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Comment by skrtskrt | Hacker News Reader

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.

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> 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.

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 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.

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'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).

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.

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.

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

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.

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

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