Today's hair transplants are great and are the only proven and effective method of growing hair in completely bald areas. However, surgical hair restoration does nothing to stop the progression of female or male pattern baldness. But why do some surgeons refuse to perform surgery on hair loss suffering men unless they use Propecia and have been on it for at least a year?
Propecia (finasteride) is the most effective and only antiandrogen (DHT blocker) proven to stop hair loss. Young men with minimal hair loss may be at great risk of advanced balding in the future. Doing nothing to stop its progression while implanting hair to thinning areas or bald spots may leave men with unnatural looking hair patterns or "patches" of transplanted hair.
Many hair transplant surgeons won't even consider transplanting young patients with a severe family history of baldness. However, others may simply provide a warning and proceed with surgery under "informed consent". This is when patients have been fully informed of all the risks associated with surgery and choose to have the procedure done despite them. Written documentation and a formal signature is typically required by physicians before they will proceed with surgery.
Due to the possibility of short and even long term side effects associated with Propecia (finasteride), many men refuse to take it and are left with nothing to stop the progression of their genetic balding. Alternatives such as Rogaine (minoxidil) and other topical ketoconazole based treatments such as Extina foam (prescription only), Nizoral or Revita shampoo may also help to reduce the effects of balding.
Some expert hair restoration physicians will be willing to work with patients who refuse medical hair loss therapy. However, those who choose to undergo hair surgery without using non-surgical solutions should be aware of the risks and work out a long term hair restoration plan with their surgeon of choice.