Month: January 2023

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If Propecia Only Slows MPB, What Eventually Happens?

I was curious, if drugs like propecia only slow mpb and genes usually overcome them after time and you get hair transplants, what do you do later on when the drugs looses it’s effect and you loose hair in the non transplanted areas, and by chance you don’t have the donor hair to compensate. Thank you for your time.

Norwood Class 7Great question! The treatment of male pattern baldness with drugs and possible transplants requires a good Master Plan with your doctor. The Master Plan will balance the eventual worst case scenario for your balding pattern (only 7% of men go all the way to a Norwood Class 7 pattern — see illustration at right), the donor supply, and the reconstruction. For example, a person who has a Class 3A balding pattern at 35 years old, has a worst case scenario of a Class 5A pattern, but probably wont get there if he is treated with Propecia (finasteride 1mg) and is a good responder. I find that I can restore almost all Class 5A patterns with reasonable hair density, good laxity and average or better than average hair weight. When you discuss your balding problem with your doctor, this should become the central focus on your consultation.

Like you suggest, going into transplants blindly could not work in your favor if your hair loss pattern eventually works to a Class 7 pattern. With that said, people who may evolve into a Class 7 pattern could accept coverage in the front and top, leaving the crown out of the reconstruction if their pattern goes too far. A frontal reconstruction with a Class 7 pattern looks great in the mirror and is a reasonable option for the worst of the balding patients.

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If Propecia Doesn’t Work, Is the Hair Loss Unrelated to DHT?

Is it possible that if you are one of the people who didn’t respond to propecia that your hairloss is unrelated to DHT? I’ve read the Diffuse AA can look like diffuse patterned baldness and even chronic TE can end up looking like thinning on top. I’ve tried propecia for a long time now coming up on 16 months and my hair on top is gradually thinning.

a little background for you, I have lived with anxiety, stress and depression problems for a long time and think that having these problems chronically has lead to hair thinning. I only have slight recession in the temples but everything else is evenly thinning on top. In summary, for the 10 percent or so that Merck reported as not responding, could they have hairloss unrelated to DHT? Thanks.

As you suggested, there are many causes of hair loss that are not DHT related. I have no way to know the reasons for your hair loss, though. That being said, there are patients with genetic hair loss that just do not respond to Propecia and this can be tested for with the HairDX Finasteride Response test (written about before).

You need to get a proper diagnosis from a good, caring doctor. I can not help you without examining you, at which point I could map your scalp and conduct a hair bulk analysis in our office.

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If Propecia Didn’t Regrow Hair, Will It Stop Maintaining My Existing Hair Sooner?

I’m 23 years old with early frontal thinning but am currently a NW2. So I been on Propecia for 7 months now and everything is the same! By now I assume I should have seen if my hair was getting thicker or regrowing so I guess I should be happy if I just get to maintain. Now my question is if I won’t get any regrowth or my miniaturized hairs won’t get thicker are my chances to maintain my hair the way it is right now lower for 5 years which is the number of years for most men!? Because I read something that your hair count increases the most the first year and then gets less and less each year. So if I get nothing this year, I mean in like 5 years I will definitely look thinner although probably better then without Propecia but still thinner and I don’t want that.

The peak result from Propecia seems to occur by about 18 months, then some loss is common in the hair counts done by the drug company, Merck, in their FDA studies (over a 5 year study period). Some people have held their hair for years, while others slide in the hair counts. I can’t say for sure how you’ll respond to the medication, so I wouldn’t know how you’ll be 5 years on. I don’t know of any data that shows regrowth (or lack thereof) from Propecia correlating to the length of time the medication can halt your hair loss.

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If Propecia Can’t Stop Progressive Hair Loss, How Can it Regrow Hair?

If Propecia eventually can’t stop the natural hair loss progression, then how does that explain it growing hair again in people who take it?

Every drug has limitations. Propecia (finasteride 1mg) has its greatest effect in the first two years, but it’s important to note that it still works even after those first two years by slowing the hair loss. The drug may reverse hair loss in younger men, particularly if the loss occurred within the past couple of years.


2008-05-09 10:51:02If Propecia Can’t Stop Progressive Hair Loss, How Can it Regrow Hair?

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If Nikola Tesla Castrated Himself, Is That Why He Didn’t Bald?

I’ve read in a hairloss forum that Nikola Tesla castrated himself so he doesn’t get distracted from his research. Maybe that’s the reason he didn’t go bald. I’m amazed from what you can read today in the internet.

If one is castrated, they will stop their balding process where it was at the time of castration. Taking testosterone can reverse that, producing balding in men with the genetic traits for hair loss (even without testicles).

If Nikola Tesla was castrated (I am not sure about that), then he will not be balding… as shown in these photos at Neatorama. The man was a genius, but he looked like hell with considerable weight loss as he aged (as seen here). He did seem to maintain his hair pattern, even with the weight loss.

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Inheritance from mother or father’s family?

I heard that hair loss is dominant trait in males. So if you mother carries the gene you will 100% get it. She is 52 years old and recently started losing alot of hair. Also my grandfather went bald not sure if its because of heart medicine but yeah. Wondering if fpb is the same gene as mpb.

Woman’s hair loss is very different from men’s hair loss. You have a 50/50 chance of inheritance from your mother or dad’s family. Some women get it when they are young especially seen when their mom and sisters got it when they were young. 50% of women get it after menopause when their estrogen levels drop. Estrogen usually protects women from the genes for hair loss and women almost never go bald like some men do.


2020-04-19 10:42:01Inheritance from mother or father’s family?

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If My Libido is Higher on Propecia and Avodart, Does that Mean DHT is Increasing?

I started taking propecia when i began noticing my hairline receding and hair becoming thin in the crown. About 1 year later i decided to give dutasteride ago. Throughout both medications my testosterone increased quite alot, causing increased libido to such a degree that i was getting an erection almost 3 times a day compared to almost never (unless needed) when i wasnt on the medication. i have been taking these medications now for 3 years and my testosterone shows no sign of of decreasing back to normal.

My question is, if i am taking medications to reduce as much DHT as i can and my medications are actually increasing my testosterone which inturn is creating more DHT as its a by product isnt it a paradox and useless. I have however heard that this increased testosterone isnt almost a momentary thing that may last a while because my bodys thinking ‘we need to make more testosterone’ due to the decrease caused by the medication.

Thanks NHI Team

Few men will complain of an increased libido or an increase in the frequency of erections. As you noted that the increase in erection function has been now two years since you started it, I would imagine that it will continue. How do you know your testosterone levels increased? Did you have them measured before and after you are taking Propecia and/or dutasteride? These blood levels need to be compared to the normal values established by the lab testing you.

The connection with your sex drive and the DHT block from the drugs you are taking, and possible increased levels of testosterone are unclear. Without knowing testosterone levels before and after you started taking the DHT, I can not tell you much. I personally think that you are going overboard with analysis here, and should just enjoy the moments as long as everything is working well.


2009-11-03 10:14:40If My Libido is Higher on Propecia and Avodart, Does that Mean DHT is Increasing?

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If My Juvenile Hairline Was Asymmetrical, Will My Mature Hairline Be Too?

Hey Doc,

My juvenile hair line was asymmetrical. The right side of my hair line was higher than my left.Now im starting to develeop a mature hairline. Do you think my mature hairline will be asymmetrical? Have you ever seen a asymmetrical mature hairline?

thank you for you great site.

Only time will tell. It is possible that when and if the juvenile hairline is lost, that you will balance out what you see.

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If My Hair Can Be Pulled Out Easily, Does That Mean Rogaine and Propecia Are Becoming Less Effective?

Hello Doctor,

I have been loosing my hair since the age of 16 and finally took notice months before my 18th birthday. Currently I am on both propecia and 5% Rogaine and have been for the past year (prior I relied on just 1.25mg finasteride).My current results with my regimen have been satisfactory, as I can not for sure say what I’d look without the medication.

My question is regarding the ease of hair falling from the scalp when rubbed and the amount of hair strands that can been pulled by gently using your index finger and thumb. Recently I have been able to pull about 3-5 strands at a time out of head and hair tends to fall out easily when I rub it (a common habit of mine while studying). This has been occurring on and off for the past couple of months- especially after I was off rogaine for a period of 2 weeks in January while I awaiting for new shipment to arrive (I order the foam online through ebay since it is not available in Canada).

Do these symptoms indicate that the drugs are becoming less effective now, leaving genetics to take its course? Is there any shampoo or conditioner that you recommend or heard from prior patients to help strengthen the hair follicle?

Maybe you should stop pulling on your hair. How easily your hair falls out has no real clinical significance with Rogaine or Propecia use.

There is no magic drug, shampoo, conditioner, or potions that will help strengthen hair. There are hundreds of products out there. Try them. I am not against them, but you WILL end up spending a significant amount of money and likely be left without any benefit.


2012-11-13 08:41:15If My Hair Can Be Pulled Out Easily, Does That Mean Rogaine and Propecia Are Becoming Less Effective?

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If My Father Lost All His Hair, Am I Wasting Time Trying to Prevent My Hair Loss?

I have slight frontal balding and some thinning at the top of my head. I have no blad spot yet but its getting close to that. I am 28, my dad was completely bald on top, a stage 7 I guess. I have been using Propecia for 3 weeks.

I have 3 questions,

  1. Is Nisim or Nizoral any help to my hair loss?
  2. Seeing my father lost almost all of his hair on top am I wasting my time trying to prevent my hair loss.
  3. Do you know of any good hair loss doctors in the Tampa, Florida area.

Thanks in advance.

If you are 28 years old and are not completely bald as your father almost certainly was, then you will probably not be following his pattern. All Class 7 men have lost most of their hair before they were 28 and if you have no bald spot now, I would doubt that you would in the Class 7 hair loss pattern. If you get your hair mapped out for miniaturization you might be able to tell where you will be losing more hair, possibly even when (short term vs long term). See an expert and find out for yourself.

The answers to your questions are as follows:

  1. I’ve said it before, but, “Nizoral is a good shampoo. I do not believe it is necessarily good at regrowing hair. There is not enough scientific data to support hair growth claims.” As for Nisim, they make yet another herbal product that is not proven by the FDA to work. As regular readers of this site should know, I do not recommend products that aren’t FDA approved for treating hair loss. You can try it if you want. They say they offer a guarantee, but I’ll leave that up to you. Buyer beware.
  2. The choice for you is to be proactive or not. I think that you are not going to follow your father’s pattern, considering you said he was a class 7 by the time he was your age.
  3. I usually do not supply referrals for transplant docs, but you can check ISHRS.org‘s physician search to find one in your area. Be sure to use the internet to research the doctor you chose.


2007-05-01 17:39:35If My Father Lost All His Hair, Am I Wasting Time Trying to Prevent My Hair Loss?