A close friend (who is younger than me, I might add) recently started getting injections in his scalp for hair loss. The hirsute gene does not run in his family, and his hairline is already starting to taunt him with the slightest hints of receding. The ebb of hair is not visible to the naked eye unless he pulls it back to unveil thinning at the roots; but the distress of losing his precious locks to the aging process has gotten inside his head, literally. Upon his visit to a leading dermatologist in New York City, the doctor advised him to begin preventative treatment: “Start early and be aggressive!” By his next visit, he was happily submitting to a round of injections in his scalp.

From the sound of it (and from the look of his 50-something father), my friend is predestined for male pattern baldness, which follows a typical path from receding at the hairline in the form of an “M” shape to thinning of the hair on the crown. Its cause is a combination of hormonal changes and genetic factors (hence the name Androgenetic Alopecia). As explained in detail on MedlinePlus, each strand of hair grows between 2 and 6 years from a cavity called the follicle, which shrinks over time. As the follicle shrinks, it leads to shorter, finer hair that ultimately shrivels to nothingness. In spite of the follicle’s lack of outgrowth, it remains alive. Hope is not lost, even if hair is.

OTC medications like Minoxidil (sold under the trade names Rogaine and Avacor) provide a temporary solution, slowing hair loss only as long as the product is used, and only in a targeted area of hair loss. The prescribed oral medication Finasteride (trade name Propecia) works by arresting the conversion of testosterone into the biologically more active dihydrotestosterone (DHT), the hormone culpable for shrinking hair follicles. This androgen hormone inhibitor, which has a 80% success rate, is the only FDA-approved pill that can successfully treat male pattern hair loss both on the vertex and anterior sections of the head.

Studies have proven that lowering DHT levels leads to a slower progression of hair loss. However, like Minoxidil, Finasteride stops working as soon as you stop taking the drug. My friend’s goal was to protect all the hairs on his head and stave off the effects of aging for as long as possible. What’s a self-admittedly vain young man clinging to his youth to do?

The same thing college kids do when they want to get drunk fast: shots. Instead of relying on a pill that can take up to a year to deliver results, my friend is getting a highly potent dose of a liquid DHT blocker injected directly into his scalp every few months. Each visit to the derm entails 20-30 shots of the mystery substance (he doesn’t know what’s in it, only what it does). This new program also requires a twice daily application of an ointment (probably Anthralin, an emollient often prescribed by doctors both to treat psoriasis and to simulate new hair growth).

Injecting shots of a Finasteride-like substance into your scalp does not come without risks. Finasteride is not approved for use in women. In fact, it poses an extreme danger to women of childbearing age, since the drug can be absorbed into the bloodstream and cause serious birth defects in male fetuses. In men, a common side effect is low libido, so if you’re trying to regain luscious locks for the sake of seducing someone, you might lose interest in the end goal before you get there.

Another consequence of Finasteride is that it inhibits the production not only of DHT, but also of neurosteroids. Low levels of neurosteroids are linked to the pathophysiology of psychiatric disorders like depression. A study on mice found that injections resulted in a reduced number of newborn cells and young neurons in the hippocamus. These results support studies showing depressive symptoms following Finasteride treatment. So it only stands to reason that a more aggressive dosage of something with the same effects as Finasteride could have equal if not worse repercussions.

I’ll close with the same advice I gave my dear hair-glorifying friend, who now checks his scalp in the mirror multiple times a day for evidence that the treatment is working. Be careful when forcing your hair to drink from the fountain of youth. The physical and emotional aftermath may not be worth a few extra hairs on your head. That’s why hats were invented.