Here is a question I received from a prospective patient and my answer.

Question: My wife keeps telling me that I need a hair transplant so here I am doing some research. Here’s my situation, I am 31 years old and seem to be a 3V on that baldness scale. One of my friends is taking propecia a says it’s great stuff, but I am afraid of the side effects that I keep reading about. Is it even worth having a hair transplant if I don’t take Propecia to stop the rest of my hair from falling out?  I’ve also read that once I start this process I might have to go through several surgeries and if I don’t take Propecia I can still look bald in time. Please advise. Thank you.

Answer:

This is an excellent question. Firstly, there have been reports of sexual side effects with Propecia, but the vast majority of people taking Propecia report no adverse side effects and the benefits of taking Propecia, especially in younger patients, are significant. In my practice, I have all patients read and sign a detailed Propecia consent form that discusses in depth the benefits of Propecia as well as all the possible side effects and any associated risks. I let the patients know if they start to feel any of the adverse side effects to discontinue the medication. In addition, to patients who are thinning in the crown region, which it sounds like you are, I also recommend Rogaine 5% foam twice a day. Studies have shown that patients who use Rogaine and Propecia together experience a synergy between the 2 medications which show more positive results than either medication taken independent of the other. I routinely perform a video microscopy on the scalp with my patients and if I see a large amount of miniaturization of follicles I may also recommend low light laser therapy. I have become a fan of the new LaserCap which, with it’s ease of use, provides excellent compliance among patients. I have seen great results with it low light laser therapy in patients who have a large amount of miniaturization. Finally, in order for me to determine if you are a candidate for Hair Transplant surgery I would need to see you in consultation or look at your photos, but if you are a 3V it sounds like you likely could be a candidate. I always tell my patients that you will definitely have between 2-4 procedures in your lifetime to keep up with continuing hair loss. The number of procedures is affected by the rate of your future hair loss, which Propecia, Rogaine, and Laser Therapy can markedly slow down. I hope this answers your questions.

All the best,

Marc Dauer, M.D.