how does propecia affect eyes

[Dogs3]

it seems a lot of people believe that propecia affects the eyes by causes bags under them. Ive even heard that it causes irreversible wrinkles and the bags caused are permanent as well. I dont know if thats true, but my question is: are these bags likely caused by swelling, like monox? or is it something else, like increased estrogen? What can you do to rid them, use a cold compress? What is the deal with these supposed symptoms and what exactly causes them by taking finasteride?

 

[Pondle]

This isn't a reported side effect and hasn't been noted by doctors who prescribe the drug.

http://www.baldingblog.com/2007/05/23/d ... -propecia/

In the Proscar PLESS study, a higher incidence of cataracts (4.2%, finasteride vs. 2.5%, placebo) was observed in patients receiving finasteride. None of these cases were considered drug related by the investigator.

 

[Mew]

I'd believe Dr. Rassman as much as I believe Merck -- which is a big fat 0%.

He's a propecia-pushing derm prescribing their drugs, and is likely getting some good Merck-funded kickbacks for it -- funny how everytime someone mentions side effects on his blog, he essentially fobs them off or tells them to look elsewhere for the cause of their symptoms instead of the drug. Please...

Anyway, that's just my personal opinion about him. Anecdotally, many guys have experienced dark circles under the eyes while on finasteride, self included. Furthermore, there are studies out there noting the effects 5AR inhibitors (such as finasteride) have on eye function -- or rather, causing dysfunction. Here are some experiences and documents to note:

http://72.14.253.104/search?q=cache:IrB ... cd=1&gl=ca

http://www.merckfrosst.ca/assets/en/pdf ... 2_06-E.pdf
-- As Pondle noted:
"PAGE 7: Although the clinical significance is unclear, a higher incidence of cataracts (4.2%, finasteride vs. 2.5%, placebo) and diabetes (2.8%, finasteride vs. 1.7%, placebo) was observed in patients receiving finasteride. "

http://www.blackwell-synergy.com/doi/ab ... 04.00770.x

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Effect of Androgen Deficiency on the Human Meibomian Gland and Ocular Surface

ONLINE: http://jcem.endojournals.org/cgi/conten ... 85/12/4874
PDF: http://jcem.endojournals.org/cgi/reprint/85/12/4874.pdf

Selected bits:

Our results demonstrate that patients taking antiandrogen treatment, compared with age-related controls, had a:

1) significant increase in the frequency of appearance of tear film debris, an abnormal tear film meniscus, irregular posterior lid margins, conjunctival tarsal injection, and orifice metaplasia of the meibomian glands;

2) significant increase in the degree of ocular surface vital dye staining;

3) significant decrease in the tear film breakup time and quality of meibomian gland secretions; and

4) significant increase in the frequency of light sensitivity, painful eyes, and blurred vision.

In addition, the use of antiandrogen pharmaceuticals was associated with significant changes in the relative amounts of lipids in meibomian gland secretions.

Our findings indicate that chronic androgen deficiency is associated with meibomian gland dysfunction and dry eye.

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We also compared the relative frequency of the signs and symptoms of dry eye between patients taking finasteride (n = 4; age, 67.3 ± 2.8 yr; diagnosis, prostatic hypertrophy; average duration of treatment, 3 yr) vs. other antiandrogen medications (i.e. predominantly leuprolide acetate, as well as bicalutamide, goserelin acetate, and flutamide) (n = 11; age, 72.2 ± 2.3 yr; diagnosis, prostatic cancer; average duration of treatment, 3 yr).

The rationale for this comparison was that finasteride, but not the other antiandrogen compounds, might act to inhibit the local conversion of testosterone to DHT (24). If so, finasteride actions might reflect the importance of local steroidogenesis per se in providing potent androgens to ocular surface tissues.

These comparisons showed that the left and right eyes of patients taking finasteride had a significantly higher frequency of appearance of conjunctival bulbar injection (finasteride group, 100%; other treatment group, 50%; P < 0.05), lid collarettes (finasteride group, 66.7%; other treatment group, 15%; P < 0.05), metaplasia of meibomian gland orifices (finasteride group, 100%; other treatment group, 54.6%; P < 0.01), and corneal fluorescein staining (finasteride group, 87.5%; other treatment group, 31.8%; P < 0.01).

Finasteride-treated patients also had a significantly greater sensitivity to wind (finasteride group, 75% positive responses; other treatment group, 0% positive responses; P < 0.005).

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Consequently, given that this tissue is an androgen target organ (26), contains both androgen receptor protein and 5-reductase mRNA (9), and responds to androgens with an enhanced lipid synthesis, production and release (11, 12), it would seem that antiandrogen therapy and the resulting androgen deficiency would lead to meibomian gland dysfunction.

... the meibomian gland is a large sebaceous gland, and androgens are known to control the development, differentiation, and lipid elaboration of sebaceous glands in nonocular sites (27, 28). Antiandrogen treatment and the related androgen insufficiency, in turn, lead to a marked decline in sebaceous gland activity and lipid output.

... The impact of antiandrogen therapy on the conjunctiva, cornea, lid, and ocular surface symptomatology may have been due, in part, to decreased meibomian gland function. Meibomian gland dysfunction typically leads to an increase in the signs and symptoms of evaporative dry eye. Indeed, this condition has been estimated to be a contributing factor in over 60% of all dry eye patients.

...Another consideration in the response of the conjunctiva and cornea to antiandrogen therapy is that these tissues express Types 1 and 2 5-reductase mRNA and/or androgen receptor mRNA and protein. Furthermore, androgens have been shown to influence the functional activity of both the conjunctiva and cornea .
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Thus, finasteride administration, compared with the analogs of LH-releasing hormone or the nonsteroidal antiandrogens, seemed to be associated with a greater frequency of conjunctival bulbar injection, lid collarettes, metaplasia of meibomian gland orifices, corneal fluorescein staining, and wind sensitivity.

 

[Pondle]

Bill Rassman wouldn't be my first choice for a hair transplant (actually, I wouldn't want a hair transplant at all) but he does have the advantage of actually being a trained doctor, which is more than can be said for most posters on HairLossTalk.com (including me). As for being a "Propecia pusher", well, he prescribes Propecia but then it is the only approved oral pill for male pattern baldness and the most effective treatment on the market. The statements he makes on his blog seem to indicate that he understands the limitations of the drug. If you don't want it, no one's forcing you to take it.

I see that a number of sources including theNHS clinical knowledge summary database note the suggestion that androgens promote the secretory activity of the meibomian glands. This might help to explain why dry eyes occur more frequently in women than men and particularly effect post-menopausal women. I can see the logic of the study Mew has posted, i.e. that finasteride reduces the exposure of the meibonian gland to androgens, and could consequently be associated with dry eyes. However, two caveats with this - a very small sample with only four research subjects taking finasteride, and it appears to be the only published study of its kind.

It's also worth remembering that there are other causes of dry eye syndrome including various medical conditions, lifestyle and environmental factors. In individual cases it may be difficult to isolate the particular causal factor. I experienced the problem after LASIK surgery, several years before I started taking finasteride, luckily it resolved within a few months. The condition is manageable for most people through the use of lubricant eye drops but it can have a big impact on quality of life in the more severe cases.

As for dark circles, well they seem to be poorly understood. To attribute them to finasteride seems highly speculative. I had never heard claims about this 'side effect' until I saw posts by guys from propeciahelp.com on HairLossTalk.com. Possibly more examples of coincidence being mistaken for causation.

 

[Dogs3]

pondle,

yah i find it unlikely as well, although i dont have evidence either way, I just dont see how it could cause bags under eyes, wrinkles, aging and a lot of other complaints i read on propeciahelp.com.