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My dad has hair, both my grandpas have hair, and my brother who is four years older than me has hair. I don’t know if cousins matter, but I have four male ones that all have hair too. Its not just hair though, all these family members have full heads of hair, there is not one male in the my family who is balding, and yet im 18 and seem to be losing all my hair. Im trying to except it, but im curious if there is anything I can do?

The expression of the balding gene does skip generations, though I am not sure how many it could potentially skip. The more generations that are skipped, however, the less likely it will be. I’ve written about it before here.

As for what you can do — I’d see a doctor and ask about a prescription for Propecia. If you have early genetic hair loss, the drug should halt the progression for some time.

Hi Doc,
I started propecia 5 months ago for a receding hairline. My hairline appears to still be a norwood 1, but it is closing in on the second one very quickly. I don’t think the propecia has helped at all. I don’t even think the recession is slowing down. Is there any way the propecia could help from here on in, even if it hasn’t even slowed down the hair loss in 5 months?

Propecia (finasteride) will not stop the appearance of a mature hairline, as that is what it sounds like you’re describing to me. You should send me photos and I will give you a more definitive answer. Mature hairlines are convex in shape, while juvenile hairlines are concave.

Dear dr. Rassman,

I hope you answer my question.I am at a very desperate stage in my hairloss. The daily appplication of minoxidil is making me look horribly bald. Can I drink the minoxildil solution twice per day rather than put it in my scalp? will it give the same results? I do not care about the heart side effects as looking into the mirror is enough to give me chest pains and anxiety attacks. Please answer my desperate plea.

The stomach will probably destroy the minoxidil when taken orally unless it was put into some compounds for oral ingestion. Minoxidil was originally on the market for blood pressure control many years ago, sold as a pill called Loniten… but for the best results as a hair loss treatment, topical is the way to go.

I wouldn’t expect the topical form to be safe to ingest, considering it contains propylene glycol (which may cause gastrointestinal irritation with nausea, vomiting and diarrhea). Plus I doubt it would be effective. I think that you need to meet with a doctor and get your problem surrounded.

To sum it all up though, do not drink the minoxidil.

Hey Doc Thank you in advance for such an informative sight. I found this excerpt from a web page concerning shedding from propecia. I was wondering what was your take on it as I have experienced a considerbale shed within 4 weeks of starting propecia. The hairs come from not just the balding areas but from the back and sides as well. Just curious as to your assumptions.

Myth: Shedding is an indication that Propecia is working

I have heard that in some patients, there is a period of increased shedding after starting Propecia, but this will stop within a few months in almost every one experiencing the problem. Some doctors believe that Propecia increases the cycling of hair, but I have no way to ascertain if this is the cause or not.

Dear Dr. Rassman,

I’ve got some puffy nipples since I was 15 (now I’m 22) and after 4 months using Propecia it seems that they are a little larger. (anyway not a big change). I’ve read about this gel “andractim” and seems it’s a good treatment for those who have slight gyno. I don’t want to stop using propecia, cause it works really well for me. The thing is andractim is a topical DHT… which should be applied on your nipple area, so maybe will stop propecia from working. Do you know any way to keep taking propecia and not making my slight gyno/hair fall worse?!

Best regards!

I can not tell you what using Andractim (topical DHT gel) will do for your gynecomastia. This condition is common in boys of your age as the hormones your testicles produce along with other hormones are all over the place while you are maturing. I doubt that the topical medication will hurt you or make Propecia stop working, but I would not go along using it for too long without having your doctor examine you and determine just what is going on.

Hi doctor how are you?

This is my question regarding propecia.

Most people think only DHT destroys hair but the follicles are sensitive to testosterone as well. Its interesting to note the first thing that goes on most guys is the hairline mostly the juvenile hairline which is often made up of small vellus like hairs. This is because they are sensitive to testosterone more so than DHT. And we all know finasteride lowers DHT and raises testosterone.

Can that make a persons hairline even worse by trying propecia or can propecia help maintain it? Basically is propecia good for one thing on the scalp and bad for other areas such as the hairline.

I would really appreciate if you could answer my question, because I have searched in your blog and haven’t found a clear answer when regarding testosterone and hairline balding and not DHT.

Propecia has the same impact on the frontal hair and the crown hair, but it appears that it is less effective on the frontal hair, which is often caught later after the hair loss is detectable. The crown seems to have a slower loss rate and that is probably why Propecia (finasteride) works so well in the crown. Finasteride is not bad for frontal hair and I have even seen people reverse frontal hair loss with it in the very young man, although it is rarer in the front than the crown.

Hi Doc,

Couple questions:

1. Is 37 too late to take propecia (I hear its less effective as we get older)?
2. I suffer an ironic twist of fate - have too much body hair (back, shoulder, chest, etc) and thinning head hair (MPB). Can I use FUE to remove the body hair (even if I dont want to use it on my head - i.e. just want to permanently get rid of it).
3. Finally, if I am travelling to visit your clinic for a procedure from an international location, is there any rebate/discount?

Thx!

1. 37 years old is not too late for finasteride use, but you are correct, the drug tends (not always) to work better in the younger man in his 20s, rather than older men above 40.
2. Taking out body hair with FUE instrumentation is expensive and unnecessary as there are good hair lasers that accomplish this better, faster, and less expensively.
3. Yes, we do offer travel reimbursement for all patients coming from out of town. See details here.

Hey Doctor Rassman.

Last night I just tried propecia for the first time, and after a couple of hours I started to get dizzy, and I was dizzy almsot the next day as well. I just decided not to take it anymore and start using rogaine. Im more comfortable with topical than a pill. My question is, by stoping it after the first try, will it have any significant difference on the hair loss (in terms of making it worse) or my over all health just by one trying it once?

What you are describing sound psychosomatic, not physiologic. Stopping it at one day will have no impact on you at all. Rogaine (minoxidil) is just not the answer for a young man losing hair through genetics. I’ve seen Propecia work miracles, and just haven’t seen the same kind of results from minoxidil. Keep in mind that what you experience may be on your mind and not in your body.

Hi Dr. Rassman,

Quick question: What happens if you miss a day(or two) of your finasteride dosage? Can the benefits quickly be reversed? If you miss a week, do you start from scratch when you start taking it again? Thanks a lot.

A day should not make a difference, but skipping many days may make a difference and many weeks will make a difference that may not be reversed by taking proper doses of finasteride.

hey doc(s) There have been a lot of questions about if propecia will lose it’s effectiveness, but I haven’t seen any on if rogaine will too. Can you shed (pardon the pun) some light on that?

Thanks lots

I am not sure about the loss of effectiveness for Rogaine or Propecia. It is my opinion that these medications continue to work. In other words, they do not stop working as long as you use as directed. The reason I say this is because I have seen patients who have been on Rogaine and/or Propecia for many years and decide to stop the medication for their personal reasons (as they may believe it is not worth it or has lost effectiveness). These patients often come to me expressing regret for their decision to stop the medication, as they notice an increase in their hair loss within a few weeks. The main issue here is that hair loss is a continuing process that can accelerate at times, but the dose of these medications is constant.

There is no single medication that STOPS hair loss forever. At this point there is no cure, however, the medication does slow it down or minimize the loss. It is just that medications do a better job for certain patients and at certain times in their hair loss process.