Propecia or Rogaine

[Johnny1386]

Hello all

 

what would you reccomend , perhaps both ? I dont like the idea of taking a pill that may have side effects , even though the Dr said I could split each pill into 4 pieces and take a 90 day supply and stretch it to a year ........Something I apply like Rogaine since its extrenal may not have the side effects but what is going to work potentially better.......also any shampoos you would reccomend ? I have been using Nioxin , I feel that is may have subdued the hair loss, but some say there is no clinical proof ------

Having my Hair transplant procedure in 3 weeks ------

[RCWest]

Yes! Use both treatments. Or at least try the Finasteride for a year, then add Minoxidil to it.

[TakingThePlunge]

Johnny,

 

For any male experiencing hair loss, the best medical treatment to preserve and potentially restore thinning hair is to use both Rogaine (minoxidil) and Propecia (finasteride).

 

I completely understand your reluctance to use a medication that may produce side effects. All of us that are currently taking this pill had to grapple with the issue. However, only about 2% of men will experience any significant sexual side effects on finasteride. I recommend taking it for at least a month to see if any side effects occur. If not, then stay on it for a year before assessing your results. Again, I would combine this with minoxidil.

 

Lots of guys here (including me) are using Nizoral shampoo three times a week. Nizoral contains ketoconazole which may provide some mild DHT blocking. I have no idea if it's having a positive effect on my hair loss but I like the way it makes my hair feel and it smells good.

 

Best of luck!

[Spanker]

I just use propecia cause I don't think I would like the daily maintenance of Rogain and I think only like 40 percent see good improvement....I also TRY to not look in the mirror too much.

 

I also use Nizoral 1 percent because it does not disrupt my daily routine. My get some 2 percent when I go to the doctor again.

[Dr. Michael Beehner]

Johnny,

In my experience using finasteride the past 13 years or so and topical minoxidil for the past 17 years, I feel finasteride is at least 10 times more valuable. Finasteride can take a wispy, limited-length hair and change it to a coarser and longer hair the next hair cycle. I find that around 80% of my patients have a positive response to it and it is easy to maintain the treatment, since it only involves taking a pill 3-4 times a week. Minoxidil has more muss and fuss to it, and you have to be fanatically, religiously faithful in its use or you turn into a pumpkin and lose your gains if you take a month or two off. It also is more useful for preventing hair loss than it is for growing hair. That all having been said, when I get a 19 year old young man who is losing his hair and wants to do everything possible, I strongly recommend using BOTH drugs, as they are synergistic (the sum result is greater than the parts) and I have been very impressed with this approach in these younger patients, especially since I can't offer such a young man hair restoration surgery.

The middle aged and older men in my practice I find just don't stay with the Rogaine routine. They don't like the greasiness, the mess, etc and only a small percentage of them follow the treatment instructions on a month in and month out basis.

Sexual side effects with finasteride treatment are very rare in my practice in the men in their 20's and 30's. I have read on the internet of a patient or two who have claimed permanent sexual side effects from finasteride, and, all I can say, is that I am in e-mail communication with a lot of my colleagues on a regular basis and none of them including myself has ever witnessed this, despite having given it to tens of thousands of patients.

Mike Beehner, M.D.

[Sean]

Dr. Beehner, thanks for that detailed explanation. I guess those two therapies used together, would be a big benefit. Now, if you are using both therapies together and decide to let go of Minoxidil, would hairs grown by propecia be affected? Would they shed too or just the ones grown with rogaine. Propecia is easy to use, just a pill a day whereas rogaine you have to take time to apply it and all and wait for it to soak in. I'd imagine a lot of patients end up just sticking to propecia if they get sick and tired of applying rogaine.

[Dr. Michael Beehner]

I'm not sure anyone knows that exact answer - that is, namely to the situation where a man has been using both for a good long time, such as a year, and then stops the Rogaine. I have not seen any studies on that issue. My hunch is that there may be an occasional person who does shed and takes a small step backwards. I do know that we generally do recommend that a man who has been on Rogaine and wants to go on finasteride instead, we have him continue the Rogaine for another 6 months and then slowly decrease it. We have noted some shedding in some men when abruptly switching one for the other.

Mike Beehner, M.D.