Snippet from the study:

Before now, there has been no study of finasteride use exceeding 1 year in Japanese men with androgenetic alopecia (AGA) except the study subsequently conducted from the development phase. Since the launch of finasteride, no study in a larger population had been reported. Ethnic variation of the onset age, progressive nature and degree of hair loss of androgenetic alopecia are known. The therapeutic effect of oral finasteride (Propecia) was examined on androgenetic alopecia of Japanese men. The efficacy and safety of finasteride (1 mg tablet) was evaluated in Japanese men with AGA in the long term.

Read the full abstract — Evaluation of efficacy and safety of finasteride 1mg in 3177 Japanese men with androgenetic alopecia.

A new study has been published on the use of finasteride 1mg in the Japanese Journal of Dermatology, addressing the safety and effectiveness of finasteride in 3177 balding men, and the impact on 2561 men in this group was observed. Safety data was obtained by interviews and laboratory tests. Of the 2561 men who followed through the study, the published report says that “the overall effect of hair growth was seen in 2230 of 2561 men (87.1%), in whom hair greatly (11.1%), moderately (36.5%) and slightly (39.5%) increased”.

Adverse reactions were reported in 23 of 3177 (0.7%). It is interesting that the higher degree of sexual side effects in some other studies were not matched in this study at a single Japanese institution. If one subtracted the placebo group’s side effects in the US studies, the number seems to come closer to this recent Japanese report. The article also showed increasing benefits over time in those individuals who had the best results from the drug.

Snippet from the article:

It’s getting harder for me to deny that I’ve reached middle age, and the most obvious sign is that the men in my life are losing their hair. Many men struggle to come to terms with hair loss and yearn for a way to turn back the clock. Although I’m no expert on the subject, I’ve suggested they look into Propecia, a medication used to treat male pattern hair loss.

Invariably, they’re intrigued. It works by preventing testosterone from turning into another hormone that causes hair loss. Over five years, the majority of men who take the drug report that their hair loss slows, their bald spot gets smaller and the appearance of their hair improves. However, the threat of drug-related side effects such as impotence, male breast cancer and perhaps prostate cancer has caused many of my friends to seriously reconsider the importance of a full head of hair.

Read the rest at the LA Times — So what’s the risk of taking that medication?

You should always weigh the risk vs reward for any medication, and this article touches on Propecia side effect risks. The bigger message in this piece is how oftentimes people will give more weight to the negative than the positive. Regardless, the FDA is looking into ways to make drug information easier for the consumer to understand so you can make the choice that is best for you.

Hello Dr.

I am on finasteride for hair loss and dutasteride for my prostate. Is their potential risk or benefits from combining the two since they are similar compounds. I am also on TRT hence the prostate growth prevention.

Thank you

I would ask this question to your prescribing doctor. I do not know your complete medical history or your issues. If you are being prescribed finasteride (Propecia) from one doctor and dutasteride (Avodart) from another doctor, you need to tell each doctor your complete medical history and ALL the medications that you are taking.

In general, taking these medications should be fine. If you are on dutasteride daily, the finasteride may be unnecessary.

Hi there

I am 25, have been told by multiple doctors around that I have pretty good hair, but maybe within 10 years might have some noticeable troubles. I have wanted to be proactive, and find a good at home program to combat and keep thicker hair.

I was told to use a year program of laser therapy, but then directed otherwise by others as it might be a scam. I decided to start basic and work to more advanced ideas: Currently using Rogaine Foam 2 times a day, and Finestride 1mg a day.

Research just leads to thousands of new avenues: I am looking for a proven system and no sales rep with a bogus product:

considering Kevis, Provillus, or Revivogen, are any of these good, if so which is best?
Shampoos: are they helpful with DHT blockers and reducing oily hair? Which is best?
Laser: Igrow/comb worth a try?

Would definitely love the shampoos for the reduction in oil and itching, look forward to hearing from you. Thanks.

If your doctors have told you that your hair is fine, there’s no reason to start using any product proactively. You might end up doing more harm than good. I hope you’re not treating yourself, but since you’re on finasteride (Propecia), I’ll assume your doctor prescribed it to you because he/she saw some loss… and in that case, stick with that daily routine. I’ve seen finasteride slow down and even reverse existing hair loss in young men. Rogaine hasn’t shown to be as beneficial, but many people do use it and it has been proven to show some regrowth benefits in the crown.

If you get your hair bulk assessed in different parts of the scalp and follow that up with yearly tests, you will know where you are on your hair loss timeline. The key is to stop the hair loss from happening, and the earlier you start the finasteride (provided that your bulk analysis says you are in the balding process) the better you will keep what you have.

Unfortunately, there are many scams out there, and many products that are marketed and sold to people that will seemingly pay anything to stop the future from happening. Treating hair loss isn’t perfect, for if it was you wouldn’t likely see many balding men. We’ve have covered much of these shampoos and treatments here before, so using the search in the top right of the site should show my opinions on those. Most of them don’t show benefits that match the claims they make. You can try out as many shampoos or lasers that you’d like… but keep in mind that if you waste your time on things that don’t work, then each passing day is another step closer to meeting your genetic balding state.

Hi there,

I have an appointment to come and see you guys in about a month or so (combining it with a California adventure) but I had a question that I wanted to send you in advance.

I started proscar 1mg/daily last September, but cut down the dose (and also took it irregularly) this summer. Over that time, I started to notice a lot of shedding – which I never observed before, even before the starting propecia.

I had cut down the dose at the beginning of the summer because I felt that I’d put some fat on my midsection and in my breasts – I’m in pretty good shape, so the change was noticeable – that I thought was due to the propecia. Since I didn’t know if it was even doing anything, I cut it out. And then brought it back! Since September, I’ve started again at 0.5 mg/day. But I’m still shedding.

What I’m wondering is if I should just stop taking the medication again so that I can establish a non-propicia’d baseline with you when I come for my consultation, which I neglected to do before starting the drug in the first place and which I regret. Or, should I stay on the 0.5 mg/day and then increase it to 1.0 after seeing you to see if there’s improvement?

Hope that’s not too confusing. I’m just trying to have something clear established so I can figure out what hair I’m losing and at what rate. I like the idea of having an empirical baseline. I guess I don’t mind the minor chubbification if I know that the propecia’s doing something. But I want to know that it’s doing something!

Just wondering if you had any thoughts. Anything you could offer would be appreciated. Thank you so much for this resource.

First and foremost, lets discuss the facts. Propecia is a brand name for finasteride in 1mg. Proscar is a brand name for finasteride in 5mg. For the treatment of androgenic alopecia (AGA) the recommended dose is finasteride 1mg (Propecia) taken orally once a day. Some take 1/4 pill of Proscar (finasteride 1.25mg) once a day. Ideally, you should cut it in 5 pieces, but that is difficult to do with a small pill. Taking more than 1mg of finasteride will not be of benefit with respect to your hair loss issues. More may just cause increased incidence of negative side effects. Taking less (finasteride 0.5mg for example) is about 70 to 80% as effective as the full 1mg dose.

In general, Propecia does not cause shedding. I realize other websites and forums state this (and we’ve published emails about this), but it is not something I usually see in my practice. If you are seeing shedding and you think it is from Propecia, then I will take your word. But you should also note these important facts:

1. Propecia does NOT stop hair loss forever.
2. It takes 6 to 12 months of taking Propecia before you see any effect with consistent use.
3. Your genetic predisposition will always win over Propecia in the long term (which could be years).
4. When people start taking a medication to do something, such as taking Propecia to stop losing hair, you will generally be more astute to any changes in your hair (that you would have never noticed).

That all being said, I can’t tell you what you should or shouldn’t do with your prescription medication dosage, as I didn’t prescribe it to you and I’m not your doctor. Talk to your prescribing physician to help figure out what you should do next and then when you come in for your visit to my office, we can go from there.

Hello Doc, following is a brief summary of finasteride experiment on myself, maybe you share it.

Age: 25
Gender: Male
Ethnicity: Caucasian
Hair: Light Brown / Fine hair
Hair Loss: Norwood 2

Treatment: Propecia (3 months just finished), Minoxidil (Over a year), Nizoral Shampoo

Sides: Watery Semen and decreased volume of ejaculate, slightly weight gain. No loss of libido. I think watery semen is much more common than %2, at least %40 in my opinion.

Recovery During Medication: After 3 months semen is looking dense as before, volume increased. Body weight is back to normal. These are my observations however, i dont exactly know drug effect and my body reaction to it detailed.

Hair loss: I believe this drug works. I dont see hairs in my hand as before. I dont think i even shed 100 hairs a day which is even normal. However my expectation is high and i expect new hair growth. With the help of minoxidil there is slight but visible hair growth on my corners(hairline)

Thank you for sharing your experience.

You are correct in stating the “watery semen” phenomenon probably occurs more than 2% of the time. I suspect it is in the 20% range. I’m sure you’re still losing the normal amount of hair daily as your hair cycles (perhaps in the shower or even when you walk down the street), though.