Propecia on Hair loss

This section reviews the two FDA approved medications for hair loss, Propecia and Rogaine, as well as future, natural and alternative drug treatments:

Propecia

In late 1997, The U.S. Food and Drug Administration approved Propecia for distribution in the United States as a hair-restoring drug. Propecia represents a medical breakthrough. It was the first pill that effectively treats genetic hair loss. Since it has emerged Propecia sales have been brisk. Some analysts are already predicting sales of $1 billion over the next five years.

The active agent in Propecia is a drug called finasteride. The manufacturer of the drug, Merck, deduced that Propecia might work to stimulate hair growth when it found men taking the company’s prostate medication Proscar were growing hair. Propecia is a lower-dose form of Proscar developed specifically to fight hair loss.

Propecia is an option only for men. Propecia is dangerous for women of childbearing age and can lead to severe birth defects. In addition studies have determined that it is not even effective for postmenopausal women.

The result of a study with 136 women of postmenopausal age was released in the summer of 1998. This study showed that women taking Propecia once a day showed no significant change in hair count as compared to women who were taking a placebo.

Even Merck Research Laboratories accepted that no positive effect for Propecia on hair could be claimed for women. Propecia is currently available only as a prescription medication. It comes in the form of 1mg tablet. The normal recommended daily dosage is a 1mg tablet to be taken with or without food.

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What makes propecia work?

Propecia works through its main ingredient finasteride. Finasteride is known to work on a key underlying chemical cause of hereditary hair loss. It is known that men with hereditary hair loss have increased levels of a hormone called Dihydrotestosterone (DHT) in their scalps. DHT is a by-product of the male hormone testosterone. Testosterone is converted to DHT when it reacts with a natural enzyme that is found in human skin cells called 5 alpha-reductase.

The presence of DHT in the scalp is related to the thinning of hair follicles and the resulting emergence of hereditary hair loss. Propecia does not directly counteract DHT to combat hair loss. Instead, Propecia reduces the presence of DHT in the scalp by blocking the action of the enzyme 5 alpha-reductase.

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How effective is propecia?

Propecia seems to be at least as effective as Rogaine. It may not regrow hair for everybody, and it may not regrow a full head of hair, but it does seem to have significant impact in first stopping further loss of hair in the case of most men, and in actually regrowing some significant amounts of hair for many.

The largest and most promising study conducted on Propecia was a two-year study conducted by Dr. Kieth Kaufman senior director of Merck Research Laboratories. This trial studied the effects of Propecia on 1,215 men with varying degree of hair loss in the vertex of the scalp. According to this study, p 83 percent of men who participated had the same amount of hair or more hair after taking Propecia for a two-year period.

Significantly, in the same study 72 percent of those taking a placebo lost more hair over the two-year period of the study. Also in the same study, of all those who took Propecia 66 percent gained hair, of whom 30 percent were classified as having minimal increase, 31 percent as having a moderate increase, and only 5 percent as having a great increase.

In another 12-month study, the effects of Propecia were tested on over 1800 men aged between 18 and 41, who suffered from mild to moderate hair loss.

In this study participants were divided into a group that received Propecia and another taking a placebo. All participants, however, also received in addition a medicated shampoo called Neutrogena T/Gel. The results showed that men who took Propecia maintained or increased the number of visible hairs in the first year, which they maintained over a second year.In contrast, hair counts for men who were not given Propecia continued to decrease.

In summary, studies suggest that about 80% of balding men can stop any further hair loss by taking Propecia. In addition, as many as two thirds of balding men may have a significant regrowth of hair as a result of taking Propecia. Like Rogaine, Propecia tends to work only on the upper vortex and the anterior mid scalp, and not along the front hairline. In addition, it only works for people who show mild to moderate hair loss.

Balding men with major or complete hair loss will not benefit from Propecia. In general Propecia must be taken for at least three months before results can be expected. Hair generally grows at a rate of about 1/2 an inch per month. As a result it takes between three to six months to see the full effects of Propecia on a given individual. If no significant hair grows after 12 months it is unlikely that Propecia will ever work.

Like Rogaine, Propecia is effective only as long as it is taken. This means that like Rogaine it must be continuously taken to retain its benefits. Hair that is saved or gained due to Propecia will eventually be lost unless it is taken regularly for the rest of your life. This is important to consider when deciding whether to employ Propecia.

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For whom is propecia not safe?

Unlike Rogaine, Propecia is only available for usage by men. It is not a treatment for hair loss in the case of women and children. This is because the active agent in Propecia, finasteride carries with it severe side effects for women of child bearing age. It may cause birth defects, particularly of the genital areas of male fetuses. Propecia is considered such a threat in this regard that it is not even recommended for women to handle broken or crushed tablets.

Propecia tablets have a protected coating to protect women, and normal handling of Propecia should not be dangerous for women, provided that they have not been broken or crushed. Studies support the idea that men who take Propecia pose no threat to women or their fetuses. This is despite the fact that men taking Propecia will have trace remnants of the drug in their semen.

In one significant study where 35 men took Propecia daily for 6 months, it was found that Propecia levels were undetectable in 60% of cases. The mean level of Propecia found in the samples was 0.26% ng/mL, with the highest level measured being 1.52 ng/mL.

This amount of Propecia is simply not enough to pose a likely danger to women or their fetuses. 750 times this amount of Propecia have been injected into pregnant Rhesus monkeys without any effect to the health of the mother monkey or her male offsprings.

In the case of men there are three circumstances that may prevent or limit the usage of Propecia. First, men with allergies to finasteride or to other medications related to finasteride should not take Propecia. Second, men with liver function abnormalities should only employ Propecia with extreme caution. This is because Propecia is metabolized in the liver.

Lastly, men for whom the noted side effects of Propecia are unusually severe or long lasting should continue using it only with caution and under the direct guidance of a medical doctor.

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Are there any side effects to using propecia?

Contrary to the severe side effects associated with taking Propecia in the case of women, the drug is generally well tolerated in the case of men. The Food and Drug Administration described Propecia as having only infrequent side effects that effected only a small number of men. Results of the major studies conducted showed that a very small number of men experienced certain sexual side effects such as diminished sexual drive, difficulty in achieving erection, and decrease in the production of semen. Fewer than 2 percent of Propecia users displayed signs of each of these side effects.

It is notable that sexual side effects appear to be only temporary in the majority of cases. Not only did less than 2% of users experience sexual side effects, in more than 58% of these cases these side effects disappeared when Propecia usage was continued. This means that the only significant side effects known for Propecia are really only a factor in less than 1% of cases. In addition, these sexual side effects were reversible.

In all cases when men complaining of these side effects stopped taking Propecia these sexual side effects disappeared.
Patients participating in the main clinical trials of Propecia were given a sexual function questionnaire to detect more subtle changes to sexual function.

While differences regarding sexual interest, erections, and perception of sexual problems were noted by men taking Propecia for 12 months as compared to men taking the placebo, it was clear that these did not impact on sexual performance. Men taking Propecia and men in the placebo group did not indicate any significant difference regarding overall satisfaction of their sex lives.

The short term prospective on Propecia is good; howver, it must be emphasized that no one knows for certain its long-term effects. Propecia has simply not been around long enough to test its effects after decades of usage. At the same time it should be noted that the same can be said of the majority of common drugs now employed.

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Are there any other ways in which i can use propecia?

Although Propecia is relatively new on the market, there have been several novel approaches to obtaining greater results from Propecia. One approach has been to formulate finasteride as a topical solution, much like Rogaine.

This approach is more common outside of the United States, but some American companies are already selling finasteride in this form. At this point this approach remains experimental. There are as yet no clinical studies that have shown the effectiveness of finasteride topical solution.

Another novel approach to using Propecia that has emerged has been to combine its use with Rogaine. The idea has been conveyed that Propecia and Rogaine can compliment each other. It is believed by some that Rogaine is an agent that is more effective in stimulating hair growth, while Propecia is more effective at retaining existing hair.

Again this approach is relatively new and there has not yet emerged scientific studies that can verify its effectiveness.

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