Balding Blog

Hi, thanks for this service. While I am somewhat suspicious of your constant hawking of propecia to the exclusion of topical solutions (pun intended) such as minoxidil in your earlier entries, I would still love any insights you have on that topic. I am a 25 year old man. At age 18 or 19 my internist noted some frontal hair thinning/loss, evident to me retrospectively when I examined pictures (esp. if flash was used). I was immediately placed on minoxidil, which seems to have not only arrested the loss but perhaps, over the last 6 or 7 years, even allowed some regrowth toward the front. Finally, now, at age 25, I am noticing some thinning and folicle miniaturization in the center and back of my head for the first time, though I am still at the point that only other balding men notice—my female friends and loved ones think I’m neurotic and that even my minoxidil use is unnecessary. What I wonder is whether I should expect acceleration of the loss or merely loss at the same rate; if the loss rate itself is constant then I think I’ll try to hold on by using topical minoxidil.

Second, if I were to switch to a dht blocker, would you recommend avodart or propecia, and would you recommend cessation of minoxidil? I worry that after 6+ years my hair could do unpredictable things without the minoxidil. Lastly, I don’t think I yet qualify on any of those charts as balding, though I myself notice some thinning and, of course, many hairs in my hands when using hair products.
Thanks.

A DHT blocker impacts the cause of male patterned hair loss, so it is the best approach to use a drug that is known to be effective and safe. Avodart is not proven to be effective or safe (no scientific study for hair loss victims) for treating hair loss, but I believe that it is effective. Notice I did not say I believed it to be safe, because long term use of this drug has been on older men with prostate problems, not young men with hair loss problems. Is there a long term Vioxx type problem hiding in the closet? I don’t know, nor does anyone really know.

I tell everyone who is on minoxidil that when it is working to stay on the topical medication, for stopping it often causes ‘catch up hair loss’. Frontal hair loss and early crown hair loss indicate you may be a Norwood Class 3V pattern. You need to have your hair and scalp mapped out for miniaturization to make the diagnosis, otherwise you are flying blind.

I have no connection to Merck (producers of Propecia) and I am not ever paid by them for my opinions on this drug. I do not now, nor have I ever owned stock of this company (as I’ve stated before), so I am clean in expressing my opinions on this drug, because it has had wonderful results that I have seen in many of my patients.

Doctor, how are you. I have been on propecia for 2 years, with fairly good results. hair is about the same, but my question is why do I still shed alot of hairs. I just want your opinion on this from your experiences with propecia and hair restoration field. I mean I know your suppose to shed up to 150 hairs a day, but I feel like I shed more. The hair still looks the same, but why is the shedding so much?

The amount of hair I shed I should be slick bald now, but still have a full head of hair with a bit of thinning like it was 2 years ago when I started propecia. when I wake up theres like 20 hairs on pillow, when I shower I shed so much, when I comb I shed so much, and its been like this even before starting propecia, but still have hair.

are there people that shed more and its still normal? I shed thin weak hairs, to thick hairs, and hair still looks same. As I said with the amount I shed I should be slick bald

We still cycle hair and the thin, weak hairs will eventually be lost. Propecia delays the long term hair loss, but it does not stop it completely. If you have not had your hair bulk analyzed, you should have it done. A baseline of hair bulk will tell you over time what is really happening to you.

I am a male, 24, and experiencing thinning on the crown of my head to the point where other people are saying “are you going bald?” and poking the thin area. Real nice. I tried a 5% minoxidil safeway knockoff and began to get redness and irritation on my scalp. I discontinued use but now have no idea what to do about my hair loss. Was this reaction due to the cheaper safeway brand? Should i try finasteride/propecia? What type of doctor should i see about the persciption pills? Dermatologist? please help I’m single and balding!

What you are describing sounds like classic male patterned genetic hair loss. You need to see a good doctor who will map out your scalp for miniaturization and then, assuming I am correct, put you on Propecia (finasteride 1mg). If the balding spot is the only sign of balding, then you have an excellent chance of reversing it with Propecia. It sounds like you had a bad reaction to minoxidil, but minoxidil is not the best medication, assuming that I am correct in the diagnosis (difficult without an examination). Some people experience irritation of the skin when using minoxidil (might be brand independent). A good dermatologist will do the right thing, but so can your family doctor. Make sure that no one even tries to suggest a hair transplant, as there are some less-than-ethical doctors that might recommend one for you.

Hello Doctor,
I am 26 years old and have been taking Propecia 5mg for almost 2 years. Till last month I used to get prescription refilled from Duane Reade. Then I came to know about Target Pharmacy they give 30 tablets for 10$ only. To save some bucks, I had last prescription refilled from Target, but for last two days, I am experiencing more hair fall. Is it just a coincidence or something else?

Thanks

I would say it is coincidence, mostly because nothing changes in the matter of days. And generic finasteride 5mg should be same everywhere, unless it is a counterfeit medication that is widely sold through the internet. There was just a segment on the 60 Minutes TV show about the fight against counterfeit drugs. But… seeing as how you bought it at a large New York based pharmacy chain, I wouldn’t think fake meds would make it into their system.

Generic aspirin or Tylenol (acetaminophen) works just the same no matter where you buy it or how much money you spend, but I would assume there is a negative placebo effect where people believe a product is not as good when you pay less. Think about that when you buy expensive brand name shoes or clothes. I have heard from a few readers that say they’ve had similar problems to what you’re experiencing after switching to generic, but there is very little information on it.

Hi Dr. I have gone through your response for this thread:

now this is my situation. I am also taking finasteride 1mg for the past 15 months and am taking fin only not minox .also experiencing the body hair growth. Before taking fin i was having more hair in my body than any one in my family. and now fin is worsening the situation. Actually am happy for what fin is doing for my head. But the effect of it on my body, am fearing of being called a MONKEY MAN!!. By the way am indian aged 24. on norwood 2 with thinning on crown and forehead.

As stated in my previous post: “Propecia (finasteride) blocks DHT. DHT is known to be responsible for secondary male characteristics, such as body hair. At least in theory, if you block DHT you would have less body hair. I have heard and seen on several occasions patients stating they got less body hair after a year of taking Propecia.”

Now you would be the 2nd person that has mentioned seeing more body hair as a direct result of Propecia. It’s interesting, but this can also be coincidence as well. As I indicated in the prior post, the increased body hair may also be due to the fact you are maturing into your secondary sex characteristics, since like the original poster you are also in your early 20s.

I’ve still yet to get any reports of this from one of my own patients, but I will make a note of your experience.

Hello doctor,

I’ve been on propecia for about 8 months and its going well my hair is stronger and the crown is looking better every day..

I’ve noticed some long thin white ‘baby’ hairs on the front of my head where my hair recedes that were never there before. Could I be one of the lucky ones and get hair growth on my front too?!

Perhaps you are one of those rare lucky patients that sees some regrowth at the hairline from Propecia (finasteride). It would be nice to see your before and after pictures.

What you are calling ‘baby’ hair is not the strong hair that you need to consider it regrowing, but give it a full two years to see what emerges.