Late Onset of MPB? (with Photos)

Hi Dr. Rassman,

Consider this permission to use the photos if you use my question.

51 years old, full, thick head of hair until recently. I have been thinning for about 2 years I guess, it has been a few hairs here and a few there. Didn’t think too much of it until this last 6-8 months when it really seemed to accelerate. My brother is 59 and has no balding in the crown/vertex. I started on Propecia in December of this year and have been tolerating it well. So far no side effects. Have a very stressful life ( I’m in Healthcare ! ) and this Year has been the worse.

My question is ? I would like to try the propecia for a full year to see if it can help. Given my age and late onset of what I think is MPB do you think this is a good course of action ? At what point would I be a candidate for a hair transplant ?

Thanking you in advance, maybe one day we will meet !

It is unusual for a man of your age to start genetic hair loss, but I have seen it before. You want to make sure that you do not have a medical illness that is causing it. Propecia is most effective with recent hair loss of 2-3 years duration. Thank you for giving me permission to post your photos (click them to enlarge).

You have some options. You can try taking Propecia for 8-12 months. As a general rule, the older you are, the less likely will be the response, but with your gray hair, any response will add value and with the 2-3 year history of hair loss, you may break the ‘rules’. If you still have no response after that period of time and wish something done about it, then a hair transplant may have value. Alternatively, you can have a transplant and take Propecia. There is no doubt that the hair restoration will be good with the transplants alone, and any gain you have from the Propecia is a bonus. The more the grafts, the better the fullness if you go forward to transplants. I’d estimate between 1000-1500 grafts might give you reasonable coverage.