If Propecia stops DHT and balding is just a result of DHT damaging the follicle over time then why do we get catch up hair loss?

If propecia stops DHT and balding is just a result of DHT damaging the follicle over time then why do we get catch up hair loss? Surely propecia should protect the hair until the person comes off it and then balding continue at a normal rate (or even reduced rate if natural testosterone then lower)... Also if a man in his mid 30's goes on propecia what are his chances of regrowth at the crown and of keeping his hair as it is?

Doctor Answers 4

Catch up hair loss

Catch up hair loss refers to when you stop propecia and the hair loss that propecia held at bay is now falling out.  Basically, the hair loss catches up to what it would have been had you not been on propecia. Propecia only works while you take it as it does not offer future protection.


Beverly Hills Hair Restoration Surgeon
5.0 out of 5 stars 28 reviews

Hair Loss and DHT

Propecia is most effective in stopping and regrowing hair in the crown area. A few individuals will get a little benefit in the mid scalp area as well. However, it needs to be taken long term for it to continue to work.  Most individuals if they have at least 30% of their crown hair will get an improvemnet of about 5-10%. If the crown is completely bald the Propecia may stabilize the fringe. 

Brian Goertz, MD
Seattle Hair Restoration Surgeon
5.0 out of 5 stars 23 reviews

DHT

DHT is a competitive inhibitor for DHT which is about 70% effective. Catch up hair loss occurs when you stop finasteride, and the body returns to where it normally would have been had you not been ever on finasteride. 

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 27 reviews

Understanding Propecia--Hair loss, PRP, Progesterone, Viviscal, Rogaine, Finesteride, Spironolactone

I recommend an evaluation with a hair loss expert. Propecia will only work as long as you take it. If you stop, the hair will go back to its normal cycle and eventually fall out as if it would based on your genetics. There are non invasive options such as PRP/progesterone injections or transplantation for improvement. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

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.