Hi Dr. Rassman,
First of all, kudos for the very informative and educational blog – I have used it extensively to become knowledgeable about the options available for MPB. My question concerns propecia and the impact of lowering DHT in the follicle…By taking propecia – one reduces the amount of DHT being generated by the body but what of the levels in the follicle? The conversion of testosterone to DHT occcurs in the prostate gland, liver and skin but how does propecia reduce the existing DHT molecules in the follicle? By halting the conversion – would the DHT levels in the follicles reduce on their own (over time) and result in either reduced hair loss, hair re-growth or increased fiber size?
I am not aware of any studies of what or how DHT is doing at the follicular level, so I really cannot get into the exact biochemical process behind hair loss and hair growth related to DHT.
However, in general DHT does impact hair follicles for those men who are specifically predisposed to androgenic alopecia (also known as male pattern baldness). So the concept behind Propecia (finasteride) is to lower the DHT level in your body and thus diminish the impact of androgenic alopecia. For a specific biochemical approach to your question, I will defer to the biochemists.