PE teacher, 31, who was obsessed with not going bald took his own life after switching to an unlicensed drug in Dubai to treat his hair loss, inquest hears
A teacher obsessed with not going bald took his own life after switching to a powerful unlicensed drug to treat his hair loss, an inquest heard today.
Sam Applegarth, 31, who had no history of mental health problems, hanged himself in Dubai after starting an online course of dutasteride - a drug not licensed for hair loss in the UK.
The PE teacher, who had first sought help for his hair loss aged 22, had used 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 Mr Applegarth's heartbroken girlfriend Anya Guy, 30, urged anybody having suicidal thoughts after taking dutasteride to inform medical experts in the hope of preventing similar tragedies.
Mr Applegarth 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.
After his death one parent praised him as an 'absolute diamond and role model'.
Wakefield Coroner's Court heard that since 2015 he had been concerned about losing his hair and visited top specialist Dr Bessam Farjo at his trichology clinic in Manchester.
Dr Farjo told the hearing that Mr Applegarth visited for consultations and advice, but was never prescribed any drugs.
Sam Applegarth's heartbroken girlfriend Anya Guy, 30, pictured outside his inquest in Wakefield today, urged anybody having suicidal thoughts after taking dutasteride to inform medical experts
He was aware that Mr Applegarth had started taking minoxidil, which is easily available over the counter at pharmacies such as Boots.
The teacher later complemented it with doses of finasteride, which has been linked to terrifying side-effects including erectile dysfunction, depression and anxiety.
Dr Farjo told coroner Oliver Longstaff that Mr Applegarth had 'self-sourced' those drugs and both had been happy with their effects.
In 2017 Mr Applegarth underwent a successful hair transplant at the clinic.
In follow-up consultations Mr Applegarth informed the doctor that he had also 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.
Mr Applegarth last saw Dr Farjo in July 2024, two months before he flew to Dubai.
Leading hair loss expert Dr Bessam Farjo, who saw Sam Applegarth at his clinic in Manchester but did not prescribe him medication, told today's inquest in Wakefield there may be an under-reporting of suicidal ideation by patients following a course of dutasteride
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 his 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 them after the drug is out of their system.
Dr Farjo said he was unaware that Mr Applegarth 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 the fact finasteride has been reported by the British National Formulary to cause suicidal ideation.
Dr Farjo acknowledged, under questioning from Ms Guy, there may be an under-reporting 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 for Mr Applegarth to access a course of dutasteride himself.
'Unfortunately, it is not difficult to get medication online,' he said.
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 Mr Applegarth 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 Mr Applegarth had no history of mental illness or self harm and 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, the inquest heard.
However, he was found hanging in his apartment by a work colleague on September 19 - just five weeks after arriving in Dubai.
He left no suicide note and a post-mortem found no alcohol or drugs in his system.
Following Mr Longstaff's conclusion of suicide, Ms Guy said outside court that she hoped people who may be suffering suicidal thoughts whilst taking dutasteride would 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.'
Last month the European drugs regulator said it was not possible to establish a link between suicidal ideation and dutasteride tablets based on the reviewed data.
The European Medicines Agency confirmed suicidal thoughts as a side effect of anti-hair-loss drug finasteride but said the benefits of both medicines continue to outweigh their risks for all approved uses.
Following Mr Applegarth's tragic death, Craig Shepherd, who recruited him to work at Wakefield Trinity Rugby League Club, said: 'It was inevitable Sam went on to be a massive success in teaching.
'He was so loved by all who knew him. RIP Sam.'
Anita Godfrey responded by posting: 'An absolute diamond and role model he really engaged my three in rugby league and would go above and beyond.'
For confidential support, call the Samaritans on 116123 or visit samaritans.org
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