I hope this is not a stupid question. I know in a perfect world no man would ever go bald and we would all have perfect hair. But, since its not the case and I know most men have some degree of hair loss as they age.

My question is regarding men who started balding when they were 18, but with the aide of finasteride it has been a really really slow balding process. Do you usually notice that these men, once they are in their 30’s, they are a norwood 2-2a and then when they are in theirs 40’s they are a norwood 3-3a and then in their 50’s they are a 5-5a and then 60’s either a 6 or 7?

It’s not a stupid question, but I think you’re confused about what the Norwood classifications are for. The Norwood chart (see below) classifies the final patterns of balding. By final, it generally means that there is no going back. Of interest, the patients with the most advanced pattern of balding (class 7) usually get there in their 20s and rarely show up becoming a Class 7 at the age of 60. Norwood classes are not a guideline for balding by age or decade.

Finasteride can slow the balding process and in very young men without advanced balding, it may reverse crown loss and occasionally even frontal loss (as it did in my son). The projections you did in your question is the work of a dreamer.

Dear Mr. Rassman,

Thank you for all the help you are providing the public. I am 23 years old and suffering from thinning hair. Unfortunately, we have limited options in Dubai. We have only one product of minoxidil 5% which is regaine, however, I develop scalp irritation from using it. A dermatologist asked me to try ordering rogaine foam from the US. He believes that the irritation was caused because regaine 5% is an alcoholic solution.

1) Do you think rogaine foam does not have alcohol? If yes, can you recommend any other product that contains minoxidil 5% but is not an alcoholic solution. Minoxidil is my only option and it is very important for me to find a way to avoid irritation.

2) I used the total daily dosage of regaine 5% at once a day, not twice as recommended. Do you think that is the reason for irritation?

3) I want to study whether regaine is effective with a microscope and taking pictures. How can I be sure that I am comparing the same spot with the same amount of zoom. For example, I zoomed a little and found 10 hairs in area A in the first month. I am worried that I might zoom less and find 12 hair counts after six months. Moreover, I might take a snap of another spot (beside the original one) in area A.

Thank you very much in advance.

1. Rogaine Foam does contain alcohol, but it is the propylene glycol that is generally what causes skin irritation in some people. Rogaine Foam doesn’t contain propylene glycol. If it is the alcohol that’s causing your irritation, unfortunately I’m not aware of any particular minoxidil currently sold with zero alcohol content. I have no way to know exactly what is causing your skin irritation, though.

2. Using it only once a day might just not be as effective as the recommended twice daily application, but I doubt the lesser dosage is what is causing your irritation. The irritation is probably from the propylene glycol in the Rogaine liquid, or perhaps an allergy to one of the other ingredients.

3. I suppose you could have a permanent dot the size of a pen mark tattooed on your scalp to be sure you have the exact spot monitored each time, but I think that’s a little overkill. The better way to go about this is to have a professional check the overall hair bulk using the HairCheck instrument, then recheck it again in a year to see if the numbers changed (increased bulk means you’re having more hair growth).

I am on finasteride for 4 months. I think I suffer side effects. I would like to know how ‘real’ these side effects are, so actually ‘test’ the side effects.

Therefore, what if I stop for 2 weeks?
– would side effects go away in 2 weeks, so can I feel a difference in that time?
– would a stop of 2 weeks hurt my hair?

Reason for this: I just want to know what if side effects are psychologically or if they are ‘real’.

I suppose you could try it. To be thorough, I’d talk to your prescribing doctor before you make any changes to your medication.

In two weeks, I doubt that you will lose the benefit of taking the finasteride over the past 4 months. The side effects should be gone by then (I’m not sure which side effects your experienced or how quickly you saw them), unless there is some psychological reason for them to persist.