Gone Today, Hair Tomorrow: Propecia, Key to Keeping Your Hair

For many young men, dealing with hair loss can feel daunting. But with modern treatments like hair transplants and medications, managing it is not only possible—it’s practical. One of the treatments I often recommend is finasteride, commonly known as Propecia when used for hair loss.

Recently, I spoke with a 31-year-old patient experiencing advanced balding—enough to require a hair transplant. While it’s not unusual for men to notice thinning hair in their 30s, when it gets advanced at such a young age, the stakes feel higher. After getting his transplant, we discussed the next step: using finasteride to maintain and protect his new hair. Hair transplants work wonders, but they’re not a cure-all. Propecia plays an essential role in keeping the remaining natural hair from further hair loss.

The key thing to remember with finasteride is this: it’s best used to stop hair loss before it gets severe. If you still have some thinning hair, finasteride can help thicken it and prevent further loss. But once the hair’s completely gone from an area, no medication can bring it back. It’s a case of “use it before you lose it.” Hair transplants can fill in the gaps, but keeping what you have intact with finasteride is crucial for the long-term.

Some men are concerned about potential side effects, particularly when it comes to sexual drive, “lust” or “libido”. In my years of experience, I’ve found this to be rare among my patients. And if any issues arise, there are ways to manage them. The important thing is not to let fear hold you back from a treatment that could be life-changing. A colleague of mine started using Propecia 25 years ago. Back then, he was 40 and noticed the typical “crown pattern baldness,” with thinning at the corners of his forehead and a growing bald spot on top.

Now, in his 60s, he has a full head of hair and remains as active as ever, competing in squash and tennis. His physical fitness and libido haven’t taken a hit—if anything, the natural aging process has had more of an impact than the medication.

For young men like my 30-year-old patient, the decision to use finasteride doesn’t have to be permanent from the start. You can try it for a year or two to see how your body responds, adjust as needed, and keep control over your hair loss. There’s no rush—just options.

Another angle to consider is prostate health. While it’s not something most young men worry about, finasteride has proven benefits here too. The drug is also prescribed in higher doses (5 mg, marketed as Proscar) to treat benign prostatic hyperplasia (BPH), an issue that tends to show up in middle age. Even the 1 mg dose for hair loss seems to help keep the prostate healthy. So while you’re tackling hair loss, you might also be lowering your risk of prostate issues in the future.

And that’s not all. In 2024, researchers from the University of Illinois found that men taking finasteride had cholesterol levels that averaged 30 points lower than those not on the drug. In animal tests, high doses of finasteride delayed atherosclerosis (hardening of the arteries) and reduced liver inflammation. This was an unexpected but welcome finding and could add another layer of protection for men using the medication.

So if you’re a young man facing hair loss, don’t let fear of the unknown stop you from considering finasteride. It’s a well-studied treatment with more benefits than drawbacks, especially when it comes to preserving your hair and possibly safeguarding your long-term health. Start while you still have hair to save—tackle the problem early, and you’ll thank yourself later.

At the end of the day, the choice is yours. But for many, finasteride can be a game-changer, offering a smart, proactive solution to keep your hair and your confidence intact for years to come.

Understanding Hair Loss

Hair loss, also known as alopecia, is a common condition that affects both men and women. It can be a distressing experience, impacting not just your appearance but also your confidence. The causes of hair loss are varied, ranging from genetics and hormonal imbalances to certain medical conditions. Alopecia areata is a type of hair loss characterized by patchy hair loss that can spontaneously regrow without treatment within a year. Understanding these causes is the first step in finding an effective treatment. Whether you’re dealing with male pattern baldness or female pattern hair loss, knowing what’s behind your hair loss can help you take control and explore the best options for maintaining your hair.

What is Androgenetic Alopecia?

Androgenetic alopecia, commonly known as male or female pattern hair loss, is a prevalent condition that affects millions of people worldwide. This type of hair loss is primarily driven by the conversion of testosterone to dihydrotestosterone (DHT), a hormone that causes hair follicles to shrink over time. While it can affect both men and women, it is more frequently observed in men. The condition is hereditary, meaning it can be passed down from your parents. Factors such as hormonal imbalances, stress, and certain medical conditions can also trigger or exacerbate androgenetic alopecia. Understanding this condition is the first step in finding an effective hair loss treatment.

Patterns of Hair Loss

The patterns of hair loss associated with androgenetic alopecia differ between men and women. In men, hair loss typically starts above the temples, creating a receding hairline that eventually forms an “M” shape. The hair at the crown of the head also begins to thin, often leading to complete baldness over time. Women, on the other hand, experience a different pattern. Female pattern hair loss usually begins with gradual thinning along the part line, followed by diffuse hair loss that spreads from the top of the head. Unlike men, women rarely experience a receding hairline or complete baldness. Recognizing these patterns can help in diagnosing the type of hair loss and choosing the appropriate treatment.

Causes and Types of Hair Loss

Hair loss can be triggered by a mix of genetic, hormonal, and environmental factors. For men, the most common culprit is male pattern baldness, or androgenetic alopecia. This condition is driven by the conversion of testosterone to dihydrotestosterone (DHT), which causes hair follicles to shrink and eventually stop producing hair. Women, on the other hand, often experience female pattern hair loss, which is also influenced by hormonal changes and genetic predisposition. Both types of hair loss can be frustrating, but understanding the underlying causes can help you find the right treatment to slow down or even reverse the process. Treatments like minoxidil can help prevent losing hair and promote regrowth of lost hair.

Genetics and Hormones

Genetics and hormones play a crucial role in androgenetic alopecia. The condition is inherited, meaning if your parents experienced hair loss, you are more likely to as well. The primary hormonal culprit is DHT, which is derived from testosterone. DHT binds to androgen receptors in hair follicles, causing them to shrink and eventually stop producing hair. This process, known as miniaturization, leads to the thinning and loss of hair. Understanding the genetic and hormonal factors involved in androgenetic alopecia can help in developing targeted treatments to combat hair loss effectively.

Hair Growth Cycle

The hair growth cycle is a fascinating process that occurs in three distinct phases: anagen, catagen, and telogen. The anagen phase is the active growth stage, where hair grows rapidly and can last for several years. During this phase, the hair shaft is produced from the hair matrix within the hair bulb, playing a crucial role in the hair growth cycle. Next is the catagen phase, a brief transitional period where hair growth slows down. Finally, the telogen phase is the resting stage, during which hair is released from the follicle and eventually falls out. By understanding these phases, you can better appreciate how treatments like finasteride and minoxidil work to promote hair growth and prevent hair loss.

Medical Management and Hair Regrowth of Hair Loss

When it comes to managing hair loss, there are several medical treatments available that can make a significant difference. Medications like minoxidil and finasteride are popular choices. Medical treatment is essential for stabilizing hair loss and improving outcomes, especially when used prior to and after surgical interventions like hair transplants. Minoxidil is a topical solution applied directly to the scalp to stimulate hair growth, while finasteride is an oral medication that helps slow down hair loss by reducing DHT levels. For those looking for more permanent solutions, hair transplantation is a surgical option that involves moving hair from one part of the body to another. Additionally, low-level laser therapy offers a non-invasive way to stimulate hair growth using light-emitting diodes. With these various treatments, you have multiple avenues to explore in your journey to combat hair loss and regain your confidence.

Propecia and Hair Growth

Propecia, or finasteride, is a widely used medication for treating androgenetic alopecia in men. It works by inhibiting the enzyme responsible for converting testosterone to DHT, thereby reducing DHT levels in the scalp. This action helps to slow down hair loss and can even promote hair regrowth in some cases. Propecia is taken orally in pill form, usually once a day. It’s important to note that it may take several months to see noticeable results, and continuous use is necessary to maintain hair growth. For many men, Propecia offers a reliable solution to manage hair loss and improve hair density.

Other Treatment Options

Beyond Propecia, there are several other effective treatments for androgenetic alopecia:

Minoxidil: This topical solution is applied directly to the scalp and works by stimulating hair follicles to promote hair growth. It’s available over-the-counter and is suitable for both men and women.
Hair Transplantation: A surgical procedure where hair follicles are moved from a donor area (usually the back of the head) to the balding areas. This method provides a more permanent solution to hair loss.
Low-Level Laser Therapy: This non-invasive treatment uses low-level lasers or light-emitting diodes to stimulate hair growth. It’s a painless option that can be done at home or in a clinic..
Hair Growth Supplements:: These dietary supplements contain ingredients like biotin, vitamin B, and keratin, which are essential for healthy hair growth. They can be a supportive addition to other treatments.

It’s essential to consult with a healthcare professional before starting any hair loss treatment. They can help determine the most suitable option based on your individual needs and medical history, ensuring you get the best possible results in your journey to combat hair loss.

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By Dr. Ryan Welter

August 13, 2025