The pattern shown in this photo shows that the grafts were removed with FUE in two stripes and will cause a see-through donor area when the hair grows out particularly if he cuts his hair short. The lower FUE harvest seems to come from the neck which is not permanent hair.
Did my dermatologist prescribe Finasteride too liberally ? Context : 27 y/o. Father and his 4 brothers have full heads of hair. Mother’s side : 3 out of 4 bald uncles. They were bald in their early twenties. I went to the derm two weeks ago. He didn’t look closely at me or do a hair count. He was like “yep, looks like MPB alright” and gave me a prescription for Fin (1mg). First pic is Aug 2017. Rest of the pics are from the last 2-3 months.
I would have performed a HAIRCHECK and a miniaturization study before committing you to a lifetime of finasteride. Too many men go on the drug not knowing for sure if they are balding. I like to make the diagnosis with instruments first, then use these instruments to establish a ‘metric’ which I can follow yearly to see the effectiveness of the finasteride yearly. That is the value I believe doctors should add to this treatment process.
This is called sublingual dosing of a drug. For some medications, slow action is better than fast action, especially for drugs that drop the blood pressure or have heart effects that are supposed to be taken as a pill. See this article here: http://journalofpharmaceuticalresearch.org/index.php/kpc/article/viewFile/118766/81984
They say a picture is worth a 1000 words. He is one of the best surgeons in Brazil and he learned SMP here at our office. In addition to learning, he was one of our patients and we repaired some very old work of the plug era hair transplants. The SMP he had done wiped out all of the scars he had from the old surgeries.
I know how it works chemically. I mean in practice. I’ve been on finasteride for 4.5 months now and haven’t noticed any regrowth and my hair is starting to shed quite a bit again. I obsess over this every day and it’s destroyed my confidence. My hair is about an inch long right now so i think it would be difficult to notice subtle regrowth anyway. Most of the hair fall I’ve been experiencing lately has been pretty short hairs. Maybe about a centimeter on average. I know finasteride takes time to strengthen miniaturized hair follicles but I guess my question is, is it common for hair to start growing back and then just fall right back out? I’m wondering if maybe it can take a couple of growth cycles for the hair to actually be strengthened enough to grow out and stay without falling. Anyone have any insight?
Hair cycling between growth and rest, is mediated by an enzyme called 5 Alpha-Reductase which is present in small amounts and converts testosterone to dihydrotestosterone (DHT). Testosterone affects lean body tissue, muscle size, muscle strength, and sexual function in men. In men who are genetically predisposed to develop androgenetic alopecia (AGA; male pattern hair loss), endogenous androgens alter scalp hair follicles, resulting in production of vellus-like, miniaturised hair, rather than cosmetically significant terminal (normal, full bodied) hair. This change leads to a progressive decline in visible scalp hair density, readily perceived by the patient as thinning and, eventually, baldness. The benefit to finasteride occur over from 6 months to 2 years.
You should not know that you are taking finasteride when you are on it in terms of how your body functions normally.
Look at the picture and you decide!
This is an excellent review of the causes and the progression history of genetic balding in the male. Rod Sinclair is an Icon in this field and is senior author on this article.
https://www.tandfonline.com/doi/full/10.1517/14656561003752730
This is very exciting article which shows that it can significantly improve communication and social skills in autistic adults.
Hi doctor, just a question, do you have hundreds of patients on Fin without any sides? And if they do have any do they just call you? And what dosage do you recommend, Im thinking of 0.25mg
I have thousands of patients on finasteride without side effects. Usually, I start at the recommended dose, unless the patient is unusually concerned about the sexual side effects. If that be the case, I might start with 1/4 dose and slowly over weeks increase the dose until it reaches the 1mg dose provided that there is no deleterious side effects reported.
I get a good family history and try to match the patient’s hair loss pattern with his family history. Then I mark where the patient is in his hair loss process, usually deploying the HAIRCHECK instrument test. Then I discuss the various options that are age related. Many of the men under 25, who may be balding and wanting a hair transplant, I discuss the need to delay such decisions and offer the various treatment options such a minoxidil and/or finasteride. Then I see the patient yearly to find out the effectiveness of the treatment and may make adjustments. Once the man has passed 25-26, I may or may not discuss the hair transplant option. Throughout this process, I develop a relationship with the patient so we get to know each other and I learn and understand who he/she is, what their concerns are and acting like a doctor, do the things that good doctors do, that show concern about the course that the hair loss undergoes during this period, year to year.
Assuming that you don’t have an infection because your doctor cleared this diagnosis, then your hair and skin color often produces sensitive skin. To find out if this is the cause, you can scratch your forehead with your fingernail by pressing it into your forehead and moving it about 2 inches. IF the scratch area stays red for more than a few minutes, you have Histamine positive response and may be able to treat your red recipient area with topical steroids. ?
That would not make sense to me. One or the other is the way to go. If the oral is working for you, don’t switch as the expense is considerably different.
This is a very impressive study on 76 men which took place over 24 weeks and got substantial growth. Mean hair count increases of 40% were observed in PSO-treated men at ‘just’ 24 weeks, whereas increases of 10% were observed in placebo-treated men (P < 0.001). Adverse effects were not different in the two groups. I think that this is worth a try for many men thinking about doing something simple and inexpensive for treating their hair loss.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017725/
The pattern shown in this photo shows that the grafts were removed with FUE in two stripes and will cause a see-through donor area when the hair grows out particularly if he cuts his hair short. The lower FUE harvest seems to come from the neck which is not permanent hair.
Did my dermatologist prescribe Finasteride too liberally ? Context : 27 y/o. Father and his 4 brothers have full heads of hair. Mother’s side : 3 out of 4 bald uncles. They were bald in their early twenties. I went to the derm two weeks ago. He didn’t look closely at me or do a hair count. […]
This is called sublingual dosing of a drug. For some medications, slow action is better than fast action, especially for drugs that drop the blood pressure or have heart effects that are supposed to be taken as a pill. See this article here: http://journalofpharmaceuticalresearch.org/index.php/kpc/article/viewFile/118766/81984
They say a picture is worth a 1000 words. He is one of the best surgeons in Brazil and he learned SMP here at our office. In addition to learning, he was one of our patients and we repaired some very old work of the plug era hair transplants. The SMP he had done wiped […]
I know how it works chemically. I mean in practice. I’ve been on finasteride for 4.5 months now and haven’t noticed any regrowth and my hair is starting to shed quite a bit again. I obsess over this every day and it’s destroyed my confidence. My hair is about an inch long right now so i think […]
You should not know that you are taking finasteride when you are on it in terms of how your body functions normally.
Look at the picture and you decide!
This is an excellent review of the causes and the progression history of genetic balding in the male. Rod Sinclair is an Icon in this field and is senior author on this article. https://www.tandfonline.com/doi/full/10.1517/14656561003752730
This is very exciting article which shows that it can significantly improve communication and social skills in autistic adults. https://www.medscape.com/viewarticle/913220?src=WNL_recnl_190527_MSCPEDIT_surgery&uac=128368AK&impID=1975986&faf=1
Hi doctor, just a question, do you have hundreds of patients on Fin without any sides? And if they do have any do they just call you? And what dosage do you recommend, Im thinking of 0.25mg I have thousands of patients on finasteride without side effects. Usually, I start at the recommended dose, unless […]
I get a good family history and try to match the patient’s hair loss pattern with his family history. Then I mark where the patient is in his hair loss process, usually deploying the HAIRCHECK instrument test. Then I discuss the various options that are age related. Many of the men under 25, who may […]
Assuming that you don’t have an infection because your doctor cleared this diagnosis, then your hair and skin color often produces sensitive skin. To find out if this is the cause, you can scratch your forehead with your fingernail by pressing it into your forehead and moving it about 2 inches. IF the scratch area […]
That would not make sense to me. One or the other is the way to go. If the oral is working for you, don’t switch as the expense is considerably different.
This is a very impressive study on 76 men which took place over 24 weeks and got substantial growth. Mean hair count increases of 40% were observed in PSO-treated men at ‘just’ 24 weeks, whereas increases of 10% were observed in placebo-treated men (P < 0.001). Adverse effects were not different in the two groups. […]