Q: I started to notice a general thinning around my hairline about 3 or 4 years ago – nothing to be overly concerned with, just a slight difference from what I remember having in my early 20′s. Since then, the hair loss has slowly progressed. It is very thin in the front now and I would like to know the best way, if any, I can stop my hair loss and improve on what’s been taken from me so far. I have done a lot of research over the past year including seeing a dermatologist and receiving consultation from a surgeon. Both recommended Propecia and Rogaine. My confidence in their advice was lost when I researched each of these products and found that they do not improve receding hairlines, only lost hair in the crown area. I’d like to know if there are any other options available to me that work and if a transplant is something that should be done on someone with my hair loss level.
A: Both Propecia and Minoxidil definitely can work in the front of the scalp as long as there is some hair in the area. Although their mechanisms of action are different, both Propecia (finasteride) and Rogaine (minoxidil) act to thicken miniaturized hair wherever its location. Neither of these medications can grow hair on a bald scalp. I would ignore the package insert in this case, because the FDA limits the indications only to the areas tested in the clinical trials. That is why doctors have the liberty to prescribe medication the way they see fit.
I suggest staying on the medications for at least a year — results can take this long. If you have not gotten satisfactory growth by that time then a hair transplant can be considered.
For more on this topic, see Dr. Bernstein answer this question in our Hair Transplant Videos section.
Topic: Drugs (Medications)
Tags: Consultation, Crown, Dermatologist, Front of Scalp, Hair Transplant, Hairline, Hairline Receding, Propecia (Finasteride), Rogaine (Minoxidil)
Robert M. Bernstein M.D. on March 12th, 2010 at 4:37 pm