Hi Dr. Rassman,
Consider this permission to use the photos if you use my question.
51 years old, full, thick head of hair until recently. I have been thinning for about 2 years I guess, it has been a few hairs here and a few there. Didn’t think too much of it until this last 6-8 months when it really seemed to accelerate. My brother is 59 and has no balding in the crown/vertex. I started on Propecia in December of this year and have been tolerating it well. So far no side effects. Have a very stressful life ( I’m in Healthcare ! ) and this Year has been the worse.
My question is ? I would like to try the propecia for a full year to see if it can help. Given my age and late onset of what I think is MPB do you think this is a good course of action ? At what point would I be a candidate for a hair transplant ?
Thanking you in advance, maybe one day we will meet !
It is unusual for a man of your age to start genetic hair loss, but I have seen it before. You want to make sure that you do not have a medical illness that is causing it. Propecia is most effective with recent hair loss of 2-3 years duration. Thank you for giving me permission to post your photos (click them to enlarge).
You have some options. You can try taking Propecia for 8-12 months. As a general rule, the older you are, the less likely will be the response, but with your gray hair, any response will add value and with the 2-3 year history of hair loss, you may break the ‘rules’. If you still have no response after that period of time and wish something done about it, then a hair transplant may have value. Alternatively, you can have a transplant and take Propecia. There is no doubt that the hair restoration will be good with the transplants alone, and any gain you have from the Propecia is a bonus. The more the grafts, the better the fullness if you go forward to transplants. I’d estimate between 1000-1500 grafts might give you reasonable coverage.