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I’m a 23 year old male experiencing male pattern hairloss around the crown. I’ve noticed it for 8 months and it’s been getting substantially worse recently- more hair loss in the shower, more strands on my pillow every morning, hair follicles on my hand as I run it through my hair. I’ve also been experiencing Dry Scalp recently which I think is related to the balding. I’m meeting my Primary Care Physican soon, I plan to ask him for a 5mg Proscar prescription and get a pill splitter with that. I do not want to use Rogaine, as I’m a medical student and expected to look professional all the time. I’m afraid it might mess with the oils on my skin. As for the shampoo, I’m thinking of ordering shampoo either nizoral or DR regenpure. Which one do you recommend using? Are there any additional tips you can provide? Could the hairloss be associated with medical school stress to any degress? Thank you for your time!

I believe that there is a 99% chance you have genetic hair loss in process and the best treatment is finasteride 1mg/day or as you said split a Proscar into 1/4 or 1/5th. You don’t have to be 100% accurate as long as you end up totallying 5mgs every 5 days. If you can find someone with a HAIRCHECK instrument (https://baldingblog.com/2017/01/10/value-haircheck-bulk-measurements-two-patients-seen-today/), get your hair bulk measured and then you can get a metric on the value of the drug over time. I don’t believe that the shampoo makes any difference, but for a douoble wammy, if you are having crown loss as well, I would consider adding minoxidil once daily to the crown.

At 10 weeks, many of the grafts will have shed. This may give the appearance of gaps that may not be real. Wait until the 8th mont. By then, you will see 80% of the growth and know if the gaps are real or not.

Snippet from the article:

To evaluate its association with environmental factors, the researchers at Chung-Ang examined 3,114 Koreans with androgenetic alopecia who attended dermatology clinics between March 2011 and February 2012. Then dermatologists evaluated the patients using a questionnaire to ascertain the perceptible duration of hair loss and personal factors including family history, disease and medication history, and drinking and smoking habits. They also medically classified the hair loss based on shape and density of the hair.

The research showed that the men in the “both the drinking and smoking” group tended to have more severe hair loss. In female patients, however, they found no association, probably due to the relatively small number of the women in the smoking and drinking group.

“The mechanisms by which smoking causes hair loss may be multi-factorial. Cigarette smoking may be deleterious to the microvasculature of the dermal hair papilla and to the DNA of the hair follicle itself,” noted the research.

Read the rest — Drinking, smoking aggravating hair loss

You can see the full results as published in Clinical and Experimental Dermatology — An epidemiological study of androgenic alopecia in 3114 Korean patients.

The survey included 1883 males and 1231 female patients in South Korea, and looked at eating, sleeping, alcohol, and smoking habits. It’s an interesting survey, but I’ve noticed that many (if not most) men I see at my clinic do not smoke cigarettes, yet they are balding.

If the study finds that smoking and drinking can worsen hair loss, then maybe this is a good thing. Perhaps it will get some people to stop smoking and drinking in excess, even with the previously established health risks.

This man used all of the approaches to regrow his hair including Finasteride, Minoxidil and a Dermaroller once a week with great results

This man is clearly sensitive to the medications and the microneedling

Very nice growth from using finasteride. You can even see the new hair growing at the hairline in the second photo. Keep to the plan and growth can only get better. You must be sensitive to this drug