July 2007


I started losing my hair at 19 and I had a hair transplant when I was 25.
So technically I look like 5a on the Norwood scale. I Wonder if it is feasible to
have a new hair transplant with good aesthetic results or should I quit since I am 30
and my baldness may progress?


The decision to have a hair transplant as a young man is a complex one.
Once you’ve taken the step, however, it seems an easy decision to try keep your scalp as natural-appearing as possible.This may require additional hair transplant procedure(s). In general more hair mass is better than less hair mass so another important component of your long term plan would be using finasteride (1/4 of a 5mg tablet daily) and
minoxidil 5%. These medicines have a high likelihood of stopping the progression of hair loss and of regrowing hair in over half of us.

(Study periods regarding this have only been for 5 years but informal data on these patients suggests the benefits are still present at 9 years and theoretically the benefits should continue for longer term.)

So in summary, I think you should shift your focus to the long term plan instead of the short term one that may have precipitated your initial decision to have the surgery. This long term perspective would include careful consideration of where to place the limited donor hair that you have remaining in a position that will produce a natural-appearing result if you discover that your balding progresses despite using hair loss medicines. In general this means a higher hairline, few grafts into the crown and the greatest density in the central aspect of the pattern.

i am only 25 years of age and I am noticing some hair loss along my hair
lines. This makes me feel very bad about myself anytime i look at myself in
the mirror. I am only a student and do not have money for any hair loss medications.
Please, what should i do to stop the hair loss and regrow back my hair?

I was about 24 when I first started to really notice my hair loss. It really “sucked” and I felt like I was being cheated out of my youth. There really weren’t any decent hair loss treatments at the time either.

The good news is 20 years later there are decent hair loss treatments that actually work like Propecia and Rogaine. I suggest you consult with a doctor and get a prescription for Proscar (which has the same active ingredient “Finasteride” as Propecia but at 1/3 the cost). It shouldn’t cost you more than $20 a month to stop or perhaps even reverse your hair loss. Now that’s good news.

Cheer up and get on Proscar and get on with enjoying being young.

Best wishes,

Pat Publisher of the Hair Transplant Network and the Coalition Hair Loss Learning Center

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I’ve recently purchased some 5mg Proscar pills which I’ve been advised to take half a tablet every other day. I’ve read conflicting articles and desperately need the following questions answering.

1. is it ok to take proscar as treatment for hair loss
2. are they any long term fertility effects on my side
3. what do i do if I’m taking proscar and want to start trying for a baby
4. if the answer to the above is come off the proscar whilst i try. How long does it take to completely leave my system so its safe to start trying.

Proscar, like the FDA approved hair loss treatment Propecia, both contain finasteride as their active ingredient. However, Proscar contains a 5 mg dose of Finasteride, while Propecia has only a 1 mg dose.

Proscar has been prescribled and used for years as a treatment for male prostrate issues. However, researchers noticed that Proscar also had the effect of lowering the hormone DHT, which interacts with bald vulnerable hair follicles and causes hair loss. By reducing the DHT in the patients body the finasteride in the Proscar proved to slow and even stop or reverse hair loss in many men.

However, it was determined that only a 1mg daily dose of finasteride was needed to achieve this hair loss reduction effect. The maker of Proscar, Merck, then sought and got FDA approval several years ago for the use of finasteride as a hair loss treatment. This treatment has been marketed as “Propecia”. However, many patients save money by cutting up the much cheaper Proscar into quarters to create doses of finasteride that are approximately equal to Propecia.

I am twenty years old and hoping to halt and somewhat reverse my hair loss. My father is bald, my brother is on his way, and I am just starting to show signs. I was interested in getting “the corners” of my hair line filled in and made “sharp” again, while ceasing any current hairloss/thinning. It is nothing major, and it has only happened in the last year and a half, but month by month is getting more severe. Can “catching it early” help with results? Is it possible to get back that “sharp” look I had a year ago.


Dr. Bill ReedYou ask a hard question to answer: whether you can regain the “sharpness”. There is a possibility that you can by using finasteride tablets orally and minoxidil topically. You might find it very satisfying to know that you have stopped the progression of balding, if not restored your hairline as much as you like, by using these medicines as well.

It is very important to stop the progression of the balding early as it seems that you have the opportunity to do. It is probably not a good idea to do hair transplant surgery to the leading edge of the hairline of a 20 year old. Doing so means placing grafts that are so far forward that it would be hard to be sure that there is enough donor to take care of all the other areas that are at risk of balding over your lifetime. This could result in an embarrassing pattern of hair growth down the road.

Recently I’ve been getting a number of emails from patients who are asking just what is the difference between standard follicular unit hair transplantation and the more recent “Ultra Refined Follicular Unit Hair Transplantation”. While the differences are subtle they can be important to patients.

Since I first became a hair transplant patient (see my blog) and began learning and sharing hair transplant information online over ten years ago, I’ve seen hair transplantation evolve from small sessions of large grafts and incisions (”mini/micro grafts” containing up to 7 or 8 hairs) to much larger sessions of ultra refined follicular unit grafts that are placed into tiny minimally invasive incisions.

This evolution – while improving the naturalness, fullness and healing time for patients – made the procedure more challenging and even less profitable for many clinics. Some clinics embraced these patient friendly evolutions while many resisted them and argued against having to implement these changes.

Those physicians who rose to the challenge of successfully providing their patients with true follicular unit hair transplantation came to be recommended on the Hair Transplant Network (View list of recommended hair transplant physicians).

Patients have been getting positive life changing follicular hair transplantation from these physicians for several years. When patient results and care have proven to not be top notch these physician/clinics have been promptly removed.

Follicular Unit Hair Transplantation 2.0