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I’ve Taken Finasteride for a Year, So Is it Too Late to Map for Miniaturization?

Hello Doc,

Within the next days, I’ll map my own scalp for miniaturization for the first time. However, I have been taking finasteride for one year. (It kept most of my hairline but didnt regrow anything.) So without having done the test before, how accurate can the results be after such a long time?

Besides, currently only my left corner is receding (between NW 1 and 2) and the whole side is more see-through than other, where my hairline has already receded 3 years ago and then stopped at a Norwood 2. Is it common to see one side go up because of maturation, while 2 years later the other catches up by MPB? Or do hair characteristics (such as curliness or color) vary in diff areas, create the see through appearance, and will these hairs thus look differently under a microscope? Thanks again

A miniaturization study is an attempt to objectively quantify the degree of thinning and place a metric to different areas on the scalp so that you can compare one spot to another, as well as compare the measurements over a period of time. It is better than just looking in the mirror or running your fingers over your hair to judge the degree of thinning.

Ideally, one should get a baseline miniaturization measurement and even a photograph before starting on any hair loss treatment. If you have been on finasteride for about a year, I would at least get one objective measurement to record for comparison at another date.

If you are categorizing yourself as a Norwood 1 or 2 and the degree of thinning is on the front corner hairlines, I would point out that finasteride is taken mainly for men with thinning on the top / crown areas. Any hairline asymmetry will likely even out eventually. I generally like to get bulk measurements in people like you to establish a baseline from which future comparisons can be made.

I seem to repeat this theme over and over, but you need to follow up with the doctor who is prescribing you the medication and understand your treatment goal and Master Plan.

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I’ve Taken Finasteride 5mg for MPB, And I Had Total Impotence and Penis Shrinkage in 3 Months

Hi doctor, I’ve been using finasteride 5 mg for MPB, but in the third month I had total impotence and shrinkage, i stopped, sexual organs returned to normal size hear some gain libido,but erectile Dysfunction persists even after 6 months ( no morning erections, or nocturnal) and and I also have pain in the prostate, what should I do? ( I used previously for 2 years finasteride of 1mg without side effects.

We never recommend taking the 5mg dose of finasteride for the treatment of hair loss. Did you increase the dosage on your own to 5 times the normal amount for treating hair loss, or did your doctor prescribe this to you? And if you took the recommended 1mg dose for years without side effects, why was your dosage even increased?

In any case, you should see a urologist. These are prescription medications, and I don’t know enough about you (medical history, age) to really have an idea of what is going on.

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I’ve Seen 2 Doctors About My Hair and Think Both Are Wrong

I’m a 25 year old male and my frontal hairline began receding rapidly about 9 months ago. From reading your blog and my own observations I assumed it was male pattern baldness kicking in earlier than I would have liked.

I have now seen two doctors (One family doctor and one dermatologist) who have both told me that It would grow back by itself as they both said it was due to stress (About a year ago my dad passed away right after I moved to a new city and I had to start a new job the day after the service). The family doctor briefly looked over my hair and the dermatologist asked me my family history (No balding on my mom’s side, and my dad started balding in his early 40s) and did a pull test (No miniturization test)

The problem I’m having is that from reading your blog it seems like they’re both incorrect. There is obviously miniturization at my hairlines which to my understanding means there its is MPB which could have been triggered by the event.

Does my hair growing back by itself like they both said sound at all realistic? Should I try yet another doctor?

Thanks for your time.

I agree with you that a mapping of your scalp for miniaturization will make the diagnosis for you. The pull test that your dermatologist did will check out conditions like telogen effluvium (see article at eMedicine), which if positive might indicate that the process will reverse, but people with genetic hair loss will not have a positive hair pull test. See another doctor who can make the correct diagnosis for you.

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I’ve Noticed My Hairline Recede and Thin

Hello, I am a 23 year old African American male my hair has thinned drastically over this last past year. In 2007, I had a full head of hair. Later that year, I noticed my hair line slowly recede, but my hair remained full. Currently, my hair is thin and I have a nearly bald spot in the front of my head. Can you please recommend any treatments? Are there specialists I can see? Can this be the result of stress or does it signal some other sort of health issue? Thank you very much for your assistance and have a wonderful day.

Stress loss isn’t usually limited to the hairline. It sounds like you’ve got genetic male pattern baldness. Treatments include Rogaine (minoxidil) and Propecia (finasteride), though they aren’t known to work that well in the hairline. The Propecia could prevent further loss, however. You can try to find a doctor in your area by checking the physician search at ISHRS.org… and though the listings are for hair transplant surgeons, I’m not suggesting you should rush into surgery. These doctors are knowledgeable about hair loss in general, so either try them or a dermatologist.

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I’ve Lost Leg Hair

(male)
I have lost all of the hair on the outside of my legs from the knee down. I do not have any medical conditions that should affect this. Thank you

I do not know enough about you — like your age, for starters. If you know you have nothing wrong with you, then what value can I have? I think you need to link with a good doctor and then let him/her tell you that you have no medical conditions, and/or possibly identify something that is wrong.


2007-05-08 10:23:19I’ve Lost Leg Hair

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I’ve Lost Hair Since Starting Keppra (Epilepsy Medication)

(female)
I have lost my natural curl and half the amount of hair that I had as a side effect of Keppra. I would like to know since I have taken myself off it, will my hair grow back with the natural curl that I lost?

Hair loss is a known rare side effect of Keppra (levetiracetam), but I can’t say for sure if your hair will regrow now that you’ve taken yourself off of it. You’d have to wait out about a year to see if it regrows.

You were taking Keppra for an important medical reason (like seizures), and you should not be taking yourself off of medications without speaking to your doctor. I can’t even say for sure if Keppra was the cause of your hair loss.

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I’ve heard quite a few stories claiming that generic finasteride is not as effective as Propecia.

Hi Dr. Rassman. I’ve heard quite a few stories claiming that generic finasteride is not as effective as Propecia. Do you prescribe both, and if so have you noticed a difference in your patients responses?

Some patients have reported reduced effectiveness when they switch from propecia to the genetics but there are a few manufacturers of the generics and I have not kept a record of which is which.


2019-04-08 13:31:25I’ve heard quite a few stories claiming that generic finasteride is not as effective as Propecia.

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I’ve Heard of Everything Before, but Getting Your Hair Back With a Blood Pressure Type Cuff on Your Head, Mmmm? (Very Long Video)

The theory is that tight scalps cause hair loss. There is no evidence whatsoever that this is true. The goal of this video is to sell you a device to loosen up your scalp. I don’t believe any of this but still will present it to you for the purposes of always presenting contrary opinions.

https://www.youtube.com/embed/sq5QYSNL_Ds?fbclid=IwAR0nXulCoyXy4Er3V6XrwwS1tTDx8rVEpU8SRgvyP_C1ApTgxLBF943_Ldc


2019-11-05 10:04:57I’ve Heard of Everything Before, but Getting Your Hair Back With a Blood Pressure Type Cuff on Your Head, Mmmm? (Very Long Video)

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I’ve Had Significant Diffuse Hair Loss On My Entire Scalp and Face

I’ve experienced significant diffuse hair thinning/hair loss over my entire scalp and facial hair about 8 months ago.

Could this be anything else besides Androgenic Alopecia? I’m 41 and was slowly losing hair only on top since I was 20. Been on finasteride for 7 years. Should I see a dermatologist first?

You should just see your primary doctor to make sure you do not have any other medical causes of hair loss.

Androgenic alopecia is also known as male pattern baldness (MPB). As the name implies, there is usually a “pattern” to the balding. Diffuse hair thinning all over your scalp, including in the donor area, would not be MPB… but could point to something like alopecia areata.

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I’ve Had Sexual Side Effects Since Switching to Generic Finasteride 2 Years Ago

Hey Dr. Rassman,

Have been taking propecia for approximately 4 years and for the past two switched to finasteride due to it being cheaper. Have had fantastic results with my hair (have more hair now at 30 than I did at 24!)

However, I have slowly been developing sexual side effects over the past 2 years which has come to a breaking point recently. It is now difficult for me to get and maintain an erection and my semen is watery/decreased volume. I am currently taking 1.25 mg of fin a day. I am seeing a doctor today to get my hormone levels checked. I have two questions for you:

1. Do you think these side effects may go away if I lower my dosage to 0.5 mg/day and do you even think that is worth doing? I would love to keep my hair but I am worried I am poisoning my body.

2. If I want a hair transplant in the future, will me being off finasteride significantly limit my options?

Thanks

Lowering the dose of finasteride may lower the side effects, as I have seen this in my practice. Always discuss your medication changes with your prescribing doctor.

While it is advantageous to be on finasteride when considering a hair transplant surgery, it is not an absolute factor. Many patients undergo hair transplantation without taking finasteride.