Thank you for your question. You are 19-years-old and you are asking if you start Propecia or
finasteride as well as minoxidil or Rogaine, will you need to continue these drugs to maintain
your hair for the rest of your life.
Well, I can certainly give you some guidance on your question on how we consult our patients
in our practice. Just a little bit of background, I’m a board certified cosmetic surgeon and
fellowship trained oculofacial plastic and reconstructive surgeon. I’ve been performing
hair loss treatment and including hair transplant as well as medical and non-surgical treatments
and I’ve been in practice for 20 years. In fact, I am the founder of TrichoStem™
Hair Regeneration centers and this treatment, we developed in our practice for several years.
We have now been able to deliver to patients outside our offices using a method combining
platelet-rich plasma (PRP) and Acellular matrix amongst other things. And so certainly, we
spend every day in our practice counseling patients on medical, surgical and non-surgical
options for hair loss.
So as far as your question is concerned, you have the benefit of long history of experience
since minoxidil was first used by prescription only in 1988 and finasteride or Propecia has
been around since 1997. Now that being said, I can tell you that in my practice, when we
meet patients who have been on these drugs for this length of period of time, majority
of them, if not all of them, has probably as skewed view because these are people who
are still losing hair and still they lose hair. The benefits of the drugs still have
a certain limitation.
Finasteride, if you have done your research, you’ve learned is a drug is a pill that
you take daily to inhibit an enzyme called 5-alpha reductase. This is the enzyme responsible
for the conversion of testosterone to dihydrotestosterone or DHT. It is quoted that 60% of men respond
to finasteride. What this means is that only 60% men may have DHT-sensitive hair loss.
So the idea is if you reduce the DHT, you will allow continuous hair growth. As far
as minoxidil is concerned, it is a topical preparation that’s still true mechanism
remains not well defined. However clinically, we all observed that it appears to prolong
the growth cycles of thinning hairs and as well as stimulate short term hair growth.
In a pharmacological manner, you are responsive to these drugs then you need to take these
drugs as recommended. So for finasteride, you need to take a pill every day. For minoxidil,
you have to apply it topically and that it can be customized to a degree.
In our practice, we have learned long time ago that it is challenging for people to continuously
take a drug. Currently, there is a lot of concern about the long term sexual side effects
of finasteride and people are very often questioning whether or not there is a value of continuous
application of minoxidil. We know that the drug has a value from a scientific perspective
but it may not have the consistency that people want in order to see the benefit. That being
said, we have had the opportunity in developing a procedure called Hair Regeneration and I
was eluted to this when I talk about TrichoStem™ Hair Regeneration. Basically a lot of people
come to us from around the world for a non-surgical treatment that is very different from the
pharmacologic approach to hair loss. What we have been able to establish is that 99%
of men and women with pattern genetic hair loss who come to us with essentially a single
treatment are able to maintain and not only stop the progression of hair loss but have
re-growth of hairs that are not actively growing as well as a reversal of the thinning process
so thinning hairs becomes thicker.
At this time, we see more than 5 years of data that the hairs do continue to grow. We
customize and there are some people that we will do a second injection somewhere to 15-18
months. And we are always continuously evolving the procedure but the significant advantage
is that our rate of response for male pattern hair loss exceeds the response of finasteride
and doesn’t even compare to minoxidil. Majority of our patients, once we have done this treatment,
we don’t ask them be on either drug and if they choose to be on those drugs, they
can be but essentially they don’t need to take those drugs. We find that majority of
people who come to us particularly for male pattern hair loss don’t want to take finasteride
at all or have taken it and had issues with side effects. So in reality, we can only encourage
them to use any other medical treatment but we have been able to establish success with
Hair Regeneration as a standalone treatment.
With that being said, this is a distinction and it is intended to help you differentiate
a surgical, a non-surgical, and medical and pharmaceutical. The pharmaceutical, you take
a drug, you get the effect. So the question of using this for the rest of your life, if
you are a responder, then most likely yes. Compliance has always been a challenge for
hair loss medication whether it is oral or topical so this has lead to a lot of consistent
interest in our treatment. We treat patients from all over the world and alternative surgical
hair restoration which has benefit and value but our goal is to catch people early enough
so that people can strengthen their hair, give them coverage they are looking for and
avoid surgery as long as much as possible. To answer your question, if you are a responder,
you will need to take it as long as you can but if there are side effects, consider other
treatments like Hair Regeneration.
So I hope that was helpful, I wish you the best of luck and thank you for your question!