Hair Restoration Blog

Q:

I feel the Propecia takes an unbearable toll on my health, so I’m planning to drop the dose about 25% following the surgery. Provided that I have diffuse thinning all throughout, do you find this irresponsible?

Before seeing these latest photos, I thought the middle and back would hold out for a couple years on less finasteride, but it looks thinner to me now. Please let me know your thoughts overall on this subject.

With utmost respect,

A:

Decreasing the dosage of your medication may be considered if you present real side effects from your use of finasteride. It is easy to attribute many different health conditions to whichever medication that you are taking on a regular basis, but the best way to determine your next steps and how to properly decrease your dosages is to have your side effects evaluated by a specialist.

By having your side effects properly evaluated, your physician can ensure that you have no other conditions or causes for your bothersome effects. If we find that the problems you are experiencing truly are the side effects of finasteride, we may consider changing the dose or frequency of the medication.

Q:

Hello, I have a question, can you please help verify the answer to this. I am really stressed out regarding the situation. I can’t ask my doctor because he is on vacation for the next month.

I was prescribed propecia for hairloss, but I am reluctant to take it because of hyperandrogenicity from finasteride. Is there any truth to that? is there a chance that a person can develope hyperandrogenicity from taking propecia and making a persons hair loss even worse. By the way I also have acne, and I am scared that the hyperandrogenicity can make my acne worse and skin more oily.

Please help me. Can propecia(finasteride) cause hyperandrogenicity, or is it not true. Can the increase in testosterone from propecia cause more hairloss and make the situation even worse.

thanks in advance

A:

Finasteride (Propecia) is a 5 alpha reductase inhibitor. That means that it blocks the enzyme that converts testosterone (male hormone) to Dihydrotestosterone (DHT) in the body. The main cause of baldness is DHT and not testosterone in addition to having the gene of hair loss. When first getting started on Finasteride, some men may even have an increase in their testosterone levels because it is no longer being converted to DHT and therefore its levels goes up. However, please be aware that these changes are temporary. Some men may feel an increase in sexual urge due to the increased testosterone for a few days but it is temporary. Since testosterone does not directly cause hair loss and its effect is due to the production of DHT, elevation of DHT should not worsen your hair loss in any way.

The increase in testosterone levels can affect your acne. I am not sure how significant the slight elevation of the testosterone could be on your acne and for that you need be seen by a dermatologist.