How much will drugs help in stopping Norwood progression?

[Guest]

We've discussed this a bit before, but hopefully we can discuss it again.

This discussion will have to be based on estimations, because neither drug has been on the market for long enough to make real solid conclusions:

Case 1: 25 year old NW3. Assume that he will be NW6 at age 50 without drugs. What Norwood do you think he will be at 50 with Propecia? What Norwood do you think he will be at 50 with Avodart?

Case 2: 35 year old NW5. Assume that he will be NW7 at 45 without drugs. What Norwood do you think he will be at 45 with Propecia? What Norwood do you think he will be at 45 with Avodart?

Case 3: 20 year old NW2. Assume that he is not just getting a mature hairline and that he has male pattern baldness. Assume that he will be NW5 at age 50 without drugs. What Norwood do you think he will be at 50 with Propecia? What Norwood do you think he will be at 50 with Avodart?

Keep in mind that you should not say the same future Norwood as the placebos listed above for each case, because that would mean that the drugs basically do not delay loss. If someone who was destined to be NW5 at 50 without drugs was still NW5 at 50 after 30 years on Propecia, that would mean one of a few things could have happened. Propecia held his hair loss at bay for a few years, then the loss speeded up to match the Placebo guy. Or, Propecia just did nothing for him and he continued to thin at the same rate. I think that both of these scenarios are very unlikely.

So how many Norwood classes ahead will Propecia 1.0 mg and Avodart 0.5 mg put an average male pattern baldness sufferer? If someone would have been NW6 at 45 without drugs then would he only be an NW5 at age 45 with Propecia and an NW4 with Avodart?

Let's hear it. And for the purposes of this discussion, please leave out all discussion of any hair loss treatment besides Propecia and Avodart. No discussion about how minoxidil could keep someone an NW3 for two extra years or something like that, because that just makes it more complicated. Likewise with proxiphen. I don't want this thread to degenerate into a thread with Dr Proctor supporters and foes. If you have other proposed scenarios for Propecia and Avodart that you want to introduce to the discussion, please say so. If you have personal testimonials about how these drugs have maintained a certain Norwood classification for you, please share those as well, but only if it's been longer than 5 years.

 

[Apoc]

Completely impossible to predict the results as they vary from person to person. There is only one thing certain without the drugs you will go bald but drugs will only buy you time and not prevent you from going bald. Sooner or later you will be bald unless some better treatment comes along.

Propecia did nothing for me. In fact I think it has speed up my hairloss. My regimen that I'm using right now has made considerable improvement after 4-5 months and I'm quite satisfied. Foam minoxidil has proven great for me, it covers the smell of spironolactone very well and I have less shedding from it than no PPG 5% minoxidil.

 

[Strat54]

Like Apoc said, it´s hard to predict.

But in my case, I lost hair between 20 and 25 aprox. Now I’m a NW3 at 40 and I thought I was going to be as bald as a hairless cat at 30.
But may hairloss stopped and I remained a NW3 without any drugs.

I think I’m a good responder to Propecia (don’t know about Avo yet) and minoxidil, because I’m growing some hair after all those years.

But I’m sure that if I took Propecia or Avodart and minoxidil, I could’ve saved at least one step on the scale.

 

[Guest]

Completely impossible to predict the results as they vary from person to person. There is only one thing certain without the drugs you will go bald but drugs will only buy you time and not prevent you from going bald. Sooner or later you will be bald unless some better treatment comes along.

Why do you think it's a certainty? 0.5 mg a day of Avodart blocks the production of 98.5% of type II DHT, the main culprit in male pattern baldness.

So basically after Avodart reaches a steady state in your body, your type II DHT in the follicles is only at 1.5% of its original levels. How much damage can 1.5% of original DHT really do? Yeah there are other androgens at play, but DHT is 30 times as potent as testosterone supposedly. After 6-7 years on Propecia, the average responder again started to lose hair(drop below baseline), but the rate at which he was losing hair was only 15% of the average placebo user. So if we assume that Avodart's decline would only be 12-13% of the average placebo user, then if it would take someone 2 years to progress one step on the Norwood scale with the full amount of DHT(say II to III), then we could estimate that it would take 20 years for that person to progress one step on the Norwood scale while on Avodart(say II to III). Why is this so hard to believe? And I think I'm being conservative with my 12.5% as fast estimate. I feel that 15-20% of circulating type II DHT left by Propecia can still do too much damage, but Avodart leaving only 1.5% of type II DHT may allow some users to stop their hair loss in its tracks permanently, or stop it so much that the decline isn't even noticeable(lik a progression of one Norwood scale over their lifetime).

Take a look at the 5 year Propecia chart, Apoc:

Look at the Propecia line compared to Placebo. From years 3-5, the person on Propecia goes from 60 hairs above baseline in the test area, to 49 hairs above baseline, then 38. Losing about 11 hairs in that area per year. The guy on placebo, on the other hand? He's losing about 80 hairs per year. It is not unreasonable to expect that Propecia line to at least continue its current slope. The line is getting flatter and flatter meaning that, extrapolating it out, the average Propecia user will still be 5 hairs above BASELINE after 8 years on the drug. And I haven't even mentioned Avodart, we don't have an Avodart chart, but I don't think it's too ridiculous to estimate that the average Avodart user could stay above baseline for 12 years, and then start that slow average decline, which will probably be a lot slower than the Propecia decline even, maybe only losing hair at 5% of the rate that a Placebo user would.

Following my logic, let's look at Case 1:

Case 1: 25 year old NW3. Assume that he will be NW6 at age 50 without drugs. What Norwood do you think he will be at 50 with Propecia? What Norwood do you think he will be at 50 with Avodart?

Let's just look at Propecia even. Let's use the 12.5% rate. Let's assume that he stays above baseline for 8 years like in the chart. So at age 33, he is still an NW3. Now it would have taken him 25 years without drugs to progress 3 Norwood scales from Norwood 3 to 6. For the purposes of simplifying this, let's say that it takes him 8 years to progress one step on the Norwood scale. The placebo guys is NW3 at 25, NW4 at 33, NW5 at 41, and NW6 at 50. The Propecia guy is still NW3 at 33, and he he's not even NW4 by age 50. He may never get to NW4, but if he does, it's probably the worst that he'll get.

 

[CCS]

I hope we could stop hair loss, but we know that on propecia even the back thins in 17% of men at the 1 year mark, which is where it is best.

I would not be happy just slowing down. Yeah, I'd be happier than full speed, but not happy. I want to be a NW1 until age 70. And no white hair.

That propecia graph does not show the frontal results, which are probably worse.

 

[Guest]

I hope we could stop hair loss, but we know that on propecia even the back thins in 17% of men at the 1 year mark, which is where it is best.

I would not be happy just slowing down. Yeah, I'd be happier than full speed, but not happy. I want to be a NW1 until age 70. And no white hair.

That propecia graph does not show the frontal results, which are probably worse.

i bet that avodart is much stronger at holding onto the mid scalp and back than propecia is. Meaning most people on Avodart won't get worse than NW3. and i'd be happy even going to NW3 at 50, because then I could just get transplants to get back to NW1.5, and still have some hair left and not worry about the crown.

 

[Ramboner]

stop worrying about the state of your hair so far into the future. You are looking too hard for reasons to be worried. Just take your f'cking drugs and suck it up. Hypothesizing these scenarios will only raise issues that will bring you down. Issues which unfortunitely we have no control over. Unless you want to look for that rare flower in Syria that grows back all your hair; you know what your options are, your only options.

RAMBONER

 

[Guest]

stop worrying about the state of your hair so far into the future. You are looking too hard for reasons to be worried. Just take your f'cking drugs and suck it up. Hypothesizing these scenarios will only raise issues that will bring you down. Issues which unfortunitely we have no control over. Unless you want to look for that rare flower in Syria that grows back all your hair; you know what your options are, your only options.

RAMBONER

I am a bit worried and I'm never going to stop taking my pills. But the conventional wisdom on here of the drugs only delaying the inevitable makes no sense to me.

 

[Aplunk1]

Re: How much will drugs help in stopping Norwood progression

Case 1: 25 year old NW3. Assume that he will be NW6 at age 50 without drugs. What Norwood do you think he will be at 50 with Propecia? What Norwood do you think he will be at 50 with Avodart?

Case 2: 35 year old NW5. Assume that he will be NW7 at 45 without drugs. What Norwood do you think he will be at 45 with Propecia? What Norwood do you think he will be at 45 with Avodart?

Case 3: 20 year old NW2. Assume that he is not just getting a mature hairline and that he has male pattern baldness. Assume that he will be NW5 at age 50 without drugs. What Norwood do you think he will be at 50 with Propecia? What Norwood do you think he will be at 50 with Avodart?

(Hypothetically, of course)

I have no reason to doubt that Propecia or Avodart will lose their effectiveness in time. Using these treatments at the first signs of hairloss will obviously ensure better chances of regrowth.

And while I suggest that minoxidil be used in every hairloss sufferer's regimen, I'll go ahead and make a few "educated" guesses on this:

CASE #1
Someone beginning Propecia at a Norwood 3 is unlikely to surpass a Norwood 4 until his later years (70's and 80's). I think he will maintain his Norwood 3 or 4 status for decades before succumbing to upper levels of hairloss.

Same goes for Avodart, although I would think that Avodart would stop the hairloss progression in its tracks-- Norwood 3.

CASE #2
Someone beginning Propecia at a Norwood 5 at age 50 has little chance of regrowing any hair. He will likely progress to a Norwood 6 in his later years, given he continues Propecia.

Someone beginning Avodart at a Norwood 5 at age 50 is likely to maintain a Norwood 5, or have beginning progression of Norwood 6.

CASE #3
A 20-year-old taking Propecia at a Norwood 2 at age 20 will probably progress to a Norwood 3 or 4 in his or her lifetime, but no more, given that he or she will continue taking Propecia.

A user on Avodart (ahem!) will not surpass a Norwood 3 until his later years, 70's or 80's.



These are just my opinions, and they're more about how I FEEL progression would take place.

 

[Guest]

Re: How much will drugs help in stopping Norwood progression

CASE #3
A 20-year-old taking Propecia at a Norwood 2 at age 20 will probably progress to a Norwood 3 or 4 in his or her lifetime, but no more, given that he or she will continue taking Propecia.

A user on Avodart (ahem!) will not surpass a Norwood 3 until his later years, 70's or 80's.

God I hope that's true. But my grandpa was NW1 into his fifties, and NW2 till 5 years ago, and he's just an NW3 now in his early eighties. He has great hair genes as you can tell. I'm stunned that you think it's possible for an NW2 to do that well if they're patterning an NW5. I am somewhat optimistic but that would really be amazing if true.

And considering propecia has only been out for 10 years, and avodart for 5, there may very well be better drugs in 10-15 years to ensure that someone who is NW2 can never get worse than NW2 even. What do you think about that? And we're not even bringing HM into the discussion, or hair transplants to bring NW3s and NW4s back to the NW1-2 range.

The future is pretty bright for people just starting to bald now I think.

Also, Aplunk, how do your projections account for diffuse thinners? Do you think that diffuse thinners would thin at about the same average rate as non-diffusers? And I wonder if adding topical spironolactone to the hairline would help maintain that frontal hair for longer? That's not to say add spironolactone to protect against increase in test from dutasteride. Rather I would perhaps add topical spironolactone 2x a day in the future to combat the remaining androgens outside of DHT. What do you think?

 

[Aplunk1]

I never even thought of diffuse thinning when I wrote that.

The Norwood Scale, unfortunately, doesn't incorporate diffuse thinning into its patterns....

But in my opinion, and I don't want to put any upsetting thoughts into your head, but I don't think medicines like Propecia or Avodart are good at increasing the densities of hair FOR diffuse thinners...

I think they're better at "holding the line."

For added density for diffuse thinners, I would think minoxidil would be a better treatment.

 

[Guest]

i was more concerned about holding the line like getting no worse than nw3 if on avodart. so would a diffuser get no worse than the equivalent in your estimation?

i do disagree about effectiveness of regrowing on avodart for diffusers because i am regrowing some hair in my crown and on my temples and hairline, as well as a patch on the top part of the left side of my head, part of the non-permanent horseshoe. then again these parts are not diffuse parts. we will see in a few months, i suppose.

thanks.

 

[Aplunk1]

That's a really tough question, but I think that if a user in the BEGINNING stages of hairloss treats probably won't lose any more density.

Again, I don't have anything to support that, just my feelings and experience on the subject.


I think you've made a good decision, J. I think that you're going to benefit in the long-run, hair-wise, for getting on Avodart. I doubt your diffuse hairloss will increase, at least (hopefully) for a good many years.

I think down the line you should hop on the minoxidil train to keep your follicles alive (by avoiding apoptosis)-- until better treatments come out.

 

[Guest]

Thanks.

Don't worry about supporting evidence, because none of us have it. There will never be an Avodart study or any more Propecia studies so in a few years all we will have to go by will be anecdotal reports on forum like this one and, of course, our own experiences on these drugs as well.

I think you will benefit too from being on it. You already have in your crown. I hope I get my crown too. I have a crown spot about the size of a quarter that's embarrassing.

I'll try minoxidil next August or so if dutasteride doesn't give me satisfactory results. I have respect for minoxidil and its capabilities, when combined with dutasteride or finasteride.