Posts Tagged: Propecia

Are There Sexual Side Effects from Propecia Hair Loss Medication?

July 20th, 2005

Q: I had some side effects from Propecia 1mg a day after being on the medication for about 10 days that included decreased sex drive and difficulty in holding an erection. I would like to try to continue taking the medication. What should I do?

A: First, you should discuss this with your prescribing physician. In my practice, I generally advise patients to:

  • Discontinue the Propecia until the side effects have gone
  • For 2 weeks, take 1/4 pill a day
  • If there are no problems, for the next 2 weeks take 1/2 pill every day
  • If you still do not have side effects, return to full dose of 1 pill every day
  • If you experience side effects, go back to the level that you had no problem and stay at that level for at least 1-2 months before trying to increase the dose again

Posted by Robert M. Bernstein M.D. at 1:20 pm

What is Recommended Treatment of Early Hair Loss?

July 1st, 2005

Q: I am 27 years old and have a Class 3 degree of hair loss. Should I should do a hair transplant or consider non-surgical methods of hair restoration?

A: At age 27 with early hair loss, you should consider non-surgical options first.

Propecia is the most important medication, but you need to be on it for one year at the full dose of 1mg a day to assess its benefits.

If you have done this and other parameters are OK for a hair transplant, such as adequate donor hair density and scalp laxity and you have little evidence that you will become extensively bald (i.e. no donor miniaturization and no family history of extensive baldness), then hair transplantation can be considered.


Posted by Robert M. Bernstein M.D. at 12:17 pm

Should One Consider Hair Transplant with Early Hair Loss in Crown and Donor Area?

May 18th, 2005

Q: I’m currently 24 years old. Ever since turning 20, my hair on top began to thin little by little. I have noticeable thinning on the top part of my scalp and on my crown, but have no recession at the temples. My hairline looks amazingly young and hair on the donor areas seems quite thick. Am I in the early stages of male patterned baldness? I cannot place myself in the Norwood scale since my thinning doesn’t seem to follow the classic pattern. I just started on Propecia. Should I be considering a hair transplant?

A: From the description, it sounds like you have typical Diffuse Patterned Hair Loss or Diffuse Patterned Alopecia (DPA).

Please see: The Classification of Hair Loss in Men for more information.

In this condition, the top of the scalp thins evenly, the donor area remains stable, and the hairline is preserved for a considerable period of time.

Propecia would be the best treatment at the outset. When the hair loss becomes more significant, patients with DPA are generally good candidates for surgical hair restoration.

It is important, however, that your donor area is checked for miniaturization to be sure that it is stable before a hair transplant is considered.


Posted by Robert M. Bernstein M.D. at 2:13 pm

Will Increased Propecia Dosage Improve Hair Growth?

April 28th, 2005

Q: I have been taking Propecia for three months. Would it help to up my dose?

A: For most people (of average body weight of approximately 150 pounds) 1 mg is the ideal dose.

This is a statistical statement, however. There are some people who fall outside the bell curve. As we don’t know who these people are, we occasionally increase the dose on non-responders after 1-2 years, particularly for those who weigh significantly more than 150 pounds.

Remember, an increased dose also results in an increased risk of side effects and most people experience no additional benefit. There have been no scientific studies to support this regimen.


Posted by Robert M. Bernstein M.D. at 1:34 pm

When Can One Judge Effectiveness of Treatment with Propecia Hair Loss Medication?

February 7th, 2005

Q: I was wondering why you chose two years as the amount of time one should wait to judge the effectiveness of Propecia. Have you had patients who only saw results after that long? Why does Merck say 3-6 months and Dr. Rassman at New Hair say 6-8 months? I know these numbers aren’t arbitrary, but I’m just wondering what the logic is behind this and how does this relate to planning a hair transplant?

A: The Merck data showed that over 90% of patients had peak response at 1 year and this has been my experience as well.

Most patients show the most dramatic response between 6 to 12 months with some getting additional benefit up to two years. Prior to 6 months, the results are quite variable and there may even be a net loss due to shedding during this period, as the Propecia stimulates a new anagen cycle.

If one is planning to go on Propecia before a hair transplant to minimize any shedding from the surgery and to prevent future hair loss, one should start the medication at least one month prior to the procedure.

If one wants to use Propecia for the purpose of possibly avoiding hair restoration surgery, then one needs to wait at least a year to see if there will be enough regrowth.

Finally, if one is younger (i.e. in the 23-25 age range) one should be on Propecia for at least two years to give it every possible chance of working and see its maximum benefit before considering a hair transplant.


Posted by Robert M. Bernstein M.D. at 12:51 pm



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