I am writing this post as a form of catharsis and really to help anyone who is weighing up switching to dutasteride when finasteride stops working for them.
I had an incredible 9 year run on finasteride but then it just stopped working the summer before last and things rapidly fell apart over the last 1.5 years. Essentially I wasted almost a year's worth of hair loss trying out double dosing finasteride/ laser combs (total junk)/ vitamins etc when I should have just switched to dutasteride at the first signs that finasteride had stopped working. I received bad advice from several dermatologists (namely that finasteride doesn't stop working) and left it too late to switch. I'm now kicking myself every minute of every day. Ask yourself would you rather be taking a drug that is a bit too strong for your situation (but hopefully maintaining your hair) or would you prefer to wait it out and risk losing your looks in the space of a year? My hair now looks terrible, my confidence is totally shot and the regret I feel is like nothing I've ever experienced before. I am crying every night. I wasted 11 months in denial, thinking it was just a shed that would return. I lost 70% of my hair. With hindsight, I should have taken action and switched to dutasteride after a maximum of 3 months.
Bear in mind that even 0.5mg dutasteride daily may not stabilise you (it didn't for me) and so it's better to go into the decline with more hair so at least you look better for longer and can try other things. These medications are at best preventatives- they are not miracle cures- really don't expect regrowth from dutasteride. It's just a little bit better than finasteride. Scratching around trying to stabilise with experimentals when you're already past a point that you can live with is a desperate place.
Additionally, don't fear dutasteride- my dermatologist is extremely cautious but even he has no problem with me being on it.
My advice to others in this situation is:
On noticing increased shedding/ loss of density:
*From the outset take photos of hair wet and dry in natural light every 2 weeks so you can track progress*
1. Make sure that you're using brand name Propecia and not a generic- give it 2/3 months to check it's not just a shed, keeping a close eye on shed hair for miniaturisation. Perhaps buy a hair catcher for the shower to see if shedding decreases over 3 months. Get a blood test immediately to check vitamin levels etc. My derm pinned my loss on Vit D deficiency... It was not this but had this been ruled out in the first 3 months minimal time/ hair would have been lost. If you really don’t have hair to spare then at this point start taking 1/2 dutasteride capsules per week from when you notice thinning just in case.
2. Speak to a dermatologist who specialises in hair without delay- time really is the enemy in this situation. Certainly don't take their word as gospel though- mine was far too cautious and told me to wait, telling me that finasteride doesn't stop working. I believed this and waited 11 months, rather than utilising the info on this forum, and hopping straight on dutasteride.
3. If no improvement after 3 months I would recommend taking 0.5 mg dutasteride every other day. It seems that those who do transition successfully to dutasteride and continue to maintain all did so at the first signs of thinning. You have so much to lose if finasteride has stopped working, it just isn’t worth taking the risk of waiting longer.
4. If hair fall hasn't been stabilised at 6 months (and you have less density than in your initial photos) I would recommend taking 0.5mg dutasteride daily, under the supervision of a dermatologist. Continue to take finasteride at the same time as dutasteride for at least the next six months, just for peace of mind. It takes time for dutasteride to kick in and override finasteride, you can probably drop finasteride at 6 months of dutasteride. Get regular blood tests if it puts your mind at ease. dutasteride is not heavy medication so don't let fear put you off taking it until you're desperate and it's too late.
5. All the information that you need is on this forum. Remember that this is your hair and your life, it is your decision to make, don't let a doctor talk you out of it. I have only had bad advice from every specialist that I've paid to see. Truthfully, believing a consultant hair-specialist’s advice over my gut feeling has ruined my life. Certainly see derms to get prescriptions and discuss the safety of meds but be aware that often they are quite ill- informed on hair so do not believe everything they tell you. Real life experience trumps a derm's advice every time.
6. Absolutely on no account should you drop dutasteride to go back to finasteride if you want to keep your hair. I did this after trying dutasteride out for 1.5 months and the shed was catastrophic. I realised the damage 3 months later then panicked and got back on dutasteride but it was too late, it was already over.
I hope my experience can help others to act before it is too late. I want something good to come from this. At least if you stick to this plan you'll know you did everything you could.
Lastly, I think we all blame ourselves when it doesn't work out. The reality is that hair-loss is cruel and there is no way to predict the outcome, we just do the best we can with the information we have at that time. | hate to say it but also, hair loss is unfortunately inevitable, we can only delay it with drugs. That doesn't mean you shouldn't throw everything you can at it to give yourself as many good years as possible. If you're maintaining at the moment then enjoy it for the time it lasts.
Comforting advice that I read on this forum (which I am still struggling to internalise) is:
Remember that none of this is your fault. Speculating about what you should/ should not have done does no good.
Good luck!
I had an incredible 9 year run on finasteride but then it just stopped working the summer before last and things rapidly fell apart over the last 1.5 years. Essentially I wasted almost a year's worth of hair loss trying out double dosing finasteride/ laser combs (total junk)/ vitamins etc when I should have just switched to dutasteride at the first signs that finasteride had stopped working. I received bad advice from several dermatologists (namely that finasteride doesn't stop working) and left it too late to switch. I'm now kicking myself every minute of every day. Ask yourself would you rather be taking a drug that is a bit too strong for your situation (but hopefully maintaining your hair) or would you prefer to wait it out and risk losing your looks in the space of a year? My hair now looks terrible, my confidence is totally shot and the regret I feel is like nothing I've ever experienced before. I am crying every night. I wasted 11 months in denial, thinking it was just a shed that would return. I lost 70% of my hair. With hindsight, I should have taken action and switched to dutasteride after a maximum of 3 months.
Bear in mind that even 0.5mg dutasteride daily may not stabilise you (it didn't for me) and so it's better to go into the decline with more hair so at least you look better for longer and can try other things. These medications are at best preventatives- they are not miracle cures- really don't expect regrowth from dutasteride. It's just a little bit better than finasteride. Scratching around trying to stabilise with experimentals when you're already past a point that you can live with is a desperate place.
Additionally, don't fear dutasteride- my dermatologist is extremely cautious but even he has no problem with me being on it.
My advice to others in this situation is:
On noticing increased shedding/ loss of density:
*From the outset take photos of hair wet and dry in natural light every 2 weeks so you can track progress*
1. Make sure that you're using brand name Propecia and not a generic- give it 2/3 months to check it's not just a shed, keeping a close eye on shed hair for miniaturisation. Perhaps buy a hair catcher for the shower to see if shedding decreases over 3 months. Get a blood test immediately to check vitamin levels etc. My derm pinned my loss on Vit D deficiency... It was not this but had this been ruled out in the first 3 months minimal time/ hair would have been lost. If you really don’t have hair to spare then at this point start taking 1/2 dutasteride capsules per week from when you notice thinning just in case.
2. Speak to a dermatologist who specialises in hair without delay- time really is the enemy in this situation. Certainly don't take their word as gospel though- mine was far too cautious and told me to wait, telling me that finasteride doesn't stop working. I believed this and waited 11 months, rather than utilising the info on this forum, and hopping straight on dutasteride.
3. If no improvement after 3 months I would recommend taking 0.5 mg dutasteride every other day. It seems that those who do transition successfully to dutasteride and continue to maintain all did so at the first signs of thinning. You have so much to lose if finasteride has stopped working, it just isn’t worth taking the risk of waiting longer.
4. If hair fall hasn't been stabilised at 6 months (and you have less density than in your initial photos) I would recommend taking 0.5mg dutasteride daily, under the supervision of a dermatologist. Continue to take finasteride at the same time as dutasteride for at least the next six months, just for peace of mind. It takes time for dutasteride to kick in and override finasteride, you can probably drop finasteride at 6 months of dutasteride. Get regular blood tests if it puts your mind at ease. dutasteride is not heavy medication so don't let fear put you off taking it until you're desperate and it's too late.
5. All the information that you need is on this forum. Remember that this is your hair and your life, it is your decision to make, don't let a doctor talk you out of it. I have only had bad advice from every specialist that I've paid to see. Truthfully, believing a consultant hair-specialist’s advice over my gut feeling has ruined my life. Certainly see derms to get prescriptions and discuss the safety of meds but be aware that often they are quite ill- informed on hair so do not believe everything they tell you. Real life experience trumps a derm's advice every time.
6. Absolutely on no account should you drop dutasteride to go back to finasteride if you want to keep your hair. I did this after trying dutasteride out for 1.5 months and the shed was catastrophic. I realised the damage 3 months later then panicked and got back on dutasteride but it was too late, it was already over.
I hope my experience can help others to act before it is too late. I want something good to come from this. At least if you stick to this plan you'll know you did everything you could.
Lastly, I think we all blame ourselves when it doesn't work out. The reality is that hair-loss is cruel and there is no way to predict the outcome, we just do the best we can with the information we have at that time. | hate to say it but also, hair loss is unfortunately inevitable, we can only delay it with drugs. That doesn't mean you shouldn't throw everything you can at it to give yourself as many good years as possible. If you're maintaining at the moment then enjoy it for the time it lasts.
Comforting advice that I read on this forum (which I am still struggling to internalise) is:
Remember that none of this is your fault. Speculating about what you should/ should not have done does no good.
Good luck!
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What is CB?
