thanks so much for your work with this blog. i am 25, with what i would describe as a hairline that has receded about 1.25 inches at the corners and generally thinned in the front. i have been putting some thought into propecia’s timeframe lately, and would love to hear your thoughts on this.
merck of course has their (FDA approved!) literature, about what to expect after 3 months, 6 months, 9 months, etc…there are of course many variables that go into the whole equation, but what are your thoughts on the ratio of time an individual has taken propecia/total time the individual has experienced some degree of hairloss? i have been taking for just under 4 months now, and not really noticed anything. some people lose hair quickly, what has happened with mine has happened over 3+ years.
would you hypothesize there is a correlation between not only degree of hairloss and propecia’s effectiveness, but also between the amount of time that hairloss occured versus how long a person has been taking propecia? thanks!
There is a genetic test called HairDX Test for Finasteride Response that can check your overall sensitivity to DHT blockers like finasteride, as we are all different genetically. It scores a CAG repeat test, and when the patient scores low (less than 22, for example) they will have a better response from finasteride than when the score is high (above 22). In this way, it is possible to find out your overall sensitivity to these drugs (hence, effectiveness). Add this into the other variables you mentioned above, and you can get a more clear picture of what my happen to you over time, but the reality may not be as simple as just getting a genetic test.
The medical profession is at the doorstep of understanding genetic tests like this and fitting them into the course of patient’s balding patterns and the rate of the balding process. At 4 months, there is just not enough time to know how you will respond to the drug, but at a year or so out you may know more. Finasteride does not work as well in the frontal hair at reversing the process as it does in the crown. You can get yourself tested with this genetic test to anticipate your personal response to finasteride, but what you do with the information is not easy to ascertain. You will have to sit down with your doctor to explore the process further.
In all people, the effectiveness of Propecia over time will change because the balding process will change (it is progressive) and the degree of change varies with the individual. There are no rules other than what I discussed above, but I believe that as long as the balding person is taking Propecia, the drug is effective. To prove this, stop taking it and see that the hair loss just gets worse in a matter of months. Actually, I don’t advise you to try to prove it, because the cost in hair loss would be too great.
Male pattern baldness (MPB) can start with the onset of puberty, but it is not usually socially noticeable until more than 50% of your original hairs fall out. This can take many years. In general, for those who go completely bald (Norwood class 6 or 7 — see image at right) it can take 5 to 10 years, but there are always exceptions. For some men it can take 20 to even 30 years. 
You should be on finasteride. Didn’t I tell you that? If I met you and you’re a Norwood 4A, I surely would’ve suggested you get on Propecia.
hey doctor, im a 19 year old male with terrible acne, i have had acne since i was about 15 years old. and since then i have been taking all kinds of acne medications like creams etc…(only external not orally) and i can bearly grow facial hair im wondering if that could be the cause of it, is there any possible chance that it could? my dad, grandparents all have full thick beards. is there any ingredients in acne creams that would prevent hair from growing?