I have been on Propecia for 2 years; I am 45 years old and have seen no improvement in my hair. I am somewhere between a NW 2 and a NW 3. The fontal forlock has thinned significantly while on Propecia. In your practice have you seen any patients quit Propecia and not get any worse or do most people experience increased hair loss once they go off the medication?

Also, I would do a hair transplant immediately if I was confident that I could go back to work undetected after 2 weeks. It would be a big help to get your thoughts on this as I think this is probably the biggest reason people do not get transplants. Perhaps post some pictures of patients at 14 days. Your blog is great and NHI would be my choice once I decide to take the plunge

Assuming that you have the balding gene and a HairDX finasteride response test indicates that you have an average sensitivity to Propecia, then I would expect that you, like many other men, had their hair loss stabilized on the drug. If that is the case, then you can assume that you may very well lose hair by stopping the Propecia. The series of steps and events are important in the building of a good Master Plan so that whatever happens, it will be planned for. I am sure you can see a series of potential scenarios here, so a good working relationship with your doctor is all important.

Here are some previously posted examples of patients just days after surgery:

• Female Hair Transplant (2 Weeks Post)
• Norwood 6 Patient (10 Days Post)
• Scabs After a Hair Transplant (11 Days Post)
• Norwood 3v Patient (10 Days Post)
• Norwood 5 Patient (12 Days Post)
• 2 Different Patients (1 Day and 10 Days Post)
• Hair Transplant (10 Days Post)
• Hair Transplant (2 Weeks and 5 Months Post)

Can Regaine cause hair growth all over even if i don’t put it on that part of the skin? I think I read something about this happening, but i can’t find the source. thanx

A patient reported last week that when he used minoxidil regularly (also known as Rogaine/Regaine) some years ago, he eventually saw hair grow over the entire face and forehead, giving him a Wolf-Man type look. I wish I had photos, but it was just a story he told me. After stopping the medication, he said the abnormal facial hair disappeared. This might sound ridiculous to some people, but I believed him. There have been similar reports posted before.

I asked some other prominent hair doctors (part of an email group of physicians I am in) about this, and some reported seeing this rare phenomenon in patients as well. We do see facial hair growth in some people that can be substantial, and it’s a particularly rare problem for some women on this medication as well. And when I do have photos, I’ll do my best to get permission to publish them…

Hey Doc – I emailed you a while back and wanted to thank you for your response on the blog. I recently upped my dosage of finastride to 2.5 mg proscar after a 10 yrs of propecia (1mg), based on my HT surgeons advice. My hairloss had really progressed so this was a clear course of action. I intially had great results on proetica in my early 20s.

1. My first question was related to dosing – I lift weights/workout intensely 6 days per week (often twice per day) and wondered if it would behoove me to split this dosage – 1.25 prior to weight lifting in the early evenings and 1.25 first thing in the morning, as recommended in your book.
2. My second question was, does taking Finastride with a multivitamin, a vitamin C, a vitamin E, vitamin D, Potassium, Magnesium, and Calcium – all in seperate pills, and a protein shake (organic from non hormone cows) in the morning before I do some intense cardio (I eat no real food till I come back from the gym) have any impact on Finastride absorbtion/effectiveness?

I have read your book and realize it is ok to take Finastride with food but this may be a tad different.

Thanks in advance

1. If you can keep up the regimen of taking a pill twice a day without forgetting, then go for it! Theoretically, it should give you a consistent level. Be sure to talk to your prescribing doctor to clarify this.
2. I do not believe taking finasteride with your supplements or food or exercise has any real impact on its absorption.

Whats up Doc?
I am 25 and in the early stages of balding, almost 4 months on propecia (112 days to be exact) and the front of my hair line, not at the temples, but the the middle, is noticeably worse/thinner than it was when I started. Now here are my questions: Is it just that it hasnt started to work yet (I know its still early). Or am I experiencing a shed? Or at the worst case scenario is it making my hair worse! I dont really see any hairs on my pillow or shower drain or anything, but im def losing them. In all of your years of experience, is this normal at around the 4th month mark? I know I have to wait a year, to start seeing results but, the hair loss seems to be quickening! I go to a dermatologist who is convinced it will work for me, but at the same time doesn’t really seem to know what they are talking about when it comes to hair loss. I am aware that you can’t make a diagnosis over the internet but how about an educated guess? Ive read on some sites that this is normal and that new thick hairs will grow in, but im still starting to get a little freaked out here. THANKS!

It could just be a shed situation. Many men will lose hair after a hair cycle is complete (ending in catogen) and not restart another cycle right away due to the genetic situation. This could be what you’re experiencing. I wish that I could be of more help, but you will probably know for yourself in another 4-6 months.

For me, the measurements that I take when I start a patient on Propecia (miniaturization mapping) are good for comparison purposes down stream, when there is a change going on. Change tells a great deal with regard to miniaturization and I would hope that the miniaturization that you had present when you started the drug has reduced, rather than increased. I like all of the insights I can get to render a prediction as to where a patient’s hair loss pattern is going.

Dr. Rassman,

I’m a 25 year old male that noticed a few months ago that i was starting to thin on the crown of my head. I started using rogaine foam. About a month or so into using the foam I read about Propecia, and vistited my doctor who said that he thinks Propecia would work the best for me. My question is; since I’ve only been using Rogaine for two and a half months, do you think I’d be okay quitting the foam and just using Propecia (which I’ve been on for the last month)? I haven’t noticed any improvements with the rogaine yet(which makes sense to me since the package says it could take many months to start seeing results). I’m just wondering if I can quit the foam without losing hair. I figure I should be okay since I haven’t seen improvements yet.

Thanks so much, doctor. I appreciate your blog very much.

I would hope (though I am not sure) that you did not build minoxidil dependence on the miniaturized hairs. For men of your age, Propecia is a better choice.