On December 22, 1997, the FDA finally approved Propecia for treating hair loss in male candidates. This approval made Propecia the first FDA approved treatment for male hair loss that comes in pill form. The basics of Propecia are as follows:

The active ingredient that is causing the hair regrowth in Propecia is finasteride. Finasteride was first approved and used in 1992 as Proscar. Proscar is a treatment used for prostate enlargement. Proscar helps suppress the formation of DHT which is the hormone thought to cause the increase in size. By treating an enlarged prostate with Proscar, the need for surgery was reduced.

There is 1 mg of finasteride in Propecia (for the purpose of hair growth) and 5 mg in Proscar (for treating prostrate enlargement). While treating patients for prostate enlargement, it was noticed that their was some regrowth of hair in areas of male pattern hair loss.

Being a little tongue in cheek. Its no comfort to know that the side effects of one treatment become the basis of treatment in another.

In further studies, 1 mg of finasteride and demonstrated hair growth in male pattern hair loss. The number of hairs (I’m not sure if it was 4 or 6 hairs, just kidding) increased in the anterior midscalp and vertex.

Patient feed back showed that there was in fact more hair regrowth with the finasteride treatment versus the sugar pill. Side effects were infrequent (it was not stated exactly what infrequent meant) and were related to sexual function.

That’s fantastic! So infrequently, does that mean that I will attract more of the opposite sex and then not be able to do anything with that? I’m just saying!

Propecia has not and will not be marketed for women because it causes birth defects, and the safety and amounts needed have not been established in women.

But its o.k. apparently for us men because we are disposable and don’t give birth. Any time I see a chemical that is not advised for women because it can cause birth defects, I just have to feel that male or not, there is something going on that shouldn’t be.

The FDA’s Dermatologic and Ophthalmic Drugs Advisory Committee sat down and had a chat about Propecia. The committee offered labeling suggestions in the context of an overall generally favorable discussion. Merck & Co. of West Point, Pa., produces both Proscar and Propecia.

We all know Merck & Co. track record with lawsuits. Vioxx and the osteoporosis drug Fosamax are the first that come to mind. Almost seems to make about as much sense as trusting Exxon to handle your neighborhood environmental project.

Make sure that when you start seeking treatments for hairloss and male pattern baldness that you weigh the pro’s of hair regrowth with the possible health concern cons.

Have you heard of Finasteride? Well it is the key behind stopping and re-growing hair for men who have male pattern baldness (MPB).

It was first used to help men with benign prostatic hyperplasia (BPH) or an enlarged prostrate. The help came in the form of improved urination, or a more uniform urination pattern.

When used for treating MPB it was found to improve the hair growth in 2 out of 3 men who took the pill. The men who did not take the pill actually lost hair.

So what is Finasteride, how does it work, and who should use it?

What Is Finasteride? Finasteride is a synthetic anti-androgen. An anti-androgen is a hormone that is capable of stopping the biological effects of the male hormone testosterone. It was approved in 1992 to help men with BPH. In 1997 it was approved by the Federal Drug Administration (FDA) for use by men to treat MPB.

How Does It Work? This synthetic drug actually acts on the enzyme, 5 alpha reductase, by preventing it from converting testosterone into DHT (dihydrotestosterone).

DHT is the culprit hormone that causes MPB and FPB. It does this by attaching itself to the hair follicle. In doing this, it stops the flow of nutrients to not only the follicle but also the hair strand. Eventually the hair strand will fall out and the follicle will wither and die.

By preventing the formation of DHT, the hair follicle continues to get nutrients and will continue to produce hair. This action stops MPB and will actually help in re-growing hair.

Who Should Use It? In a study, it was shown to be effective in stopping hair loss in men 42% of the time. And in the same study, 48% of men have been shown to actually re-grow hair. Only men should use Finasteride since it has been found to produce birth defects. Doctors may prescribe Finasteride to women, but only after effective birth control measures have been put in place.

Conclusion – Finasteride can be found under the product name Propecia. It has been approved by the FDA for use by men. Women may use it, but it should be done under a doctor’s care.

Other FDA approved hair loss products that both men and women can use is Minoxidil. Men may use it at 5% solution strength, while women are cleared to use the 2% solution strength.

No matter which one you use, you should consider taking saw palmetto. This is an herbal supplement that helps regulate DHT.

Minoxidil and finasteride are two excellent options for men and women who want to do something about their hair loss. These are two of the most widely available hair loss medications and have been proven to be effective at preventing further balding and even re-growing hair.

The main difference between minoxidil and finasteride is the application process. Minoxidil is sold as a liquid solution that must be applied directly to the scalp in the area of hair loss. Finasteride is an oral tablet.

Tips on Using Minoxidil – Men:

Minoxidil was the first FDA approved medication for the treatment of hair loss. Minoxidil is a topical solution that is applied directly to the scalp. It can now be purchased without a prescription and in generic formulations in concentrations of 5% (for men) and 2% (for women). The exact mechanism by which minoxidil works is not known, but the drug is felt to increase the duration of the hair follicle growth cycle (called anagen), improving the length and thickness of miniaturized follicles. Minoxidil solution comes in a generic formulation and can be purchased over the counter. The foam is available in brand-name only.

Minoxidil only works where you apply it. Apply it to all areas that are thinning.

:: Minoxidil can work anywhere there is miniaturized hair (where the area is not totally bald)
:: Minoxidil will work in the front part of the scalp and temples if these areas are just starting to thin – so it is important to apply it to the front part of your scalp and hairline if you are thinning in these areas.

Minoxidil must be applied to the scalp to work – it doesn’t work on the hair per se.

:: Minoxidil 5% solution is the most effective if you have some hair, as the solution will be easier to apply to the scalp.
:: If the 5% solution is irritating to your scalp, try the 5% Foam which does not contain propylene glycol, the most common irritant.
:: If the 5% solution is too greasy and you find you are not using it, switch to the foam.

Although the minoxidil works best when used twice a day, using it once a day will also be effective (and better than not using it at all).

:: Many patients find applying the medication once a day at bedtime to be the most convenient way to use it.
:: When using minoxidil once a day, use at least double the recommended dose, so that it will be applied to the entire area of thinning.

Minoxidil can be applied to damp scalp when you first get out of the shower and this can make grooming easier.

For minoxidil to be effective it must be used continually and regularly. Do not stop and start it. You may experience shedding during the first 3-6 months of treatment. This generally is an indication that the medication is working, so unless you are having side effects, do not stop the medication. If you do stop the medication, you will lose all of its benefits (although you will not be any worse off than if you had never used it).

Minoxidil works best when used with finasteride. Of the two medications, finasteride is more effective.

Tips for Women Using Minoxidil – Women:

Minoxidil solution is available in a brand name and a generic formulation and can be purchased over the counter. The foam is still available in brand only.

Minoxidil is generally prescribed as a 2% solution for women to be used twice a day. If twice a day is inconvenient, then use the 5% men’s formulation just once a day.

Minoxidil can cause increased facial hair. Although the 5% is more likely than the 2% to cause this, when the 5% is used one a day, the side effects seem to be about the same.

Minoxidil only works where you apply it. Apply it to all areas that are thinning.

:: Minoxidil can work anywhere there is miniaturized hair (where the area is not totally bald).
:: Minoxidil will work in the front part of the scalp and temples if these areas are just starting to thin.

Minoxidil must be applied to the scalp to work – it doesn’t work on the hair per se.

:: Minoxidil solution is the most effective if you have some hair, as the solution will be easier to apply to the scalp.
:: If the solution is irritating to your scalp, try the Foam which does not contain propylene glycol, the most common irritant.
:: If the solution is too greasy and you find you are not using it, switch to the foam.

Tips on Using Finasteride:

Male pattern baldness or androgenetic alopecia is caused by the effects of the male hormone dihydrotestosterone (DHT) on genetically susceptible hair follicles that are present mainly in the front, top, and crown of the scalp (rather than the back and sides).

Finasteride causes a significant drop in both scalp and blood levels of DHT and its effect is felt to be related to both of these factors. Finasteride 1-mg/day decreases serum DHT levels by almost 70%. Finasteride is a prescription oral medication that is now generic (in the 5mg dose). This formulation is just as effective as the brand name version and is about 1/3 the cost.

The general starting dose of finasteride for hair loss is 1mg a day. For this dose, you can either take one 1mg brand name tablet or ¼ of a 5mg tablet of generic finasteride each day. Your doctor may increase the dose over time, based on your response to the medication.

If you chose to use the generic medication, a pill-cutter can be purchased from any pharmacy for a few dollars. Please cut only two pills at a time.

Finasteride does not have to be cut into equal parts to be effective. Just cut it into the recommended of pieces and take one piece each day.

Finasteride can also be taken any time of the day without regard to food or other medications.

You may experience shedding during the first 3-6 months of treatment. This generally is an indication that the medication is working. Do not stop the medication if you see shedding.

It takes up to a full year to see the effects of finasteride, so be patient.

Common Misconceptions about Finasteride -

Myth: Women can’t touch the medication.
Fact: Pregnant women should not handle crushed or broken tablets.
Myth: It only works in the crown.
Fact: It potentially works any where on the scalp where there is some hair, even in the front of the scalp.
Myth: Once you start it you must take it for ever.
Fact: You can stop the medication any time you want – you just lose its benefits when one stops.
Myth: Finasteride lowers testosterone
Fact: The medication, on average, causes a rise in serum testosterone levels by 9%.
Myth: The sexual side effects are frequent and irreversible.
Fact: The sexual side effects occur in 2% and are reversible when the medication is stopped.
Myth: Finasteride causes birth defects if a man takes it when his wife is pregnant.
Fact: Exposure of pregnant women to semen from men treated with finasteride poses no risk to the fetus.
Myth: Brand name finasteride was originally a prostate medication that was found to prevent hair loss.
Fact: Any kind of finasteride is not a prostate medication that was by chance noted to have a side effect of hair growth, it is a medication that was known since its discovery that it could grow hair.

Of course, in some advanced cases of hair loss and balding, medication is not an effective treatment option. Individuals in these cases are often candidates for receiving a hair transplant or other forms of hair restoration surgery.