Author: Dr. William Rassman

The internet has spread a great deal of information and misinformation about Propecia (finasteride) which is much over-blown. You need to put the decision in perspective. The risk of these sexual side effects are between 2-4% depending upon the sources you read. My son has been on this drug for 15 year and found an increased sexual drive, not a decreased sexual drive which his girlfriend appreciated very much. How often do you hear about an increased sexual drive? Answer: very, very rarely.

If you were one of the unlucky men to get the sexual side effect, 99+ % of these men find that the side effects go away within 2 weeks upon stopping the drug. Some very small percentage report long term sexual side effects; however these risks are very, very infrequent (less than 1% of the 2-4% people who get negative side effects that persists). Many of the people who reported these sexual side effects may have had sexual dysfunction (normally present in 30% of men 40, 40% of men 40, 50%+ in men over 50) so it is easy to blame this drug for sexual side effects when reduced sexual drive is unfortunately, a sign of aging in many men. Rarely do we see this in 19 year old men, however, you can have a placebo effect if you believe you will be one of them.

The real decision before you, of course, is the problem of progressive balding which this drug is very effective in treating in men of your age. It even reverses the hair loss in many men under 20. You are clearly in the drivers seat, so be careful about what you read and put everything you research into a proper perspective.

I’m 19 and started to notice I was shedding a lot about six weeks ago. In those six weeks I’ve lost probably half of my density at the front, and a decent amount at the crown. What the hell is happening? How can this happen so quickly, this is genuinely devastating. I have an appointment with my GP on Friday where I’ll be trying to get a fin prescription, but I don’t even know if fin can help. If the GP won’t give me a script I’ll probably end up having to wait 8-12 weeks to see a dermatologist, by then it’ll be too late I imagine.

See a doctor who has the HAIRCHECK instrument to find out exactly how much hair you have lost. I doubt that you lost half of your hair in just 6 weeks. If your doctor prescribes you the drug finasteride, then when taking the drug you will know which way you are going, better or worse over time. See here: https://baldingblog.com/2017/01/10/value-haircheck-bulk-measurements-two-patients-seen-today/

Wow, your hair loss at this stage is an advanced Class 3 pattern but the real question is where is the hair loss going? Of course you can have a hair transplant now, then do another in a year and a year later do another etc., if you get what I am saying. You don’t want to be addicted to having hair transplants every year until you use up all of your donor hair and then have an incomplete job to show off, not good. At 18, we always discourage boys in going the hair transplant route. You need to consider yearly measurements with the HAIRCHECK instrument by a doctor who has one, then you also need to consider taking the drug Finasteride which is the only drug that MIGHT stop the hair loss. If your family history is one of advanced balding, then you and your doctor need to work out a Master Plan for your future with regard to hair loss, drugs and eventual surgery when you are much older.

I’m 18 and I lost part of my frontal hairline. Am I too late to start taking Finasteride?

For an 18 year-old with early frontal hair loss, it is the right timing for the drug Finasteride. The drug works best in young men and may even reverse the hair loss provided that what you are seeing is not a maturing hairline. A maturing hairline will not be affected by Finasteride. Your doctor will tell you if this is a maturing hairline or not. See here for pictures of a mature hairline: https://baldingblog.com/2007/01/12/maturization-of-a-hairline-moving-from-juvenile-to-mature-with-photos/

This is a great result. I would hope that if you continue it you will keep the hair for a long time. What is really impressive is the according to the creases on your forehead, the hairline came back to its normal mature position which is what I would have done had I transplanted your hairline.

I have have a really bad, receding hairline with dense hair and no crown problems. I was going to start minoxidil and add finasteride in 2 to 3 years since I still haven’t finished my puberty. I really want to try to recover my hairline, the thing is, I am okay with getting a HT in a few years.

I often prescribe finasteride to 18 years old men. This drug often works very well with a high degree of reversal. If after one year it doesn’t reverse, add oral minoxidil to your routine and worst case, add microneedling 6 months after than it it doesn’t work. Actually, I don’t think that the first or second will fail. A hair transplant is out of the question for at least 7 years and by that time, if you don’t treat it now, you may bald far more than you see now.

The answer is a clear no. Finasteride works well when you are young, but less well as you get older. Sooner or later, your genetic hair loss will prevail over the drug Finasteride.

In just two months, this young man stimulated early hair growth that can only get better over time. It is always amazing how quickly microneedling accelerates the growth process. Of course, we never would know if it would have grow without the microneedling, but with the huge number of men who presented these results, one has to believe that the three approaches (finasteride, minoxidil and microneedling) are intertwined.

I’m 19 and went to a doctor about my hair and he refused to give me finasteride. What can I do? I am very depressed about this situation.

Find another doctor! Connect with me at williamrassman33@gmail.com and we can talk and I will prescribe it if indicated. You may not be balding and just maturing your hairline but I can work with you on this over the phone to find out what it is that is bothering you.