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Comment by LewisVerstappen | Hacker News Reader

Yeah, but there is Finasteride for male pattern baldness which has fantastic results and is incredibly cheap (I got a 3 month supply for $12).

A 10 year study published by the Tokyo Medical Clinic of finasteride carried out in Japan found that more than 99 percent of men with male pattern baldness experienced no worsening of their hair loss during treatment [1]

Tons of additional clinical evidence showing that Finasteride works.

[1] - https://www.researchgate.net/publication/337105943_Long-term...

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The key being that it doesn't give any hair regrowth in the vast majority of people, so you have to get people taking it before they see much balding, which is an interesting challenge - why worry about something you can barely see or notice until it's already a problem?

There are ad campaigns from male order providers such as Hims and Keeps around this, I wonder how effective they are.

I take it, and it stopped the balding progression as far as I can tell, but I had to get an FUE hair transplant to get some lost hair back.

> why worry about something you can barely see or notice until it's already a problem?

So, you measure hair loss with the Norwood scale. You don't go from 100% hair to bald spots immediately.

First, you'll see diffuse thinning where the thickness of your hair drops significantly.

In the first stages of diffuse thinning, it won't be apparently to 99% of people that your hair is thinning but you'll immediately notice when you take a shower / apply shampoo (it's really obvious when your hair is wet).

I'd say that's when most men realize they're losing their hair and that's when they should get on Finasteride.

It may still be too late at that point. In my experience people who care about a man's hair (women, mostly) see hair loss as a binary thing - you either have a full head of hair, or you're balding. They don't see a guy in the earliest stages of hair loss and say "Oh, he's got a pretty decent Norwood score!", they say "he's bald".

I've known two women that mentioned they'd rather date a man with a full head of hair who shaves his head than a balding man who shaves his head. I pressed it as far as asking "Well, what if they keep shaving it for life?" Same answer.

It also depends on your head shape, I see a lot of men who are very good looking still with a fair amount visible recession, and they do quite well with their dating life.

Personally I just felt like the relatively small amount of recession I had looked terrible on me because I already had a tall forehead to begin with, and I'm still in my 20s.

To be honest: most women care way less than you think. Personality trumps hair 95% of the time. A good barber can make you look good even with thinning hair, fine someone you like, stick with them, and tip well.

Keep in mind Finasteride isn't for recession, but for loss at the crown, though it is known to work elsewhere - it isn't approved for that.

That is not true at all. I have been taking finasteride for years, since I noticed a little recession around my temples and a small loss of density around the front. I noticed it because I know my hair well.

The only other people that might actually be able to tell it are my parents. Except for that, every other person to whom I mention I use finasteride and minoxidil says something of the sort: "wtf, you have a full, dense head of hair, why would you take anything?".

I think it's more likely that if someone's in the earliest stages of balding, people are more likely to say "he has a widow's peak" than "he's bald". Until someone hits Norwood stage 4, there's no visible bald spot, just recession around the temples.

I don't think that's true. Nicholas Cage in Con Air is pretty obviously balding, but no one would say he's bald.

He's been wearing different hair pieces for years.

For some reason actors get a pass.

Keven Smith was tired of Bruce Willis talking about his weight. So, in a friendly guy's banter, he started calling him Cue Ball on a set.

Everyone said Bruce can make fun of us, but never mention his hair.

Whomever did Elon Musk's hair line did a good job.

> For some reason actors get a pass.

Being able to spend a lot of time and money to look good does wonders to help take the sting out of whatever physical flaws one might have.

Not to mention most of them are generally attractive which also helps in a similar way.

I've been on finastride for about 12 years. I'm never sure if it's working or not. Scared to stop!

How well did the hair transplant work?

Never stop!

Hair transplant worked really well. Natural-looking hairline, which is the most important part. You'll see a lot of before and afters where the hairline looks like a Lego block hair piece was snapped into place - choose your doctor carefully here.

You'd only notice if you're looking really closely, where you'll see that the hairs are quite a bit thicker, as they were transferred from the back of my head where everyone's hairs are thick, but I have especially thick hair in general.

Thanks for this

One thing I think worth mentioning is that you should anticipate having to get multiple transplants if you expect to have much future hair loss. I just saw a guy a few weeks ago who had gone mostly bald on top but had an obvious row of hair across his hairline. It looked like he had gotten a transplant early on and then didn't continue as his hairloss progressed.

There's surgery to replace the lost hair (with hair moved from somewhere else, granted). It's certainly much more expensive than catching it early and treating it with minox or whatever, but it's within the reach of many people (<$10k).

What happens to the old area from where the hair is taken?

It's taken in small strips from the back and sides of the scalp which, for whatever reasons, aren't prone to the mechanisms causing male pattern baldness on the top of the head and hairline. So theoretically those areas where the hair was mined will now be thinner, but they do it in a manner that you'll never notice the decrease in hair in those areas.

I heard from a barber, that despite claims hairs from the back of the head are different follicles, and won't die off, this is all lies and marketing bs.

So you need endless treatments, or else take testosterone blockers.

Well

1. even back of head hair thins eventually in balding people, but generally many decades later than the front or crown. By the time you're losing that hair, you're probably a lot older and care much less

2. taking finasteride indefinitely is supposed to drastically slow or stop further thinning or loss. Of course as in point 1, you're probably going to lose that battle eventually, but again you'll be much much older when the damage gets serious than you would have been otherwise

And you continue to recede so you will need follow-up treatments for that. If you're too far gone it's just not practical.

It's a meme at this point, but for most people shaving their head is the right option.

iirc there's a largely genetic component to it, so one could simply proactively take it if they carry the genes. But the side effects can be unfortunate (depression, libido) . Seems like topical is better than oral.

I took it way too late and it didn't really help. I shaved after and I'm really happy with that decision.

Same. Not much, if any, regrowth

Leaving this here for other men who might stumble on this: Oral finasteride drives your DHT way down. However, driving DHT down is essentially the binary goal of stopping hair loss.

And that's all fine and good, but having 'just enough' DHT is important for good health. (Psychology, sexual function, etc)

If you're on finasteride, do yourself a favor and consult with a TRT ('low T') doctor, have your DHT level tested, and consider modulating your finasteride dosage according to its effect on your DHT level.

A good balance is worth working towards. Don't blindly take finasteride without keeping an eye on its effects to your DHT.

Given the potential serious, life-changing adverse effects that persist even after stopping use - no thanks. Just cut your hair short / shave your head.

Minoxidil is highly, HIGHLY toxic to cats. Pregnant women shouldn't handle finasteride because the hormonal effects could cause them to lose the baby. I decided I'd rather go bald than put any cats or women in my home, or my unborn child, at risk. That was before I learned about the long-term detrimental sexual side effects of finasteride.

I wouldn't worry about Minoxidil with cats unless you plan to feed it to them. It's not different with dogs and chocolate.

Same thing with pregnant women and Finasteride. Doesn't really matter unless you plan on feeding your pregnant wife your finasteride pills.

Maybe in the 70s/80s it was weird to be bald, but there are so many bald people now, it's like whatever. If you think I'm ugly or you're not into it fine, but there are plenty of women who are.

I think it depends, bigger and stockier guys seem to pull it off pretty well.

I don't think I could pull it off though, at least right now. I have a taller, lankier statue and I worry I'd look like a skinhead.

I've seen some smaller guys pull it off as well, but they're usually shorter. Most guys that go clean shaven with my kinda build end up looking goofy.

On the flip side, long hair on bigger guys always looks odd to me.

13 years ago I started going to the gym because my hair started thinning. I was convinced a tall slim guy would look weird bald. I still have my hair albeit thinner than it was then but still there. I wonder if a life style change helped with that.

Clean shaven and bald is definitely a difficult mix, probably a reason most people try to grow a beard. The hipster bald glasses beard look is cliched but preferable to your hair being half missing!

Kojak made baldness popular in the 70’s and 80’s: https://en.wikipedia.org/wiki/Telly_Savalas#Baldness_and_sta...

At the very least growing up as a kid in the '80s and early '90s, the only time I ever heard someone get compared to Kojak was as an insult. Shouting "Hey, Kojak!" at a bald guy was a good way to start a fight.

What ever happened to toupees? Young men seem to not even consider them as an option, even though the quality is better now than ever.

You never notice the good toupees.

Be strong brothers. Turn to baldness.

"I'm proud of myself, for the way I accepted my baldness." - Larry David, the president of bald people.

https://youtu.be/Le4tih0tfbs?t=194

Finasteride seems like a miracle drug (cheap and effective) but unfortunately is not without risk for some users:

https://pubmed.ncbi.nlm.nih.gov/22789024/

i wish when people talk about Finasteride they always mention it that you won't be able to donnor blood after that. (FDA says you need at least 30 days Finasteride free for doing that)

What about just accepting who you are and realizing that baldness is potentially even a blessing, less maintenance and if you're athletic, I think it's a good look, lots of women have complimented me on it since shaving my head and embracing it.

Umm yeah fuck that. I'd much rather pay $4 a month and keep my hair haha.

Is it more important than keeping your sexual function, though? https://pubmed.ncbi.nlm.nih.gov/22789024/

Sexual side effects are rare and I haven't experienced any. I also get regular blood work done so I can keep track of my metrics and my doctor will let me know if anything goes awry.

So yeah, not really concerned and will definitely keep taking Finasteride.

The point is that in all this thread, including in your previous comment, people are talking about it as if it had no possible side effects. So, great for you that you track your metrics and consult your doctor, but next time you stand behind a potentially devastating medicine, mention the downside and the care you take as well.

Some people simply look better with hair than without. If you have no side effects, and it's dirt cheap, why not just take a pill a day and be done with it?

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