Generic Finasteride in the US?

/by William Rassman, M.D./2 /

Dr. Rassam,

Finasteride Generics in 1mg dosage are available in Europe and I wanted to know if you are familar with the products being available in the US? Is generic Finasteride the same as Propecia?

THanks

Generic finasteride 1mg is not available in the US legally due to patent laws. Generic finasteride 5mg is available in the US. There are a variety of makers of the product overseas, and I’ve written about it before here. Just make sure that the generic finasteride is 1mg — sometimes it is sold as 5mg to treat the prostate (and it needs to be cut into 4-5 pieces for treating hair loss).

Tags: finasteride, proscar, propecia, hairloss, hair loss

Hair Loss From Stopping Minoxidil

/by William Rassman, M.D./2 /,

No question this time, but I wanted to share a quick story…

A 58 year old patient of ours was transplanted in the corners of his frontal hairline. He had used minoxidil for years with what he thought was no effect. After his corners were transplanted, he stopped the minoxidil and in time, lost hair behind the transplanted corner on his right side. In hindsight, this complication could have been avoided had he gone back on the minoxidil, but neither he nor I realized the dependence of the minoxidil over the previous years.

As a rule, men in his age range do not suffer from shock hair loss (very, very rare), but in this case, minoxidil was far more effective than we thought. He is now only 2 months post surgery and was immediately restarted on the minoxidil. I am hopeful that the drug will regrow the hair he lost behind the transplants on his right side, but only time will tell us. The lesson here is that when you are a long term user of minoxidil, you really do need to stay on the drug for life.

Tags: minoxidil, rogaine, hairloss, hair loss, hair transplant, hairtransplant

Just Turned 18 and My Facial Hair Is Growing While My Scalp Hair Falls Out!

/by William Rassman, M.D./0 /,

I’m a male who has just turned 18. In the last 4 months, I have had growth in my facial hair, but am losing hair on my head as fast as I am gaining it on my face. As soon as my facial hair started thickening, my pattern baldness got aggrivated. The hairs on the edge of my hairline are thin, small and weak (like a baby’s hair). Why is this happening now?

What you are describing is the unfortunate results of DHT (dihydrotestosterone) doing its job on growing your beard and taking advantage of your genetic defect in causing hair loss. Your facial hair isn’t the reason for your hair loss or vice versa. If genetic hair loss is the case and you confirm it, then the drug Propecia (finasteride 1mg) will be the best approach to this problem. Don’t wait, as time appears to be working against you. You should see a doctor to find out if you have genetic hair loss, as Propecia is only available by doctor’s prescription.

Tags: propecia, facial hair, beard, hairloss, hair loss, finasteride

In the News – Propecia Prevents Prostate Cancer

/by William Rassman, M.D./2 /

Snippet from the article:

For the first time, leading medical groups are advising millions of healthy men who are regularly screened for prostate cancer to consider taking a drug to prevent the disease.

The advice stops short of saying men should take the drug finasteride, sold in generic form and as Proscar. It is already widely used for urinary problems from enlarged prostates as men age. Merck and Co sells it as the baldness remedy Propecia. However, it has not been widely prescribed as a cancer preventive, and it may carry some risks. The new guidance tells men to talk to their doctors and decide for themselves if the good outweighs the bad. This advice is bound to be confusing, doctors admit. For one thing, it doesn’t apply to men who choose not to have screening with PSA blood tests, which no major medical groups recommend.

In men who are regularly screened, finasteride can cut the odds of being diagnosed with prostate cancer by about 25 percent.

See the full article: FOXNews.com – Medical Groups Advise Men to Take Baldness Drug to Prevent Prostate Cancer

For those that already take finasteride, it’s likely not news to you that the medication has prostate cancer prevention benefits (I’ve mentioned it as far back as 2005). Finasteride was at first used as a prostate treatment called Proscar (in 5mg dosage), with Propecia becoming available as a hair loss treament a few years later (in 1mg dosage). Still, it is important to point out the health benefits of this drug.

Here’s the National Cancer Institute’s page about their Prostate Cancer Prevention Trials, since there’s bound to be questions — Prostate Cancer Prevention Trial (PCPT).

Tags: propecia, proscar, finasteride, cancer, prostate, hairloss, hair loss

Hair Thickening, Thinning, and Thickening Again from Minoxidil

/by William Rassman, M.D./1 /

Doctor

Just read a recent post regarding someone who notices his hair thickens and thins and thickens again. I’ve noticed that for years and just assumed it was from Rogaine. That it was either synch shedding which happened after first using the drug and just continued through the years or that at times realized I’ve been missing areas and after reapplying those areas came back. But again that was Rogaine not Propecia which the previous post was on. Wonder if other minox users noticed this.

After reading your reply made me wonder if TE tends to reoccur in people. It would make sense if it is in response to a stress. People who have physical ailments in response to stress tend to have the same physical responses repeat throughout their life. I wouldn’t be surprised if some people are predisposed to TE under stress. Just as some develop IBS that comes and goes.. acid reflux.. back pain.. IF TE happened once it will probably happen again under stress.

Thanks for your comments. I’m posting this to hopefully get other readers to share their experience with back and forth shedding from minoxidil, as you describe.

To put this all together, a good relationship with a doctor is a good idea. Yes, telogen effluvium can reoccur in some people. See eMedicine for more info.

Tags: telogen effluvium, stress, hair loss, hairloss, minoxidil

Retane

/by William Rassman, M.D./0 /,

Hi Dr Rassman, like many others, I’d like to thank you for taking the time to maintain this blog. I’m 40, have considerable recession at the temples, but recently I started noticing more in the middle front and overall thinning. Obviously that’s not sitting well with me, probably causing a chicken and the egg situation, as its stressing me out, which can be a major contributor.

Do you think Propecia would still do anything for me? In addition, Retane is another product I’ve read about. Have you heard of it and if so, whether its worth looking into further. I hope you will be able to respond to my question. Thanks very much in advance.

RetaneRetane doesn’t appear to have anything of value in it to regrow your hair or cease your hair loss. This list the ingredients on their site as inositol, biotin, protodioscin, folic acid, vitamin B5, vitamin E, aloe vera, and ginseng panax extract. These ingredients simply don’t have value in treating hair loss. The product’s website references an 86% success rate over and over — and a closer look at the clinical study they reference shows that it was conducted 7 years ago, included only 22 people (15 men, 7 women), and was only 4 weeks long. Their website informs us that you might see regrowth at the 6 week mark, so why their “study” went to only 4 weeks is beyond me. That is such a half-cooked study for a hair growth treatment that I don’t think I need to go further with my comments.

As for the other part to your question — I haven’t seen your photos and don’t really have a full history of your hair loss, but if your doctor prescribes Propecia to you, I don’t see why it couldn’t work. At the very least, it could halt the hair loss from progressing for some time. As long as you know that you for sure have genetic balding (think miniaturization mapping), you should spend your money on a hair loss treatment that is proven to work, like Propecia and minoxidil.

Tags: retane, hairloss, hair loss, propecia, finasteride

Doctor Told Me to Use Protopic for My Alopecia

/by William Rassman, M.D./2 /,

Hello, I have alopecia and i lose my hair and eyebrows. Also I am losing my body hair. My dermatologist told me to try protopic once a day. Some scattered white hair in my head is growing. Also told me to take rogaine pills. I didn’t start this yet. What do you suggest for me. I really need your advice.

Protopic is a prescription medication which you can read about at Drugs.com. This medication can be dangerous and must be prescribed by doctors who are experienced in its use. Some cancers can be induced at the skin level by this drug. For our readers, you should know that this is not a medication to get for treating hair loss.

I believe you’re describing alopecia totalis (see NAAF), but it is not really clear where you are in the disease progression. Also, your doctor likely mentioned Rogaine (minoxidil) topical — not pills. Do not take minoxidil pills to treat hair loss.

Tags: alopecia, totalis, hairloss, hair loss, minoxidil, rogaine, protopic

If Propecia Didn’t Regrow Hair, Will It Stop Maintaining My Existing Hair Sooner?

/by William Rassman, M.D./0 /

I’m 23 years old with early frontal thinning but am currently a NW2. So I been on Propecia for 7 months now and everything is the same! By now I assume I should have seen if my hair was getting thicker or regrowing so I guess I should be happy if I just get to maintain. Now my question is if I won’t get any regrowth or my miniaturized hairs won’t get thicker are my chances to maintain my hair the way it is right now lower for 5 years which is the number of years for most men!? Because I read something that your hair count increases the most the first year and then gets less and less each year. So if I get nothing this year, I mean in like 5 years I will definitely look thinner although probably better then without Propecia but still thinner and I don’t want that.

The peak result from Propecia seems to occur by about 18 months, then some loss is common in the hair counts done by the drug company, Merck, in their FDA studies (over a 5 year study period). Some people have held their hair for years, while others slide in the hair counts. I can’t say for sure how you’ll respond to the medication, so I wouldn’t know how you’ll be 5 years on. I don’t know of any data that shows regrowth (or lack thereof) from Propecia correlating to the length of time the medication can halt your hair loss.

Tags: propecia, finasteride, hairloss, hair loss

Synthroid and Propecia

/by William Rassman, M.D./0 /

Hi,
I’m currently on Synthroid 50mcg and I take this medication in the morning on an empty stomach. I read that Propecia should be taken in the morning (ideally) because testosterone levels are highest during this time. Is it OK to take Synthroid at the same time as Propecia or should I start taking my Synthroid at night?

Yes, taking both Synthroid (levothyroxine) and Propecia (finasteride) in the morning is not a problem.

Tags: propecia, synthroid, hairloss, hair loss, medication, finasteride

What If I Want a Hair Transplant, But Don’t Want to Take Propecia?

/by William Rassman, M.D./2 /, ,

First off, thanks for everything you guys do! Doc I am 26 yrs old and I had several questions. I apologize in advance if any of them are stupid questions! I am closest to Norwood III Vertex, but not completely there yet. I actually have a fair amount of hair on the top, problem is it’s really thin. The back and sides of my hair are complete opposite, they are very thick. I want to do a hair transplant, but is there any point to doing so if I do NOT want to take Propecia? I am open to taking Rogaine. Everybody keeps telling me to wait till my 30’s to get a transplant, since if I do 1 so early now, I will still lose other hair. If this does happen, I just get a 2nd transplant, correct?

The problem with a 26 year old experiencing hair loss is that your balding pattern is in transition. Will you become more advanced in your hair loss? You can try to predict it by performing a miniaturization analysis and see how far back this process goes (see Mapping Your Own Scalp).

Having a hair transplant at age 26 without Propecia on board will just accelerate the hair loss you are likely going to see in the years ahead. Not taking the medication will allow what nature has planned for you to happen. The choice is yours. Rogaine will not offer the same degree of protection. Why keep putting yourself through more hair transplant surgeries as your hair loss progresses if a daily pill could be the solution?

Tags: propecia, finasteride, hair transplant, hairtransplant, hairloss, hair loss

Is Straight Hair Always Fine Hair?

/by William Rassman, M.D./0 /,

Hello Dr. Rassman and thank you for your time.

I see that you talk a lot about the difference between course hair and fine hair. It seems to me that someone with really straight hair almost always has fine hair and one with even slightly wavy hair has a courser hair. Is the straightness of your hair usually a good indicator to how course or fine your hair is?

Also i have lost a fair amount of hair in my frontal area and the remaining hair in the front is now kind of crinkly, (very unhealthy, hard to style) Is this more because of the miniaturzation or the loss of hair. If it’s mainly the miniaturzation hopefully Propecia can reverse it?

There is no connection between hair straightness and hair thickness. No connection at all. If the hair character has changed from the balding process, taking Propecia may cause some reversal of the hair character more like it was. That effect is more common in the back of the head than in the frontal area.

Tags: hair characteristic, hairloss, hair loss, propecia, finasteride

Can I Still Use Urine Therapy Orally if I’m Taking Finasteride?

/by William Rassman, M.D./2 /

hello doctor,
i have been prescribed a combination of 2% minoxidil to be applied once a day and 5 mg finasteride to be taken once a week, is it safe to practice urine therapy in oral intake form or topical form while under medication. thank you

UrineI do not know much about urine therapy, but I’m not big on drinking my pee or applying it to my scalp in the hopes of regrowing hair. Or are you doing it for some other reason? For those that want to learn a little more about urotherapy, I was just trying to get up to speed by reading this article about “the medicine you make yourself” — Telegraph.co.uk – A wee drop of amber nectar.

With respect to taking finasteride, I do not think urine will have any impact on it… but the dose you are taking is not the recommended dose (it should be 1mg each day, not 5mg once per week).

Tags: urine, hairloss, hair loss, finasteride, propecia, urine therapy

Transplanting Red Hair

/by William Rassman, M.D./0 /, ,

Hello,

I am a 27 year old with red hair. Over the past several months it has been receeding quite quickly especially in the temple region. I went to a specialist today in Toronto to learn more about hair transplants to see if I might get one in the future. He told me that because I have redhair & fair skin that a transplant would look unnatural on me? I suffer from depression & this made me very sad as I was thinking that my hair loss is not so bad because if worst comes to worst I could always get a transplant. Now I’m afraid because of what he said that this is not in the cards. Please I would really appreciate it if you could let me know if you’ve ever transplanted a fair skinned ginger & if the results have looked natural? He also recommended provillus & advised against propecia, which I have been on for a month now? Thanks for your time.

Red hairI don’t know what this “specialist” you went to is talking about in regards to the results being unnatural. I have some of my best results from transplanting people with red hair. Plus, all of his advice on Propecia (which I believe is a great medication) and Provillus (which I do not believe has much value) seems opposite to everything I’ve written here on this blog.

If you’d like me to set your mind at ease, we can arrange to have a telephone consultation. First, send me photographs of your hair loss and your contact info (reference this post when sending), and I’ll be in contact so I can address the misinformation with you.

Tags: red hair, ginger, hair transplant, hairtransplant

If I Lose 200 Hairs After a Shower, How Long Would it Take for Propecia to Stop That?

/by William Rassman, M.D./0 /

Good day Dr.,

I know that every day, the average human loses between 40 and 100 hairs a day. As those of us balding can attest to, I can see about 200 on my hands after shampooing my hair. I’m about to start taking Propecia and was wondering how long it would take before I stop seeing so much hair coming out in the shower. I know you shouldn’t see results for a few months, but I figured maybe something like that might see an effect sooner (as unscientific as it may be).

Thanks for the awesome website

You should see benefits on reducing hair loss in 1-3 months. It differs for each man taking Propecia, of course.

Tags: finasteride, propecia, hairloss, hair loss

Dutasteride and Sterility?

/by William Rassman, M.D./0 /

Hi Dr Rassman,

I have a growing concern about a couple of blogs you answered stating that dutasteride “could”, but not definitely cause permanent sterility. wondering if you have come across this situation,or a site on the net with some further info. I am a 40 year old male and have been on dutasteride (0.5mg) for 9 months. no side effects to date, unless it is mental, and have 3 children. results are good to date.

Thanks.

At the 0.5mg dosage you’re taking, risks of sterility likely aren’t great, if any. The FDA trial results should be released sometime this year. When the results are out, the answers to your questions will hopefully be there.

Tags: fda, dutasteride, avodart, sterility, results, fda, hairloss, hair loss