Hi doctor!

I was researching before and after pics for finasteride results when I stumbled on this link from Dr. Bernsteins website.

According to his site these are all patients who took finasteride or minoxidil or both ONLY. No surgical procedures on these patients. And I must say the results are pretty thumping good! I am 22 and recently was prescribed about a month ago for early hairloss. At this point i seem to be heading towards a Norwood 3 with a persistent forelock (as of now) no major recession or erosion of the hairline just many shorter hairs in the front that “appear” The same thickness but just aren’t getting as long as my “long hair”. My coarse dark hair however does look incredibly thin when wet but when dry it’s extremely thick appearing. I get compliments on how much hair I have. So there is no noticeable balding or thinning happening to the outside world yet.

My question is why do you say in many posts that finasteride and minoxidil do not work in the frontal scalp and hairline?

According to these patients almost EVERY person of all age ranges seem to have gotten a good bit of positive results from the medications alone including crown AND frontal regrowth. I only ask because I am hopeful that finasteride will produce similar results for me and if nothing else maintain what I have. I currently have no thinning in crown, that’s actually my thickest area of my hair.

I am 22 and given where I currently stand would you say that finasteride has a good chance of working for me? About what percentage of men see NO RESULTS from finasteride and continue to thin At the same pace? I am worried that I will be one of the patients that see no response from it :(

Thanks for your time and your informative site!

The photos you saw on Dr. Bernstein’s site are amazing, and I have seen results like this for myself on occasion at my office. But regrowth at the front is rare (probably under 5%) compared to the results that are more common in the top/crown.

The photos show what is possible, but you have to remember that everyone will react differently to medication. Dr. Bernstein was not implying guaranteed results, but just showing some examples of positive growth. Medication might regrow your hairline, but you shouldn’t expect it to.

I have no way to know if finasteride will work for you, but you can have a HairDX finasteride response test done if you’re curious. If anything, I would expect to arrest your hair loss to give you more time with hair. If it regrows, that’s the icing on the cake.

Doc,

Thanks for the great blog.

I started taking Propecia about 7 months ago at age 21 and have had great results. I’ve had some regrowth even at my hairline.

Is early success any indication of future effectiveness/longevity? I’m trying to gauge how much time I can expect Propecia to hold off baldness. Have you found any sort of correlation with your patients?

Thank you.

It appears that people who had a good response to finasteride early do get better long term results. Like I’ve said before, I’ve had patients on this medication for over a decade with continued great results. I won’t be able to know what kind of time frame of success you’ll have, though.

If you’ve had regrowth at the hairline, that is fairly rare, but exciting!

Dear Dr Rassman, thanks again for the great blog and thoughtful responses.

Afraid I have yet another propecia related inquiry! I noticed in a recent post you informed another reader that there have been cases of your patients on propecia developing lumps in the breast region and that your are now working with another Dr to treat this side effect.

While I’m aware these are not necessarily related to their propecia course I was wondering if you could give an approximate indication of what percent of your patients have suffered this side effect?

Many many thanks again

I believe what you are referring to is gynecomastia (enlargement of breast tissue). They are not necessarily “lumps”. I believe the reported incidence is about 1 in 300 to 1 in 700 or so. In my clinical practice I think the incidence is lower.

The top of my hair looks like it’s thinning when it’s wet or when you apply gel (can see the scalp). Currently I’m 24, and when I looked back to pictures from 8 years ago, it seems that I had the same thing. I went to a dermatologist who mentioned mild miniaturization and pushed propecia.

My question is it possible my hair has always been like this, and there is no hair loss or miniaturization at all? He did not want to look at any pictures from my young age. I recently took notice because I have friends losing hair and became fixated on it. When my hair is dry you cannot see my scalp.

Propecia is an elective medication you take for treating androgenic alopecia. If you do not believe you need it, do not take it. If you do not want to take it, do not take it. If you think your doctor is wrong, then get a second opinion. I’m curious to know why you saw a doctor for thinning hair when you didn’t think your were losing hair.

Some hair styles can cause your hair to look thinner. Direct light can also do that. Perhaps your hair gel is sticking your hair together and causing more scalp to show through, giving the illusion of thinning. I really have no way to know.

I travel abroad a good deal, often for long periods and for indeterminate periods, I therefore regularly miss my propecia intake for a couple of weeks up to a month every, for example 6 months. Am I increasing my chances of side effects or the drug becoming ineffective by doing so?

I do not believe you would be increasing the risk of side effects by failing to take Propecia for several weeks, but you may be increasing the risk of the drug not doing its intended job (of keeping your hair). Perhaps you should make a note to pack your medication on your travels.