Should I start finasteride? (photo)

The decision to start a medication is between you and your doctor after an examination and consultation.  Low self esteem is not a reason to start a medication.

Your photos are very suggestive of androgenic alopecia.  There is not blood test for this condition.  Hair loss is a normal occurrence in at least 50% of men and women.  I would seek the advice of a dermatologist locally for an evaluation and treatment plan.  We know that the sooner you begin on Propecia and minoxidil, the sooner you will slow down and rarely reverse your hair loss.  Thus, if this is destroying your confidence, it is wise for you to seek the advice of a physician as quickly as possible.  It is also important for you to study the risk factors for taking Propecia.  Propecia could turn into a life long commitment.  If you stop it in later years, you will likely advance very quickly with your hair loss.

For an experienced hair specialist - the diagnosis of AGA is what we call a "clinical diagnosis." .... This simply means that a qualified physician can make the diagnosis after listening to all your story about your hair loss and examining your scalp....Blood tests are not necessarily needed for men with classic male pattern balding. However, I often screen for cholesterol issues in young men with balding along with blood sugars and blood pressure. A thyroid and hemoglobin is also sometimes ordered.