This young man decided to shave his head and with the help of scalp micropigmentation (SMP) he looks like he has a full head of hair and maximizes this good looks. This is an option that is being taken up more and more by young men wanting a perfect looking head of hair, even when they are balding and our practice is booming performing this procedure. This is a non-surgical process that can be performed on any many with any degree of balding provided that he shaves his head like the man below.


smp 2 smp 1

We see these types of hairlines all of the time on various forums on the internet. The hairlines are straight and will look unnatural when it grows out.  Look carefully at the ‘line’ of frontal grafts. That will look like a line of hair once grown.

pic straight hairline

I’m wanting to start taking fin but I have a couple of questions on my mind if you don’t mind answering. I have an inconsistent sleep schedule. Would there be much of an issue if my pill taking is not spot on 24 hours? If for example I take 1mg at 12pm and then the next day 1mg at 10am and the following day 1mg at 11am, would that be fine?

My other question is if side effects are obvious or do I need to be searching for them? I’m thinking a lot of the sides i’ve read about would be obvious so I don’t need to stress about looking for anything bad.

Finasteride can be taken anytime during the day. Just so you don’t forget to take it, I generally recommend that patients take it in the morning when they wake up. If you get the sexual side effects, you will know in many ways.  First, you might lose interest in women, won’t get an erection in the morning if that is your usual routine or the erection you do get is not hard as it usually is.  You will know if you have the side effects because men focus on their penis, often too much (according to some women) but that is our hormones telling us to procreate.

I have a questions about finasteride. Is it something I could add to help with my balding? I already take 100mg of spironolactone daily. I have gone on/off spiro afew times d/t having kids but now haver had a hysterectomy so do not have to worry about any teratogenic concerns.

Finasteride has been shown to work on some women but because of its unpredictable action, most doctors don’t prescribe it for women. It works better when women have gone through menopause. For women who can have children, as you seem to understand, the impact on the baby in pregnancy can produce abnormal sex differentiation.



In the most recent issue of the Scientific American, the role of Aspirin has been shown to contribute to the prevention of many cancers. It even has value in people with some cancer in limiting the metastasis of malignant tumors. The mechanism was explained by the impact of aspirin on our platelets, the small particles that help us clot our blood when we cut ourselves to stop bleeding. Aspirin has been known for some time to weaken the ‘stickiness’ of platelets and we know that the value of this action is significant in people who might have a heart attack or stroke, i.e. it is the clotting at the wrong time and the wrong place that causes strokes and heart attacks. But the article focused on some new evidence on the mechanism on the mechanisms that cancers exploit platelets to to their ‘bad things’ to us. When the platelets are less sticky, cancers have difficulty to hijack these platelets for their nefarious purposes. You don’t have to understand this logic or the science behind it, all you have to do is to take one baby aspirin each and every day of your life.  This single pill should be part of everyone daily routine.

I have an identical twin brother who never took Fin while I have been on it for four years. He has less hair than I do on his head so I guess the drug is working to stop my hair loss. He has a ferocious beard. I, on the other hand have a pretty light beard with no hair on my cheeks, only on my chin/neck and less body hair than he has. Is it possible that Finasteride could have played a role in this? Did I take Fin at a critical developmental period and miss that window?

Yes, it is possible that finasteride has reduced your body hair and the hair in the beard as it is a known side effect of this drug. If you have an identical twin, talk with him about the timing of your taking the drug and the disappearance of some of your beard hair. By doing this, you can confirm if this is a real finasteride side effect.

I’m male, 23. It’s been one month since I started to take finasteride (1/4th of a proscar pill) and my DHT levels are just as high as they were before I started. I still experience shedding, and it seems like it worsened. Scalp is itchy. I don’t have any photos though (it’s not that bad yet)

January 2017: (before fin)

Testosterone 10.000 ng/ml (reference values: 1.420 – 9.230) HIGH

Dihydrotestosterone 832.18 pg/ml (reference values: 250.00 – 990.00)

April 2017: (1 month after taking fin)

Testosterone 9.580 ng/ml (reference values: 1.420 – 9.230) HIGH

Dihydrotestosterone 824.78 pg/ml (reference values: 250.00 – 990.00)

What do you think this might be? A fake fin (proscar)? I will buy a generic produced in Hungary to test this theory.

If new generic fin won’t help me as well, I guess I will try Avodart.

I think that you are on the wrong track. The effect of finasteride is to compete with the effects of DHT at the 5-Alpha Reductase enzyme level in the hair follicles. This competition is generally only 70% effective.  Your gene activities is what is propelling your hair loss. Think of it as a ‘tug-of-war’ with one side being the genes + hormones + hair follicles, and the other side being the drug finasteride blocking the hormones through its action on the 5-Alpha Reductase enzyme at the hair follicle level.  If the ‘action of the drug’ is stronger than the effects of the genes + hormones + hair follicles, the you can slow down the hair loss or even reverse it.  But if your genes are more powerful in this tug-of-war’  you keep losing hair.

FDA Warns Against Bogus Cancer Treatments Sold On Internet

ABC World News Tonight (4/25, story 12, 0:25, Muir) reported the FDA has issued warnings to 14 companies that sell “more than 65 allegedly illegal cancer cures” without FDA approval.

The AP (4/25) reports that the agency “says these products, mostly sold on websites and social media, can be harmful, waste money and result in people not getting approved, effective treatments.”

CNN (4/25, Tinker) reports, “Products included in” the “crackdown include pills, creams, ointments, oils, drops, syrups and teas.”

The Washington Post (4/25, McGinley) reports that Douglas Stearn, director of the FDA’s Office of Enforcement and Import Operations, said, “Consumers should not use these or similar unproven products because they may be unsafe and could prevent a person from seeking an appropriate and potentially lifesaving cancer diagnosis or treatment.”

Comment: People don’t like bad news, so if they have a cancer and the doctor tells them that their cancer is not curable, they often seek other solutions and go anywhere and almost to anyone that promises a cure. People can’t deal with the idea that they may have an incurable cancer, but going outside the normal proper medical channels may accelerate their death.  This is really a “BUYER’s BEWARE” situation.

Men always worry about hair loss and young men are hung up on the 3-4% risk of sexual side effects of the drug finasteride; but form time to time we see the huge impact of this drug on hair loss reversal in young men as shown in this photos of a young man on the drug for 2 years. Many doctors are now not prescribing this drug for fear of being involved in the Class Action law suits brought by men who are suing the drug company Merck as they fell that they are part of the 3-4% of those with sexual side effects.  Nevertheless, here are the pictures I am referring to.

2 years on finasteride

This is a picture of two patients with a hair transplant. Please note the alignment of the grafts, like soldiers in a field. It should look like a random pattern and not a series of circular lines as hair grows in random patterns.  In these patients, when the hair grows out, you will see a similar circular pattern and know that it was a hair transplant.  I have seen this problem in too many doctors who have this ‘orderly mind’ and do not have the artistic flair needed to do this right,

soldiers of hairsoldiers 2

If I stop fin and or minox, is the rate of balding accelerated to greater than it would have been without trying treatment or just go back to pre treatment levels? thanks

When you stop these drugs you go back to point zero, where point zero is the amount of hair that you not only saved with these two drug but the amount of hair that you would have lost without taking these drug.

I currently have been taking proscar for 9 months and have still been thinning out. Im confused as to wait a year, when it hasn’t been working? Some people even say 2 years?. I guess what I am asking is how likely is it that I’m just a late responder ?

The drug finasteride (Proscar., Propecia) takes time to work. A year minimum, For young men, it is patience that you need. Sometimes it looks like it is not working but it may be slowing down the hair loss and without it, it might fall out faster

What if blocking the DHT does’t work?

The hair follicles in genetic balding have a limited number of hair cycles to their life span. Let’s say, for example, that the hairs in the leading edge of your mature hairline have 8 hair cycles of life to them and each hair cycle is 3 years, then at the age of 24, the hair will undergo Apoptosis (cell death).  When using a DHT competitive inhibitor like finasteride, this slows down the anagen cycle and the trigger that causes Apoptosis, but it is not always successful. I tell my patients that there is a ‘tug of war‘ going on between DHT and the genes that determine Apoptosis . Like any war, there are winners and losers. When finasteride does not work any longer, you may have lost the war.

You need to see a doctor to scope out the problem and then discuss many of the solutions which could include FUE of the recipient area, laser hair removal or just excision of the part of the hairline you don’t like. ?When I create a hairline with my patients, I always draw it on the head and get the person consent prior to doing the surgery because when it is made too low, it is a real problem because these hairs are permanent.  See a doctor with experience in managing these complications from other practices, like mine.

When you stop finasteride for as long as 8 months, you have given your genes control of your balding process.  The drug no longer has any impact on your balding. The drug, if you restart it, will probably be less effective and the hair that you lost, is lost.