Hair Getting Thinner with Rogaine Use

I am nearly 23, and my hair has begun to thin out quite a bit (in my opinion). There doesn’t appear to be a pattern at all, so I believe this may be diffuse thinning. About six months I felt that the front of my scalp felt thinner, but the rest didn’t. When I got my hair cut two months after, I became alarmed at the thinness of my hair behind my hairline and decided to go on Rogaine in September. I spoke with a dermatologist, and he described it as “minor thinning” and after a blood test (nothing abnormal although I initially tested positive with the lupus test), he prescribed Propecia for me which I went on in the beginning of November. Since I initially have gone on Rogaine (about 3 months), I have noticed that the thinning has seemed to spread throughout my hair – in fact my hairline has thinned (not receded) significantly in my opinion. I know without a miniaturization test (I’m going to go back to my dermatologist in a month to do this), it is difficult to diagnose, I would like your opinion on my prognosis. Although the thinning only is noticable to me (my parents can’t tell in pictures and no one has commented on it to me) when I apply the Rogaine in the morning and at night, it looks quite thin in parts, particularly behind the hairline. I don’t know if I’m responding to the Rogaine yet (it has only been three months on it, and since its diffuse thinning, it would probably be difficult to see results at this point), although on my hairline, I do feel small hairs (which could either be new hair or old hairs being miniaturized).

My maternal uncle and grandfather both had receding hairlines and went bald at young ages, but my father still has an extremely thick head of hair. I have always had thick and coarse hair like him, but in the last six months I feel that I have lost half the density of my hair. The dermatologist described it as “minor thinning” and said usually when he sees hair loss in someone my age, it is usually stress (I moved to New York to begin a job in finance six months ago), but I don’t believe it’s TE as I don’t shed (either on my pillow or in the shower to the best of my knowledge), nor have I. I would appreciate your advice/opinion.

Thank you.

Nothing replaces a good exam, but it sounds as if you are experiencing (possibly accelerated) genetic hair loss, regardless of your Dad’s currently thick hair. Rogaine typically takes at least nine months for maximum results and the Propecia needs about that long to show a change as well. It will be difficult for anyone in your position to make an objective assessment because of the emotions involved with losing one’s hair. Before starting more medications, you will want your scalp mapped out for miniaturization to determine if you have premature genetic balding. I suggest the following:

1. Stay on the Rogaine/Propecia for at least a year. Neither of these drugs are associated with hair loss unless you stop them. Be patient and 9/10 times you will see results.
2. Each month, have a good friend take a photo of your head where you are concerned about the loss. I will warn you that hair loss often looks worse in photos (especially if you use the flash), but the benefit is that if you standardize the lighting and the pose in the photo, you will be able to compare them over time and make an objective assessment.
3. Do follow up with your dermatologist or a good hair surgeon (since you are in New York, I recommend Dr. Bernstein) to both document any miniaturization and classify your hair loss according to the Norwood-Hamilton Scale. These people can take photos for long term documentation as well.