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Doc..I am a pharmacist..37 y/o male..I was started on propecia approx 2 weeks ago and noticed that I have become moody and irritable. do your patients complain of similar sx? is this common? does it resolve or should i consider stopping? thanks

You are a pharmacist, so your post-graduate training has been the study of drugs. You do not need me to tell you about side effects and how Propecia works. In fact, you are one of the rare few that can read the entire drug profile insert that came with the medication and actually understand it!

If you are asking me if I have personally seen anyone with your complaints at my private practice, I would say yes, on rare occasions people have discussed personality changes with me and mood swings. This is not a common complaint, and I don’t have information about whether it goes away or not. If you do enough research on the Internet to see if people have complained about your possible symptoms, I am sure you will find it.

I have come across a Neuroendocrine Physician, Dr. Alan Jacobs, and he wrote an interesting blog post on his site that you may wish to read.

Dear Drs,

What’s the incidence been of people using finasrteride to treat hair loss getting male breast cancer? I heard it’s high and that the FDA is not investigating it.

For people not wanting to take oral medication for hair loss, is there any other “gold standard” approach? Like minoxidil with alzeic acid or the like…

Finally, what’s your take on caffeine and soy protein (said to create a substance that stops DHT from being made).

Instead of focusing on lowering DHT levels, hasn’t there been research into stopping the hair follicle from reacting to DHT? I’m assuming the DHT was always there and then the hair follicle got programmed to be ruined by it, or does the DHT increase as a sign of aging.

Many thanks

Huh? I don’t know where you heard the incidence of breast cancer from finasteride is high, but I’ll assume it’s F.U.D. as I’ve never seen any published medical studies showing that. I am not aware of any existing studies designed to connect breast cancer and finasteride. The FDA just announced they’re investigating finasteride and dutasteride (5-alpha reductase medications) in relation to breast cancer risks, but the probe just began .

Unfortunately, there is no “gold standard” medication for treating hair loss other than DHT blocking with finasteride. Minoxidil works, but the results are mixed.

There is no scientific proof of a connection between caffeine and soy protein and hair loss.

Finasteride is a competitive inhibitor for 5-alpha reductase and as such will compete with DHT at the hair follicle level.

Doc,

It’s hot and humid outside! what’s the best way to store your generic finasteride in these hot months? I keep it in a drawer away from light and try to keep my non AC room as cool as possible. Thanks a lot!

I would say store it in the bottle it comes in, and only cut one 5mg pill at a time. The situation you describe sounds reasonable for many people. It sounds like you’re doing the right thing in terms of medication storage. I doubt there would be any problem with the finasteride effectiveness if it is kept in a drawer with limited light and kept as cool in the room as possible.

Here’s some more tips on storing medication.

Hello, my question is about hair loss and headphones. I am a gamer which means I spend sometimes up to 6 hours per day or more on my computer wearing headphones.

Do headphones cause hair loss/thinning? I wear them for long periods of time but luckily they are padded. I am very concerned about this. Thanks.

Properly fit headphones, like any hat that does not rub or pull on the hair, will not cause traction alopecia. You more than likely have nothing to be concerned about regarding your headphones causing hair loss.

First off, I just want to say that I love your blog and I thank you for your willingness to offer advice to the general public. I’m a 24 year old male who recently stopped taking Propecia after 1 month because well, basically I began to experience sexual side effects and let’s just say I’m not man enough to risk losing my manliness for good. You’re well aware of the information available on the internet, so I won’t go too much into detail. There have been in-depth studies in other countries and I trust their scientists know what they’re doing.

I guess what I wanted to know is what my other options are. Right now it looks like the next best option would be Rogaine, but coupled with diet and exercise and overall good health, is there any thing else that I can do to prevent further hair loss? I’m a very early NW1, so my main goal is to maintain my hair.

Thank you

I’d wonder why your doctor would prescribe Propecia to someone with a “very early” Norwood Class 1, which isn’t even considered balding. That causes me to think that you weren’t prescribed the medication to begin with. I won’t lecture, but I sincerely hope this isn’t the case. If you had these side effects, perhaps you should’ve gone back to the prescribing doctor and gone over your options (lower dosage, etc). Or maybe you went to an inept physician. Regardless, don’t start trying to treat something that isn’t there.

Get your hair and scalp mapped out for miniaturization and find out if you have any real balding going on. Everything else follows a proper diagnosis, which you most certainly need. As for treatment options, you’re correct in that the next best would be Rogaine (minoxidil)… but again, I do not recommend that you start using hair loss medications preventatively.

As for your claims that “there have been in-depth studies in other countries and I trust their scientists know what they’re doing” — how in-depth are we talking here, and does that mean you don’t trust studies performed in the US? If you’re referring to the Swedish Medical Products Agency study from 2008, I wrote about that already.

Dear Dr. Rassman:
I’ve read that following a hair transplant stitches are routinely removed in 10 to 12 days. However, I was told by a physician that he could remove them in as little as 6 days, because at that point the skin has already healed. Is it safe to do this within 6 days, and can this cause harm to any grafts?

Thank you

I would go by what your doctor/surgeon recommends.

I personally do not use sutures that need to be removed. I either use self-dissolving sutures or staples that are routinely removed in 10 to 14 days. Wounds can be sealed and stay closed with stitches removed at 6 days, but there is no strength in the wound at 6 days. If you do not pull on the edges, 6 days will probably work for many people. Removing sutures (or staples) has to do with how well your donor wound healed. In my opinion, 6 days is a bit too early… but the ultimate decision is with the surgeon who performed the procedure and their comfort level.

I just have a question. Why is it normal and why do everyone has whispy hairs in the corner or temple area???, even women have this whispy hairs which make their hairlines look thin. My mother also has thinner temples and has a great head of hair

What you’re referring to are vellus hairs, which are faint and like peach fuzz. As to why it is there… well, that is just the way we are. Most women have thin vellus hairs around their front hairline corners where the rounding appears to shape it in a concave manner. This is what we sometimes refer to as a female hairline. Some men have it too and this can give the appearance of youth or a feminine face. Most children (boys and girls) have them as well.

Hi Doc. Rassman. Thank you for this blog! The best!

I’ve been taking propecia for 10 months. Ok results. But I was wondering. Have you ever heard about people who have seen an increase in the amount of semen when ejaculating? In the last 3 months I’ve seen an massive increase in the amount of semen.

Best regards

Nope, I have not had any reports from patients that the amount of semen increased with the drug Propecia.

There is a known side effect of decreased ejaculate volume from finasteride, though I believe that was only found in less than 1% of users.

I have heard that there is a new technology call ADDHAIR. It adds fake hair to receding hair lines, balding areas etc. They said people can go swimming and engage in everyday activities with it. They also provide saloon service to make sure the Added hair and the still growing real hair blend together nicely. It’s expensive I think. What do you think?

Addhair site

Hair weaves have been around for years and Addhair doesn’t appear to be any new “technology” judging from their website.

I recall one company that attached individual strands of synthetic hair to individual hair shafts used a specially developed clip. As your natural hair would grow, the clipped synthetic hair would be pushed forward with your natural growing hair. That particular company charged $50,000 for the first application and then monthly charges to keep up with the advancement of the hair. For weaves, the same things happens as your hair grows out: the weaved hair advances with your natural hair.

The problem with these techniques is that the weaves tend to cause traction alopecia (hair loss from the pulling of the weaves). The weaves can look great, but with hair loss as a complication of them, you need to beware. Costs are also very high for weaves.

Firstly, I would like to express my gratitude for this incredible site. It has really been incredibly helpful. I just have a couple questions I’ve had difficulty finding the answers to.

1) I’ve read that the appearance of chest hair is an indicator that DHT is working on your body. Would that mean that people who have MPB would begin experiencing hairloss around the same time that they notice chest hairs growing out?

2) Recently I’ve noticed that my own hairline has been receding in the corners quite a bit. I know this may just be the effects of a maturing hairline, but i fear that since it is occuring so early (I am a 17 year old caucasian male)my chances of eventually going completely bald are greatly increased. Is this typically the case?

You are correct in stating DHT is responsible for male chest hair growth, but it does not mean when you start seeing chest hair growth you will start seeing male pattern baldness. Things do not happen so synchronously. In fact, the appearance of chest and beard hair have independent cycles, just as the hair loss associated with genetic hair loss. So if you’re seeing your hairline start to recede just as your chest hair starts growing in, it is just a coincidence.

Male pattern balding can start at the onset of puberty, but you cannot say you have an increased chance of going bald just because you noticed some front corner hairs thinning. Best to see a doctor, and get your hair mapped out for miniaturization, which will show early signs of genetic balding if that is what you have.