Hair loss: which drug, or both?
April 15, 2021 5:20 PM   Subscribe

Two simple questions, anecdotes welcome

I went to keeps.com, for no better reason than they advertise, and they offer the following advice for which drug to use:

-Minoxidil: Help grow thicker, longer (and just more) hair on the crown and vertex.
-Finasteride: Proven effective at reducing hair loss along the hairline, crown, and vertex
-Both: This combination is best for reducing overall loss and helping with regrowth.

Are these accurate descriptions of the effects? Wikipedia emphasizes rather than de-emphasizes finasteride's effectiveness on the crown.

Is this the cheapest way to get the drugs? I found an amazon listing for a yearly supply at half these prices, but it was expired. Their description makes the $320/year option sound best for my situation, but I wouldn't expect them to push me toward the $120 option.

Notes:
I understand there's a third one, dutasteride, which I'm open to as well. I understand that finasteride and dutasteride may have some feminizing effects. That's not a negative for me.
posted by Sterros to Clothing, Beauty, & Fashion (7 answers total) 2 users marked this as a favorite
 
Check out Alldaychemist.com

I have used their version of Latisse and their version of a prescription cream for a skin issue, both very expensive through normal channels, and extremely reasonable through Alldaychemist.com.
posted by Dolley at 6:54 PM on April 15


I'm an emergency physician/medical toxicologist, and fairly knowledgeable about hair loss treatments

FINASTERIDE

The standard starting dose is 1mg in tablet or liquid form.

Finasteride blocks an enzyme (5-Alpha Reductase) that converts dihydrotestosterone (DHT) to testosterone. This slow downs hair loss, but doesn't stimulate hair growth

Effectiveness of Finasteride is highly variable, and determined by an individual's level of DHT sensitivity, which can't be tested for or determined beforehand

The big factor to consider with Finasteride are its (sexual) side effects; specifically, erectile dysfunction, lower sperm count, and lower sex drive. These occur biologically in less than 1% of people; however, because there's such a large mental component w/r/t sexual functioning, they occur psychosomatically in a higher percentage (anywhere from 3-6%) of people

MINOXIDIL

Re-growing hair on the crown of the head is its strength. To a lesser extent, it also slows hair loss

Standard starting concentration is 5%, and comes as both a foam and a liquid. It comes in tablet form as well, but for reasons I don't understand, oral administration is little used

The first step when using Minoxidil is figuring out which of the two formulations you prefer with regard to (potential) skin irritation, and how they make your hair and scalp look and feel (the liquid form is notoriously oily).

I would suggest doing a 1-month supply of foam, then a 1-month supply of liquid. In that time, you may also get an idea of which formulation you respond best to physically (ie, which stimulates more hair growth)

Insurance never covers the cost, but Walmart sells a three-month supply for about $50.

FINASTERIDE + MINOXIDIL

Because the two drugs work in different ways, using them together is an option. No research supports the claim they work better together than either one alone, but there's plenty of anecdotal reports from patients who have found that they do

I wouldn't recommend doing both right out of the gate. Do one, then the other, to independently assess side effects and efficacy.

FWIW, compounding pharmacies are able to make a pill that contains both medications. This is by far the most convenient option should you decide two is better than one.
posted by BadgerDoctor at 8:36 PM on April 15 [5 favorites]


Have you talked with a doctor about getting screened for causes other than male pattern baldness? MPB is the most common cause for men, but not the only one, so if it's something like a thyroid issue, addressing that rather than just using a hair promotion drug is going to be a better solution for you.
posted by Candleman at 6:52 AM on April 16


Losing your hair blows.

I've taken Finisteride for like 15 years now. For me it doesn't do anything for the front of the head, but works great for the crown. I'd say it stops loss and allows some to regrow there. Minoxodil is way more expensive (finisteride generic is like $5 a year on my insurance) vs $20-30 a month. I took it for 2 years, and for me it didn't seem to do anything worth its cost, also mostly working on the crown, so I don't use it anymore.

I never had any side effects for either one.


Good luck.
posted by The_Vegetables at 7:39 AM on April 16


I would suggest doing a 1-month supply of foam, then a 1-month supply of liquid. In that time, you may also get an idea of which formulation you respond best to physically (ie, which stimulates more hair growth)

You can't do this. It takes like 6 months for any noticeable regrowth, unless you are going to the doctor constantly. I've gone to the doctor for it, and they have never suggested such quick results.
posted by The_Vegetables at 7:41 AM on April 16


The cheapest minoxidil I have found is at Costco (but you have to be a member): $50.00 for 6 mo of the foam, or $17 for 6 mo of the liquid. As others have said minoxidil takes a while to take effect, and you may see some initial shed which is apparently a good sign.
posted by Comrade_robot at 11:45 AM on April 16


I've been taking finisteride for years and it worked to stop hair loss on the crown. No regrowth, but the loss has been frozen. No side effects in my case.

I just wish I had started a little earlier (it's fine, but I was in denial for a while before I got on the medicine and could have saved a little more hair).
posted by thefoxgod at 6:17 PM on April 16


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