Balding Blog

Experience shows that early hair loss responds better to finasteride than people who have waited for years before starting it.

I keep seeing this pop up. I am 19 right now with a NW2.5-3 and just started taking finasteride. My plan is take fin for a year then — assuming I respond to finasteride normally (just maintain hair, am not a non-responder/super responder) — get a hair transplant at 20/21ish. Why would this be such a mistake? The finasteride should roughly maintain my hair for a decade or so, right? I’ll be able to live and experience a normal young man’s experience. Once it gets bad, I can just shave it once I’m older (which is not nearly as big of a deal), or I can get another procedure. Or hell, maybe there’ll finally be a cure for this shit disease by then lol. I just don’t get why it’s considered such a big mistake. I would honestly almost rather be bald than have these shitty temples, even if my density is still solid.

It is not wise to get a hair transplant at 20 years old because you can’t make a Personalized Master Plan as your future hair loss pattern doesn’t appear for most men until 25 years of age. Without a good plan, you start the transplant, use up the donor supply (which is limited) to deal with your short term problems and then when you keep losing hair you are out of luck as there is no more donor hair left. By then you might not just be bald, but freaky looking (nobody should look freaky). I have seen too many patient who did hair transplants at 19 or 20 and ended up regretting it.

Just wondering what is responsible for the pattern of “male patterned baldness” ?

Why does the hair at the back and sides of the head seem to be more resilient than the hair at the top ?

Thanks Doc.

It is called genetic male pattern baldness. Keyword is “genetic”. Genes are responsible for it, but as to the reason it works out that way, I haven’t a clue. I posted a theory about it before — Why Does the Back and Sides of the Head Not Lose Hair?

I just don’t understand why the earlier someone starts balding doesn’t always mean they bald extremely quickly. Like what explains a 30 year old balding almost completely in 2 years vs a 20 year old who starts balding at 20 but takes 15 years to show significant loss?

Again, it is tied to the genetics. Each hair in a region has a finite number of hair cycles to it. when the hairs go through its limited # of anagen growth cycles (a growth cycle in men is between 2-3 years), then the hair often dies. The death may be partial in the Folliclular groups (normally say a hair follicle has 3 hairs in a group, one of two my die off) making the hair look like its is thinning from above (it is thinning) and eventually that last hair will fall out sooner than later. So for an aggressive balding pattern (Norwood Class 7 pattern) the number of three year hair cycles for all of the hair from the front to the crown might be 8 cycles (pre-programmed at birth) of 3 years (3 times 8 = 24 years old to balding). Not a good scenario. Most Class 7 men will be bald by the time they are 26 years old. The same thing can occur in older men 30, 40 or even 50 and they may lose parts of each Follicular group of between 2-3 hairs each) and then eventually the rest falls out at its pre-programmed death. Drugs like finasteride, prolong these cycles making the hair last longer.

I hope I didn’t confuse you, but I got stimulated to give you a scientific view of the process that you are describing in different men of different ages.

If you have miniaturization on your scalp in the areas you are balding and then have a hair transplant, the miniaturized hairs get shocked out and often fall from the head. So we call this Shock Loss following a hair transplant. Finasteride can prevent this from happening.

I mean why is it so frizzy and all over the place. Used to be super straight

That is strange. Usually hair changes with age and gets a finer hair shaft and more straight.