QuestionI realize that medical advice specific to one person and one persons ailments can not be given out through Allexperts.com. So, the following is a hypothetical situation.
"Joe" is a 29yo caucasian male of 50% Irish ancestry decent. The remaining 50% is spread out through upper and western europe; French, German, Norwegian, etc. His father, grandfathers, and great grandfathers (both maternal and paternal) all had hair loss. Joe's fathers' hair loss set in around 30's and by mid 50's was attempting the comb over with little success. Grandfathers began thinning in thier 30 or 40's with marked loss by 50's and then almost complete loss in thier 80's (I understand that still standing in your late 80's is a big enough of an accomplishment so we are not too worried about hair loss at the age of 80). Joe's mother has midly coarse but thick salt and pepper hair with no signs of recession. Joe's paternal grandmother's began to slightly thin in her 60's and it remained that way until she passed away. Joe's maternal grandmother had coarse, but mild thinning hair in her early 60's, but by mid 60's was diagnosed with breast CA and the chemo took what remained of her hair. History suggests that most females on either side of the family tree (with the exception of those listed above) maintained thick and wavy hair well into thier 80's. One great grandmother was put to rest at 96 with ten times the hair of her mid 60 year old son.
Joe, at 29 is moderatly overweight, does not smoke or use rec. drugs, takes beta blockers and tricyclics for migraine headaches and 1 adult ASA per day for good measure. His hair is thick by strand and by concentration, it is blond to red in color (some say "strawberry blond") but is definately not red like "Opie" (the andy gifith show). Blond would be the predominant color. The hair line is strong above the forehead and shows no signs of recession. HOWEVER there seems to be a very slight recession over both "corners" of the forehead. A sort of upside down "V" shaped recession. Kind of what David Letterman had in the very early days.
No matter what way Joe wears his hair there is no obvious signs of recesion, just some very subtle hints of recession to his own eyes. The crown is thick and full and there has been no graying or color changes. The scalp is healthy and pliable. The hair on top, in and around the crown area is softer and a bit wavy with length while the sides and lower portion of the back tends to be a thicker, more coarse type of hair. This type of hair falls liturally and figuratively between the hair on the crown and the beard hair on the face.
Joe thinks that at almost 30 it's time to turn on the offensive and start gearing up. Rogaine shampoos and topical applications are costly, messy, time consuming and don't seem to have much evidence to back them up. Joe doesn't need to grow any hair back. He just wants to keep what he has. Propecia seems to be the magic bullet, both in maintaing and, should the need arise, regrowing.
But there is a big "however". Joe knows that Propecia has a safe track record and there isnt much information that would give him a good reason not to use it. Except for the very limited are rare instances where propecia has acted as an accelerant in the formation and metastasizing of some rare and voracious types ofprostrate CA. Again, Joe knows that this is a very rare side effect, but it does exsist. And so does a history of Cancer in Joes family. Breast cancer in several females on the maternal side and Joe lost his father to pancreatic carcinoma. Does this history preclude Joe from using Propecia to save his golden blond locks of hair? What are Joe's chances on keeping his hair if he does nothing? What other options are worth pursuing? Just how risky is using Propecia to treat a non life threatning problem?
Thanks for the help.
AnswerJason,
A pretty lengthy question. Propecia is "safe", and your Joe's risk of prostate cancer is very low at his age. Nonetheless, taking any chemical or drug (and that includes prescription, over the counter, and vitamins/herbs) depends on the Cost/benefit ratio. All drugs carry inherent risks. I think Joe's risks of adverse events are very small, but are still present. It is "his" decision. Even if Joe were to try Propecia, it may not have the effects he wishes.
Frankly, if Joe is having that much reservation about taking an optional and elective treatment, then I would likely advise against it. While appearance is important for most, perhaps the old adage of "you can't judge a book by its cover" will play true.
My $0.02
