I have a quick question: since my balding area is small i have started using Regaine’s Extra Strength Solution rub-on applicator. so i wanna ask after applying or rubbing 1ml of it do i have to massage my scalp the part where i apply or i can leave it as it is?

There should be application instructions in the packaging, but you are supposed to rub the minoxidil gently on the scalp twice a day, and leave it on. The foam systems may work better for you with easier application and no significant rubbing.

More questions and answers about Rogaine (sold as Regaine in some markets) can be found here.

I understand that you don’t prescribe Dutasteride and that taking it is something one should carefully consider. However, I was wondering if you could answer a question about the half life of the medication. I have read that the half life of Avodart is 5-6 weeks and this got me thinking; if you were to take 3.5mg once a week as opposed to 0.5mg daily, would there be more dutasteride in your system and thus more chance of maximizing its benefits and having side effects? Or, would both dosage methods amount to the same thing?

I do not prescribe it because it is not FDA approved for treating hair loss, there are more sexual side effects with this medication, and the sterility reports are more numerous and maybe irreversible when it happens.

With the long half life, less frequent dosing should be adequate, but there is no dosing information available to guide the doctor on how to prescribe it for treating hair loss. So while it might sound logical to take a larger dose once a week, I don’t know how that plays into side effect risks or safety.

Hi Doctor, Im writing you from Argentina. First Id like to thank you for such great information you provide here. Ive been using finasteride for about a year and a half and the results are amazing. No more hair loss and even some regrowth until the point that no one can tell that I was balding. Id like to ask you, because of your experience, how long do you think I can keep the benefits from the drug, right now Im 37, not planning to quit never!. Thanks a lot from down here!

It’s great that you’re seeing amazing results! I have had some patients taking Propecia for over a decade with good results maintained, but the amount of years that the regrowth will sustain really just depends on the person. Just because you started taking it in your mid-30s doesn’t necessarily mean you have more or less time to see benefits. It depends more on how deep you were into the hair loss progression when you started the drug.

Not every patient will have the exact same benefit over the same amount of time, so I couldn’t tell you how long you’ll continue to see these full benefits. Keep your fingers crossed that you have continued success for years and years to come!

Hi Dr.Rassman,
I am a 35 year old man. I used propecia for two and a half years, three months ago I switched to 5 mg generic finasteride because of the cost. The generic finasteride that I use is manufactured by TEVA and I bought it at walgreens. I have a few questions.

1) is this a genuine medicine? or should I change to name brand of finasteride (proscar)?

2) The reason I asked the question above is, I am cutting the 5mg finasteride into four peices and take one piece a day, I have noticed that the four pieces are not exactly the same size. However my concern is I ‘think’ my hairline is receding and my hair is thinning after switching to generic finasteride. is it a negative placebo affect? I would love to keep using the generic finasteride because of the cost but on the same note I dont want to lose my hair either.

Thanks

If the drug is not counterfeit, splitting the pill into quarters should not product a problem. You bought it at Walgreens, so I’d expect the medication is fine. Teva is the largest generic pharmaceutical maker in the world.

Cutting a 5mg tablet into 4 pieces would make each part 1.25mg, which is a little more than 1mg Propecia. That shouldn’t be a problem though, as you’re probably not going to get a perfect cut each time and will even lose a crumb or two in the process. It’s much easier to cut into 4 pieces than it is to cut into 5. If you’re concerned though, speak to your prescribing doctor or pharmacist about a different generic finasteride brand.

Hello Doctor,

Thought you would be interested in this new advisory from Health Canada regarding finasteride and breast cancer:

Link: Finasteride (Propecia, Proscar): Potential rare risk of breast cancer in men

I know this topic has been discussed before, but it looks like Canadian patients using finasteride (including me for 8 years) will see the new advisory in the leaflet…

The average age for male breast cancer is 71 years old. The number of cases I can find in the medical literature are very few. As the press release points out, of the small number of cases, “Most of the reports have been in association with the 5mg formulation”.

With the average age for our patients under 40, the lack of finding breast cancer is not surprising. I recall reading that up to 50 men taking 5mg finasteride (Proscar) and just 3 men taking 1mg finasteride (Propecia) had been reported to have breast cancer, though the link between the medication and the breast cancer wasn’t proven — nor could it be ruled out. If there’s updated information, I still suspect the total number is very low considering the number of men using the medication at any dose. Nevertheless, even with this rare risk, I will add include it in my discussions with patients.

As an aside, I wonder if these 3 men had the gene for breast cancer, which (in theory) could be provoked by finasteride. The best way for a typical young patient to evaluate this should be in his own family history. Those men with a family history of breast cancer in mothers, sisters, grandmothers, aunts… should be more aware of this risk, although still very remote.