i was just wondering if i was on propecia for the last three years and my thinning hair has ceased, how do i know if the drug is still at work or my hair has done all the thinning its going to do on its own in my life and i dont need the drug no more. im 54 yrs old.

thanks

Propecia is considered a life-long medication. If you stop taking Propecia you may lose the hairs that it was maintaining.

I just saw a 40 year old man who stopped taking Propecia 8 weeks ago. He reported that his hair started to fall out in handfuls. This is what I call “catch up” hair loss. We have written about this phenomenon numerous times on this site. He asked me if he could reverse it again by starting the drug today and wanted to know if it would work on him now. My answer was to watch the change in his bulk measurement and if he came back in 3 months, this test should show if the hair loss process is reversing or if it just stopped the hair loss. Since everybody is different, talk with your doctor regarding your specific situation and your options.

Hi Dr. Rassman,

If Finasteride has a half-life of only 5 hours, how can it be so effective at stopping hair loss? If we take 1 mg or 1.25 mg of it, it would be pretty much out of our system before the end of the day. Does only a small amount of it prevent DHT from being created? Is it’s efficacy only dependent on a miniscule amount being present? Why is taking 2 doses per day not more effective than 1? And also, what are your current thoughts on what time of day to take it?

Just because a drug’s half life is 5 or 6 hours does not mean you need to take the medication according to its half life. Although half of the drug is out of the blood stream in 5-6 hours, some of the drug remains in the tissues for as long (possibly) as a week or so. Doubling the dose was not shown to be effective for better response in the original tests for Propecia.

In addition, the drug has been tested at different intervals and different doses, with trials determining that taking it once daily was just as beneficial as twice a day for treating hair loss. The best time to take Propecia is when you can remember to take it on a consistent basis.

Hi i have a somthing weird going on here. i started propecia in year 2001 because i had a receding hairline and my crown was very thin. After a year on the drug i stopped using it because it was too expensive and i only saw a little change. on month 3 without propecia my hair was very bad but i gave up and didnt care.

in 2009 my wife asked me “have you got a hair transplant or something?” i looked in the mirror and i could actually see there was something going on, but i just thought i had a good hair day. my hair just keep on growing and my hair seem better and better. what is going on? my hairline has moved a whole inch down from before propecia, and my hair is getting thicker and i dont have hair loss in temples anymore. you cant really see i have hairloss anymore. everybody thinks i got a transplant or wearing a toupee, but im not. How can this happen?

I have never heard a story like that before, so I can not comment on it. What you’re describing is highly unusual. Do you have pictures to compare where you were and where you are now?

Hi, Dr. Rassman!

I am of asian race, and I’m experiencing great progress with finasteride, greater than in most of cases I’ve read. Since almost all users of finasteride I know are white, I wonder: Does finasteride work better in asian men?

I wouldn’t assume finasteride response is related to race. Based on what I have observed for over a decade of treating patients with this drug, there is no pattern on race.

Snippet from the case report:

The significant reduction in DFI within 3 months of finasteride cessation and continued improvement suggests a causal link between finasteride and sperm DNA damage. We hypothesize that low-dose finasteride may exert a negative influence on sperm DNA integrity, resulting in increased pregnancy losses. We suggest that in infertile men using finasteride, sperm DFI should be measured in addition to semen parameters, and a trial of discontinuation of finasteride may be warranted.

Read the rest — Finasteride-induced secondary infertility associated with sperm DNA damage

This is a single case report published earlier this year in Fertility and Sterility about a 48 year old man that shows a casual link between finasteride and sperm integrity. It summarizes that some negative impact of finasteride on sperm’s DNA fragmentation index (DFI) which was reversible with stopping the medication.

I’m asked all the time about finasteride and fertility, and all I can go off of is what is in the literature and from what my patients have told me. I’ve had many male patients with no problems getting their wife/girlfriend pregnant, but perhaps for men who are taking finasteride that wish to conceive children, they should talk to their prescribing physician about discontinuing the medication during the period of the female’s cycle between 11-21 days from the onset of menses. There is no assurance that such a step will address the problem identified in this article or that you will have such an issue to begin with.

Hey Doctor.
I use Vichy Dercos Aminexil energy spray for like 2 month and im pretty sure I got some nice shedding from it. is it possible to have shedding from aminexil? Cause I saw that you wrote it acts in similar ways as minoxidil and this one has a known shedding effect. one more question is if there is any difference between the aminexil energy spray treatment and the aminexil sp94.
thank you.

I really do not know much about Aminexil, nor do I have any patients on it that I can recall. I do know some people use Aminexil topically to treat hair loss, but I do not know if it works or if it causes shedding.

In theory, if Aminexil is similar to minoxidil then it may cause the similar shedding you sometimes see with topical minoxidil use.

Dr. Rassman, First of all, I really appreicate your great site. I learned a great deal from your answers. One of the most comforting answers was that some of your patients on propecia have retained their hair more than a decade. However, in other posts you mentioned that propecia does not work well in the front, especially for hairline. I am just curious that if patients seeing great result originally had loss limited to their crown or if Propecia actually maintained their front as well. If it has, did it completely prevent their hairline from receding also?

Another question is that do you see any particular trait in the ones with excellent result from propecia such as their lifestyle, diet or even their general personality(pessimistic, optismistic so on..)? Lastly, by rough estimate, talking about great result over a long-term, is it like only few of the total patients or is it actually some significant percent(like 30-50%)?

I apologize for these repetitive questions but just wanted to clear up if there’s any chance. Thank you very much in advance for your time and care for people from all over the world!

I don’t know that there have been specific studies, but (if I had to guess) less than 10% of patients who are on Propecia show benefit to their front hairline area, but even more rarely will they see regrowth there.

I’m not sure if I follow your question. If someone is just losing crown hair and takes Propecia, I wouldn’t consider the medication to necessarily be the cause of their hairline staying put. It could just be that their genetics limited their hair loss to the crown. There is no trait or lifestyle that predisposes someone for responding to the drug, though. It is just how their body reacts to it.

Propecia slows down the hair loss process and can reverse (in the first few years) hair loss in the crown, and it can also make enough of a significant visible difference by filling in behind the frontal hairline and in the top areas. But just keep in mind that Propecia does not COMPLETELY maintain or prevent hair loss. This is impossible.