My hair is very long and losing it

Hey Dr. Rassman,

I’m a 21 year old guy who’s concerned about balding in the future. The main reason for that is that I’ve got hair that falls to my hips, so losing my hair would really suck! I wanted to reach out to you to kinda see if there was any way for me to predict if I’ll go bald or not since I’m so nervous about it.

My dad is 55 and he has a full head of hair. All 5 of his male siblings still have a full head of hair and his dad had a full head of hair when he died, albeit with a little bit of thinning. On my mom’s side things are a bit weirder. None of my mom’s brothers nor her father lost hair in their 20s or 30s, but both of my mom’s brothers as well as her father began developing a bald spot on their crowns in their late 40s/early 50s.

I know it’s basically impossible to really predict balding but I just am scared of losing my hair in my 20s or 30s since it’s my crowning glory! I also know this is basically just a random lottery when it comes to whether or not you will lose your hair. At the moment my hairline looks fine and I don’t see any signs of balding. Do you think it would be worth it for me to start propecia/finasteride ASAP to preemptively counter potential genetic baldness?

At 21, the hair cycle often decreases in men, so if your hair grows to your hips that might mean that you have more than a 3 year cycle as hair grows 1/2 inch per month. Measure the length of your hair and if you don’t regularly cut it, then the length of the hair cycle will be easy to calculate. A two feet hair length, for example would suggest a 4-year cycle. If you were shortening your hair cycle, maybe the long hairs will be falling out and look like more hair loss. Seeing a doctor with a trichoscope, will define if you have miniaturization which would suggest genetic hair loss.  Before you commit a lifetime to drugs, be sure that you have genetic balding and that is why a good doctor examining you with the proper instruments, is the only way to go so that you get a proper diagnosis.