Propecia: The Goose That Lays the Golden Eggs
March 2005
in “Skinmed”
TLDR Finasteride is popular for treating male hair loss but may increase the risk of serious prostate cancer and has other potential side effects.
The document discusses the success and concerns associated with finasteride (Propecia), an oral medication for male pattern hair loss. Sales of finasteride reached $65 million in the second quarter of 2004, reflecting its high demand due to limited previous success in treating male pattern hair loss, its low side effects, and aggressive advertising. However, a study involving 18,882 men aged 55 years or older, which was published in the New England Journal of Medicine in July 2003, found that while finasteride reduced the incidence of low-grade prostate cancers, it increased the rate of high-grade cancers by 1.3%. This raised concerns about the drug's safety, particularly at a daily dose of 5 mg. The document also mentions other potential side effects such as loss of libido, cataracts, and gynecomastia. The authors suggest that dermatologists prescribing finasteride for androgenetic alopecia should now discuss these new findings with patients, monitor them appropriately, and possibly refer them for routine urologic evaluations. The enthusiasm for prescribing finasteride must be balanced with the potential risks associated with its long-term use.
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Cited in this study
research Gynécomastie et finastéride (Propecia®) : 4 nouveaux cas
Four new cases of gynecomastia (male breast enlargement) linked to finasteride (Propecia) have been found.
research Follow-Up of 1 mg Finasteride Treatment of Male Pattern Baldness-Difference between Clinical Trials and Private Office Follow-Up: Influences on Prescribing Habits Evaluated
Finasteride showed limited hair growth and low patient compliance in treating male pattern baldness.
research Clinical Case Notes. Propecia-associated bilateral cataract
Taking Propecia might lead to the development of cataracts.
research An Open, Randomized, Comparative Study of Oral Finasteride and 5% Topical Minoxidil in Male Androgenetic Alopecia
Oral finasteride works better than topical minoxidil for hair growth, both are safe.
research Psychological effects of androgenetic alopecia on women: Comparisons with balding men and with female control subjects
Hair loss affects women's mental health more than men's, causing anxiety, low self-esteem, and social insecurity.