Dr. Bernstein Discusses Propecia And Rogaine Hair Loss Medications

December 13th, 2013

Dr. Bernstein is interviewed on Propecia (finasteride) and Rogaine (minoxidil) hair loss medications, which ones are most effective, how they work, and any side effects.

Dr. Bernstein: There are two main medications, Propecia and Rogaine. Propecia is a prescription medication that is taken orally, and Rogaine is a topical medicine that stimulates hair. And that has been really the mainstay of treatment over the last decade.

Interviewer: How would you rate those two in effectiveness, side-by-side?

Dr. Bernstein: Of the two, the oral medicine, Propecia, is far more effective. But to get the best results you should use both.

Interviewer: And [about] side effects from Propecia, which were heavily publicized in the beginning?

Dr. Bernstein: Propecia has side effects of sexual dysfunction, but it is limited. It usually occurs in the beginning of treatment, so it’s not like you’re going to take the medicine for years and all of a sudden you get side effects. Usually either you can take it or you can’t.

Interviewer: These two also work well in conjunction? Or do you take one or the other?

Dr. Bernstein: The medications are really best used together. One stimulates hair follicle growth. The other blocks DHT, which is what causes hairs to shrivel up and die. So blocking DHT with Propecia really permits hair to grow naturally.

Interviewer: So, you can regain lost hair with Propecia?

Dr. Bernstein: If the hair loss is early, you can.

Interviewer: Medication is better for what kind of candidate?

Dr. Bernstein: Medication is always best used when you have some existing hair, because what it does is it thickens the hair and prevents it from being lost. Once the hair is gone, then the hair transplant steps in.

Watch more videos on Hair Loss Medications
View before and after photos of treatment with Hair Loss Medication
Read about Propecia (finasteride)
Read about Rogaine (minoxidil)

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Posted on December 13th, 2013 at 2:46 pm

Does Propecia Work On The Front of the Scalp?

October 29th, 2012

Hair loss medications are a topic of interest to a great number of people around the world. While the treatment of hair loss with Propecia (finasteride) and Rogaine (minoxidil) have proven to result in a reversal of hair loss, patients still have a number of questions about the drugs’ efficacy and safety. Sometimes these concerns can be exacerbated by reports in the media. Dr. Bernstein discusses these issues in this clip.

Here is a more detailed summary of the video:

Many patients have the erroneous assumption that medications, such as Propecia and Rogaine, don’t work on the front of the scalp. The problem is, the medicines were originally tested just on the back of the scalp. So the FDA limits the claims that they can make, what they can say.

All of us that use these medications know they work in the front of the scalp just as well as the back. The important thing, though, is that they don’t grow hair on a bald scalp. What these medications do is reverse the miniaturization process.

When you’re losing your hair you don’t go from a full head of hair to being bald. Gradually, what happens is the hairs decrease in length and diameter, and this thinning process, called miniaturization, is what eventually ends up in baldness. While the hair is thinning, there’s a window for the medications to reverse it, to actually elongate the hair and increase its thickness.

Both Propecia and Rogaine will work to do this, regardless of whether this process is going on in the back or the front of the scalp. If someone tells you, “You should have surgery because the medicines don’t work on the front.” [You should] say, “Whoa, whoa, whoa. Let’s give these medicines a try.”

It’s also important to have these medications tested for at least a year. Medications work very slowly — as does surgery, surgery takes a year to grow in. You can’t rush these things. After using both Propecia and Rogaine for a year, then we will have some sense as to whether we’ve exhausted our medical options and then go to the next step, which would be a hair transplant.

There’s been a lot of publicity about the side-effects of Propecia. Propecia does have side effects, perhaps in about 5% of patients. There have been some very rare cases of side-effects persisting after the medications have been stopped. This is, of course, a big concern and we’ve been looking into this in detail. Cases seem to be very rare. It’s not clear always whether there’s a cause and effect relationship, whether the medications are actually causing the persistence or there may be there are some other reasons. Examples of other reasons could be, certainly, psychological effect after the medicine is stopped, or that the patient would have sexual dysfunction from some other cause. Sexual dysfunction is relatively common, especially as people get older.

It is very important to put everything into perspective. Unfortunately, it is very difficult to show cause and effect in this situation. A lot more data needs to be accumulated to try to sort out what exactly is going on.

View before & after photos of medical treatment with Propecia and Rogaine

Read about Propecia (finasteride)

Read about Rogaine (minoxidil)

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Posted on October 29th, 2012 at 10:07 am

Which Is Better: Rogaine Foam Or Liquid?

May 4th, 2012

In this audio clip, Dr. Bernstein answers a frequently asked question about different types of the Rogaine topical hair loss medication and their efficacy.

Listen to the clip (2 minutes 22 seconds):

Which Is Better Rogaine Foam Or Liquid?

Here is a transcript of the audio:

Rogaine comes in a number of different forms. It comes in a 5% solution for men, a 2% solution for women and a 5% foam. The original formulation was the 5% solution for men, which has propylene glycol in it. The propylene glycol is what actually allows the medicine to penetrate into the scalp. That’s the best vehicle, the most effective way of getting the medication into the follicles. And that’s why it was originally designed that way. Many medications have propylene glycol as a base.

The problem with propylene glycol is that it is irritating to the scalp in some patients, and some patients actually can have an allergic reactions to it. Also, it is a little bit greasy. So because of that, for women, they put the minoxidil in an alcohol-based solution, so it’s going to be a little less effective, but less greasy.

Then, a number of years later they came out with men’s foam which has no propylene glycol in it. The problem with the foam is that, even though it is aesthetically a little bit nicer, it doesn’t really allow the medicine to penetrate quite as well into the scalp. Also, the foam is very hard to get on the scalp, especially if you have a lot of hair. It seems like the foam gets caught up in the hair, where with the liquid, you can separate the hair and get the liquid directly on the scalp.

What’s interesting is that although Rogaine has been prescribed in the packaging insert to be used twice a day, often people can get the same results if they put it on more liberally just once a day at night. So if you can put it on at night and use the propylene glycol based solution, the 5% men’s solution, then you can circumvent the cosmetic problems with it being greasy because you can wash it off in the morning. Most people take showers in the morning.

So what we advise most people to do is use the more effective 5% just once a day, at night, wash it out in the morning and then you’re done.

The other thing is we find that when people use the medication twice a day, it’s kind of a nuisance. They kind of just dab it on and you really want to get a good even coat of the entire areas that have the potential to be bald, not just the areas that are thinning a lot. Because the medications work, as you know, as a prevention just as much as regrowing hair back.

Read about the various Rogaine (minoxidil) products

Read our page with tips on using Rogaine (minoxidil)

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Posted on May 4th, 2012 at 8:15 am

Can Propecia Or Rogaine Improve Receding Hairline?

December 8th, 2011

In this clip, Dr. Bernstein discusses the efficacy of Propecia and Rogaine hair loss medications on the front of the scalp.

Here is a more detailed summary of the video:

Once hair is totally lost, medications such as Propecia (the brand name for it is Finasteride), or Minoxidil (the brand name is Rogaine), can’t really do anything.

The reason is, the medicines work by reversing the miniaturization process. In other words, in genetic hair loss hairs progressively get finer until they disappear. These medicines can take a fine hair and then make them thicker, but they can’t grow hair on a totally bald scalp. So they can’t actually lower your hairline. But the important thing is, even though the medicines can’t lower your hairline, they actually do work in the front of the scalp and it’s very important to use them for this purpose.

Unfortunately, the drug companies tested the medication in the crown, and therefore they are limited to saying, in package insert, that they only should be applied in the crown. However, since the disease process is exactly the same in the front and back of the scalp, it’s only logical that it should work in the front of the scalp also. And, in fact, they do work in the front very very well.

So, although they may not grow new hair in the front of the scalp, they certainly can thicken hair in the front of the scalp, and they can prevent further hair loss in the front. So, just to use the medicines for the back really doesn’t make any sense.

On our website, we’ve posted a series of photos showing how effective these medicines can be in the front of the scalp. And if you go into the Medications section on BernsteinMedical.com, you can see a series of photos that — these are all very recent, you can see how many there are. These are all patients who were on medicines for about a year. [They] usually used a combination of both Propecia and Minoxidil, but some of them were on Propecia alone and it will say it under the photo.

View Before & After Photos of Medical Hair Loss Treatment

Visit the Hair Loss Medications page

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Posted by Robert M. Bernstein M.D. on December 8th, 2011 at 12:51 pm

Dr. Bernstein Featured In Hair Loss Report On ABC News

April 15th, 2010

WABC-TV Eyewitness News; channel 7 in New York, NY; featured Dr. Bernstein in a special report on hair loss and hair loss medications. In particular, the report, by ABC correspondent Kemberly Richardson, asked Dr. Bernstein about the effectiveness of Propecia/Finasteride and Rogaine/Minoxidil in the treatment of male pattern hair loss.

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Posted on April 15th, 2010 at 7:59 am

The Today Show Features Dr. Bernstein In Segment On Eyelash Enhancement

February 9th, 2010

Dr. Robert M. Bernstein was interviewed by The Today Show on eyelash enhancement and the eyelash medication Latisse.

View the complete video:

For more on this topic, visit our eyebrow transplant page or our Latisse page.

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Posted on February 9th, 2010 at 10:01 am

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