Propecia and Moobs—Worth the Risk?
Men take more care of their appearance nowadays than ever before. Typical guys at least watch their weight and dress with some sense of fashion; many take it a step further and work out to keep in good health as well as in good shape. Many are also willing to try a variety of products to enhance and preserve their looks— Propecia®, a pill marketed by Merck & Co., Inc. to treat male hair loss, is one drug thousands of men have used with the goal of maintaining and possibly re-growing hair.
Unfortunately, a known side effect of Propecia (finasteride) is that the drug can cause the growth of breast tissue. While acknowledging this risk, the manufacturer tends to refer to it as “swelling,” which implies a temporary condition, or “enlargement,” which is somewhat vague. The truth is that men who experience this unfortunate side effect are left with additional breast tissue that will not disappear if they discontinue using Propecia.
To date, no studies have been performed to help quantify the risk. For the prospective patient, there’s no way to know the odds of developing man boobs with Propecia treatment, let alone whether he as an individual is at risk. A guy with thinning hair who wants to look his best faces an interesting—and ironic—challenge.
In our practice, we have worked with many Propecia patients with gynecomastia, or enlarged male breasts. We offer the following suggested courses of action based solely on our observations of the relationship that seems to exist between the drug and breast tissue for some men:
- For patients who developed moobs while taking Propecia, we suggest discontinuing the drug after male breast reduction surgery as breast growth could reoccur.
- For patients who had gynecomastia that worsened after taking Propecia, our recommendation is the same: discontinue use of the drug after gynecomastia surgery.
- For patients with moobs who started Propecia and experienced no further breast development, we suggest they may be able to continue using the drug and watch carefully for breast tissue growth.
As a plastic surgery practice specializing in male breast reduction, of course our experience is with men with gynecomastia. The most difficult question of all is whether a given man without moobs will develop breast tissue after starting Propecia. Unfortunately, there is just no way to know this.
It’s up to each individual with thinning hair whether to take the risk. If you’re facing this decision, the only advice we can give is to consider carefully the implications of the choice on you as an individual. If hair loss is having a tremendous impact on your outlook and self-image, it may be worth the risk of breast tissue growth to try Propecia. After all, according to Merck, 90% of users maintain or improve their hair with the drug. Not every man develops moobs as a Propecia side effect, and you can be vigilant for hints of breast growth.
If you do develop gynecomastia, male breast reduction is an option; in fact it’s the only way to remove the unwanted breast tissue. Not that we advise people to embark on a particular course planning to “fix it” later with plastic surgery—and that’s not the mindset of our patients. Some were not fully aware of the association between Propecia and moobs; some were so intent on trying to conserve as much hair as possible that they were willing to take the risk.
In any case, along with other board certified plastic surgeons who have years of experience with male breast reduction surgery, we’re here for you if needed. Whether you developed moobs while taking Propecia—or if your gynecomastia has no connection to the drug at all—consider us a resource for you.
