Efficacy of Hair Loss Medications on the Front of the Scalp

[rbernstein]

There is some misinformation being passed around suggesting that hair loss medications (finasteride and minoxidil) are not effective in growing hair in the front part of the scalp. With our patients’ permission, we have posted the results of treatment with Propecia and Rogaine to show that medications do work well in many cases. It is important to note that most patients have used the medications consistently for at least a year to achieved the desired results.

Below are some examples of Bernstein Medical patients who have treated their hair loss with medication alone. Visit the Bernstein Medical website to see additional before and after photos of medical treatment.

Click for larger versions:


Patient OVQ


Patient KMJ


Patient QTC

[Zao]

Great post Dr. Bernstein. I read so much misinformation about Propecia and the frontal hair loss issue is always something that comes up. I have personally kept my hairline in check sine 1998 using Propecia and I was losing hair in that area aggressively before I started.
Here’s my story, you might remember me

http://www.baldtruthtalk.com/showthread.php?t=435

[8868alex]

Dr Bernstein - Many thanks for this. I congratulate you on highlighting the success of medical therapy as a stand alone treatment. Surgery obviously has it's place but I think it's testament to your integrity that you don't merely focus on the surgical apsects.

Zao - Great story, all the best for continual success!

[25 going on 65]

Great post Dr. Bernstein. I read so much misinformation about Propecia and the frontal hair loss issue is always something that comes up. I have personally kept my hairline in check sine 1998 using Propecia and I was losing hair in that area aggressively before I started.
Here’s my story, you might remember me

http://www.baldtruthtalk.com/showthread.php?t=435

13+ years on finasteride and your hairline is solid?? Have you noticed any loss n front and at the temples since you started? Also, are you using any other treatments?
Your story gets me excited because I've been worrying a lot lately about finasteride losing its effectiveness after 3-5 years, especially in front. If this drug could maintain my hairline for more than a decade that would be a dream come true for me.
Also, have you noticed any side effects?

[blakes33]

There is some misinformation being passed around suggesting that hair loss medications (finasteride and minoxidil) are not effective in growing hair in the front part of the scalp. With our patients’ permission, we have posted the results of treatment with Propecia and Rogaine to show that medications do work well in many cases. It is important to note that most patients have used the medications consistently for at least a year to achieved the desired results.

Below are some examples of Bernstein Medical patients who have treated their hair loss with medication alone. Visit the Bernstein Medical website to see additional before and after photos of medical treatment.

Click for larger versions:

[ATTACH]13104[/ATTACH]
Patient OVQ

[ATTACH]13105[/ATTACH]
Patient KMJ

[ATTACH]13106[/ATTACH]
Patient QTC

I have used propecia since it was released (almost 14 years) but recently became VERY worried about the new studies showing potential of permanent hormonal changes and impotence. Even Merck revised their side effects warning in the last 6 months to include "erectile dysfunction that persisted even after stopping the drug".

Do you know if catch-up hairloss is real - if so, how much will I lose and how soon (based on experience)? I have been off propecia now for 11 weeks.

What about minoxidil - do you think if I start using that instead of propecia it will stop my hairloss the same way propecia has done?

[25 going on 65]

From everything I've read, catch-up hair loss is real. If you quit finasteride, all the benefits gained from drug will disappear - I believe it takes less than a year. This is true whether you've been on the drug for a couple years, or for 14.
Minoxidil has a different effect than finasteride and won't stop your hair loss. It stimulates growth where your follicles can still grow hair, but the number of follicles capable of growing hair will continue to decrease if you have male-pattern hair loss and are not using finasteride or dutasteride.

[blakes33]

thanks 25 - very scary to risk ANY kind of permanent sexual dysfunctioning but also scary to lose hair that one has kept 14 years. Obviously, the unknown is HOW MUCH hair I might lose by staying off, and how quickly!!

[Tracy C]

I have used propecia since it was released (almost 14 years) but recently became VERY worried about the new studies showing potential of permanent hormonal changes and impotence.

If you have been using this medication for 14 years and have not yet experienced any side effects, you are not likely going to experience any side effects.

Propecia and Rogaine do two different things. Propecia treats the cause of hair loss. This effect can prevent further hair loss and possibly allow hair follicles that can still grow hair to grow hair - but it does nothing to stimulate hair follciles to grow hair. Rogaine stimulates hair follicles that can still grow hair to grow hair - but it does nothing to treat the cause of hair loss.

[TheDude]

My question is, when you have been using propecia for 5 years and the effects are noticeable wearing off especially in the frontal region, what options do we have?

Increase the dose? already tried with little success or

move onto avodart, at the moment im too worried to make that jump.. yet im balding faster than ever..

[25 going on 65]

You could try an increased finasteride dose but it may take a year before you can really tell if it's working.
RE: dutasteride (Avodart). I'm considering it myself. But it's not FDA-approved to treat hair loss, which makes it a bit more challenging to get a prescription in my experience. And compared to the 5 mg finasteride tablets I've been using (cutting into quarters), Avodart is expensive.
We also don't have as much info on any long-term side effects it might have, though I've heard of people taking it at least 5-6 years straight for hair loss. Short-term, if your body handles fin well it will probably handle dut well, but there's no guarantee since dut has an additional mechanism of action that fin does not.

[PatientlyWaiting]

I have been on Fin for over a year, and only am able to hold on to what I have. I wonder why it works so well on those guys in the photos, giving them regrowth. I also use minoxidil as well. I don't get it. I guess hair losses are more aggressive than others, and it may take longer than a year for some.

I know for sure without fin/minoxidil, I would have been way worse. The rate I was losing hair was very aggressive, but never as bad as the guys before pics on the photos, that's what I don't get.

[25 going on 65]

I have been on Fin for over a year, and only am able to hold on to what I have. I wonder why it works so well on those guys in the photos, giving them regrowth. I also use minoxidil as well. I don't get it. I guess hair losses are more aggressive than others, and it may take longer than a year for some.

I know for sure without fin/minoxidil, I would have been way worse. The rate I was losing hair was very aggressive, but never as bad as the guys before pics on the photos, that's what I don't get.

Yeah man, the effectiveness seems to vary quite a bit from person to person. I've read here about some kind of test you can have done that would predict how well your body responds to finasteride; might be worth checking with a hair loss specialist about.
On the brighter side I've heard a few people report that it took 2+ years to see their full results on fin. I've been on it 15-16 months I think, and I'm kind of feeling like the results have capped, but I guess the next 8 months will tell.

[blakes33]

If you have been using this medication for 14 years and have not yet experienced any side effects, you are not likely going to experience any side effects.

Propecia and Rogaine do two different things. Propecia treats the cause of hair loss. This effect can prevent further hair loss and possibly allow hair follicles that can still grow hair to grow hair - but it does nothing to stimulate hair follciles to grow hair. Rogaine stimulates hair follicles that can still grow hair to grow hair - but it does nothing to treat the cause of hair loss.

Thanks Tracy. Yeah, I tend to agree for the most part that after this long I probably won't develop any sexual side-effects if I go back on. I have been off for 12 weeks now, so I probably need to start very soon if I am going to. But the other part of me is worried because I have read that a few of the men who developed permanent problems were in fact guys who had been on the drug 10+ years..... argghh very discouraging!!

I will say that for the last year while on the drug, nothing sexually happened but i developed SEVERELY dry skin on my hands that would not heal (went to 2 dermatologists who could not help even with steroid creams). 3 weeks off propecia and my hands healed up!! strange huh... Also, I did have testicle pain for about the first 9 weeks after coming off the drug that was pretty disturbing.

[TheDude]

Thats the problem, the people that are on avodart either don't frequent hair loss forums or choose to remain silent or hairloss sufferers are to worried about this drugs effects to take it..

I actually have a box sitting in my cupboard but i almost feel like its too risky to take the stuff, like the risk is not worth any positive effects it may have and any positive effects aren't guaranteed.

I would trade my hair any day for ability to function like a normal human being and the ability to have normal children if i so choose..

Been thinking about applying it topically with the use of minoxidyl thereby limiting the percentage in my blood stream..

I really don't know.. this hair loss shit really gets me down.. but i think there is a light at the end of the tunnel.. whether its shaving it an just getting over it or whether some form of better treatment happens in the near future..

[25 going on 65]

I'm feeling pretty resolved, at this point, to go on Avodart once my finances are in better shape. I'm willing to stick it out with finasteride until the two-year mark, but I really am starting to feel like my results have hit a wall.
If I do make the switch, I'll let the forum know how it goes.