I’ve Been Taking Finasteride for a Year and Had No Baselines Done
Dr. Rassman,
I would like to request your insight into my situation. I am a 20 year old male and have been on finasteride 1.25mg and minoxidil 2% for one year now. I went to my doctor at the age of 19 requesting finasteride for minor hair thinning. I had not yet lost any hair, or even had any major thinning, but my scalp was visible in the front to middle area of my head under moderate lighting. I have also been expecting to lose my hair for a few years now because of a horrible family history; father, both grandfathers, and all biological uncles but one have progressed to NW5+. My doctor agreed based on sight that there was initial thinning and she prescribed. But I have not ever taken any actual photos or measurements of my hair.
Now, one year later, I am unable to tell by the naked eye whether there has been any improvement or not. Essentially, I seem to have basically the same full hair that I had last year, with maybe some minor thinning visible under the right lighting. I have had no side effects on the medications and I continue to use them.
What would you recommend I do at this point? I know that you do not give medical advice online, but this is more of a procedural question. Is it worth continuing both medications if I am uncertain that they have even been needed at all? Should I try to take some measurements now to gauge my hair loss progress for the future? I am not aware of any doctors in my community, in Hamilton Ontario, who perform bulk measurements or miniaturization tests.
Thanks a lot. All the best.
Did you ever receive a diagnosis of androgenic alopecia? I mean, do you even have actual balding or did you get prescribed a medication base on your insecurity? Almost everyone has their scalp visible under moderate lighting, but that doesn’t mean you’re necessary losing hair. Taking a life-long medication like finasteride without a good diagnosis just because you have a fear of balding is not good common sense.
At this point, I would voice your concerns with your doctor. If that does not help, I would find another doctor for a second opinion.
You may be able to get some help even in your current situation. If you see a good hair transplant doc who can do miniaturization tests, he can see whether there is any miniaturization at the top of your head. When I went to my doc, he used this microscope type thing attached to a computer screen to show me how the hair at the top of my head was thinner than the hair at the sides. This is a classic sign of miniaturization and that the balding process was underway for me.
If you are indeed balding, you probably have this difference between the hair at top of your head and the sides of your head, even after a year of minoxidil and finasteride. That would mean you are balding and that right now, you are actually doing the right thing.
But I’ve been at this for 2+ years now, and it is a real effort the keep up with the process. Using minoxidil 2x a day is particularly a pain, and you wouldn’t want to do this for the rest of your life if you don’t have to.
Get checked out for miniaturization by an IAHRS approved doc to make sure you are not wasting your time. The sooner the better.
Good comment. Lighting often shows the scalp – even in women with no balding of any kind – just ask photographers how many models need to use scalp concealers with studio lighting. You often find that you can see the sides of the scalp too but as they aren’t pointing up at the light source like the top you don’t notice!
The only reliable guide is bulk hair tests and microscopic minituarization studies. Otherwise it’s just guesswork and paranoia. You may have no hair loss at all or a normal change to a maturing hairline as most men your age might experience.
The family history is important but even if every male member of your immediate family has balding there’s no cast iron guarantee you’ll have the same pattern. Genetic hereditary is complicated.