Does a History of Hair Loss Mean I Will Definitely Lose Mine?

i am a male 24 yrs old and i have family history of hair loss. my brother has it , my dad has it and so does my grandfather from both sides. my dad says that he started thinning at 22 yrs of age and im about to turn 25 and i still have a full head of hair.

my question is that i just dont know if i will lose my hair or not. is it possible that i could just be lucky? or will i 100 percent lose my hair? i have however been taking finasteride for the last 5 yrs however.

Doctor Answers 4

Will I go bald?

Nobody can predict if you will lose hair or not, but certainly your odds are increased compared to individuals without a family history.  Men using finasteride may find their hair loss slowed considerably.

But having a family history increases the chances of developing male balding:

In a study of 572 men ages 16-91, young men with a balding father had a 5.5 times increased risk of balding than young men who did not have a balding father.

In another study, only 1 of the sons of 50 non balding men had Hamilton Norwood type III balding or worse. In contrast, 32 of 54 (60 %) of sons whose fathers were bald had Hamilton Norwood scale type III baldness or greater.

Clearly, having a father with balding greatly increases the chance a given male with develop male pattern baldness. 

Birch MP Eur J Dermatol 2001; 11-16
Ellis JA. J Inv Dermatol 1998 110: 849-53

Male Pattern Baldness and Propecia

It is likely that you would have experienced male pattern baldness, since the condition does have a strong genetic component and it seems to have a considerable presence in your family history. However, this is not 100% certain. The fact that you have been using Propecia for the past 5 years (and began using it early on) would ebb your hair loss, making it difficult to determine if you do, indeed, have male pattern baldness. Finasteride is proven highly effective at inhibiting DHT, which is the hormone that causes MPB. You cannot tell while on finasteride what might be the evolution of your hair pattern.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
5.0 out of 5 stars 28 reviews

Hair Loss in Men

Even without a family history of baldness or hair loss, most men do experience hair loss or thinning with time.  How many 70 year old men have a full head of hair like they did when they were 18?  Very few.  Thus, preventing hair loss before it happens is important to many men.  If you are concerned about the potential for future hair loss, I recommend making an appointment with a board certified dermatologist.  The dermatologist can evaluate your current situation and recommend various strategies such as Rogaine and/or Finasteride based on your individual condition.

Anthony Perri, MD
Houston Dermatologist

Family history of hair loss

A family history of early or significant hair loss often but not always reflects on what will happen to you.  I would not assume that you will go bald even with a family history.  If you are destined for thinning, the pace at which that would happen is also unpredictable.  If you were to show real evidence of thinning early in your life (e.g. in your 20s) then that might be a stronger clue than family history that you are more likely to go bald.

Daniel Berg, MD
Seattle Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.