Author: Dr. William Rassman

Great results from the use of finasteride for 13 months and minoxidil for 3 years

Today, I performed a HAIRCHECK test to see if there was any evidence of hair loss present in this 33 year old male. He went on Finasteride 11 years ago and was convinced at that time that he had hair loss. However, the doctor who prescribed it did not really examine him and make an objective assessment of his “hair problem.” Since then, he has been worried about his hair loss. He knew that Finasteride could contribute to a reduced risk of prostate cancer, and since his father has prostate cancer, he is happy to stay on the medication today, even if he is not balding. He has no sexual side effects or any other side effects from the drug since the time he started it, 11 years ago.

It is my firm belief for those of you who read this post, before you start the drug Finateride, to get a HAIRCHECK test. It will help determine:

• If you are really balding
• If you are balding, get a baseline for your hair loss, so if you start on the drug Finasteride or any other treatment for hair loss, you will have an objective way to determine if you are balding while on the treatment, and
• If you are getting worse or getter better with the treatment.

Knowing what is happening to you is very important from a Master Plan perspective because hair loss is progressive in 100% of men who have genetic balding. The HAIRCHECK on this patient showed that his hair bulk in the front, top, crown and back of the head was equal by HAIRCHECK measurements.

I am surprised to see your Finasteride does being so low as the studies of effectiveness puts it down to less than 25% effective at the 0.1mg dose. The minoxidil dose is 5% and microneedling all occurring at the same time. The time frame between photos is 9 months and I suspect that the microneedling plus the minoxidil working together gave him the benefit he can see.

This shows some good value with the use of finasteride for 10 months adding a dermaroller the last month.

I mean, they’re not really wrong. The only way to stop balding is to never go through puberty. Futhermore, hair loss happens with age, as we slowly slink towards the grave. Minoxidil is a growth stimulant that doesn’t address the mechanisms for why we bald, it simply provides a cosmetic effect, which is what most people care about. Finasteride helps reduce the amount of DHT below a certain threshold that would cause hair loss otherwise, but as you age, the body may become more sensitive to DHT. These both work, and most people are happy enough to go on them, but we’re still balding. Some people have wonderful, Disneyland results, but they’re still losing their hair, and it would go as quickly as it came if they were to cease treatment. It sounds like your derm is just managing your expectations, as we do here; It’s easier to keep what you have than gain anything back.

I always say that when you are 17-18, something happens and the hair loss starts like the gate of a race track. We know that there is a process called Apoptosis (cell death) which occurs with hair follicles that are genetically programmed to shut down. Each hair follicle has a number of cycles that they will have before ‘dying’ and as the typical male has a 3 year growth cycle, if the hair is destined to not come back after 6 cycles, that is 18 years, 7 cycles is 21 years, 8 cycles is 24 years. We see much of the hair loss in those under 24, so it appears that 8 cycles is a magic number. Finasteride, extends the anagen (growth) phase in hair so these loss cycles slow down while on the drug.

These photos, although not identical ‘shots’ does show movement towards reversal. More time and better photography should be dramatic.

I am writing because I’m am wondering about the effects of finasteride on my hair. I understand you said to wait until at least a year to see results. I go through various mini sheds where I notice a portion of my hairline receding. I started fin when my hair loss was minimal and it has only sped up or continued to recede on finasteride. I have had no sides. Will my hair go back to what it was when I first started taking finasteride or am I stuck with what I have until the sheds finish. I am slightly confused because I don’t necessarily feel like I’m shedding more then the average person would. It has been 3 months today. Any advice or clarity would be much appreciated. Thank you

You must be patient. There is no guarantee that finasteride will work on you, but although it may not reverse the hair loss in a year, it will probably slow or stop it

This young man was 19 when he started the finasteride and his crown loss disappeared. He should stay on the drug or he will lose the hair again. This drug works well in very young men.

Yes. If this is a change, then it is possible that you have developed early gynecomastia of the right breast. If there are no lumps (painful or otherwise), then you should see your doctor for advice on what to do.

If you are over 26, you might be a reasonable candidate for a hair transplant. Why 26? Because the patterns of balding become more evident at the age of 26, but the risk or more balding make it difficult, at times, to plan appropriately. If you use up your donor hair as many men do, then you are left deformed when the balding patterns finalize.