Hair Restoration Blog

Here at US Hair Restoration, we are constantly hearing about the concerns of our many patients who have been prescribed the popular hair loss preventative medication known as Propecia (finasteride). Most patients with concerns have seen recent news reports, commercials, or magazine ads talking about the dangers of taking Finasteride. Since this is an effective medication proven to aid in the sustainment of receding or thinning hair, it is important to explain the facts in comparison with the rumors.

Early side effects (1 year)

The reported side effects based off of precise medical research for Finasteride at the 1-mg dose are uncommon and reversible. The one- year drug related side effects were over 1% greater than in the control group. The data showed that 3.8% of men taking Finasteride 1mg experienced some form of sexual dysfunction verses 2.1% in men treated with a placebo.

Most reported rumors center around sexual dysfunction occurring after beginning use of the medication, but there have been reports of sexual dysfunction that have occurred at later points in time. When studies were performed based through proper research methods, the sexual side effects were reversed by all the men who discontinued therapy, and in 58% of those who continued treatment. Once the medication was stopped, side effects generally disappeared within only a few weeks.

The initial studies done on finasteride for 12 months show that 1.4% of patients taking Propecia (945 patients) were discontinued due to adverse experiences which may have been drug related.

Here is the break down on the sexual side effect of finasteride in the patients who used it for one year only.

The men who continued using finasteride resolved some of the side effects in many cases. The resolution of the side effects was compared in the drug and placebo group. The incidence of each of the above adverse experiences decreased to ≤0.3% by the fifth year of treatment with Propecia.  This shows improvement of the side effects in the patients who took it over time.

In a study of finasteride 1 mg every day in men showed some decrease in volume to ejaculate of 0.3 mL (-11%) compared with 0.2 mL (–8%) for placebo in 48 weeks after beginning the treatment. Decrease in ejaculate was shown more significantly in higher doses (5mg) of finasteride which is approximately 0.5 mL (-25%) compared to placebo in ejaculate volume.  However, the decrease in ejaculate has been seen to be reversible after the treatment has been stopped.

In the clinical studies with Propecia, the incidences for breast tenderness and enlargement, hypersensitivity reactions, and testicular pain in finasteride-treated patients were not different from those in patients treated with placebo.

Long term side effects (up to 4 years)

Long term side effects of Finasteride were extensively studied in the Finasteride 5mg (Proscar) Long-Term Efficacy and Safety Study for 4 years in 3040 patients (1524 on Finasteride 5 mg/day and 1516 on placebo). 3.7% (57 patients) treated with finasteride 5 mg and 2.1% (32 patients) treated with placebo discontinued therapy as a result of adverse reactions related to sexual function, which are the most frequently reported adverse reactions.

Although the initial side effects of Finasteride has been higher than placebo over time the difference decreases to the point that in years 2-4 of this research, no significant difference between the two groups (treatment groups and placebo) was reported in terms of the incidences of impotence, decreased libido and ejaculation disorder.

The new study published in the Science Translational Medicine Journal has shown there is an association of prostaglandin pathways in hair growth.  The study was done at the University of Pennsylvania and was published in March 2012 by Catseralis et. al. which reveals a new pathway for balding.  This has the potential to be a revolution in the treatment of hair loss in the most common type known as male pattern balding (see link).  Dr. Catseralis and his lab team at the University of Pennsylvania are known for their work on hair growth and its association with wound healing.  They have done similar research to what we performed at Johns Hopkins on wound healing and hair growth.  Their work on discovery of wnt-pathway has proved a link between wound healing and hair growth and has been one of the milestones in the field of hair restoration.  His other work was published in Nature Journal in 2007 (see link).

The authors review the main cause of male hair loss as testosterone.  Although the authors announce that the real mechanism of androgens on male patterned baldness is not clear, they try to go deeper and find the main mechanism of male patterned baldness at the molecular level. The study shows that the enzyme prostaglandin D2 synthase (PTGDS) is elevated at both the mRNA and protein levels in men with typical men hair loss (AGA). It is also documented that the product of PTGDS enzyme activity or prostaglandin D(2) (PGD2), is elevated in scalp skin. The animal studies show that during normal follicle cycling in mice, the levels of those prostaglandins increase, suggesting an inhibitory effect on hair growth.

They showed that applied prostaglandin (PGD2) minimizes hair growth in human hair follicles that are planted in mice. Hair growth inhibition requires the PGD(2) receptor G protein, but not the PGD(2) receptor 1 (PTGDR).

These scientists have proven that prostaglandin in the mouse skin is associated with development of men hair loss, hair miniaturization, and scalp oil gland enlargement which are all hallmarks of male patterned hair loss. The study is especially significant because it introduces prostaglandins as a main player in inhibition of hair growth in male patterned hair loss. It suggests the prostaglandin related pathway as a potential target for treatment of common hair loss in men.

As announced before, the next webinar series will begin in less than one week. This event will allow patients and those looking to learn more about the science and art of hair restoration an opportunity to hear popular topics discussed by Medical Director Parsa Mohebi, MD who will be available for questions as well.

The last webinar featured 3 topics which are frequently asked about by persons wanting to know more on hair transplantation. The first discussion was “Hair Loss Psychology” where Dr. Mohebi spoke about the embarrassment some people experience because their appearance is lacking its former more youthfulness look. This situation is difficult for many people and Dr. Mohebi spoke about the different situations people speak of.

The second topic was, “Hair Transplant: How Does It Work” which explained the different options for a hair restoration procedure and what can be anticipated before, during, and after the surgery is completed.

The conclusion to the 3 lectures was “The Latest Technology In Hair Transplantation” which explained the updated and current methods in the world of hair restoration. New products such as the Laxometer, and popular surgical methods were discussed.

The next webinar is on Tuesday April 10th at 6PM. Dr. Mohebi will discuss 3 new and popular hair restoration topics. There will be a time for Questions and Answers as well as special incentives for joining. If you would like to be a part of US Hair Restorations next webinar and have a chance to personally connect with the staff please send an email to webinar@ushairrestoration.com or call (888) 302-8747.