Hello Mr rassman

Why does almost everyone all over the internet claim propecia causes the hairline to recede and bald even faster? is this true. can it be because of the testosterone rise. because we all know testosterone does bind and hair thinning just like dht

Where are you getting your source of information? Hair loss from genetic male pattern baldness (MPB) cannot be stopped forever, but it is not accelerated by Propecia. In other words, you can be using Propecia, but still have receding hairline. Propecia does work mostly on the top/crown area and not so much on the hairline, so I suspect most people you are referring to are just noticing their recession and blaming it on Propecia.

lol Dr. Rassman,you say that masturbation has no effect on mpb but then how do you explain that when i stop masturbation for 3 days,my hair feels and looks stronger and thicker and the longer i dont masturbat,the better it gets..but when i do masturbate,my hair looks and feels weaker and thinner..you asked for a controlled study,im your controlled study..my father is bald,my brother balded so im geneticaly set for mpb but using certain methods and limiting masturbation to a minimum,i seem to have some control over my genetic mpb..i think someday you will see that we are right

I think you should go back and look up the what a controlled study actually is. I am posting your email because some other men may feel as you do, but there is no evidence for your thesis. Everyone is in control of what they do with their body, like when they choose to use non-approved topicals on their hair or the frequency of masturbation. If you think your hair is better now, congratulations.

Note the importance of buying legit Propecia from a real pharmacy!!

Couple years old but a UK Press Release about fake Propecia rings true today.

Press release: Counterfeit medicines gang convicted

Thanks for sending this in. Yes, it is from late 2007, but it goes to show that counterfeit Propecia does exist and is a problem. One crackdown (no matter how large it was) in the UK doesn’t eliminate the problem altogether. Buyers need to use common sense when buying prescription drugs off the internet without a prescription.

thanks so much for your work with this blog. i am 25, with what i would describe as a hairline that has receded about 1.25 inches at the corners and generally thinned in the front. i have been putting some thought into propecia’s timeframe lately, and would love to hear your thoughts on this.

merck of course has their (FDA approved!) literature, about what to expect after 3 months, 6 months, 9 months, etc…there are of course many variables that go into the whole equation, but what are your thoughts on the ratio of time an individual has taken propecia/total time the individual has experienced some degree of hairloss? i have been taking for just under 4 months now, and not really noticed anything. some people lose hair quickly, what has happened with mine has happened over 3+ years.

would you hypothesize there is a correlation between not only degree of hairloss and propecia’s effectiveness, but also between the amount of time that hairloss occured versus how long a person has been taking propecia? thanks!

There is a genetic test called HairDX Test for Finasteride Response that can check your overall sensitivity to DHT blockers like finasteride, as we are all different genetically. It scores a CAG repeat test, and when the patient scores low (less than 22, for example) they will have a better response from finasteride than when the score is high (above 22). In this way, it is possible to find out your overall sensitivity to these drugs (hence, effectiveness). Add this into the other variables you mentioned above, and you can get a more clear picture of what my happen to you over time, but the reality may not be as simple as just getting a genetic test.

The medical profession is at the doorstep of understanding genetic tests like this and fitting them into the course of patient’s balding patterns and the rate of the balding process. At 4 months, there is just not enough time to know how you will respond to the drug, but at a year or so out you may know more. Finasteride does not work as well in the frontal hair at reversing the process as it does in the crown. You can get yourself tested with this genetic test to anticipate your personal response to finasteride, but what you do with the information is not easy to ascertain. You will have to sit down with your doctor to explore the process further.

In all people, the effectiveness of Propecia over time will change because the balding process will change (it is progressive) and the degree of change varies with the individual. There are no rules other than what I discussed above, but I believe that as long as the balding person is taking Propecia, the drug is effective. To prove this, stop taking it and see that the hair loss just gets worse in a matter of months. Actually, I don’t advise you to try to prove it, because the cost in hair loss would be too great.

If you knew that natural cures to hairloss existed, you wouldn’t be holding back on us just to get a few more bucks, would you?

Also, it’s been one year exactly since I stopped my 58 days on Propecia, and I still have these mental side effects of stumbling over words/lack of fluidity when speaking/lack of wit and smoothness. The only other thing in the world this could be would be the high soy diet I put myself on for hairloss measures a few weeks after I started Propecia, and right before I felt my first side effects. I’ve seen a thyroid doctor (who said everything at Whole Foods was a fraud), a neurologist, and a psychiatrist (the latter just for kicks really), and apparently I’m the foremost expert in soy isoflavones and their effect on the thyroid. Just because someone has a medical degree doesn’t mean they’re knowledgeable in every arena. I still never had any sexual or physical side effects, and my wit is still present when I type or write, so something is only affecting my speech, which lends me to believe it really has to do with the physical properties of the thyroid and perhaps the larynx. Any thoughts?

Would I hold back the cure for balding if I had it? The answer to that is… absolutely NO. I obviously spend all of this time answering questions on this site just so I can squeeze money out of you, telling you there’s no cure when secretly I’ve been hiding it in my wall safe. Did you catch the sarcasm there? If you truly think a natural cure for hair loss is out there, by all means keep rubbing onions on your head and coffee in your eyes… or whatever the “cure of the day” might be.

I can not tie the speech/voice problems you have with the drug Propecia. What you said about soy is interesting and noted. There have been some patient reports that finasteride may have caused some impact on brain function but, I suspect, that would be extremely rare and not proven in the medical literature.

Dear Dr. Rassman,

I have a question regarding Propecia side affects on the hair (!) if you stop taking it. If one stops using it after a long period (months or years), are there any chances the hair loss would increase? Meaning, if one took it for, lets say, one year and his body got used to the drug, can the hairloss get worst when he stops using it? I know of course that when one stops using propecia the shedding returns, but could it be more severe than if he had not taken the drug for the same period of time before he stopped?

Thank You

If you stop using Propecia, you may experience “catch up” hair loss. You will in effect lose all the hairs that grew from Propecia and lose all the hairs that would have been lost if you never took the medication in the first place. I have personally seen such cases and they can be pretty dramatic. The hairs that are lost will not likely come back if you re-start Propecia. I don’t know of any evidence showing that upon stopping Propecia, your hair loss even more severe than it would’ve been.

In the past, you have reccomended .5mg of propecia for those experiencing side effects. Why not .75mg?

As long as you have a good way to split a 1mg oval/circular pill into the correct geometry to make it 0.75mg, I don’t see a problem. Then you can take the 0.75 and save the 0.25 remaining for the next three days when you can combine three 0.25 to take the 0.75 dose. Or I guess you can just throw away the 0.25. Get the point? It makes practical sense to split a 1mg pill in half to make 0.5mg.

Dear Dr. Rassman,

I have a question.. I have a nine year old sister who has been losing a lot of hair for about four months now. She loses a lot when combing her hair, putting up in a pony tail, and when showering. She loses the most hair when she showers. She doesn’t have any bald spots, but my mom and I are getting really worried. What do you think the reason might be? Should we consult this with her doctor? I would really appreciate your help. Thank you.

Yes, I’d definitely would have her doctor take a look. There could be many causes for hair loss in women including an iron deficiency (if she is presently menstruating). The showering isn’t causing the hair loss, as you probably suspect, but constantly combing the hair can cause it to come out.

I have a question regarding Diffuse Patterned Alopecia (DPA). My hair loss follows this diffuse pattern, with no loss on sides and back. I was wondering is the success rate for DUA treatment with propecia the same as typical norwood pattern hair loss? Also does DPA typically progress more rapidly than norwood patterns?

If the sides and back are not miniaturized, then you may have a form of MPB, which in young men responds usually very well to Propecia (finasteride). Diffuse unpatterned alopecia (DUPA) usually does not respond to finasteride, but a rare few cases I have seen have gone against the grain and responded to lessen the amount of miniaturization, although some of it did remain. DUPA is essentially not treatable and we really do not understand what is happening in those who have it.

On the other hand, with diffuse patterned alopecia (DPA), this is a form of male patterned balding that is genetic and can be effectively treated with finasteride. The presentation is more generalized in the pattern of balding and rather than lose hair from the front to the back in a progressive manner, the hair loss is subtle and generalized, but ends up at the same point as if it were classic patterned balding.

Hello Dr.Rassman!

My question: When MPB starts, how long does it usually take for the hair loss to become noticeable? I am starting to lose hair/thin (only visible by me) and with MPB in my genes on both sides of the family, I am curious how long it will take for it to become apparent.

I’m sure there’s no exact answer for my question, but I assume there is an average time frame.

Thank you!

Male pattern baldness (MPB) can start with the onset of puberty, but it is not usually socially noticeable until more than 50% of your original hairs fall out. This can take many years. In general, for those who go completely bald (Norwood class 6 or 7 — see image at right) it can take 5 to 10 years, but there are always exceptions. For some men it can take 20 to even 30 years.

There is no general time frame that fits everyone. Maybe you should ask your family members who have MPB how long it took them to notice their hair loss.