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Any Considerations for an 18 Year Old That Wants to Start Propecia?

My son has shown signs of balding from the age of 14/15. We have very successfully been using minoxidil, and he has just turned 18. We are about to start propecia and I would like to confirm that there are no additional considerations I need to take into account because of his age.

Many Thanks

Yes, you should have him visit a doctor who uses the HairCheck device, which is a bulk measurement tool for the hair. I believe that this is important, because it tells us where he started from, then in a year when the measurement is repeated it will tell us where he is going with his hair loss.

I have recently had two patients who had their hair bulk measured with us when they were 16 and 17 years old. One was stabilized on Propecia (finasteride) and the other showed a downhill course on his hair loss. That meant some important counseling needs to be considered if he has emotional problems resulting from balding before he turns 20.

In the case of your son, he is 18 years old and has completed puberty. If a young man was to start the drug at say 14 years old, I don’t know what the growth effects might be. I don’t believe that clear documentation is available to answer that question.


Results of SMP into a Hair Transplant Scar (with Video)

This patient had one Scalp MicroPigmentation (SMP) treatment on his hair transplant scar. The AFTER video was taken immediately after SMP, so you can see some redness on the scalp, which will go away in a day or two.

SMP scalp scar video


In general, SMP to a scalp scar takes two to three sessions. The patient above will come back in one week to make sure everything blends in. He will be able to shave his head or keep his hair long without worrying about the scar. For more information you can visit or email us at You can include a photo of yourself for a consultation. The most common questions asked about SMP can be found here.


In the News - Stem Cells Created from Adults

Snippet from the article:

Scientists have moved a step closer to the goal of creating stem cells perfectly matched to a patient’s DNA in order to treat diseases, they announced on Thursday, creating patient-specific cell lines out of the skin cells of two adult men.

The advance, described online in the journal Cell Stem Cell, is the first time researchers have achieved “therapeutic cloning” of adults. Technically called somatic-cell nuclear transfer, therapeutic cloning means producing embryonic cells genetically identical to a donor, usually for the purpose of using those cells to treat disease.

But nuclear transfer is also the first step in reproductive cloning, or producing a genetic duplicate of someone - a technique that has sparked controversy since the 1997 announcement that it was used to create Dolly, the clone of a ewe. In 2005, the United Nations called on countries to ban it, and the United States prohibits the use of federal funds for either reproductive or therapeutic cloning.

Read the rest — In a cloning first, scientists create stem cells from adults


Hair Thinning in a Young College Student

I’m 23 years old, male. I was concerned about my thinning hair and my forehead is also very high. I was wondering if my forehead could be lowered along with hair transplant in one session and also a general estimate of what it might cost. Could the surgery be financed?

Another concern that I have is whether my transplant area and donor area would be red and swollen for various number of days. How many days are we talking about here? Since I am a college student I am concerned if people will be able to tell I had a hair transplant surgery after I come home from the procedure. Will the transplanted hair and the hair from donor area shed very badly and leave me looking like I have thinner hair than I used to and how much pain should I expect?

Thanks for addressing my concerns.

Thinning hair in a 23 year old man is usually caused by genetic balding. You should see a good doctor to have your hair mapped for miniaturization and have your hair bulk analyzed to be sure that you have genetic balding. If this is the case, then the use of medications like Propecia will be critical to stopping or slowing the balding process from progressing.

The redness after a surgery depends on two factors — the color of your skin (white skin is more likely to turn red), and the general way your body reacts to a wound (scratch your forehead with your fingernail and then wait 5 minutes to see if it turns red). If and when you become a candidate for a hair transplant by presenting with a clear balding pattern, then you can at the time of the transplant, lower your hairline. Costs vary depending upon what has to be done. Financing is available.


Is Telogen Phase the Same Length for Balding and Non-Balding Men?

Dear DR, hi,

I found your blog by searching about duration of telogen phase on Men with male pattern baldness. I’ve a pretty simple question: is the telogen phase the same for Baldness suffering peoples and “normal” peoples?

I’m asking you that because ive checked your blog, and i saw tons of guys complaining about masturbation/working out incidence on MPB. Alot said they saw some changes in the daily shedding (in good or worse) after 3-5 days only… How is that possible? I though a “dead” hair fell 100 days after the beginning of the telogen cycle. So how can they check the result of abstinence OR over masturbation only after a couple of days? Do i misunderstood something? As nobody never corrected them about this point, do that means the telogen phase for MPB men is equal to less than 2 weeks and not 2-3 months like for others men?

In advance, thank you. Regards.

The duration of the telogen phase varies in everyone. The cycle can be longer when there is miniaturization present . If a hair dies (apoptosis), it can die within a follicular unit or miniaturize within a follicular unit. The telogen cycle, I believe, is significantly longer than 2 weeks. So, for example, if you have a high density and many three-hair follicular units, one hair may go into miniaturization and at some point in the follicular unit’s cycle, that hair can die off.


When Should I Apply Minoxidil After I Take a Shower?

I have thinning hair on the top of my head. Should I apply minoxidil after a shower when the hair is still damp, or wait till it dries? If I apply when it is wet, it seems like more gets to the scalp since less gets absorbed by the hair and is easier to apply in between the hairs. But if the skin is nearly saturated with water, won’t less medicine get absorbed? The instructions don’t cover this.

I would use a towel to dry your hair and then apply minoxidil while the scalp circulation is increased from the warm water.


I’ve Been Taking Finasteride for Years, So What Should My Next Step Be?

Cheers doctor. I live in the UK and there is not much information regarding hair loss as there is in America. I have been steadily going bald for the past 14 years and have been on proscar for some time. My doctor was reluctant to put me on proscar but finally gave in, bless him. Anyways, fast forward to now, I am 32 years old and have been seeing an increase in my hair loss in my temple area, hairline, and behind it. It is not that noticeable yet because nobody has really commented on the loss but I know in certain lighting it is very apparent and when I style my hair in different ways it is apparent.

What are the stages I should be taking at this point?
A. Continue with the medication or not take it anymore because I am losing hair regardless
B. Wait for my hair loss to continue until I have a more prominent bald spot and then go for a procedure
C. Go for a procedure now and try and stay on top of my balding
D. Get those micro dot tattoos on my thinning area
E. Do nothing and hope for the best

I always wondered about people who stay on top of their balding but the problem is when they start losing the hair behind their implants or their donor hair runs out, that is what is sort of preventing me from doing anything. Your comments and feedback would really be appreciated. Cheers.

There is no substitute for a good doctor to help you in this process. If you are really losing hair, then stopping Proscar (finasteride) could be a disaster that would lead to “catch-up” hair loss. I assume the Proscar you’re taking is cut into 4 or 5 pieces, and not the full table, which would be too much medication for treating hair loss.

You don’t need to necessarily wait for more prominent balding before you plan for surgery, but as hair loss is progressive, your pattern would need to be determined so that any surgery accounts for potential future balding. Having Scalp MicroPigmentation (SMP) is also a possibility, depending on the hairstyle you plan on having. I can’t really answer your questions without pictures at a minimum.

So really, your next step should be to sit down with a good doctor (you are fortunate to have both Drs. Bessam and Nilofer Farjo in the UK) and build a Master Plan with them.


I Keep Seeing Stuff About TRX2 in the In-Flight Magazines When I Travel

What is TRX2? I’ve never even heard about it prior to seeing it mentioned in two in-flight magazines on my travels this year; yet it boasts on it’s website that it is Europe’s number one best selling hair loss medication. How does it differ from propecia? Does it really have no side effects whatsoever as the in-flight article claims? I’m sensing there is a catch. Is it more expensive than propecia; why have I never heard of it before?

The way it differs from Propecia (finasteride) is that Propecia is an FDA approved hair loss medication with peer reviewed studies of efficacy and safety, while TRX2 is some sort of dietary supplement without any FDA approval. The ingredients in it should not work at all in curing or treating balding, though I’m sure it does allow the maker of the product to become quite rich.

We’ve written about TRX2 before here and here. I’m not impressed by the product, though their marketing efforts seem to be working to their advantage.


In the News - Breast Cancer Patients Find Strength in Hair Loss

Snippet from the article:

Kim Irish had just started a new job and was in California for a training session. She had her tests and was waiting for the results but had asked the doctor not to call her so she could concentrate on the training.

She was set to return to Indianapolis when she got the call from the doctor confirming she had Stage 2 breast cancer. “I was standing in the security line at San Francisco airport when she called me, and I can still see the people in line around me,” she said.

Irish had a lumpectomy followed by four rounds of chemotherapy and 33 sessions of radiation. “My doctor told me my hair would start to fall out three weeks after my first chemo. The moment he said it would start — it started.”

Read the rest (and watch the video) at — Breast cancer patients find strength in hair loss

Fair warning: The video automatically loads when you click that link.


I Was Diagnosed with PCOS Six Years Ago and I’m Losing My Hair!

I am 23 years old. I was diagnosed with PCOS when I was 17 and was placed on birth control pills. I started to take them regularly, but they started making me sick, so I quit taking them and didnt take them for several years. Just recently I went back the the practitioner who diagnosed me with this and she placed me on a slow-release iron tablet daily along with a new birth control that has iron in it.

I have started losing hair around the middle-back of my head mainly around the crown area. It looks like my part is getting a lot wider, and the part is spreading down to the back of my head. I used to have really thick curly hair but now it is getting thin around the top, and in some patchy areas.

At first, since I am a Registered Nurse, I thought stress was causing it. The last time I went to the doc, she said I was anemic with low iron levels, hence putting me in daily iron, so I thought my anemia was causing it. I’ve been on and off birth control, so I thought that could be another cause.

Am I too young to use a topical treatment such as Rogaine? or Sephren? Sephren is an oral and topical treatment for hair loss in women. What do you recommend? I feel like I am losing more and more hair by the day and it really stabs a knife into my self image and self confidence. I’m desperate for some answers. I wish someone would lead me in the right direction so I can start growing hair in those thinning spots. I don’t want to be bald by the time I’m 30. PLEASE HELP!!

Polycystic ovary syndrome (PCOS) causes hair loss in women who can also inherit the genes for balding/thinning. It is a very difficult condition to treat, as the treatment is often unsuccessful. Since you’re already under the care of a doctor, I’m not sure what I can offer. You need a good doctor/patient relationship.

Hormone therapy might help with the PCOS-related hair loss, though since you mentioned stress and anemia, those are other potential reasons for your thinning hair. I just have no way to know what is causing your loss, or whether it is a combination of things. You aren’t too young for minoxidil (also known as Rogaine, which is FDA approved to treat female hair loss), but the oral Sephren is just a vitamin supplement with no peer-reviewed published clinical evidence that it works.

There is a new cosmetic treatment that we’ve mentioned here called Scalp MicroPigmentation (SMP) which we offer to address the thinning problem in many women. One such patient can be found here.