Balding Fast, Even on Propecia

I am 22 years old and have been taking Propecia for 2 years. Although the hair loss slowed a bit, I now see the rim of hair that my dad has around the back and sides of his head. What can I do? Are hair transplants the only option left for me?

You situation reflects that there will be progression of hair loss over a period of months/years, probably taking you to your father’s pattern sooner or later (sounds like sooner, rather than later). The variable response to finasteride speaks to the complexity of the factors at play. Included in these factors are variables like the sensitivity of your androgen receptors, as expressed by androgen receptor gene polymorphism. Simply stated, we can not come up with one treatment for all people, as each of us are different and have different sensitivities to the hormone environment in our body. We make androgens in our adrenal glands as well, and these androgens impact the hair end organ as well as DHT.

It is possible that you might respond better to Avodart, but even that medication may not do what you want. Avodart is not approved by the FDA for hair loss, so if you find a doctor willing to prescribe it, you should weigh the disadvantages of taking it (see previous blog entries) and the safety factors that may relate to having children when you are on the pill.

If you can already see the Class 7 pattern in the mirror that your father is showing, much of what you have lost may not be reversible. You should be checked out for other diseases, but in the probable event that your hair loss in only genetic, then hair transplantation is an option that you might consider. If your densities are good, if you have blonde hair or become blonde, if your hair thickness is reasonable, if you are willing to style your hair to take advantage of hair redistribution, you might have an amazingly good response to hair transplantation. As a general rule of thumb, most good hair transplant doctors do not take on young men prior to 25 years old, but with good support from your family, adequate financial planning, and a maturity that can allow you (best with the help of a parent) to make an informed decision, then you should explore the hair transplant option with an ethical and experienced hair transplant surgeon if you do not try the Avodart option or if the Avodart option fails to solve your problem.