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  1. #1
    IAHRS Recommended Hair Transplant Surgeon rbernstein's Avatar
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    Default Efficacy of Hair Loss Medications on the Front of the Scalp

    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:

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    Patient OVQ

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    Patient KMJ

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    Patient QTC
    Robert M. Bernstein, M.D., F.A.A.D.
    Member, International Alliance of Hair Restoration Surgeons
    View my IAHRS Profile
    Visit the Bernstein Medical - Center for Hair Restoration website


  2. #2
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    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

  3. #3
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    Thumbs up

    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!

  4. #4
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    Quote Originally Posted by Zao View Post
    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?

  5. #5
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    Quote Originally Posted by rbernstein View Post
    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:

    Attachment 13104
    Patient OVQ

    Attachment 13105
    Patient KMJ

    Attachment 13106
    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?

  6. #6
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    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.

  7. #7
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    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!!

  8. #8
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    Quote Originally Posted by blakes33 View Post
    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.

  9. #9
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    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..

  10. #10
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    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.

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