Six years ago, when I was 24, my doctor prescribed Propecia. I had some early loss in my crown and I could see through it and my frontal corners were thinning. Within a year, I saw an increased amount of hair in my crown, but still had a see through look and my frontal corners continued to disappear leaving me today with a full Frontal Class 3 pattern in the front. Should I continue with the drug or can I assume that it has done its job?

Have you considered that maybe if you did not take the drug, you would have even less hair now with a completely bald crown area? The original studies by Merck (drug company) showed that the drug may peak at 5 years showing a stabilization of hair loss. In men not on the drug (placebo group), the visible effects of progressive hair loss showed and they were more bald than those on the drug. The fact that the value of the drug over the 5 year study showed that some men actually benefited more, the more time they were on the drug. Unfortunately, the study was stopped at 5 years. From my clinical experience of prescribing the drug since it was introduced in the mid-1990s, my sense was that if men stopped it, at any time even after the 5 year period, they would develop what we have coined “catch-up hair loss” so as a result of that, we advise all of our patients to stay on the drug. The official study in the 5 year term showed that those not on the drug, became progressively more bald each and every year, suggesting that those that were treated, even if they had some progressive balding during the follow-up treated period, that it was less than if they never took the drug. We do see some men who lose hair while on the drug and I am convinced that if they were not on the drug, or stopped it after some number of years, the hair loss will eventually reflect the progressive nature of the genetic balding pattern. I am convinced that those who stay on the drug will have more hair than those who stop it. OF interest, that may not apply to all men of all ages, as men over 50, probably have less progressive hair loss than men under 30, but my general advice to most of our patients is: If you are not having symptoms or side effects from the drug and you sexual function is acceptable to you, to stay on the drug no matter what age you are. Even if you are losing hair and are on the drug, stopping it may make ‘catch-up hair loss’ a reality that you may not want to face. Also, long term use of finesteride may have a preventive impact on prostate cancer especially if you are over 50. Hopefully, you will eventually get to 50, so stick to the plan, stay on the drug.

Dr. Stuart Gitlow of the American Society of Addiction Medicine says “we’ve known that people who use marijuana when they are younger tend to have cognitive abnormalities”. He studied were people in their 40s who smoked about 6 joints a week when they were 18-20. Brain scans were done which showed volume, shape and density changes in two key regions of the brain. These areas deal with emotion, motivation and decision-making…. “This is the part of the brain you don’t want to mess with”. says Northeastern University psychiatrist Hans Breiter……” The more marijuana that users smoked, the more their brains differed from normal brains…..

As we move to more and more legalization of this drug, we should ask ourselves what is the price we will pay? This will obviously impact schooling, and everyday life. Can you afford to take this risk?

The following was sent to us from the author of the book.

Alopecia Uncovered is a fine art photography book that explores the therapeutic potential of the portrait through a series of arresting black and white images, essays and journeys of those affected by the condition.

Daniel Regan’s Alopecia Project, in which he invited sufferers to be photographed as and how they wished to be represented, was shot over a three year period. For some of his subjects it involved baring all and showing their natural selves, whilst others wished to retain their eyelashes or eyebrows. However the true message of this project is that it’s OK being you, but most importantly being the you that you choose.

Now combined with analytical texts by art psychotherapist Jennifer Chambers, Alopecia Uncovered encapsulates the emotional difficulties of sufferers by allowing subjects to reclaim their sense of self by confronting these images of themselves. This book investigates issues of self-esteem, fractured identities and perceptions of illness, illustrated through the use of empowering yet vulnerable photography that challenges the social constructs of beauty.

Hello, so I have a question that I cannot get to the bottom of. I’ve been on finasteride 1.25mg for about 14 months. Right at the one year mark I started getting a burning sensation on my left hairline area and above it ( that side had no real problems). It would come and go, but then within 2 weeks the left side of my hair/ hairline got noticeably thinner and I began shedding A LOT in the shower. It started November 1st and it is now December 7 and I still shed a litany I have lost ground on that side as well as a little I my right side to. I also have dandruff.

I went for blood work thinking maybe this is a thyroid issue causing hormonal imbalances because at the start of the burning and shedding, I noticed an increased libido. Anyway, I’m not sure if fin just stopped working after a year? I’m 23 and was thinking maybe I need dutasteride now. Any information would help greatly! Hair was doing great before this random rapid Hairloss.

The best advice I can give you here is to go see your doctor. Burning sensation on the scalp is generally not normal and likely not Propecia related. Increase in libido is something I do hear on occasion with Propecia but the decrease in libido is what is most discussed on the Internet. Finally Dutateride is not recommended for genetic hair loss and it is something I generally do not recommend.

I am a 26 year old women with what my doctor called Alopecia Areata and it has left me with many holes on my head. He said it may go away on its own, or it may last years. I want to know if a hair transplant will solve my problem.

Hair Transplants are contraindicated in alopecia areata because any hair that is put into the bare areas, may get rejected by the disease and even cause further hair loss. You can, of course, wear a wig as so many women do with this condition. The winner of the Miss Delaware contest had Alopecia Areata and you can see how she managed her hair HERE and: HERE

Bald is definitely beautiful.

Hello, I was hoping you could clear up something regarding the percentage of men who go bald or experience thinning.

I’ve read that only 50% of men are bald by 50, but I’ve also heard that the American Hairloss Association did a study that found 2/3 of men are bald by 35, and 85% of men are thinning by 50. These statistics seem in conflict with each other.

Does the American Hairloss Associations study reflect the percentage in ALL men, or just American men? Websites I’ve been on are inconsistent on which one it is. If you could clarify, I’d appreciate it.

To my knowledge there isn’t a landmark study of epidemiology or the prevalence of male pattern balding in men. Male pattern balding is genetic and it follows a “pattern” as the name implies. Thus by the definition, a slight front corner recession of a Norwood 2 could be termed a mature hairline which is not “balding”. However, when most people hear the term balding they assume a full Norwood 6 or 7 type of balding. The Class 3 pattern reflect the early corner recession in a maturing hairine (see: HERE)

I often write that about 50% of men have the genetic make up to have some type of balding (Norwood 3 to 7). I often write about 7 to 8% of men are Norwood 7 (completely bald with only a 2 1/2 inch rim of hair around the back and sides of the head). It is also understood most male pattern hair loss may begin after puberty, but most men start their balding process in their teenage years to their late 20s, and by the time you are in your middle age 40-50 you would have an established pattern of balding (or no balding). You will find these numbers may be variable depending on the source as you suggested.

The American Hairloss Associations on the website claim that by the “age of thirty-five two-thirds of American men will experience some degree of appreciable hair loss (I doubt this statistic), and I believe that by the age of fifty approximately 50% of men have significantly thinning hair” not the 85% suggested by the American Hairloss Association. I do not know where these statistics come from. Furthermore the term “thinning” can also mean gradual change of the character of the hair as one ages that is not genetic balding (just more fine hair evolves). Men who never go bald will have some thinning as they age but they will not go bald or show a “patterns” of balding as depicted in the Norwood scale.

Hi Doc, I’ve been on propecia for 4 months now and have been shedding a lot of hair to the point where my baldness is getting more visible. I’m going to stick with the treatment for a year to see how it goes I just wanted to ask if this is normal? Also the hairs that have been shedding for the last few weeks seem to only be the miniaturized hairs on the crown and hair line, could this be a good sign that propecia is working?

Genetic male pattern balding affects each individual differently. It can happen fast or slow. It can affect the front part of the scalp or the top (as it occurs in a certain “pattern”). Drugs such as Propecia help but it is not a cure or a complete solution. Each individual responds to medication (all medication) differently. Sometimes the genetic predisposition wins out. Please follow up with your doctor as it can take about 6 to 12 months to see the effects of Propecia.