Finasteride, DHT and Apoptosis

I mean, they’re not really wrong. The only way to stop balding is to never go through puberty. Futhermore, hair loss happens with age, as we slowly slink towards the grave. Minoxidil is a growth stimulant that doesn’t address the mechanisms for why we bald, it simply provides a cosmetic effect, which is what most people care about. Finasteride helps reduce the amount of DHT below a certain threshold that would cause hair loss otherwise, but as you age, the body may become more sensitive to DHT. These both work, and most people are happy enough to go on them, but we’re still balding. Some people have wonderful, Disneyland results, but they’re still losing their hair, and it would go as quickly as it came if they were to cease treatment. It sounds like your derm is just managing your expectations, as we do here; It’s easier to keep what you have than gain anything back.

I always say that when you are 17-18, something happens and the hair loss starts like the gate of a race track. We know that there is a process called Apoptosis (cell death) which occurs with hair follicles that are genetically programmed to shut down. Each hair follicle has a number of cycles that they will have before ‘dying’ and as the typical male has a 3 year growth cycle, if the hair is destined to not come back after 6 cycles, that is 18 years, 7 cycles is 21 years, 8 cycles is 24 years. We see much of the hair loss in those under 24, so it appears that 8 cycles is a magic number. Finasteride, extends the anagen (growth) phase in hair so these loss cycles slow down while on the drug.