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Hair Restoration Answers

Does Propecia Work for Life or Does it Stop Working Over Time?

Q: Can Propecia (finasteride) completely halt androgenic alopecia for the duration of your lifetime, or does it just slow down the progression of androgenic alopecia? — L.B., Scarsdale, N.Y.

A: In many patients we have found finasteride to hold on to a patient’s hair for at least 15 years. We don’t have much longer data than that since it was approved for hair loss in 1998. Although finasteride will usually continue to work as long as you take it, it may lose some of its efficacy over time. Generally after about 5 years we may notice that the patient’s hair is starting to thin again and we will increase the dose slightly. It is important to understand that even if someone thins on finasteride it doesn’t mean the medicine is not working, because they might have thinned much more without it. To my knowledge, there are no studies that have looked at the effects of finasteride for such an extended period of time.

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Hair Restoration Answers

Does Propecia (Finasteride) Work Long-Term?

Q: I have been taking finasteride for several years and I seem to be doing well. Does finasteride generally work long-term? — A.C., West University Place, Texas

A: With regard to efficacy, a recent long-term, uncontrolled study by Rossi et al. reported that the effects of finasteride were not reduced as time goes on and that a significant proportion of patients, unchanged after 1 year, improved later on. In addition these patients maintained a positive trend over time -– up to ten years. When comparing different age groups, they found that subjects older than 30 years showed a better hair growth in the long term than those who were younger. Of the 113 patients in the study followed for 10 years, only 14% worsened, whereas the remaining 86% had benefits.

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Hair Restoration Research

Propecia Causes No Statistically Significant Change in Sexual Function, Says 2004 Tosti Study

The central finding of a 2004 study led by Italian researcher Dr. Antonella Tosti, in which he and his team investigated sexual dysfunction in hair loss patients being treated for androgenetic alopecia, was that there was no statistically significant change in sexual function after four to six months of treatment with finasteride 1mg (Propecia).

Interestingly, the research team found that sexual side effects were actually less common than reported in the clinical trials of the drug.

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Hair Restoration Research

Sato Finasteride Study Points to Long-term Safety, Efficacy in Use of Propecia

Led by Dr. A. Sato, a Japanese team of medical researchers published the largest finasteride study ever performed, “Evaluation of efficacy and safety of finasteride 1mg in 3,177 Japanese men with androgenetic alopecia.” It investigated the effects of finasteride over a 3 1/2 year period in men with androgenetic alopecia, or common baldness.

The study found that patients who had experienced hair loss for an extended period of time and were treated with finasteride exhibited notable hair growth. While a fairly small proportion of patients with a hair loss duration over 10 years exhibited “greatly increased” growth, 85% of patients with hair loss duration of more than 15 years experienced “moderate” or “slightly increased” growth. Physicians have thought that people with advanced hair loss do not respond as well as patients in the early stages of hair loss. However, in light of the results of this study, that determination should be reconsidered. Continue reading this article.

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Hair Restoration Answers

Does Propecia Stop Working After Five Years?

Q: I heard that Propecia stops working after five years. Is this true and why in five years? — B.P., Stamford, CT

A: That is not correct. Although the effects of Propecia (finasteride 1mg) will diminish over time, it does continue to work. Using finasteride long-term will still be better than stopping it at some arbitrary interval. In clinical practice, I often increase the dose of finasteride, after someone had been on the medication 3 to 5 years, to help maintain its effectiveness.

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Hair Restoration Answers

Will Someone Taking Propecia For One Year Experience Any Further Regrowth?

Q: I have a friend who has been using Propecia 1mg a day for twelve months without having any regrowth. Is he likely to experience regrowth at this stage? — S.S., Long Island, NY

A: Your friend is unlikely to get any significant regrowth after one year, but that doesn’t mean that the medication is not working. He may have had even more hair loss without the medication.

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Hair Restoration Answers

Can Women Use Propecia to Treat Hair Loss and Does Their Age Matter?

Q: I have early thinning on the top of my scalp and I was told to use Propecia, but I heard that is was only for men. What do you think? — T.G., Staten Island, NY

A: Women can’t take Propecia during the child-bearing years because, if ingested, it can cause birth defects in male offspring.

In post-menopausal women, where we see the greatest frequency of hair loss, it doesn’t seem to be effective.

In pre-menopausal women who do not plan to become pregnant or who already have children, we are still cautious about using the medication, since there effectiveness has not been proven and its long-term safety in this population has not been tested.

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