Here in England a nationwide pharmacy is running a “hair retention scheme” which basically seems to be a way to prescribe propecia. I went along for an appointment but was told that I was a Norwood II and I’d have to wait until I was a Norwood III before they would prescribe the drug.

Reading previous answers I assume this is because propecia does not seem to effectively regrow hair at the temples and because of issues around mature hairlines vs balding. I am a 20 year old male who has noticed a big change in my hairline over the last 18 months, including large amounts of hair shedding. Furthermore my father, who was very bald by 24 or 25, first noticed he was going bald when he was 20.

Would propecia be beneficial for a person in my situation? What are the potential downsides of starting it now? I have read a lot that as soon as you notice hair loss you should try and do something about it but my experience so far doesn’t seem to chime with that.

I looked up the hair retention program you mentioned, and it sound like it is just Boots pharmacy’s way of marketing hair loss products.

Propecia is a medication that needs to be prescribed by a physician and it is for the treatment of male pattern hair loss. It works mostly on the crown area (rarely in the front corner areas for men with Norwood Class II or III) and it likely will not reverse the maturing hairline that we see in young men between 18-30 years old. That being said, many doctors prescribe it for this early frontal hair loss or maturing hairlines because they do not look for miniaturization, the cardinal sign of genetic hair loss and balding. Many men take it out of fear of losing their hair or on the recommendation of doctors who do not know much about the diagnosis of genetic balding. It does not work for frontal hair loss in most instances other than possibly slowing the process down, but is it the only real medication to address what you are going through.

There really is no downside to taking Propecia early on in the hair loss process, but if you are not balding why take a medication you don’t need? In the end, these choices are something you and your doctor need to discuss and come to an agreement. It sounds like there is some disagreement between you and your doctor.

Dr. Rassman,

Do you agree with the following statement: At least 50 percent of men in their 20’s today who have little or no hair on their head should not be bald.

Propecia doesn’t last forever, some can’t afford it, others will choose not to take it, and it won’t work effectively on some group of men. But for the vast majority of men, it works and it seems like most men under 30 who are visibly bald missed the chance to buy themselves a few important years by not taking Propecia.

Agreed?

The statistics indicate that men over 50 years old have a frequency of some degree of balding in half of the Caucasian male population. That does not mean than the same statistic will be found in men under 30, as some men start balding in ages beyond 30. The full value of Propecia for those that see benefits changes over time (opinion backed up by the Merck study). The choices are always yours.

The other side of the coin is that Propecia works best when hair loss is earlier. If you start hair loss at 22 years old, then you are a better candidate for value (slowing, stopping, or reversing hair loss) than if you were 32 and had hair loss for the preceding 10 years. Also, if you start balding at 35 and start taking Propecia at 36, you will have a better value in its use than if you were balding since you were 22 (14 years of balding) in that same situation.