Finasteride Side Effects
December 7th, 2007 Posted by: admin
The Good News and the Bad News
In clinical studies, approximately 20% of men taking the one milligram daily dose of Propecia grew moderate to heavy amounts of new hair after one year. Another 30% had less cosmetically apparent growth. These numbers inched up slightly when used for two years. And both Propecia and minoxidil work best in men who are losing hair on the top of their heads (instead of a receding hairline or frontal hair loss). Minoxidil also may lead to new hair production, but results are more variable because of individual inconsistencies in committing to a twice/daily program of applying the solution to the scalp.But it isn’t only Propecia’s ability to grow hair that interests some doctors. There is evidence that Propecia can help men stop losing the hair they have. So it appears that even if Propecia doesn’t help you grow lots of new hair, it’s a good bet you’ll keep what you have—at least for a while.
You must be patient, though, and be willing to take the drug once a day indefinitely. It may take 3-4 months before new hair is noticed. If you stop taking the drug, all your newly grown hair will fall out over time. The same is true with minoxidil.
There may be even more good news for the balding among us: the 2003 Prostate Cancer Prevention trial seems to have established that finasteride is effective in reducing prostate cancer risk. Since bald men may have somewhat increased risk of prostate cancer, finasteride treatment may offer benefits beyond just improving appearance.
Side Effects
Propecia has some potentially unsettling side effects. Propecia has been associated with a reduced sex drive, occasional impotence, and/or a smaller amount of ejaculate, but these side effects are not common and disappear when the drug is stopped. Comparatively, minoxidil’s side effects most commonly include scalp itch or skin irritation.
Men taking the drug should alert their physicians. One effect of taking Propecia is that it will lower PSA, a compound produced by the body in the presence of a prostate cancer or just with increased age. Blood tests checking for PSA levels may be more difficult to interpret as a result. Of course men who have both hair loss and symptoms of prostate obstruction (hesitancy in urinating, diminished urinary stream, and others) may find these symptoms improved if they take finasteride because of baldness.
In our opinion, Propecia is a valuable weapon against the hereditary onslaught of hair loss and is a much better choice than using Rogaine (Minoxidil) as a single treatment. I should be mentioned here that combining Rogaine and Propecia has a synergistic effect, which means that the benefits can be greater than the combined “solo” effects of the drugs. Another strategy that we commonly use is to combine transplanting of the front part of the head in a younger patient with prescribing Propecia to help retain the hair in back.There is a new and stronger drug, similar to Propecia, called Dutasteride (Avodart), which was recently put out by Glaxo Corporation with F.D.A. approval for use in the treatment of prostate problems. It is anticipated that many physicians will prescribe this “off label” to younger patients for hair loss. At this time I am not prescribing Dutasteride, due to concerns that I have about the elevation of testosterone that occurs and also because, if a man does have side effects from the drug, there is the possibility of these effects remaining for quite a few weeks (or months) due to the long half-life of the drug. And finally, we don’t know what the long-term effects of such strong drug are in terms of later medical effects on the patient’s health. For all of these reasons, Propecia will be the only oral hair-loss drug we will be prescribing for some time to come.
