What if blocking the DHT does’t work?
The hair follicles in genetic balding have a limited number of hair cycles to their life span. Let’s say, for example, that the hairs in the leading edge of your mature hairline have 8 hair cycles of life to them and each hair cycle is 3 years, then at the age of 24, the hair will undergo Apoptosis (cell death). When using a DHT competitive inhibitor like finasteride, this slows down the anagen cycle and the trigger that causes Apoptosis, but it is not always successful. I tell my patients that there is a ‘tug of war‘ going on between DHT and the genes that determine Apoptosis . Like any war, there are winners and losers. When finasteride does not work any longer, you may have lost the war.