Finasteride and the front hairline AGAIN (sorry)

[The Far Side]

There have been a number of discussions on this forum between ~2005 and 2009 about the use of finasteride and its impact on the front hairline, temples etc. (not the crown). Opinions/experiences seem to vary wildly between:

• "finasteride destroyed my front hairline", 2 years+ of constant shedding at the front etc.
• finasteride isn't very effective at all at the front, but it makes no sense that it could make things worse
• finasteride isn't as effective at the front, be happy if you maintain and any regrowth is a bonus
• "finasteride worked wonders on my front hairline/temples! Tons of regrowth!"

I didn't really feel like it was appropriate to bump any of the old topics but I was hoping for some fresh discussion and hopefully some advice/opinions regarding my personal situation.

Because of the way it looks on me I'm of the opinion that if I can't save/restore my front hairline then I don't care about the crown etc. and its just a shave job. I feel that once it's an "all forehead" look at the front then having some stubble or whatever at the sides/top is irrelevant, at least with my features. With that in mind I've recently decided to take one last shot at hair loss treatments before giving it up for the foreseeable future. I started a pretty robust regimen focusing on the front hairline. I was looking for signs of regrowth/thickening, and with that in mind I decided to stay away from finasteride to begin with (perhaps that's silly but I was looking for an excuse not to try it anyway). I've had some encouraging early results which have made me think about what other steps I could be taking in order to give things an extra push in the right direction. This has lead me towards the following question:

"Should I try finasteride in order to tackle things from another angle and hopefully enhance my front hairline results?"

Initially I thought this was a no brainer in the sense that getting on finasteride would pose little risk to my hairline (beyond an initial shed). I would either see some improvement or at least it wouldn't make things worse after recovering from a possible initial shed (which may or may not happen). Certainly for the crown I still feel this to be the case, but hair loss forums have numerous stories from people reporting how finasteride "wrecked" or "destroyed" their hairline. There are stories from people who persisted for a year+ having been prepared for a shed only to find that their temples etc. never recovered back to baseline. From what I gather the only real theory people had as to why this might happen is that taking finasteride can cause an increase in testosterone levels, and that perhaps frontal follicles were more receptive to damage from this source. Bryan was quick to blow this out of the water in the HairLossTalk.com threads, in terms of refuting the raised test from finasteride usage, the idea that raised test would be significant in relation to the DHT reduction and the idea of testosterone being more impactful on frontal hair. He didn't seem to have an abundance of studies to back this up but I got the impression he thought the theories were a bit daft.

That's where we were by 2009, and as someone considering these issues at the moment I was curious if we were any more knowledgeable now. Perhaps there are some people from back then who persisted through a finasteride shed (years) in their front hairline and came out the other side better than baseline eventually? Is the science any better to explain or refute peoples' theories about why finasteride could do this to the frontal hairline? Were these people just experiencing a shed and didn't stick with it long enough? People who believed the test theory in these old topics were discussing topical antiandrogens which may help the situation such as spironolactone and fluradil, a few years down the line which would we consider the best weapon for the front if the test theory were accurate?

I was looking at the finasteride frontal hair study mentioned on this site but when I follow the link it says access is forbidden (http://www.hairlosstalk.com/hair-loss-news/article52.php)

I'm just trying to decide whether finasteride for the front is an "it might help and it can't hurt" or a "dangerous coinflip" regarding the state of my front hairline and temples. That is without considering the possible sides of finasteride, which is of course another negative. The regimen I've been using for the front is in my profile and I would consider myself a Norwood 3A with a bit of diffuse thining on top if that is of any importance. I hope the length of this post isn't too daunting and I'm interested to hear peoples' stories and opinions, I know its a bit of a muddy area unfortunately...

- - - Updated - - -

There must be some finasteride users out there who care more about how the front of their head looks than a little bald spot on top, share some stories - anything!

 

[Lt. Col. Kojak Slaphead I]

I'll share my story seen as a lot don't on here!

Started losing loads of hair in the shower a couple of years ago so started taking finasteride. I was slowly receeding anyway and figured I'd better get on finasteride. About 6 months in it started working a treat and I stopped losing hair,but after a few months it started again. Recently I have been losing it at the front at a rapid rate, though my hair has seemed reasonably thing at the sides of the front of the while, and maybe it's just finally making way? I'd never thought this might be down to finasteride tbh. When I run my hands hrough my hair I still lose it at front and back though there is no bald spot YET! I'm expecting to feel thinning at the back before too long tbh, but I've been losing hair from the back for about 8 months now but it isn't showing too much yet as far as I can see

 

[Ventures]

I don't think DHT inhibitors destroy hairlines. Those rumors are maybe associated with cases of people who because of initial shed freaked out and stopped using finasteride or dutasteride. And unfortunately never got their ground back as result of progressive male pattern baldness process. So, if you continue to use the drugs there is no way effect of increase in T can overcome effect of lowered DHT. There are no studies which suggest that frontal hair follicles are more vulnerable to T then DHT. It would make no sense since we know well DHT has more affinity to AR.

Lack of efficacy of finasteride and dutasteride in frontal scalp is due to several reasons. First of all, frontal hair is located on a part of the scalp which is tight and this results in reduced blood supply of dermal papilla. In addition to that, there is less aromatic enzyme, which converts T to E, in forehead and frontal part of the scalp. Moreover, recently I've found study which suggests oxygen supply can promote conversion of T to E. As third, distribution of AR in top of our head is uneven. Apparently, Caucasians have more AR in frontal part of scalp. As we might see in hair loss forums, majority of population first start to loose hair in front (frontal and bilateral temporal recession, and then hair loss stabilize when hairline reach NW4 borderline). All these factors contribute to increased susceptibility of frontal hair to DHT and other androgens including T!

 

[abcdefg]

Yeah bottom line is we need stronger AAs preferably topical ones. We have known this for the last 20 years but still dont really have any. I do think T does hurt hair its just much weaker then DHT but both are androgens so both harm hair long term. Could the front be more sensitive to T? Anyone guess I dont think we know, but I would be curious to see how androgen receptors are distributed and what role those play in comparison to androgen levels or if they change over time to androgen levels

 

[The Far Side]

Thanks for the replies. My first thought was that it would be unlikely for finasteride to be capable of making the front worse, based on the "science" of things. I was of the opinion that beyond shedding finasteride would be a no risk treatment in terms of the state of the front hairline (not the side effects). It would either do nothing or it might help a bit. It's just there were quite a few stories from people bemoaning losses at the front that they attributed to finasteride, but it's difficult to tell how things would have gone without finasteride. I guess we're no further forward science wise than a few years ago in terms of trying to explain scientifically whether or not it was possible for finasteride to have worsened those peoples' front hairlines.

 

[jom]

Hi there,

After almost 6 months on finasteride I'm at the point of giving up and reaching for the shaver. I was in very decent shape when I started it but was still losing a significant amount of hair. I weighed up my options and figured finasteride was only hope to stop/slow down hairloss.

About a month or 2 in I noticed that I was losing a lot more hair. I wasn't really experiencing any sides so continuing with the treatment at this point was an easy decision.

Before starting on finasteride I wouldn't have noticed any hairloss from the back and sides of my head or even front middle;mainly around the temples. I am not very thin in these areas with the front being hit particularly hard. I can't say whether my hairloss would have continued at the same rate or not had I not started the drug, however there is no doubting that the ruining of my hair was pretty rapid after taking the drug.

Hairloss has not been a slow process by any means in my case;it's been frighteningly quick in fact. I don't see any point in continuing with the treatment at this stage since I am so far below baseline after almost 6 months. I'm 1mg every other day at the moment to wean off it and will be shaving my head pretty soon.

If I had my time over knowing what I know now I definitely wouldn't take the drug. Having said that, at the time I thought it was the only thing that worked and in a bit of a panic I felt it was worth a shot even taking the risks into consideration. Funnily increased hairloss was not a risk that was factored into my decision at the time.

That's my story anyway, take from it what you will!

Best of luck to the rest of you in your battle.

 

[The Far Side]

That's my story anyway, take from it what you will!

Best of luck to the rest of you in your battle.

Thanks. How old were you when you started finasteride? I'm just curious if your male pattern baldness was likely to accelerate regardless of starting finasteride. From what I gather you're just stopping now, so it will be interesting to see if things slow down again or not. Blah, bloody finasteride - I just don't know what to do, wish there'd been a development in the past 20 years...

 

[jom]

Thanks. How old were you when you started finasteride? I'm just curious if your male pattern baldness was likely to accelerate regardless of starting finasteride. From what I gather you're just stopping now, so it will be interesting to see if things slow down again or not. Blah, bloody finasteride - I just don't know what to do, wish there'd been a development in the past 20 years...

I was 27 when I started on it. Age is obviously a factor but everyone is different I suppose. Looking back at photos now I definitely started balding earlier than I realised but it wasn't until I started to notice large amounts of here on my desk/in the shower that it really started to worry me.

To be honest there's still a small part of me considering continuing with it at the off chance that by some miracle it kicks in and starts working after 6 months! They say give it a year but you would surely expect some signs of encouragement within 6 months if it was going to work. The annoying thing is I'll never know if it made it worse or not.

It's a tough call but depending on how much it's bothering you, it's still probably worth a shot given that it's the only thing out there with much evidence for actually working!

 

[abcdefg]

There is no reason if you start finasteride to stop any earlier then 1 year. One year is the minimum in my mind to tell if does anything and keep in mind your hair loss not progressing is all you can hope for. Any new hair is simply a bonus

 

[jom]

There is no reason if you start finasteride to stop any earlier then 1 year. One year is the minimum in my mind to tell if does anything and keep in mind your hair loss not progressing is all you can hope for. Any new hair is simply a bonus

Thanks and I hear what you're saying, but I think that so far there is absolutely no chance it could be slowing the progression. If anything I would say it is possible that it is accelerating it. Like I said, hair is now far far thinner on the back and sides I think could be attributed to finasteride as I had no hairloss in these areas before.

It's still a relatively tough decision to come off it. I'm taking 1mg every other day at the moment. I find it highly unlikely that I will recover any bit by continuing. I'm not expecting any recovery by coming off it either but if I'm going to lose my hair anyway, I'd rather be off the drug than on it!

These are my reasons for coming off it. I'm still open to being talk out of it so anyone feel free to weigh in with some decent logic!

Anyone see Dallas Buyers Club?? Not so sure about those FDA folk!

 

[Bowser]

Been on 1mg finasteride for about 2.5 years now. finasteride definitely has an effect on my hair line (I believe it changed overall texture but on the other hand probably maintaining it rather than regrowing) but by far the biggest influencer on how my hairline is looking is minoxidil - I quickly notice losses or gains depending on my consistency with minoxidil application.

 

[Saulus]

Is duta better for front hair or are tranny drugs like spironolactone the only option so far?

Where is the fuckin cure for gods sake