I am looking at some solutions to baldness or thinning hair, and I keep coming across the names Propecia and finasteride. Could you tell me more about Propecia / finasteride?

Propecia (generic name finasteride) has proven to regrow hair just under 50% of patients and stop hair loss in about 42% of patients in a five-year study. Propecia is taken orally and maintains its hair restoration qualities as long as it is taken, but effects will cease within one year if the prescriptions are stopped. Propecia works with in crown and the hairline areas, but more efficacy in the crown area, similar to the characteristics of the topical hair restoration treatment minoxidil or Rogaine.

Propecia / finasteride are also used in the medical treatment of prostate cancer and benign prostatic hyperplasia (BPH).

How does Propecia work?

Although its exact mechanisms of causing baldness is not known completely, DHT has been shown to have effects of miniaturizing hair follicles and even lead to the destruction of hair follicles. Thus, DHT contributes to hair loss and male pattern baldness. In the human body, DHT is converted from testosterone via the activity of 5-alpha-reductase enzymes. Propecia and finasteride work by blocking the activity of these enzymes and inhibit the production of DHT.

What are some brandnames of finasteride? what about generic versions of finasteride?

Brandname versions of finasteride are Propecia and Proscar, although the Proscar version (which is of higher dosage) is marketed for BPH and not male pattern baldness. Some hair loss patients choose to buy Proscar and split the pills in order to save money.

There are also generic versions of finasteride manufactured by companies outside the United States:

• Apprecia (from Ajanta Pharma)
• Prosteride (from Aleppo Pharmaceutical)
• Finpecia (from Cipla)
• Finax and Finast (from Dr. Reddy)
• Finalo (from Intas Pharmaceuticals)
• Finara (from Ranbaxy)

What are side effects of Propecia or finasteride that I should be aware of?

• Here are some reported side effects for Propecia / finasteride (incidence of around 1%):
  erectile dysfunction or impotence
• gynecomastia
• continued erectile dysfunction even after discontinuation of medicine
• depression
• birth effects especially in male baby, leading to strong warnings that Propecia and other anti-DHT drugs should not be in contact or handled by pregnant women

Besides Propecia, Proscar, and finasteride, what are some other solutions for hair loss and baldness that I should consider?

There are many solutions to baldness, hair loss, thinning hair, or male pattern baldness that should be investigated and considered for each person:

• Hair transplantation which is a surgical option but also the most effective and expensive option for treating hair loss or hair baldness. The most well known companies with hair transplantation surgeries and technologies are Bosley and Hair Club For Men. It is generally recognized that the newest and most naturally looking method of hair transplantation is the microscopic hair transplantation with older methods being minigrafts, micrografts, plugs, skin flaps, and scalp reductions.
• Oral prescrption medicine is finasteride (brand name Propecia) which works as an anti-DHT and indicated for androgenetic alopecia.
• Topical medicines which are applied to the scalp such as minoxidil (brand name Rogaine and Regaine)
• Herbal solutions and remedies for hair loss and baldness usually include some combination of caffeine, black cohosh, or saw palmetto.
• Hair replacement solutions also known as toupees, wigs, hairpieces, units, or hair systems. The toupees are usually matched for the user’s original hair color, can be secured via using a hair weave method, and is generally passed over for a hair transplantation solution for those that can afford it.
• Low level laser therapy using a laser phototherapy device which has been approved in Australia but not so far in by the FDA in the United States.
• Dietary and lifestyle changes such as daily and vigorous aerobic exercise and a diet moderate and adequate in fat and total calories. Stress reduction can also be helping in slowing hair thinning or hair loss.

What are some general tips for hair regrowth?

• Use only brushes with soft bristles
• Allow your hair to dry naturally after washing and showering. Avoid using hairdryers on hot and do not rub your hair vigorously to dry.
• Use a conditioner or detangler, and avoid pulling your hair with a comb.
• Wash daily with a mild shampoo since dirty hair looks flatter and sparser.

How do I make the right choice regarding solutions for thinning hair or baldness?

The first step is to understand all your options. Talk to your doctor about your options as a doctor will probably be the best person to answer any technical or medical questions you may have especially regarding the surgical and presciption options. Also, speaking to friends and family who may have some experience with baldness and hair loss treatments may yield you some important information and experiences. There is a lot of information on the internet regarding all the treatment options, so do your research, read the information, and get educated.

When choosing the treatment solution in the end, you will want to consider factors such as cost, comfort with the treatment, length of downtime, and invasiveness of the treatment. Cost is not always paramount as effectiveness and personal comfort are important factors as well. Once you have all the information you want and feel comfortable in making an educated choice, go ahead and choose the best baldness and thinning hair treatment option for yourself.