Have You Seen a Case Where Propecia Makes Hair Loss Worse?

Dear Dr –
I know there’s quite a lot of anecdotal, somewhat brutal indictment of finasteride on the web, some perhaps more grounded in reality than others. And of course, part of this revolves around frontal hair loss and so-called hyperandrogenicity, blah blah. You’ve given quite a lot of first-hand, practical and scientifically-based advice to folks who may be scared off by these reports.

My question for you is the following: Have you yourself witnessed in your thousands of patients any number of these patients taking finasteride see their hair loss situation get substantially WORSE (particularly in the frontal regions) given, say, a year of regular finasteride treatment? And, if so, is there any case in your patient-load where you might speculate that the finasteride treatment itself accelerated the situation?

I have seen hair loss progression even while a patient was on Propecia, but I do not believe that taking the medication caused the loss I saw or accelerated it. I can’t think of any case where I’ve speculated that the reason for the hair loss was the medication prescribed to treat it.