Author: Dr. William Rassman

You have a Class 3A or 4 pattern of balding. At your age, you are an ideal candidate for a hair transplant. The frontal area with a normal hairline will make the man in the mirror look like he did 10-15 years ago.

Hi,
I am curious. I have been taking Finasteride (1mg) for about six months now. I am a female of 46 years old.
I see that most of the comments are from men and that is why I am wondering if women can experience similar symptoms. I have already suffered from anxiety and panic attacks in the distant past but since six months they have come back and are much worse than ever before. I feel anxious all the time, I am not sleeping and I have panic attacks daily. I am wondering if it is the meds doing that? Could another woman tell me if this could be a possible reason for my extreme symptoms please. It is the only thing I can think of at this time. I am very upset and feel just awful every day. Those attacks are limiting my life and making feel so depressed. I had them under control before but cannot control them today! I am almost hoping it could be the Finasteride I am taking because I have read all the comments on this forum and many people have experienced the same as me. I appreciate any guidance. Thank you.
Marianne

First and foremost you need to go back to your doctor and discuss these issues.

Finasteride is NOT to be taken by women.

We have treated many women such as you with scalp micropigmentation and they have generally been thrilled with the results: (see here:https://scalpmicropigmentation.com/smp-for-women/ )

I am 40 years old. I have bald areas corresponding to Norwood 3 Vertex but thin (but stable) hair corresponding to NW6 according to two doctors. I am not taking Propecia for 18 months.

1. Can I still progress to a NW6?
2. If you (Dr. Rassman) were to transplant me, would you fix the NW3 regions or the NW6 regions or both?

Generally, when doctors assess patients with a Norwood scale, it is meant to categorize your eventual balding pattern. You may not look like a Norwood class 6 right now, but it seems two doctors that have examined you think you are going to eventually be a Norwood 6. This likely means you are not a Norwood 3V, but you have a pattern leading to a class 6.

Many men on finasteride may never lose all of the hair in the end pattern, but no one really knows. Best to get good baselines with bulk measurements along with some good pictures, and then repeat them serially year after year to know where you are actually going.

So a good doctor should recognize this and transplant the hair with both a short term focus to address your immediate needs and a long term focus leaving enough donor hair available to address the evolving situation as it unfolds. In short, this is what I always stress about on this blog and in my private practice. This must be a Master Plan for each patient before going forward with the first hair transplant in what may become a course you will follow over your lifetime.

Hi Doc, Here is an interesting msg I ran into in Craigslist, a guy who is job hunting, might be good for the blog sfo Help! I am bald and cannot get a job! “Recently, people interviewing me have been staring at my bald head. I used to have a receding hairline (a la George Costanza) so I keep my hair shaved bald now. Nobody used to stare before, now they do a lot. I notice that a lot of IT guys are bald and does not seem to keep them from getting hired. Am I being discriminated as a bald (I mean “follically challenged”) man because people in sales/marketing are supposed to be cool looking (unlike IT nerds) so they are not hiring me because of my looks? Should I do the hair transplant thing? I always thought that the bald-shaved look was cool, sort of like the no-collar shirts used to be.

Myths exist about men with hair loss reflect the superficial nature of our society which judges a “book by its cover’. These myths, at times, cut deep into the psychology of our culture. About 9 years ago, I ran a radio talk show called “The Inner Man”. It ran an hour once a week. We covered many subject from sex to religion and became fairly popular because of the controversial subject material. One show, in particular, discussed discrimination targeting bald men. The switchboard went crazy with many call-in listeners. I remember one man who called in and told us that he was a Vice President of Sales for a very large company and he was very bald himself. Then he told me that generally bald men can’t be trusted and he never hires balding men because of that. As a bald many, he must have known something about himself with that comment because it made no sense, particularly in his case.

The image of trusting men by their appeearance, however, is common issue in politics. Full header hairy men win more elections than balding me across the nation. Every elected president after Eisenhower, has had a full head of hair and many pundits infer that men with a full head of hair are trustworthy. That is not to say that a bald man is not trustworthy, but prejudices go back centuries. Women, for example, have preferred full haired men well before the 1900s because men who lost their hair often had some disease like tuberculous, making them undependable marriage candidates because they may die early leaving them with children and no support. Although tuberculous is uncommon today and we understand that balding is a genetic condition that has nothing to do with health in 99%.9 of men, but the cultural hangovers of history probably left a mark through our present time.

From what my patient’s tell me, I can assume that getting hair back, produces a man who is more self confident. I have heard this from men who have made it in their careers after I have restored their hair, particularly those who eventually became successful actors (we are in Hollywood so we get a fair number of actors). I remember an African American who wanted to be America’s first black president and believed he could not do it without hair on his head. I have heard these stories for the 24 years I have been in practice and those who have had their hair restored have reported that this surgery and this change in their appearance was a milestone in the development of successful careers. Hair does bring: freedom from the fear of the unknown, freedom from the fear of looking older, and a general feeling of more confidence for the man we all see in the mirror

What should you do? the above poster asked. Clearly this is an issue for him. He should become educated about hair restoration as the first step he might consider. He could come to one of our Open House events as he is in Southern California and he can meet many of the men who have had their hair put back back and ask them the questions he asked on Craigslist. He should research the internet and the many forums that address hair loss. He should interact with the community through social networks. He might find the answer by probing the world around him.

I use 3 pr 4 ml daily of minoxidil and I am scared of developing cardiovascular sides. I am young and it has been 3 years that i have been taking it.

Does low dose oral min ( 1.5 mg ) is safer?

Like all drugs, there can be side effects and one of the many side effects can be dangerous to the heart. If you take minoxidil, as any drug, and you get side effect, speak with your prescribing doctor or if it is not a life altering drug like minoxidil, just stop it. Are you taking it orally now? If so, what dose are you taking? Generally, the 1.5mg oral dose is safe, but there are exceptions and that is why you need to see your doctor.

Thank you for your reply doctor! I live in Germany and the dermatologist, who prescribed me Finasteride, had many patients and is really not bad in terms of hair and so on. She said, that none of their patients experienced further loss.

My plan was to stabilize my hair loss with Finasteride 1mg and keep applying Minoxidil foam 5% on my hair line. I wanted to do a small 2k graft transplant in my hair line when I am 25 in order to make it more „even“. But it seems like I should ditch this idea because my hair loss does not stabilize.

Everyone who does a hair transplant has further progression of hair loss over time. The reason that they do a hair transplant, is that they want hair and don’t want a balding appearance! They used drugs like minoxidil and finasteride to prevent further hair loss, which can slow it down considerably. By the time you are 25, your pattern should be fully detectable, especially with a HAIR CHECK instrument, that is, if you can’t see the final pattern. A good Master Plan must be created with a very good doctor who understands planning (not just how to do a hair transplant). I like to show men this picture because it tells very nicely that hair loss is progressive and you don’t want to get surprised if this is you: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/