Hi Dr. Rassman,
Your blog has been an absolutely indispensable resource for me in the last month, and I can’t thank you enough!
I am a 30 year-old male, and I recently noticed that my hairline in the front and sides has receded about a centimeter or two past what is considered the normal hairline (according to one of your previous posts). I went to a dermatologist and she confirmed that there was in fact some slight recession at the temples (beyond what is the mature hairline), and also some very slight thinning on top. She did this all by sight, and did not have a densitometer in her office (nor did she claim to use one). She then prescribed Propecia, and I have been taking it religiously for the past month.
I also had my hair mapped out during a free consultation at the Philadelphia Hair Club. The woman who examined my scalp pointed out that I had some very early miniaturization at different points on my head (top, crown), and even some in the permanent zone on the back of my head (which she said was probably due to stress). I honestly can’t remember if she noticed any miniaturization beyond my front hairline and temple prominences.
My father is 60 years old and is somewhere between a 5 & 6 on the Norwood scale. (Unfortunately, I don’t have any information about my paternal grandfather as my father was adopted.) My maternal grandfather was somewhere between a Norwood 6/7 when he passed away at age 85, and my maternal uncle is currently at about a Norwood 3 (vertex) at the age of 50. I don’t know if this is important, but I do resemble my uncle quite a bit in terms of appearance and body type.
If I am a good responder to Propecia, how long do you think I will be able to cheat mother nature and keep most of what I have right now (which is still a hell of a lot)?
Thank you.
If you’re a good responder, Propecia (or perhaps a future medication somewhere down the line) could help retain the hair you have for as long as you take it. The potential is there. Some men report seeing their hair loss pick up around the 5 year mark, but I’ve got patients that have taken it for well beyond that and their hair still looks great. It’s really not something I could guess about, but if you keep your fingers crossed…
Not everything you read on the Internet is always true. There may be a great wealth of information available, but I wouldn’t rely on the Internet for your source of medical diagnosis and treatment. A doctor will know better than some anonymous guy on a forum that has no liability or reputation (not to mention experience or even a real name). You need to see a good doctor and ask him/her if you have genetic balding… and if you do, talk to them about taking Propecia. I have not heard of such weight gain side effects from the patients I treat and side effects are rare in general with Propecia.
Good question. Propecia (finasteride 1mg) blocks mainly DHT type II, and Avodart (dutasteride) blocks both DHT type I & II. You would think if you block ALL the DHT it would be better against androgenic alopecia. Dutasteride is three times more potent than finasteride inhibiting the type II enzyme and 100 times more potent than finasteride inhibiting the type I form of the DHT producing enzyme. There are clinical observations that suggest that dutasteride is better than finasteride, but it is not approved for hair loss by the FDA and the long term safety on human reproduction for dutasteride (reports of sterility is a complication) have been suggested in some rare patients. We have received many reports by varying doctors who switch people from finasteride to dutasteride and get a better response. The next logical question should be: If we increase the finasteride dose to 5 mg or so, will it be better to treat hair loss? I don’t know if anyone really knows that answer for sure. Some of the original studies on finasteride suggested that the 1mg dose is the most universal dose, but it may be that a high dose in those who are refractory to finasteride may help. Some doctors are using a higher dose of finasteride on long term users. It’s a prescription drug, so I’m not suggesting you should take a higher dosage. The problems for either finasteride and dutasteride is that side effects rise when increasing dosages.