My 17 Year Old Son Has Been Taking Finasteride

My son is 17 and he has been receding and thinning significantly on top for the past 12 months. We took him to our derm and he rxed propecia which he has been on for 7 months today. Not only has he not seen any re-growth but has lost even more hair. We put him on generic finasteride because its cheaper. Should we move him to brand propecia?

Do you have someone in Utah that you would recommend we take him to? And last…how do we know if his hair loss is from MPB or accutane? He was on a low does of accutane for 12 months and that is when his hair loss became noticeable. His derm said MPB but I am skeptical.

In the U.S. generic finasteride is only legally sold in a 5mg dose due to patent laws, so the pill must be cut into pieces to get close to the proper dosing found in the 1mg Propecia. Aside from the difference in size (1mg to 5mg), generic finasteride has the exact same active medication as Propecia. Changing to brand name Propecia will likely not solve your son’s hair loss issue. It just may be that your son has genetic male pattern baldness (MPB) and it is running its course. Remember that there is no cure for MPB, and medication only goes so far. Having a HairDX Test for Finasteride Response may have value in that this genetic test will give insights into his overall sensitivity to the drug.

Sometimes Accutane (isotretinoin) can precipitate hair loss, but Accutane alone is not likely the cause. If there is a “pattern” to his balding, then it is likely to be MPB. The various patterns can be found here.

I don’t have any Utah-based physician recommendations, but you can try the physician search at ISHRS.org to find a doctor in your area. These are going to be transplant docs, but they’ll know hair loss. At 17 years old, no doctor should be even suggesting surgery anyway.

Your son should have his hair mapped for miniaturization, as the microscopic view will point one way or the other to the cause of the hair loss. Mapping the hair will give you the opportunity to follow any progress (or lack thereof) as it extends the science to measurement of the miniaturization process.