change or getting sick more often, nor have I heard that finasteride could cause skin aging. I am not surprised that your hair is receding fast, since you stopped the medication that was protecting your hair.

As for hair transplant guidelines, hair loss is a progressive process. You’ll need to talk with a surgeon to develop a Master Plan for treating your loss.

Hi doc
I’m into third month of propecia, and I’m glad to say it’s starting to work- woohoo! However- a strange side effect. It’s so darn effective that I’ve now grown hair between my eyebrows and my temples. As I noticed this in the daytime, I doubt I’m moonlighting as a werewolf.

How common is this? Is it adviseable to shave it off? What’s the chances of it thickening up and being a real problem? Can you hook me up with an audition for a horror film- I’ll save loads in make up costs!

Keep up the good work.

I have heard of strange hair growth patterns with Propecia, but this is a new one to me! You sound to be in good spirits with a healthy sense of humor, at least.

I suppose shaving the hair off would be the best thing to do.

I understand that I have to use Rogaine throughout my life if I want to retain my hairs but my only concern with it is its impact on other natural hairs (not affected by DHT yet). I have read somewhere that when you stop applying rogaine, not only the hairs which were grown by it would be gone but along with, your natural hairs will also be affected due to the way it works. Is it true doctor?? As you can see in the picture, my hairs are quite thick except the crown area so if I have to use rogaine, I will only use it on crown area, which means if I stop using it in future for some reasons, I will only loose regrown hairs (on crown area) and not anywhere else. But if that publication is true about the impact of rogaine on other hairs as well then don’t u think it is risky to use it as I may end losing more hairs if I have to stop it??

So to sum up, my question is that once the rogaine treatment is stopped, does other hairs (not effected by DHT) will also be lost along with rogaine dependent hairs?? Secondly, I also read that with years of using rogaine, your body becomes immune to it thus negating its positive effect. Is it true?? For how many years, it can be used before it stop working on your body.

In the end, I would like to thank you again for taking the time out to reply to me….It really means a lot to me to get an answer back from the world most renowned doctor. Thank you so much.

If you stop Rogaine, the only hairs that may be lost are those that grew as a result of this drug. What you’re asking me is something people refer to as minoxidil dependence, but that only applies to the hairs that minoxidil grew. You can learn more about that here.

Rogaine (minoxidil) should not impact normal hair in any way, nor does it impact DHT in any way. The impact of Rogaine is strictly a side effect of this drug, and DHT will still cause hair loss on genetically impacted hair. Finasteride (Propecia) is a DHT inhibitor, but Rogaine is not.

hi doc
i have serious miniaturisation but the doctors i met didn’t even look at my hair closely and gave me some vitamin pills. what can mpb sufferers do if the doctors wont prescribe drugs like proscar? i seriously doubt those docs have heard about fin

The answer seems pretty obvious to me, but if the doctor you went to won’t prescribe you finasteride to treat your MPB, seek out another doctor. It might be possible that you don’t have genetic hair loss, in which case, finasteride wouldn’t be necessary.

Finasteride has been available for over a decade, so I don’t know how your doctor might’ve not heard of it. It sounds like your doctor didn’t understand hair loss if he didn’t even examine your scalp.

I should also point out that if you were looking specifically for a Proscar prescription to treat your hair loss, your doctor should prescribe it with the direction to cut the pill into 4 pieces. Propecia is for treating hair loss, Proscar is a higher dose for treating the prostate.

Hello Doctor,

I’m a 25 year old male- who has an identical twin brother. We’ve both had shoulder length hair for about 10 years.

In the past year I’ve noticed my hair around my temples and sides thinning out a lot, and noticing my scalp more after a shower. The hair on my crown has also thinned out a bit but not as bad, and the hair on the top feels much less dense and thick than the hair at my sides and back of my head, even though I have fine hair. My brother’s hair has thinned out less, but I do stress more than he does.

I finally plucked up the courage to see my doctor who gave me topical rogaine 5% and proscar 5mg to be divided into 4 (rather than propecia due to cost).
Is it safe to take the two together? And is it ok to take proscar instead of propecia?

I’d very much appreciate your advice as I’m a bit embarrassed to ask my doctor this.

We have known for years that stress accelerates the impact on balding for genetic hair loss. Your brother may eventually catch up with you, as you both age further.

It is perfectly safe to use Rogaine and finasteride at the same time, and splitting a Proscar pill into 4 pieces is equivalent to taking Propecia.

Hi Doctor Rassman,

Thanks for all your great work you do answering people on here. Just wondering about what time I should take finasteride, and if my current regime could make it less effective? I have been taking finasteride for about a month and a half, so it’s obviously too early to tell if it’s working, but I have had no discernable side effects. I work evenings, so because of my routine I wake up around midday, and take the quartered 5mg then. I have heard that it’s best to take it very early in the am. Is testosterone highest in men generally in the early morning, or is that just because it’s when the average man wakes up? Should I wake up at 7 to take the pill then go back asleep?

Hope to hear your answer,

Thanks again

There’s no need to wake up early just to take finasteride.

I used to tell patients to take it when they woke up, but that was really just because it would help them to remember to take it as part of their morning routine. Really though, there is no evidence that finasteride in the morning or the evening is better one way or the other, as long as you remember to take it regularly each day.