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 Dr. Bernstein, founder and Chief Surgeon of the Bernstein Medical Center for Hair Restoration, is an Associate Clinical Professor of Dermatology at Columbia Unversity in New York. He is recognized world wide for developing the Follicular Unit Hair Transplantation (FUHT) technique used by the majority of hair transplant surgeons in the world today.
Joris
2006-03-28
Increased Dose of Propecia
Hello Dr. Bernstein.
I recently turned 22 and have been on Propecia for about 2 and a half years. The amount of hair that de-miniaturized with daily 1 mg peeked about a year ago and I have seen steady miniaturization since. The location of miniaturized follicles has also spread from primarily my front hairline to vertex areas though I have not yet had enough loss for it to be cosmetically significant there; my temple coverage was lost what seems like long ago. Luckily I anticipated this type of pattern even while being on Propecia (I understand it’s not a wonder drug) from looking at the Norwood charts, on which I believe myself to be a 3A. With my current degree of miniaturization I have been receiving the same subtle glances towards, or rather through, my hairline that I received prior to starting Propecia. Also, in an effort to be complete I should mention that I have used Nizoral 1% regularly throughout the course of my hair loss.
My question is whether or not an increase in dosage of Finasteride is indicated here or if I should seek other options entirely? I know it is difficult to answer my next question without a visit (or even with one), but what is my long term outlook for medical treatments in general, what is the best plan for keeping a cosmetically significant degree of coverage without a transplant? At what point can I consider a transplant, especially at my age and with my history?
I realize that your time is very valuable and as such apologize for the bulk of this question, but after having read many physicians’ answers on many different sites I believe you take the most care in your answers and would like to thank you at least for that and in advance for answering my questions.
Thank you,
Joris
At 22 years old, I would increase the dose of Propecia before considering hair transplant surgery. I usually increase the dose when someone has been on the same dose of medication for about three years. Although there is no good data on how to exactly to increase the dose I generally use finasteride 5mg every other day. Please consult with your doctor before making any decisions.
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