27 Year Old Just Started Propecia (with Photo)

Hi Dr Rassman,

Your blog is a gift so thank you for your efforts. After reading your blog and doing a bit of research I have decided to get some guts and visit my local doctor to start Propecia. I have been on it for two weeks so far with no major side effects – so any one reading scared off by all the internet hype out there – you will just have to suck it up and give it a go.

When reading your blog and looking at the Norword scale I am a little confused by my pattern, I am a 27 year old male and have progressed to the attached photo, its taken in high lighting conditions with a flash, in normal light it doesn’t look too bad and I can style it so its not very noticeable.

In January 2007 I had a full head of thick hair. I currently have many 1cm long thin miniaturised hair still left on the top of my head. I guess I was in denial for the last 2 years as I had a very difficult time plagued with family illnesses and stress. So my question is what balding do I have? Is it diffuse pattern which will end up as a Norwood 6 or 7? Or is it something else? I have a history of MPB in my family.

After much depression and why me’s!!! I have accepted the fact that I am going to be bald eventually.. On my course of Propecia what should I expect? Regards

[you have my permission to publish the photo]

I appreciate you allowing me to publish the photo (click to enlarge). Your hair is thinning in a Norwood Class 6 pattern, which means that you may lose all of the hair in the thinning area. So as a 27 year old man with what appears as miniaturization in the Class 6 pattern (this needs to be confirmed by microscopic assessment), you have a good chance at arresting the process or reversing it since it’s only been going on for 2 years. If you were over 35 years old, I would not be as optimistic. Diffuse unpatterned alopecia (DUPA) would have similar loss in the donor area, so a good mapping of your entire scalp would be warranted. Wait out the first full year on Propecia and then make a reassessment.

Get your scalp mapped out so that you can objectively put a number to the miniaturization and then compare those numbers after a year. What you see with your naked eye may be easily quantified with a good mapping of your scalp.