4 Years on Finasteride, Itching, Diffuse Thinning and me

[oyster]

Firstly, he's my original post from 4 years ago with (unhelpful!) photos - https://www.hairlosstalk.com/interact/threads/balding-or-a-silver-fox-what-are-my-chances.102535/ - rather like my doctor and a trichologist, I was told I had nothing to worry about. A doctor 6 months ago told me I had nothing to worry about. but I know my own hair.

My dad was already quite progressed in balding by the age of 30 (pretty much full bald by 35), so naturally I've always been a bit paranoid about losing my hair. Fortunately, I made it to 30 without any discernible hair loss, besides perhaps a very, very slightly thinner crown area, so was very much hoping I'd escaped the worst case scenario. However, at aged 30 I happened to ask my (fully bald) barber what he thought of my crown and he said it did look a little thin up there. It definitely wasn't significant or noticeable, even under bright light, but the mental damage was done and the fear set in. Not long after this, the dreaded itch kicked in, and it's something I've struggled with every day for the past 4 years (I'm now 34). Whether or not the itch is real and related to hair loss, or just a symptom brought about by over-thinking about my hair/scalp, we'll never know, but the sensation is very real and it seems to have correlated with areas of most hair thinning ever since.

The itch drove me crazy and it wasn't long before I decided to hop on finasteride - something I've been taking for nearly 4 years now. It seem to reduce the itch quite significantly at first, though not completely, and I still have regular days where it flares up badly - it even wakes me up at night. It's definitely much worse when I get very focused on it. Read into this as you like. The itch is hugely hard work to live with but I somehow live with it.

My hair type has always been very fine and very straight but quite dense - just as my back and sides still are. However, I noticed a very subtle deterioration in my hair between the ages of 30 and 30 and half (to be very specific!) - it just didn't feel quite the same or style quite as well. It wasn't bad, it just didn't feel quite right. This, combined with the itch, convinced me I needed to act and I began taking Finasteride.

During my time on finasteride, I can only say my hair has continued to thin - I'd say in the diffuse pattern. Overall it feels like the hair all over the top of my head has become softer and finer - I can't tell if that's a result of a loss of hairs, or whether all the strands still exist but are finer and miniaturised. My hairline hasn't moved much (bar a slight recession on one side) but it definitely feels less dense. Any moisture, or wearing a hood, and my hair just goes flat and limp - no body to it like it used to. My hair has continued to grey (I don't mind it at all!) - not sure if that could explain any of my textural changes. My hair around the back and crown seems to stick up like it never used to when I get out of bed - presumably from less density.

So I guess my question is, was I right to start finasteride? Is there a chance it could have actually sped up or caused loss, kicking off a process and change of hair texture that wasn't even there, or is it actually slowing down what could have been a quicker process? Since I've not noticed any regrowth or stabilisation in all this time, is it worth me quitting to see what happens - best case, it grows better, middle case, nothing happens, worst case, it starts falling out. I don't recall any sort of significant shedding when I took the drug or since, so not sure if that says anything about its affect on me. No side effects either. Haven't touched minoxidil yet - kind of reluctant to as I don't want to risk ruining what is an ok head of hair right now.

I appreciate my hair could still be a lot worse, but I feel like I'm at a crossroads - if it thins out much further, it will become more outwardly noticeable, rather than just in bright light and wet conditions.

Have attached a selection of photos in lots of different scenarios - wet, dry, styled, daylight, bright spotlight, normal light (in no particular order). Definitely something going on in front of my crown - where you can't see my scalp further forward I must have better density, but it still feels much less dense than it did. However, when I look at my photos from 4 years ago, it looked like my front of crown was a thin point then too. Then some photos my hair looks great.

Sorry for the brain splurge. As you can tell, I'm going mad, which isn't helped by the incessant itch! Any advice would be gratefully received. Given my progress so far, where will I be in another 4 years, or 10 years or more?

 

[Ausgebombt]

Based on you’re photos at age 26, I don’t think you needed to start finasteride. Your hair looked fine.

Hair loss genes are inherited from both parents, but you get the “make or break” AR gene from your mom. This is why men generally follow their fathers hair loss pattern, but often son and father seem to bear zero relationship in terms of hair loss.

How prevalent is hair loss in your moms direct relatives? If hair loss is not common, I would confidently say your hair is fine and you don’t need to be on finasteride. If you were going bald like your dad, your hair would be a lot worse at age 26.

Almost zero percent chance finasteride made your hair worse.

 

[oyster]

Thanks for getting back to me Ausgebombt. The original photos were actually of me at 30 (not 26) and current photos are now at 34. Only male I knew on my mum’s side was her father and he died with hair.

You think I should kick the finasteride based on my current photos as nothing much is happening? Or continue to stem what I think is gradual diffuse thinning? That itch must mean something!

 

[WaccWaccWacc]

Your hair at 30 and 34 is the same. The only difference is that you’re noticeable turning more grey now.

Perhaps you have lost density but that happens regardless of medication (finasteride) or not. Simply how ageing works.

If you haven’t noticed any side effects from finasteride then I’d continue to take it. You never know if finasteride has halted your hairloss progression over the last 4 years or not. Relatively cheap insurance policy.
As for knowing where you will be in 4years, 10years, etc... the answer is nobody knows.

Something that is certain though is, with hair like that at 34 and continue use of finasteride and the progression in the hair transplant field... you never have to worry about going fully bald. Ever.

 

[TDE97]

There is a chance that you may have reflex androgenicity from finasteride. I have similar symptoms as yours with waking up with inflammation at the back of my head.

 

[oyster]

Interesting. If it were reflex androgenicity, are there any examples of quitting finasteride and seeing an improvements as the body rebalances?

Worth remembering, I was itching badly before i start finasteride too. But the quality of my hair (thickness and fineness) only properly kicked in during my time of finasteride, so part of me does worry finasteride made a mild situation much worse.

Would be happy to trial quitting finasteride if it’s likely my body will quickly reset a to pre-finasteride state but less so if I’ve sparked off something more long term.

 

[TDE97]

If you look at some older threads regarding this, some of them gained back a bit thickness and health of their hair. But, shedding went back to pre finasteride. In most cases, you may need anti-androgens like fluridil, CB or RU. Its a gamble honestly.

There is also a chance that finasteride may not have been able to handle the current hair loss progression and you might need dutasteride.

 

[centurie]

Well done mate, seems like you've kept your hair fine and finasteride is doing its job.

 

[oyster]

Yeah, looking back it does look very similar, but it has definitely thinned out all over, even if not showing up too much in photos - just feels soft, limp and almost fluffy without thickening sprays and styling product. Stands up all over my crown pretty uncontrollably without the weight of styling products, in a way it never used to. Maybe hair just goes through a particular transition with age without following straight through to further loss? Would still like to taper off finasteride to see if it is something I actually need or not. My density has dropped throughout so it’s either the finasteride or naturally increased rate of thinning I caught just in time.

 

[Will Be an Egg in 5 years]

I know what you're saying. My hair also looks perfect on camera but it feels VERY very limp and thin. This month it got way worse.

In you're case maybe it's also the natural progression. You're maintaing hairline and top but the overall slow thinning will happen anyway

 

[oyster]

That’s it yes. So to continue with finasteride or see what happens without?

 

[WaccWaccWacc]

That’s it yes. So to continue with finasteride or see what happens without?

I don’t think you’d like what happens off finasteride. But you can try.

 

[Moz5x]

Based on you’re photos at age 26, I don’t think you needed to start finasteride. Your hair looked fine.

Hair loss genes are inherited from both parents, but you get the “make or break” AR gene from your mom. This is why men generally follow their fathers hair loss pattern, but often son and father seem to bear zero relationship in terms of hair loss.

How prevalent is hair loss in your moms direct relatives? If hair loss is not common, I would confidently say your hair is fine and you don’t need to be on finasteride. If you were going bald like your dad, your hair would be a lot worse at age 26.

Almost zero percent chance finasteride made your hair worse.

“...but you get the make or break AR gene from your mom. This is why men generally follow their fathers hair loss pattern, but often son and father seem to bear zero relationship in terms of hair loss.”

Can you elaborate a bit more on what you mean by this? “follows their father’s hairloss pattern but bears zero relationship” doesn’t make sense to me.