Propecia for a Young Man with a Mature Hairline and Extensive Family History?

I know you’re usually reluctant to prescribe Propecia in young men without visible balding beyond the mature hairline, even if they expect it to come soon. But isn’t the development of a mature hairline at a young age enough of an indicator? For example, if an 18 year old came to you with a fully mature hairline, 20% miniaturization in the problem areas, and an extensive family history of balding, would you still hold off in prescribing Propecia until he began to bald beyond the mature hairline or show more significant miniaturization?

I don’t prescribe Propecia as a preventive measure, and a mature hairline doesn’t necessarily indicate that you’re going to lose hair beyond that. Even family balding history doesn’t mean you’re destined to lose hair, as it can skip generations. Propecia works best with early genetic loss present, so upon examination I’d be able to make the determination of whether you’re a good candidate for this medication.

With bulk measurements, I can tell balding in anyone almost always. With significant miniaturization I can also sometimes (though not always) make the diagnosis.