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Hi,

I’ve been on Propecia for 5 months now. I’ve noticed a lot of the people who write in say they switch to Proscar after about a year. Why the change, isn’t it the same drug? Is Proscar a higher dose of finasteride per amount taken?

Many people switch because of the cost difference. Proscar (5mg finasteride) is the same drug, but you can cut it into 4 pieces to get about the same dosage as Propecia (1mg finasteride). Generic 5mg finasteride is legally available in the US, but generic 1mg finasteride is not here yet, as it is still under patent protection. I believe generic 1mg finasteride will be out of patent in 2013. Remember, you need to have a doctor’s prescription for either medication.

Hi Doc,

I was wondering if you had heard of any new information regarding Neosil’s NEOSH101? This seemed fairly promising for a while but it seems like things have gone silent on this one, has this one bitten the dust?

Also in my travels around the internet i found this, a study based around using roxithromycin lotion to treat baldness. What are your thoughts on it?

Finally i hear a fair amount about Saw Palmetto and how great it is as a natural alternative to Finasteride but if this where true why hasn’t there been any decent studies on it? And why aren’t the producers of it funding studies to prove it works? That indicates to me that perhaps using Saw Palmetto for hairloss is a load of bunk. Surely if they had a product that could potentially help fight baldness you’d think they’d want to be able to prove it scientifically.

Cheers

I haven’t seen any news about Neosil or the NEOSH101 product they were working on. Last I remember, Neosil was bought out by Peplin, who in turn put NEOSH101 on the backburner to focus on their other products (though they said their hair loss treatment would be a future product). I can’t find anything since then…

Regarding using roxithromycin (a drug used to treat infections) as a hair loss treatment, your guess is as good as mine. I’ve never seen such study and the clinical trial link basically says to me that if there was a study they were starting to conduct, it didn’t go anywhere. They haven’t updated any information in years and there are no results or info available. I’ve not even seen any information about why this medication might work as a hair loss treatment.

The saw palmetto / hair loss treatment controversy has yet to be proven. Saw palmetto does not work like finasteride to treat hair loss. People jumped on the bandwagon because saw palmetto is used for prostate treatment, and as you probably know, finasteride is also used for prostate treatment. People put the two together to create pseudoscience through association. The thing is, it is an over-the-counter herbal that is readily available, so nobody is going to take the time or money to fund a proper study. They figure — why prove it when people will buy it regardless? When it comes to hair loss treatments, unfortunately people are willing to spend their money on just about anything with a hint of a promise.

hi. i have fine hair but have always worn my hair long. so i first noticed it was going when i seen it wasnt growing as fast and what does grow is really stringy. i was wondering would propecia reverse this so that when it grows its thicker? im also 24 years old so hopefully i fall into the younger crowd that gets really good results!

Propecia does not grow hair any faster. It is a medication to treat androgenic alopecia. You need to see a doctor who can examine your hair for miniaturization and for signs of androgenic alopecia if you are to be a candidate for such medication. If you are actually losing some hair due to genetic causes and your doctor prescribes Propecia, I still wouldn’t know if you’d fall into that crowd that gets really good results. Each person is different. Some people get headache relief from one ibuprofen pill, some people will need to take a couple. But keep your fingers crossed!

Hello,

I was wondering how decreasing DHT levels causes the side effects that it does. Can increased testosterone make up for low DHT levels?

Thank you for your time.

The effects from decreasing DHT’s impact on the hair follicles is achieved by taking medications such as finasteride (Propecia/Proscar) or dutasteride (Avodart). There is recent evidence that DHT may be actually made in the skin and glands of the hair follicle itself. That would explain the need to get some tissue binding for such drugs as finasteride. More testosterone in theory might produce more DHT, but with finasteride on board, it will be blocked at the placed it is produced and in the hair follicle itself with appropriate tissue binding from a systemic dose, so more testosterone may not make much of a difference.

An unwanted side effect of taking Propecia is a reduction in your sex drive/erection by 1 to 2 percent and breast enlargement (gynecomastia) 1-in-300 to 1-in-500 people. The drug also impacts the prostate with less semen volume with ejaculation in many men. There may be other rare side effects that you can read about on Drugs.com. My personal feelings is that there are many false and exaggerated bits of misinformation on the web about the frequency of these side effects. The Internet is a valuable resource, but of course, not all the information you find on it is true.

Hi:
I was on Propecia for roughly six years between 2000 through 2006. I had decent results, kept the hair on the top of the head, however the temples were receeding a bit. The hairline in the front was thin as well. In 2007 I was diagnosed with stage 1 testicular cancer. It was localized to my left testicle and I was lucky to catch it early as it did not spread anywhere else. I had surgery to remove the affected testicle and undergo preventive tests on a quarterly basis.

My questions are: Could the cancer be caused by the Propecia? I would like to start taking the Propecia again to re-gain what I lost as I am starting to get the dredded “hair ring” around the head. I am 38 and was wondering about fertility since I only have one “factory” left?

Thanks!!

I would ask this question to your oncologist. I highly doubt testicular cancer is caused by Propecia. There are many men who get testicular cancer who are not on Propecia. Most of the time you cannot establish a causal relationship.

With respect to your fertility, I am not the doctor to ask this question to (as I am not a fertility doctor).

I have taken propecia for almost a year with good results and now I would like to consider switching to Proscar. Is the use of Proscar commonly understood by dermatologists to be effective for treating MPB, or should I assume that my doctor is unaware about this use of Proscar?

thanks.

Simply looking at the generic name (finasteride) will tell them that the drug is the same, but in different dosages. If you’re worried that he/she doesn’t know the differing marketing names of Proscar and Propecia, you can bring it up when you have your next appointment. I would expect it is commonly known though, as the medication has been on the market for years.

Hey doc, This site is great. Anyway, been on propecia about 8 months. Hair isnt really any better def a little worse. So what do you think a person like myself, chances are of seeing any improvement in the next 4 or so months?

Did you see a doctor before you started Propecia? Did you get a miniaturization study to see how much of your hair was thinning (miniaturized)? Did you document the process by taking pictures before you started the medication? These are some of the basic things I would look for if a patient of mine states they are continuing to lose hair while on Propecia.

Propecia is not a magic pill and it does not cure or stop hair loss completely. It just may be that your natural (genetic) hair loss is rapidly progressing and Propecia cannot stop it completely. Perhaps without Propecia you may be bald by now. But all of this, I am merely guessing.

I would follow up with your doctor to see what your progress has been. I really cannot predict your future, but if all baseline tests are done, you can have an objective idea of where you are going. At the least start the baseline measurements now (better late than never) and then see what happens in 6-12 months if you stay on the medication.

Hello Doctor Rassman,
I have come to you as you are the first and final ray of hope for me to save my hair. I’m 17.5, male, and I play guitar, longing to become a rockstar some day. I started to lose hair one year ago, yet back then it was too subtle and I was able to successfully hide it…But now it’s different. My hair loss is becoming as visible as daylight and is becoming harder to hide as we speak.

As you can probably tell, I live in a place -heck, a country- where, for my seriously bad luck, no Proscar is available. I have explored various online pharmacy sites that supposedly sell genuine Proscar without prescriptions, yet I preferred not to risk such a thing. It is because of this that I come to you and ask of a genuine Proscar prescription that can permit me to purchase Proscar from a trusted online pharmacy.

I heard that taking Proscar at this age may disrupt the growth phase and turn me more “feminine”. Is this the case in every seventeen/eighteen-year old who decides to take Proscar? Plus, do the feminine side-effects instantly wear off as soon as I stop?

I’m really confused as to whether I should take Proscar or not.. I want to grow normally, lead a normal male life, but I’ll definitely be bald by a year from now. It’s a dilemma I really need your help and advice in to solve. Please, I swear to everything holy that you are the only person who can help me in overcoming this disaster.

You’ve referred to Proscar over and over, but I have to assume you mean Propecia since you’re talking about treating hair loss. Just to clarify, Proscar is 5mg finasteride and Propecia is 1mg of the same medication. The lesser dose is for treating hair loss, the higher dose is for treating prostate problems. If you get Proscar (or generic 5mg finasteride), it should be cut into smaller pieces if you’re treating hair loss. Now that that is out of the way…

I do not prescribe drugs without seeing a patient, as it is against California law. The risks for a 17 year old are minimal (it was studied in men as young as 18, however). I have prescribed the drug for men at your age, but you need to have a doctor involved and the dose should be 1mg of finasteride if it is indicated for you. I can’t tell you if finasteride is even right for you, as I’ve not seen you and I don’t know enough about your medical history, family history, etc. Please, please see a doctor. You’re 17 and likely in the early stages of losing your hair, which is when Propecia works best. I’m not sure which country you’re in, but I’d assume if you’re having a difficult time finding Propecia or Proscar name brand, you can find the generic name, finasteride.

First of all, I’d like to say this is the best hair loss website. Thank you for all the insights.

My question is this. I’ve switched from 1mg propecia to the generic 5mg finasteride.I am a patient of Dr.Pak. The staff member at your office recommend I go to Cotsco to buy the generic finasteride to save money. I did. However, I’m concerned. My concern is that the blue 5mg pill is EXACTLY the same size as the 1mg propecia. It is difficult to cut, but ive managed. Is this the right product? Surely it says 5mg finasteride, a blue pill, but how can a 5mg pill be the same size as the 1mg pill? And even if it is, when you evenly cut it into 4 pieces (1.25mg a piece), how do you know which side has more mg while the other has less? Your honest answer would be appreciated. Thanks.

The 1mg Propecia pill contains more fillers so that the pill can be at a size that is easy to swallow, but not so easy to have it disappear if you accidentally drop it. The medication is evenly distributed in the pills, so that when you cut the 5mg pill you should have the same amount of finasteride in each piece.

It sounds like you got the right product, so long as it is actually 5mg finasteride. Some pills might be bigger with score marks (intended to be cut), but each generic manufacturer is different.

I meant to post this a little while ago, but it slipped through the digital cracks…

ABC News posted a list of drugs that have dual uses (some being for off-label use). While not all of the mentions are hair loss related, among those medications that are relevant to this site are:

1. Dutasteride — used for hair loss (off-label) and prostate
2. Finasteride — used for hair loss and prostate

Regular readers of this site will note that both medications are approved by the FDA to treat prostate issues, and finasteride is also approved in a smaller dosage for treating hair loss (Propecia). Dutasteride (Avodart) is still not FDA approved as a hair loss treatment, but some doctors in the article believe it was stalled because of side effect concerns.