In my practice, I have a fair number of young men who are feeling stressed because of hair loss. Some have a family history of baldness, while a few are setting new trends on their own. Many have been taking finasteride for a few years, to help them retain the hair on their heads, and ask my advice when it is time to renew their old prescriptions.
Widely advertised as "Propecia", this drug for baldness is identical to the prostate drug "Proscar", made by the same company. The former is in 1 mg tablets, the latter in 5 mg size tablets. Just to make things annoying to the customer, both are priced the same. So you can save five times the money by simply cutting each triangular Proscar tablet across the equator. The smaller (top) half can be cut in two, while the larger bottom half can be cut into three. If done on a kitchen cutting board with a chef's knife, the savings can be truly substantial.
However, that's assuming you even want the drug. While some dermatologists still follow the old-school program of using the drug as a first line of defense against hair loss for men (and to a lesser extent in women), more specialists are now suggesting caution.
For one thing, baldness is not a disease, it is an (obvious) cosmetic issue. However the side effects of the "cure" can be cause for concern. For one thing, researchers are now finding some cases of Erectile Dysfunction while men are on the drug, and, even more alarmingly, for years after they stop it. Other studies are showing an increased incedence of the rare male version of breast cancer. Still other studies are showing an increase of anxiety and depression for propecia users. For more details: http://www.businessweek.com/ap/2012-04/D9U3HR3G0.htm
Hair transplant specialists are now telling more of their patients to discontinue the finesteride, and focus mainly on the topical treatment of Rogaine, or minoxidyl , in either spray or foam versions. While it may seem the transplant doctors are biased against the pills for baldness, they actually are concerned about retention of hair follicles in the donor areas. In addition, they naturally want any transplanted follicles to continue to thrive. So if anything, they would espiecially want a pill to help their patients retain hair.
In balance, I remind my patients that hair loss is not a disease, but the side effects of finesteride can indeed be a big health concern. If my patients weigh the choices and still want to continue the drug, I give it to them with the above caveats.
For those who elect not to take it, I remind them to take Minoxidil in the 5% format, not the popularly available 2%. Many will find the spray version less messy, but it can cause scalp dryness and flaking. The foam is a little easier to deal with; just follow directions and apply twice daily to your scalp. To purchase, go online to http://www.minoxidildirect.com/Minoxidil.htm . Even in the group that elect to take the oral drug, these topical options can add to the retention.
Another product that dermatologists suggest is Chronostim, which can also help retain and treat thinning hair. It is not a prescription, but can be found at http://well.ca/products/ducray-chronostim-lotion-for_3462.html. These topical treatments are not magic, but they at least offer some retention of existing hair.
If you prefer, many patients get benefits from using simple oils, like coconut or aloe, applied directly after application of the topical treatments. (These elements are also found in shampoos and conditioners). An even more important tip is to not overwash one's scalp, twice a week is usually enough. Daily rinses are fine, just don't overdo the shampoo, or the hair dries out. Also, for men and women, be carefull of damage done by hot hair driers, or by excessive tugging with brushes (or rollers). In general, finger-drying with a cool blast of air is the easiest on the scalp.
If you are wishing for more definitive results, your doctor can recommend a good hair transplant specialist (an MD) who will examine your donor scalp areas, and let you know the realistic expectations you could gain from transplants of existing follicles. This surgery can now be done in a way that does not leave obvious circles of new hair clumps; they use just one or two follicles at a time along the front hairline, so the results are virtually undetectable. The costs are considerable, but at least the results are dramatic and lasting.
In any event, don't forget that many of the most admired leading role models are thin on top. From Sean Connery in his seventies to Jason Statham in his forties, to Prince William in his thirties, bald can still be beautiful!
So keep your eyes open when you are considering baldness pills, as the side effects could be hair-raising. For more specific advice, please consult your own physician.