Hi Dr. Rassman, let me first apologize as this message is quite long. I’ve got some questions about Propecia. First, I am twenty-six and I first noticed some slight bi-temporal recession about 1-2 years ago. It seemed to progress very slowly and even halt at times, but around nine months ago, the recession picked up speed considerably. I first went to Hair Club and got on the EXT regimen, which I stopped because it seemed to do more harm than good. I’m currently on my fourst month(bottle) of Propecia and for a while it seemed that it had stopped further loss. Recently, however, the middle-front part is receding inward at terribly; I’ve gone from long, thick hair with a barely noticable widow’s peak to noticable recession in just a few months. The odd thing is, I’m not seeing more than 5-10 lost hairs–sometimes none–in the shower drain and almost none on my pillows (the classic places we notice shedding/loss).
My question is: Is this the drug taking a few months to kick in and possibly an initial shed that will yield positive results later on and how would I know if I was experiencing hyperandrogenicity in the absense of any sexual side effects or increased acne?
Second, if I ultimately stop or significantly slow my loss and/or turn back the clock a little, would it be realistic to expect, say, to regrow hair that has been lost within 6 months to a year and, if so, how long do you think it might be effective in my case.
Last, I wear my hair in a ponytail at work and use a non-alcoholic smoothing product called citre shine. I notice what looks like a bunch of broken off hairs around the receding area that both my doctor and a dermatologist say looks like new growth, but I’m not sure. How can I tell breakage due to weakened hair from regrowth?
Again, I apologize for the incredible length of this message; I just wish to be as detailed as possible so as to provide you with good info. I regret that I don’t currently have photos available but I could probably get some together for you in the future.
Finasteride takes time to see if it is working. Most people notice that the amount of hair that falls out in the shower drain reduces within a month of starting the medication, so we could assume that it does stop the actual loss in many young men. You are right, more recent hair loss has a higher likelihood of regrowth, but everyone is different. The degree of hair loss that one sees over time varies with individuals and there are no rules. With regard to your questions of hair breakage, alcohol based products dry the hair and make it fragile. Breakage is usually not the cause of the balding process itself, but thinner miniaturized hair are generally more fragile to what you are doing to your hair (smoothing products, for example).
With regard to your stubs of hair at the hairline, without examining you under magnified video observation, I can not comment on your observations. Breakage usually reflects drying or direct damage to the hair shafts due to causes like the application of topicals, nutritional deficiencies, heat applications, dyes, and other such treatments.
There are know elements that can cause hair loss when one is exposed to them in high concentrations. These include:
I just spoke to a lady who had eyelash transplants 18 months ago. She wanted to know my opinion on her complications, which include: loss of native eyelashes, failure of the transplanted eyelashes to grow, and some infection. 
In continuing with the theme from yesterday of old links I forgot to post sooner…
This was sent to me months ago and I forgot to post it!