Stay with fin or switch to dut

[Plan C]

I have been taking 1.25mg Proscar for 4 months now. I went through the shedding phase; this has now stopped. However, my hairline is continuing to recede. Shall I hang in there with finasteride or switch to dutasteride? People will argue that 4 months is too early to see results but shouldn't finasteride reduce DHT levels regardless of the length of time you have been taking it for?
Both my father and my mother's father are completely bald and I'm not sure finasteride is enough to prevent me from accepting the same fate.
Note: I use Regaine twice daily + Regenepure DR and NT daily.

[Mike K]

If your hair doesn't look really bad I think most people will say stay on it a year. If its bad enough that you can't chance it getting any worse over the course of another 8 months getting on dut may be your only option. Keep in mind though that neither of these will work forever. A lot of us are on Fin now so that we have the stronger drugs like dut and RU for later when Fin loses its effectiveness. Even so, this is a losing battle in all honesty with what is available today.

[goldbondmafia]

If your hair doesn't look really bad I think most people will say stay on it a year. If its bad enough that you can't chance it getting any worse over the course of another 8 months getting on dut may be your only option. Keep in mind though that neither of these will work forever. A lot of us are on Fin now so that we have the stronger drugs like dut and RU for later when Fin loses its effectiveness. Even so, this is a losing battle in all honesty with what is available today.

some people have been able to maintain their hair on fin since its been available to the public but I agree most will lose hair over time due to hair loss becoming more aggressive genetically...

[Mike K]

some people have been able to maintain their hair on fin since its been available to the public but I agree most will lose hair over time due to hair loss becoming more aggressive genetically...

Some people yes but they probably don't have super aggressive MPB that would otherwise land them at NW7 by 30 like some of us do lol

[Plan C]

Even so, this is a losing battle in all honesty with what is available today.

Well that's grim. Wish I hadn't asked now!

[Dan26]

if you feel as though you cant afford to lose much more ground and your loss is very aggressive, consider dut....I was on fin for 5 months, had no sides so switched to dut. Both sides of family were nw5-6 by 30!!!

[Mike K]

Yes its a bleak situation for us all but my understanding is that even for those of us with aggressive MPB usage of Fin, RU, and Dut can give you at least 15 years near baseline and then continued usage of Dut and RU can give you a slow crawl from there. Provided the side effects are non-existent or manageable of course. On the plus side, there may also be better anti-androgens out during that 15 years, improvements in surgery, etc. that may buy you more time.

[Jotronic]

Finasteride in general is not known to very effective for the frontal third of the scalp but it is very effective for the mid-scalp and crown. Don't switch to Dutasteride till you've been on fin for at least a year and understand that if you do switch you may experience a stronger shed than you did on fin. I know some guys that use both, they take finasteride daily but twice a week they'll add Dutasteride to the mix.

Regarding this time line that is sometimes mentioned, the medication doesn't just stop working as if a light switch has been turned off. It either works or it doesn't but if it is working it may only be working enough to just slow the progress to a crawl. If this is the case then the cumulative effective takes years to notice which is why I think some people think it just stops working after five or ten years.

Some things to do:
1. Make sure you're taking Proscar and not generic finasteride. Name brand is better, more consistent. This is the reason why many people I've talked to have said that the medication stopped working. They were using name brand with success, switched to generic and then they started losing their hair again. They'd call me to say that their "Propecia stopped working" and then when they would get back on name brand at my urging the shed would stop and in most cases the hair would thicken up again.

2. Continue using Regaine twice daily, it tends to have a synergistic effect when taking Proscar or Propecia. Combined, they just work better. Note, I'm not the biggest believer in Regaine/Rogaine to begin with but it does have benefits that are documented and quantifiable.

3. Maybe consider adding Nizoral shampoo to your routine. If you don't have access to Nizoral then any shampoo with ketoconazole should do the trick. You'll find it with 1% ketoconazole or 2% ketoconazole. 2% is better but may have a higher chance of side effects such as itching and dryness but there is evidence to show that it is beneficial for sure.

You could also consider some supplements such as MSM and Biotin. I take both and while I know of no studies that support their use for hair loss I know for a fact that they help make hair healthier. I've experienced their benefits myself as they make hair grow faster and stronger (along with finger nails and toe nails).

My current regimen includes:

1. Proscar 1/2 tablet daily. Yes, I take 2.5mg because I believe that the higher the dose the better the result. I have not graduated to a full tablet yet but Spencer Kobren has been taking a full 5mg for 20 years. Without Proscar I would have progressed to a full blown NW7 instead of being just past a NW6 but not quite a NW7. See my website to learn more about what I'm talking about...www.hairtransplantmentor.com.

2. Nizoral four or five times a week.

3. MSM 3000mg daily

4. Biotin 500mcg daily.

I also take fish oil and tumeric daily as anti inflammatory agents. I believe that reducing and preventing anti-inflammatory reactions keeps the body in a general state of strong health. When the body has inflammatory reactions all kinds of things can happen including, yep, hair loss.

So, no you should not stop taking fin and switch to dutasteride. Stay the course and consider adding the other items I mentioned to improve your results. Good luck.

[Mike K]

Jotronic,

This chart would seem to suggest that after 5 years a finasteride user would be back at baseline. Assuming a user wanted to stay at or above baseline as long as possible, wouldn't it be advantageous to either add RU58841 or switch to Dut after 5 years? Would the same shed be expected adding Dut twice a week as would be expected switching? Assuming you did switch to Dut from Fin, can you realistically expect to return to at or above baseline when the shed stops?

[Jotronic]

Jotronic,

This chart would seem to suggest that after 5 years a finasteride user would be back at baseline. Assuming a user wanted to stay at or above baseline as long as possible, wouldn't it be advantageous to either add RU58841 or switch to Dut after 5 years? Would the same shed be expected adding Dut twice a week as would be expected switching? Assuming you did switch to Dut from Fin, can you realistically expect to return to at or above baseline when the shed stops?

I can't comment on the shedding possibilities of adding a lower frequency of intake of Dutasteride to an existing intake of finasteride as I know only a couple of people that have done this. Literally, like 2 or 3. There may not be a shed, or at least not one as severe, because the fin may be counteracting or reducing any telogenic activity from staring dustasteride. That is what would make sense to me anyway.

I've seen that chart before but I know of too many patients that we've treated for the past ten years that have absolutely maintained whereas without finasteride they would have been very bald. Dr. Hasson included. He's never had surgery but he started Proscar not long after I did and his balding crown reversed and has maintained for ten years. The evidence I've seen with my own eyes on thousands of patients and on Dr. Hasson disputes the graph. Granted, we didn't pull out scopes and count hairs but the appearance in front of us showed zero degradation. My own case would also indicate that were this true then my hair loss would have progressed down both sides and the spot in my crown would have become larger. I would be a strong NW7 and Dr. Wong would have had to perform more surgery to fill some pretty big gaps. I've been on Proscar for twelve years as of March 18th, 2014.

I have zero experience with, and do not know anyone, that is on RU so I cannot comment on this.

[Mike K]

This is encouraging. Thank you.

[Plan C]

Jotronic - thanks for your wise words. Taking everything into account, how much longer shoud I leave it until I consider using dutasteride? (Currently on month 4 of Proscar).

[Jotronic]

Jotronic - thanks for your wise words. Taking everything into account, how much longer shoud I leave it until I consider using dutasteride? (Currently on month 4 of Proscar).

I'd leave it for a full year. There is no reason to switch to Dutasteride until you know what Proscar can do on it's own. In my opinion, finasteride is very effective and Dutasteride, while stronger, has shown little to no more efficacy in the hairline than finasteride.

[Plan C]

I'd leave it for a full year. There is no reason to switch to Dutasteride until you know what Proscar can do on it's own. In my opinion, finasteride is very effective and Dutasteride, while stronger, has shown little to no more efficacy in the hairline than finasteride.

My only concern is that you mentioned that finasteride isn't particularly effective for the frontal third of the scalp and I presume that the hairline itself is part of this area. Since my main goal is to maintain my hairline (I'm not particularly fussed about my crown etc.) a year seems like a long time to wait.

For the record, I already use Regaine twice daily and Regenepure shampoo daily.

[Jotronic]

Nothing is particularly good at restoring the hairline but Propecia is better than nothing and combined with the other two items you are taking you have the best chance possible. I'm not saying it won't work because I have seen it work, I'm just saying that the chances are lower than they would be if you were trying to build up the back. And believe me, if you have a strong family history for losing the mid-scalp and crown then you'll really care when, not if, those areas start to go. They are MUCH harder to restore surgically not because of any tricks necessary for restoration but because of the numbers of grafts needed to get a cosmetically satisfying result. The key word is "prevention" because that dictates everything else.

Think of Propecia/Proscar as an insurance policy. As long as you're taking it your loss shouldn't get much worse. Also keep in mind, you are still only four months out. You may even still be experiencing the shedding effect and not realize it. Anything is possible at this point so be patient. If you don't give it time it needs to do it's thing then you'll switch things around before you can see if they actually work. That's the part that sucks about hair loss. Any efforts to fight the issue with medication takes a long time to measure.

In the end you can do what you want. Mix things up, switch out to Dutasteride completely or combine the two with your other products. The problem I see with this is that if you change things out now then you'll never really know what is working and what is not working and you may regress even further and faster because of it.