Yeah, but there is Finasteride for male pattern baldness which has fantastic results and is incredibly cheap (I got a 3 month supply for $12).
A 10 year study published by the Tokyo Medical Clinic of finasteride carried out in Japan found that more than 99 percent of men with male pattern baldness experienced no worsening of their hair loss during treatment [1]
Tons of additional clinical evidence showing that Finasteride works.
The key being that it doesn't give any hair regrowth in the vast majority of people, so you have to get people taking it before they see much balding, which is an interesting challenge - why worry about something you can barely see or notice until it's already a problem?
There are ad campaigns from male order providers such as Hims and Keeps around this, I wonder how effective they are.
I take it, and it stopped the balding progression as far as I can tell, but I had to get an FUE hair transplant to get some lost hair back.
> why worry about something you can barely see or notice until it's already a problem?
So, you measure hair loss with the Norwood scale. You don't go from 100% hair to bald spots immediately.
First, you'll see diffuse thinning where the thickness of your hair drops significantly.
In the first stages of diffuse thinning, it won't be apparently to 99% of people that your hair is thinning but you'll immediately notice when you take a shower / apply shampoo (it's really obvious when your hair is wet).
I'd say that's when most men realize they're losing their hair and that's when they should get on Finasteride.
It may still be too late at that point. In my experience people who care about a man's hair (women, mostly) see hair loss as a binary thing - you either have a full head of hair, or you're balding. They don't see a guy in the earliest stages of hair loss and say "Oh, he's got a pretty decent Norwood score!", they say "he's bald".
I've known two women that mentioned they'd rather date a man with a full head of hair who shaves his head than a balding man who shaves his head. I pressed it as far as asking "Well, what if they keep shaving it for life?" Same answer.
It also depends on your head shape, I see a lot of men who are very good looking still with a fair amount visible recession, and they do quite well with their dating life.
Personally I just felt like the relatively small amount of recession I had looked terrible on me because I already had a tall forehead to begin with, and I'm still in my 20s.
To be honest: most women care way less than you think. Personality trumps hair 95% of the time. A good barber can make you look good even with thinning hair, fine someone you like, stick with them, and tip well.
That is not true at all. I have been taking finasteride for years, since I noticed a little recession around my temples and a small loss of density around the front. I noticed it because I know my hair well.
The only other people that might actually be able to tell it are my parents. Except for that, every other person to whom I mention I use finasteride and minoxidil says something of the sort: "wtf, you have a full, dense head of hair, why would you take anything?".
I think it's more likely that if someone's in the earliest stages of balding, people are more likely to say "he has a widow's peak" than "he's bald". Until someone hits Norwood stage 4, there's no visible bald spot, just recession around the temples.
Hair transplant worked really well. Natural-looking hairline, which is the most important part. You'll see a lot of before and afters where the hairline looks like a Lego block hair piece was snapped into place - choose your doctor carefully here.
You'd only notice if you're looking really closely, where you'll see that the hairs are quite a bit thicker, as they were transferred from the back of my head where everyone's hairs are thick, but I have especially thick hair in general.
One thing I think worth mentioning is that you should anticipate having to get multiple transplants if you expect to have much future hair loss. I just saw a guy a few weeks ago who had gone mostly bald on top but had an obvious row of hair across his hairline. It looked like he had gotten a transplant early on and then didn't continue as his hairloss progressed.
There's surgery to replace the lost hair (with hair moved from somewhere else, granted). It's certainly much more expensive than catching it early and treating it with minox or whatever, but it's within the reach of many people (<$10k).
It's taken in small strips from the back and sides of the scalp which, for whatever reasons, aren't prone to the mechanisms causing male pattern baldness on the top of the head and hairline. So theoretically those areas where the hair was mined will now be thinner, but they do it in a manner that you'll never notice the decrease in hair in those areas.
I heard from a barber, that despite claims hairs from the back of the head are different follicles, and won't die off, this is all lies and marketing bs.
So you need endless treatments, or else take testosterone blockers.
1. even back of head hair thins eventually in balding people, but generally many decades later than the front or crown. By the time you're losing that hair, you're probably a lot older and care much less
2. taking finasteride indefinitely is supposed to drastically slow or stop further thinning or loss. Of course as in point 1, you're probably going to lose that battle eventually, but again you'll be much much older when the damage gets serious than you would have been otherwise
iirc there's a largely genetic component to it, so one could simply proactively take it if they carry the genes. But the side effects can be unfortunate (depression, libido) . Seems like topical is better than oral.
Leaving this here for other men who might stumble on this: Oral finasteride drives your DHT way down. However, driving DHT down is essentially the binary goal of stopping hair loss.
And that's all fine and good, but having 'just enough' DHT is important for good health. (Psychology, sexual function, etc)
If you're on finasteride, do yourself a favor and consult with a TRT ('low T') doctor, have your DHT level tested, and consider modulating your finasteride dosage according to its effect on your DHT level.
A good balance is worth working towards. Don't blindly take finasteride without keeping an eye on its effects to your DHT.
Given the potential serious, life-changing adverse effects that persist even after stopping use - no thanks. Just cut your hair short / shave your head.
Minoxidil is highly, HIGHLY toxic to cats. Pregnant women shouldn't handle finasteride because the hormonal effects could cause them to lose the baby. I decided I'd rather go bald than put any cats or women in my home, or my unborn child, at risk. That was before I learned about the long-term detrimental sexual side effects of finasteride.
Maybe in the 70s/80s it was weird to be bald, but there are so many bald people now, it's like whatever. If you think I'm ugly or you're not into it fine, but there are plenty of women who are.
13 years ago I started going to the gym because my hair started thinning. I was convinced a tall slim guy would look weird bald.
I still have my hair albeit thinner than it was then but still there. I wonder if a life style change helped with that.
Clean shaven and bald is definitely a difficult mix, probably a reason most people try to grow a beard. The hipster bald glasses beard look is cliched but preferable to your hair being half missing!
At the very least growing up as a kid in the '80s and early '90s, the only time I ever heard someone get compared to Kojak was as an insult. Shouting "Hey, Kojak!" at a bald guy was a good way to start a fight.
i wish when people talk about Finasteride they always mention it that you won't be able to donnor blood after that. (FDA says you need at least 30 days Finasteride free for doing that)
What about just accepting who you are and realizing that baldness is potentially even a blessing, less maintenance and if you're athletic, I think it's a good look, lots of women have complimented me on it since shaving my head and embracing it.
Sexual side effects are rare and I haven't experienced any. I also get regular blood work done so I can keep track of my metrics and my doctor will let me know if anything goes awry.
So yeah, not really concerned and will definitely keep taking Finasteride.
The point is that in all this thread, including in your previous comment, people are talking about it as if it had no possible side effects. So, great for you that you track your metrics and consult your doctor, but next time you stand behind a potentially devastating medicine, mention the downside and the care you take as well.
Some people simply look better with hair than without. If you have no side effects, and it's dirt cheap, why not just take a pill a day and be done with it?
This sounds like the list of side effects you'll get with almost any immune suppression drug. Odds are good that you'll never see any of those side effects, but when you take a sledge hammer to something so foundational to how your body works to try to beat it into a different shape, you can expect the possibility for unpleasant things to happen.
I was on an injection for a different disease with a similar side effect profile (sans high cholesterol and a few of the others) and (fortunately) didn't have a single side effect other than some swelling at the site of the first injection.
Then again, I was taking it for something possibly degenerative (psoriasis with signs of psoriatic arthritis). I stopped around COVID time out of an abundance of caution, and the joint pain hasn't come back, so I haven't started up again.
On the other hand, I certainly wouldn't risk it for something like hair loss. Getting a wig and some therapy (or even skipping the wig!) is a whole lot safer than potentially permanently upending your immune system. I hate how insensitive that sounds, but doctors really shouldn't be treating vanity with drugs like this.
Depends on the dose too. My poor neighbor (late 20s lady, way too young for all her problems) had to take a "might-kill-you" dose of cortisol to survive, beyond the "max" her doctor initially told her (1150 of some units, max was 1000, regular dose is 100). She suffered the whole list of potential side effects, some of which are quite terrifying and gross. Thankfully she gets to live however, which wouldn't be the case was she born a couple decades earlier.
I wish that illicit scheduled drugs, like the ones legal at the state level, just had the mere standardized study for any side effect
I hate that we are relying on anecdotes, and for recreational state level approval we have approved for every use case and that this is the best we can do while debating the polar opposite style of federal prohibition
Federal FDA approvals for everything else are for a single use case or ailment at a time, and then we get all the side effects they found for an informed decision.
States approvals have…. nothing. California industry just throws a random “maybe cancer” logo on it and calls it a day!
Given that alopecia is a kind of autoimmune disease it makes me wonder if this can also be used to treat other autoimmune diseases as well? I know they previously had some luck treating alopecia with biologics for example.
What a coincidence. I just got my first appearance of alopecia areata (only one spot, has been there for 10 weeks now --- hoping more dont pop up). It's quite annoying. Unfortunately, living in the EU I'll have to wait for you guys to figure it out first.
PS: Anyone in the know who wants to give me the straight answer to whether or not I should be expecting more holes to pop up?
This drug (baricitinib) seems to be approved for use in the EU (https://www.ema.europa.eu/en/medicines/human/EPAR/olumiant), but if EU pharmacies don't have it yet you might be able to order it on some online gray market source, which is pretty easy these days for a variety of substances.
I had it in my facial hair a few years ago. Two bare patches. My barber said it was likely stress-related (though I didn't feel stressed out at all). Then a year or two later it went away for no apparent reason. Nothing had really changed in my life that I could think would affect my stress levels. In other words, both its appearance and disappearance are a complete mystery.
I also have almost no hair on my legs below my mid-calf, and I did when I was younger.
Sample-size of 1 here: Yeah, I would prepare myself to see more. Mine came on kinda strong, both scalp and beard. Doing full shave now, still have eyebrows though!
Yes, alopecia areata is generally a progressive disease. It might be worth discussing with your doctor early. I'm not too familiar with the European regulatory landscape, but I would guess any JAK inhibitor would need to prove efficacy in a European-listed trial of AA to seek approval there, and maybe you'd be a candidate.
It will be interesting to hear how this drug impacts those with alopecia universalis, a sub type of alopecia areata. My sister has universalis from birth. I doubt she would want to do anything about it at this point, she is in her 40's.
I feel like there's a Jada Smith joke in here somewhere... I never heard the term alopecia in my life until that "slap" incident and subsequently heard it 1000 times in reference to that. Hard not to see this headline and think of it.
There's actually a conspiracy theory that the Jada Smith/Will Smith/Chris Rock incident was staged as a publicity stunt by some pharmaceutical company. The version of the theory I heard circled around Pfizer (who overtly sponsored the Oscars), but this article says Eli Lilly was the company behind this drug.
That is correct, however the doctor is a hair loss specialist (and also has alopecia himself, which I feel may mean he is quite familiar with the condition).
Agree that he can weigh in on whether the scar is not alopecia, but less so on whether it is a scar (or from what). Also, he's not saying that the balding is from a scar, which was the impression I got when I first read your comment.
