Teacher fixated on baldness killed himself after using unlicensed hair loss drug
Sam Applegarth, 31, who had no history of mental health problems, ended his life in Dubai after starting an online prescription course of dutasteride, which is not licensed for hair loss in the UK.
The PE teacher, who had first sought help for his hair loss aged 22, had used British National Formulary (BNF) drugs minoxidil and finasteride for years without any side effects.
The inquest heard that there are no known 'suicidal ideation' side effects from taking dutasteride – a drug primarily used to treat an enlarged prostate – because there has been a failure to report such feelings in men taking the drug.
Today, Sam's heartbroken girlfriend Anya Guy, 30, urged anybody having suicidal thoughts due to taking dutasteride to inform medical experts and hopefully prevent any further deaths.
Sam was brought up in Outwood, near Wakefield, West Yorkshire, and after working for the Rugby Football League took up teaching science and PE at Minsthorpe High School.
Wakefield Coroner's Court heard that he had been concerned about losing his hair since 2015, and visited Dr Bessam Farjo at his trichology clinic in Manchester.
Dr Farjo told the hearing that Sam visited for consultations and advice but was never prescribed any drugs.
He said he was aware that Sam had started taking minoxidil, which is easily available over the counter at Boots, and later complemented with doses of finasteride.
Dr Farjo told coroner Oliver Longstaff that Sam had 'self-sourced' those drugs and both he and Sam had been happy with their effects.
In 2017, Sam underwent a successful hair transplant at the Farjo Hair Institute, in Manchester.
In regular follow-up consultations Sam informed the doctor that, elsewhere, he had undergone platelet-rich plasma treatment, where a concentrated portion of his own blood was injected in a bid to rejuvenate his hair.
He had also had his head tattooed to give the appearance of hair, in a process called scalp micro pigmentation.
'He was happy with the overall appearance after the tattoo,' Dr Farjo told the inquest.
Sam last saw Dr Farjo in July 2024, two months before he flew to Dubai. He reported still taking minoxidil and finasteride tablets, which he had sourced himself.
He was also using camouflage products to conceal his hair loss and the doctor suggested cognitive therapy to alleviate Sam's anxiety about going bald.
'He was a young man with an exaggerated view about how big an issue his hair loss was,' said the doctor.
'I had no concerns he was having any side effects from the drugs.'
He stated that 'suicidal ideation' is one recognised side effect of taking finasteride, but if a patient had not experienced those thoughts whilst on the drug they would not suffer those after the drug is out of their system.
Dr Farjo said he was unaware Sam had begun taking dutasteride, which he described as 'more powerful' than finasteride.
He said the known side effects of both drugs are the same, apart from finasteride has been reported by the BNF to cause suicidal ideation.
Dr Farjo acknowledged, under questioning from Ms Guy, there may be an underreporting of suicidal ideation by patients following a course of dutasteride.
'Dutasteride is not licensed for hair loss in this country, and it is not commonly prescribed,' he said.
'The reason the BNF suicide ideation is not mentioned for dutasteride is because it has not been reported, whereas it has been reported for finasteride.'
Dr Farjo said that it would have been easy to access a course of dutasteride himself.
He said numerous private medical supply companies are 'sprouting up' to prescribe drugs to patients, without seeing them in person.
Ms Guy told the inquest that Sam had moved to Dubai to teach in August, last year, with a view to her joining him at a later date.
She said he had 'struggled at times with his self-esteem' due to his perceived hair loss, but she felt his condition was not a bad as he believed.
His GP and family told the inquest Sam had no history of mental illness or self-harm he was a 'bright and happy individual'.
He appeared to be thriving in Dubai, enjoying swims, the gym and getting in more than 20,000 steps a day.
However, he was found dead in his apartment by a work colleague on 19 September – just five weeks after arriving in Dubai. More Trending
He left no suicide note and a post-mortem found no alcohol or drugs in his system.
Following Coroner Longstaff's finding of 'suicide', Ms Guy said outside court that she hoped people who may be suffering suicidal thoughts whilst taking dutasteride to come forward.
She said: 'People feeling by side effects with dutasteride should report them, especially if they are feeling suicidal.
'People need to be aware that they may be having suicidal ideation because of the drug.'
Get in touch with our news team by emailing us at webnews@metro.co.uk.
For more stories like this, check our news page.
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