Balding Blog

Today, I performed a HAIRCHECK test to see if there was any evidence of hair loss present in this 33 year old male. He went on Finasteride 11 years ago and was convinced at that time that he had hair loss. However, the doctor who prescribed it did not really examine him and make an objective assessment of his “hair problem.” Since then, he has been worried about his hair loss. He knew that Finasteride could contribute to a reduced risk of prostate cancer, and since his father has prostate cancer, he is happy to stay on the medication today, even if he is not balding. He has no sexual side effects or any other side effects from the drug since the time he started it, 11 years ago.

It is my firm belief for those of you who read this post, before you start the drug Finateride, to get a HAIRCHECK test. It will help determine:

• If you are really balding
• If you are balding, get a baseline for your hair loss, so if you start on the drug Finasteride or any other treatment for hair loss, you will have an objective way to determine if you are balding while on the treatment, and
• If you are getting worse or getter better with the treatment.

Knowing what is happening to you is very important from a Master Plan perspective because hair loss is progressive in 100% of men who have genetic balding. The HAIRCHECK on this patient showed that his hair bulk in the front, top, crown and back of the head was equal by HAIRCHECK measurements.

This shows some good value with the use of finasteride for 10 months adding a dermaroller the last month.

I mean, they’re not really wrong. The only way to stop balding is to never go through puberty. Futhermore, hair loss happens with age, as we slowly slink towards the grave. Minoxidil is a growth stimulant that doesn’t address the mechanisms for why we bald, it simply provides a cosmetic effect, which is what most people care about. Finasteride helps reduce the amount of DHT below a certain threshold that would cause hair loss otherwise, but as you age, the body may become more sensitive to DHT. These both work, and most people are happy enough to go on them, but we’re still balding. Some people have wonderful, Disneyland results, but they’re still losing their hair, and it would go as quickly as it came if they were to cease treatment. It sounds like your derm is just managing your expectations, as we do here; It’s easier to keep what you have than gain anything back.

I always say that when you are 17-18, something happens and the hair loss starts like the gate of a race track. We know that there is a process called Apoptosis (cell death) which occurs with hair follicles that are genetically programmed to shut down. Each hair follicle has a number of cycles that they will have before ‘dying’ and as the typical male has a 3 year growth cycle, if the hair is destined to not come back after 6 cycles, that is 18 years, 7 cycles is 21 years, 8 cycles is 24 years. We see much of the hair loss in those under 24, so it appears that 8 cycles is a magic number. Finasteride, extends the anagen (growth) phase in hair so these loss cycles slow down while on the drug.

If you didn’t have side effects before, while taking taking the drug, but came off the drug, would coming back on trigger any side effects or would you assume that no side effects would be the anticipated? Have you ever prescribed it to someone with mild NAFLD?

Yes, I have prescribed finasteride to people with non-alcoholic liver disease. If you didn’t have side effects before, going back on the drug now should also give you a similar experience.

I have experienced hairloss in all of those same areas I have been losing since starting finasteride. Sexual function has also improved since starting finasteride. How common is this?

Some people report hair loss when they start finasteride and this usually subsides in a couple of months, getting improvement afterward. The increase in sexual drive is now increasingly reported by many postings.

Hi Dr’s Rassman and Pak, I came across this new hair loss cure. Have you seen this and do you think it is genuine?
https://www.significanceofhair.com/nz2OkLfSa/m/

If you read my blog, you know my answer is buyer beware. The website you point to is linked to a sales website. It is operated out of Panama and hosted in Amsterdam.

I highly doubt the article give the viewer a genuine interview. Dr. “A Chan” probably does not exist either. If she does, she probably didn’t give that interview. Thus the initials on the name to give plausible deniability. I’m sure they’ll make their quick buck and disappear into the sea of similar products or possibly re-branded the product under a different name once this sales cycle burns out. If I am wrong, then I would like to see the actual clinical study or have Dr. Chan give me a call and refer to me the “patent” who was the focus of the ‘cure’.

You mention the term “final pattern of loss?” . Does this mean some people are only destined to teach a Norwood four while others Norwood seven? When do you know you have hit your final pattern?

The issue is complex. Men at 19-22 who experience hair loss frequently don’t have the maturity to deal with it (it is a development problem of the prefrontal lobe of the brain which does not complete its development until about 22), plus there is a sense of urgency, plus there are significant financial implications of having multiple hair transplants which could be never-ending if they end up chasing the changes in their progressive balding pattern. I always say that a Good Decision Today, is a Good Decision Tomorrow. I am not insulting you here, just trust that I have years of experience in this business and I have seen too many young men make mistakes that they regret.

It has been a rollercoaster with finasteride: I first used 5 months of topical Morr-F, which at first I saw real results after just a month or 2, but after that my hair seemed to get worse again. It got really bad when in April I started oral fin and used minoxidil instead of the Morr-F, but at around June my hair had become significantly worse. I am a Nw2.5-3 with diffuss forelock, but initially saw vellus hairs fill in the temples. It could have been that not all the morr f was legitimate, I don’t know. The strange thing was that around last month I thought I finally began to see results: the vellus hairs came back and the forelock was slightly thicker it seemed, but since a few weeks it has all gone again and it is significantly thinner again.

I am very confused guys. My hair is in a terrible state in the front (at or below baseline) so am I just unlucky or should I wait even longer? It gets me quite depressed. No side effects though on fin (except abdominal fat gain since starting oral, no change in diet).

Finasteride isn’t for everyone. In some men it just doesn’t work. See a hair expert MD for how to manage your hair.