Propecia

Propecia (pronounced "propeesha" ) is the trade name of finasteride when it is used to treat alopecia androgenetica. Finasteride is a drug used to treat the enlarged male prostate. After it appeared to promote hair growth by blocking the action of androgens, it underwent clinical trials for the hair growth factor and gained FDA (Food & Drug Administration) approval in the US for use as a prescription drug. It is taken in tablet form. Propecia is of course a new treatment for hair loss which may not have received official permission to be prescribed in your country. If you are considering using it, it is important that you know a few details about it.

In hair loss, it acts as an anti-androgen treatment. As we have discussed, alopecia androgenetica (male pattern raldness) occurs when unusually high levels of the male hormone testosterone are converted to a derivative - Dihydrotestosterone (DHT). High levels of MIT cause hair follicles to age prematurely and to shrivel. Finasteride works by blocking the enzyme, 5-alpha reductase which converts testosterone to DHT. This causes DHT levels to fall by as much as 70 per cent in eight hours. In a clinical analysis involving 508 men, an increase in hair growth was demonstrated in 66 per cent of men after two years on the treatment.

US marketing clearance was based on data from three one-year double-blind muiticentre placebo-controlled clinical trials. These involved 1,879 men aged 18 to 41 with mild to moderate hair loss of the vertex (top of the head) and anterior (towards the front of the head) mid-scalp areas. In addition, 1,215 men who had hair loss of the vertex or top of the head were studied for a further year. Hair count increased during the first year and was maintained in those men taking Propecia for two years. Men in the placebo (dummy pill) group continued to show progressive hair loss. In an analysis of the men who were followed up for two years, only 17 per cent of men treated with Propecia showed any hair loss (defined by an decrease in hair count from their base line assement). Eighty-three per cent had the same or higher hair count. In contrast, 72 per cent of the placebo group lost more hair, as measured by hair count.

All the patients were asked to evaluate their response to the treatment. Those on Propecia reported an increase in the amount of hair, a decrease in hair loss and an improvement in their appearance.

How Long Does It Take to Work?
In the trials, clinical improvement was seen as early as three months after the onset of treatment.

What Type of Hair Loss Can Be Improved with Propecia?
It is for the treatment of alopecia androgenetica.

Is It Suitable for Both Men and Women?
Women of childbearing age must not use Propecia because its manufacturers, Merck Inc, fear that it may cause abnormalities in a male foetus. It may cause abnormalities of a male baby's sex organs, a condition known as hypospadias. In addition, women should not handle crushed or broken tablets when they are pregnant or likely to become pregnant. The tablets have a coating which prevents contact with the active ingredient, providing they do not become broken or crushed. Clearly, because of these concerns the, manufacturers have stipulated that Propecia should not be used by women at all, although it is known that some women outside childbearing age have been obtaining Proscar tablets privately in the UK, which contain 5 mg finasteride. As Propecia contains only 1 mg finasteride, these patients have been taking a Proscar tablet every other day instead of daily.

What Are the Side-effects?
A small number of men on the treatment have reported less desire for sex and/or a decrease in the amount of semen they produce. Each of these side-effects occurred in fewer than 2 per cent of men. They went away in the patients who decided to discontinue the therapy, and also disappeared in the 58 per cent of men who decided to continue taking Propecia.

Are Doctors Happy About the Treatment?
Says consultant dermatologist Dr David Fenton, "Results seem good but I would feel happier if more stringent tests were carried out on it to ensure that it does not affect long-term male fertility".