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For more expert advice from Dr Panagotacos, see Chapter 15: “Ask the Expert” from Dr. Panagotacos’ book, Hair Loss Answers

Should I be concerned about reported sexual side effects of using finasteride (Propecia©)?

On April 29th, 2011, the International Society of Hair Restoration Surgery published findings regarding the use of finasteride (Propecia©) and claims of persistent sexual side effects from a number of younger men. This report states in no uncertain terms that:

“there is no evidence-based data substantiating the link between finasteride and persistent sexual side effects in numerous double blinded, placebo controlled studies…”. Link to complete article at the ISHRS web site:
International Society of Hair Restoration Surgery Task Force on Finasteride Adverse Event Controversies

Why is there a 4-6 month wait for new hair growth?

There is a 4-6 month wait before new hair grows after hair transplants or pharmaceutical treatment for hair loss. This is because the hair follicles have to shift from a resting stage to a growing stage. The new hairs also have to grow out long enough so that they are noticable. All of this takes some time.

Cycle of Growth: Hairs grow from hair follicles, which are miniature organs in the skin. Each individual hair follicle grows a single hair in a cycle consisting of a long period of growth (about 5 years) followed by a relatively short period of rest (about 3-4 months). After each rest period, the hair is shed, and a new hair begins to grow, and the growth cycle starts again.

Catagen Stage: At the end of the growth period, the follicle prepares for a rest. Hair growth for that particular follicle stops. The transition to the resting period is called the catagen stage. This stage usually lasts about a month or so, and during catagen the lower portions of the follicle collapse, and the grip on the hair becomes loose, which allows the hair shaft to be shed.

Telogen Stage: The resting period, called the telogen stage, lasts for another 3-4 months, and sometimes a bit longer. Hair follicles that have been transplanted usually make a transition from growing hair to no growth, and then enter the telogen phase, shed their hair, and then after 4-6 months start growing new hairs. New hair growth resulting from pharmaceutical treatments such as minoxidil and finasteride comes from “waking up” resting hair follicles. It takes some time before these “resting” follicles shift to the growing phase.

Anagen Stage: The hair growth period of a hair follicle is called the anagen stage. The anagen stage for scalp hair follicles lasts about 5 years. The new hairs grow about 1/2 inch per month.


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