Patient Kept Hairline with Propecia, but Density is Poor (with Photos)

The photos below are of a 24 year old man who started taking Propecia (finasteride) at the age of 18. At 21, he switched to Avodart (dutasteride), but on seeing no improvement or reversal of his hair loss he switched back to Propecia, which he has maintained through today. His donor density is 25% less than the average Caucasian, which obviously means that his supply of donor hair is limited. Plus, he has black hair and very white skin and he is miniaturized to 90%.

I suspect that the hair he has is only there due to the Propecia routine he has followed strictly over the past 6 years. Starting hair transplants at this time would be the wrong thing to do, as it most certainly will accelerate the remaining hair loss. With thickening products and the use of Toppik, he does not look balding and I suggested that he continue that approach until it fails to work. Only then can the transplant option be used, but he will have to give up any thought of crown hair and accept only a frontal hair transplant.