Protecting the Follicle

A medication called Finasteride, developed by Merck & Company, first used to treat prostate enlargement (at a dose of 5 mg per day) has been shown to lower production of DHT, the hair killing Androgen; for details, go to DHT: The Hair Killer. The medication Propecia is a smaller dose form (1 mg) of Finasteride and has been studied and approved for the treatment of male pattern hair loss.

Results from global photographic studies by Merck are very significant, since 99% of patients studied did not lose any hair while on Propecia. In other words, only 1% of these patients taking Propecia experienced balding.

Also, about two thirds of patients studied had some degree of improvement. On review of the photographs from Merck & Company, a small percentage (around 5%) had what would be considered as great re-growth. The 5% of patients with great re-growth tended to have less advanced hair loss with re-growth occurring in the vertex (back of head area).

This is a remarkable advancement, since for the first time we have a medication that protects the hair follicle from the hair killing effects of DHT.

There has been some concern about possible sexual side effects with this medication. When we consider “sexual side effects”, what men are most concerned about is Erectile Dysfunction (or ED). ED was reported to occur in about 1.3% of patients while on Propecia. Of those who continued taking Propecia, however, about half had resolution of this side effect.

This makes the actual incidence of ED similar to the incidence noted in the group taking a placebo (sugar pill), around .7%. Also, very importantly, all side effects went away when the drug was stopped.

What this means is the chance of having ED on Propecia is similar to the chance of having ED on a sugar pill. Moreover, if you are part of the less than 1% of patients taking Propecia who may experience this problem, you can simply stop taking it. The bottom line is that Propecia is a reasonable option.