Dr. Mejia QUESTION...

[notgoing2gobald]

Just saw you were on here and you have previously given great insight on propecia.

 

At what point would you say propecia begins to lose eficacy on the average individual? ten years?

Once propecia loses it's effect on an individual will MPB QUICKLY run its course and they will be left with their natural balding pattern?

Have you had patients which you have first hand seen these type of results (or lack there of) on?

 

Is taking propecia Every Other Day JUST AS EFECTIVE with respect to lowering DHT levels as every day yet allows for less likely hood of side effects?

 

*BONUS QUESTION* if an individual gets "stripped out" (i.e. 3 strip procedures) can one still get a significant amount of grafts via FUE if they so elect?

[hoose]

hey ng2gb,

 

hairbank, who used to post here a lot, took propecia eod and said he got great results; even had a little growth up front I think; search some of his posts; also I remember seeing a study that .5 mg/day is almost as effective as 1 mg/day; half the dose would probably give less side effects if somebody is predisosed to getting side effects; never had any myself

[Bill - Seemiller]

ng2gb,

 

You may want to send Dr. Mejia a private message. I haven't seen him post here for awhile which is a shame.

 

Hopefully he'll come back and offer his expertise.

 

Bill

[Dr. Ricardo Mejia]

NG2GB:

 

To answer your question, Does Propecia lose its effectiveness?

First, one has to look at the 5 year data of propecia which can be viewed on their website. Additionally one has to define certain terms in your question, e.g. what do you define as "losing effect": no growth, no maintenance or stabilization?

 

Propecia 5 year data

 

When you look at the mean change in hairs from baseline there is a significant rise at year one stabilizing through year two. However, if you look at the graph, there is also a downward slight trend through year 5 , but overall significantly better than baseline. Hence, if you were to ask me about 5 years I can say Propecia continues to be beneficial over placebo through year five and beyond even if you were to extrapolate the data through year ten. . I do not have the statistical data on the ten year graph, but if it continues to plateau or even continues to dip slightly, it is still providing a better benefit than placebo. You can say that propecia has lost some effect in hair growth counts from its peak at year one and year two, but is continuing to be beneficial based on the data. I do believe Propecia continues to provide a benefit at ten years.

 

I have seen a very small percentage of patients (in the minority) that took propecia and their hair loss continued to recede. I do not have any data on every other day dosing of Propecia to say that it is just as effective. However, there have been previous threads discussing the half life of propecia and its binding that suggest it should be (http://www.hairrestorationnetwork.com/eve/showthread.php?t=154062) Of course this is "by report" theoretical and plausible and seems reasonable , yet there is no study or data to scientifically say with certainty it is just as effective as propecia.

 

You can do FUE after strip harvesting but then it depends on what you define as stripped and what you define as a significant amount of grafts. Every case is unique and deserves special considerations. For e.g. I posted a NW 6 grey haired patient with limited donor

 

(NW6 Grey Haired) .

 

I just recently did a third procedure and he did very well with no visible scar. I would be more hesitant on a fourth because of his limited donor area coverage. However; if the patient wanted more hair, I could certainly do FUE.

 

Hope this helps

[notgoing2gobald]

Dr. Mejia,

thank you very much.