Balding Blog

According to clinical studies, finasteride generally works primarily on the vertex, much less well on the midscalp, and not much at all on the front of the head. I’ve seen suggestions that this might be so because the processes that result in frontal hair loss are different than those at work in the crown. (That is, perhaps it’s something other than DHT, or in addition to DHT, that drives hair loss in the frontal and midscalp portions of the head.) Do you think there’s anything to this theory?

From Wikipedia — “in modern science the term ‘theory’, or ‘scientific theory’ is generally understood to refer to a proposed explanation of empirical phenomena, made in a way consistent with scientific method.”

Unfortunately, there really isn’t a scientific theory to explain the difference in hair loss in the frontal region and crown of mens’ scalps. Your hypotheses, which are theories that are not considered to have been satisfactorily tested or proven, may have some merit… but I do not know for sure.

In the end, it is genetics that cause male pattern baldness. That much we know. That theory is solid. At this point, I do not know why DHT (for those men who have the genes) affects mostly the crown. For that matter, I do not know why the back of the scalp in men are always spared from balding. Maybe there are other hormones involved.

From my 27 years in this business and the 20 or so years since Finasteride has been on the market, I have never seen this drug cause hairline recession. I have seen patients develop recession when the drug did not work well as the battle to control hair loss is lost.

My genetics are solid (everyone has full heads of hair except my paternal grandfather and maternal great grandfather) but, like everyone else, I can’t be sure that I’ll never develop MPB. I’m currently 21. I identify heavily with my hair. Can I rest assured that if I catch MPB in the bud early, I can expect myself to keep my hair as if I never had MPB in the first place if I keep taking it?

Finasteride works well in men under 25. The younger you are, the better it works, especially if caught early. 21 is an age where I would expect good results.

Do you know if topical fin is effective for AGA in females? I am struggling to find a study

AGA is a different condition in women than it is in men. Women are often protected by their estrogens at least until they get to menopause. Finasteride may work in women who are post menopausal.

Yes. Finasteride does seem to work more often in the crown when the frontal area has no response. I have seen finasteride reverse crown loss in men as old as 70.

No. Finasteride will eventually stabilize at some positive balance with your rate of hair loss. The original studies showed that over a 5-year period, men on finasteride lost less hair and kept more hair. I know from my practice that men on finasteride for 20 years who decided to stop the drug came crying to me to get back on it as they experienced “Catch-up hair loss”, going back in the direction of the genetic hair loss they might have had if they didn’t take it.

Asking this because i believe fin is hardly doing anything to save my hairline at the moment. Its been a solid eight months only to have seen more recession and thinning. Let me know your guys experiences!

Finasteride works less well on hairlines that on the crown. There is, however, many examples of finasteride working on the hairline on my https://baldingblog.com/ site (this is the stie) so use the search engine to find examples. See examples posted today,

Does finasteride make your penis smaller by reducing blood flow to it? Have there been any studies on that?

I know that many men have complained of this, but you must recognize that a man’s penis size changes throughout the day. It is often larger at night, and smaller during the day when not in use. I don’t have any evidence one way or the other on any connection between penis size and finasteride, but if your sexuality is impacted by this drug, I would think that it would be smaller from less use.

Finasteride is known to decrease sperm count. Although, even with a low sperm count, you can get a woman pregnant. If there is a problem, get a sperm count if you are on finasteride.