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Hair Loss: Trump or Willis Style. Which is for You?

Timothy Boyer Ph.D.'s picture
Coping with Hair Loss

For the most part, hair loss is a natural medical condition caused by aging and genetics and affects 2 out every 3 men by the time they reach 35. But if it happens to you, how will you cope with it? Here’s the latest on hair loss that you need to know that may help you decide to whether be more like Donald Trump or more like Bruce Willis. And, the biggest myth about Finasteride.


The hot health topic of late is the status of Donald Trump’s health—both physical and mental. Opinions and speculations from both medical professionals and the media are as diverse as the hyperbole along party lines on both sides. For example, a recent article in the Deccan Chronicle titled “Donald Trump’s hair loss drug may be tied to erectile dysfunction, anger, says study” teases readers that some unflattering notions about Trump may have some medical basis—and thereby, be credible.

Be that as it may, one issue that affects men faced with premature hair loss—an equalizer among men regardless of their political views—subjectively touched on by the article, is whether the hair loss medication Finasteride (more commonly known under the brand names Proscar and Propecia) is the bugaboo the article would have you suppose.

The 60-Second Baldness Test: Normal Hair Loss or Adrogenetic Alopecia?

Does Finasteride Really Work for Treating Hair Loss?

According to Consumer Reports, when men faced with hair loss took a survey asking what they took for treatment and what they found worked for them, Finasteride was a clear winner over other hair loss medications such as Minoxidil.

“We asked people a broad spectrum of questions of what worked and what didn’t when it came to treating pattern baldness…when it came to Finasteride, twenty-seven percent of those men we surveyed said it was very effective. And another forty-one percent said that is was somewhat effective. So, there’s more hope with Finasteride than there is with almost anything else,” stated Consumer Reports Senior Editor Tod Marks, who also commented on that when it came to the effectiveness of the competing brand Minoxidil (Rogaine), only 4% of those surveyed found it effective in treating their hair loss.

Is Finasteride Safe or Not?

But is Finasteride safe? Can it lead to anger and impotence?

Drugs like Finasteride are primarily prescribed for men with prostate problems. They work by shrinking the prostate, a walnut-sized gland that wraps around the urethra, the tube from the bladder through which urine is expelled. An enlarged prostate can cause such symptoms as difficulty urinating, increased urinary frequency and increased urgency. For a number of years, Finasteride has been associated with the side effect of halting or slowing down the progression of hair loss and has thus been an active ingredient (in lower doses than in the treatment of an enlarged prostate) in hair loss products. However, there are reports of side effects that promote concern.

According to the study referred to by the Deccan Chronicle article, the article states that “…it showed concrete evidence regarding the pills’ [Finasteride] mental health risks and appeared to confirm many medic’s fears that it increases risk of suicidal tendencies.”

But as it turns out, that statement may actually have a touch of exaggeration to it. According to Schulich School of Medicine & Dentistry professor Blayne Welk who co-authored the referred article, he states in a news release in April of 2017 that the use of finasteride—for the treatment of an enlarged prostate—doesn’t increase the risk of suicide, but has shown a slight increase in the risk of depression and self-harm in some individuals. Furthermore, it bears repeating that the dose for treating the prostate is greater than the dose used for treating hair loss.

In the news release professor Welk stated, “We need to remember it is a potentially rare, but serious complication, and if someone were to develop these symptoms while starting the medication, or shortly after, that would probably be a good reason to reevaluate its usefulness, and discuss with the prescribing physician to see if it’s still appropriate to continue that medication,” said Welk.

To keep the perception of risk in context, professor Welk added that more than 5,000 men would have to take the medication for a full year in order to have one case of self-harm. “When you think of it that way, the risk is really low,” he said.

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Does Finasteride Cause Impotence?

According to the International Society of Hair Restoration Surgery in an article titled “The side effects of Propecia: the facts and the myths about Finasteride side effects,” studies in clinical trials of men ages 18-41 indicate that Finasteride-related side effects were less than 2% and slightly higher in men older that 41 who often have other conditions like hypertension, diabetes, and peripheral vascular disease that can predispose to sexual side effects such as a reduction in libido and erectile dysfunction—with the caveat that It is important to note that the incidence of erectile dysfunction in the normal adult population is 20-30% in men under 40, and increases about 10% each decade.

Furthermore, less frequent side effects seen in a small number of men include a reduction of the force or volume of ejaculation. A reduction of sperm counts has also been infrequently seen in men with underlying risk factors, but generally returned to normal after discontinuation. Breast tenderness, gynecomastia, and testicular discomfort also occurred infrequently in trial studies.

In other words, the risks are very low, but still worth investigating and keeping an eye out for if and when a person decides to try Finasteride for hair loss.

But if you decide that the risks are too great and unpleasant, going the Bruce Willis route is an acceptable and healthy way to cope with hair loss. According to Consumer Reports, their survey also revealed that shaving your head to hide hair loss combined with dressing better and exercising more to look fit rated high with those surveyed.

The Biggest Myth About Finasteride

Contrary to what many believe, Propecia (Finasteride) does not re-grow hair. The greatest effects that finasteride has on hair loss is the thickening of partially miniaturized hair and reducing, or halting, the progression of hair loss. According to the International Society of Hair Restoration Surgery, Propecia is generally ineffective in re-growing hair in areas that are highly miniaturized or totally bald. In fact, the ideal or potential candidate for using Propecia are males with genetic hair loss as evidenced by miniaturization of terminal hair and progressive hair loss. The earlier that treatment is started the better the chances that hair loss progression can be slowed and/or reversed.

And Finally…

For more about dealing with hair loss, here is an informative article for women: Stop Your Hair Loss with This Latest Hair Care Advice from Dr. Oz.


Deccan Chronicle “Donald Trump’s hair loss drug may be tied to erectile dysfunction, anger, says study

Western News “Common prostate drug could increase risk of depression, self-harm

Consumer Reports “Coping with Hair Loss

International Society of Hair Restoration Surgery “The side effects of Propecia: the facts and the myths about Finasteride side effects

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