by Dr. William Rassman of NHI Medical
I understand thank you once again. I was simply asking if oral min was generally considered safer in the long term then fin?
The answer for the drug finasteride and oral minoxidil is that if you don’t develop complications from the drugs, then they are safe for you. For example, oral minoxidil has a very rare cardiac side effect that is dangerous and must be picked up early (fainting, heart palpitations, allergy).
these are known complication of this drug so should you eliminate taking it because of this potential, even if it is rare? If you get sexual or other side effects from finasteride, then speak with your doctor and see if you should still take it. A few people believe that if you get sexual side effects and you stay on the drug, these side effects will continue (Post Finasteride Syndrome)
Finasteride, when it brings back the hairline, it is usually in a younger man (under 25) but I have seen it in a 33 year old as well. This is not common and the published literature suggests that it is rare and not to expect return of frontal hair with finasteride.
The doctor recommended 10 sessions of PRP at $500/session. I would guess you might purchase a good used car for that $$ amount. So if you were shopping for a car, you would research it, right? Doubt that you will stop your hair loss with PRP and reversing it is another story! Some doctors are just not honorable. I can tell you that I would doubt that you would get much value from this PRP package.
I was wondering if you have an opinion on hair systems, or if you ever recommend them to patients with advanced balding? I know that most people prefer to keep their natural hair, but I feel like people with very advanced balding (NW5+) would look much better if they just wore fake hair rather than try to stretch out their limited donor supply over their entire scalp. I’ve noticed that people who try to get a transplant as a nw6/7 almost inevitably have to choose between a sky-high hairline, a giant bald spot surrounded by a ring of hair, or just very thin hair all over.
Differnt strokes for different folks. Hair systems work and work well; however they are very expensive (see here: https://newhair.com/baldingblog/why-not-a-hair-system-instead-of-a-hair-transplant/) and once your on them, you are hooked on them because the attachment mechanisms cause permanent hair loss and makes the balding worse. Even from a cost perspective, a hair transplant is generally less expensive unless you are a Class 7 man. In that case, a hair system is like putting on a hat, but you have to wear it all of the time and over time they start to smell and fall apart, requiring washing and replacement frequently. Also, unless you can afford the best like Donald Trump has, your system may be detectable to almost everyone. Nobody likes that.
I have a scar from my hair transplant, why did it happen, did my doctor do something wrong and what can I do about it? (photo)
You had a strip surgery and clearly scarred worse than many people do. I had three surgeries in the same place and have no significant visible scar. It is not that I had a better surgeon, I just healed better than you did. I am sure your surgeon did the surgery right. The best way to deal with the scar is to have scalp micropigmentation which covers up the scar nicely. Your picture is on the left, a worst case scar is shown on the right before and after scalp micropigmentation (https://scalpmicropigmentation.com/). There is hope!
The sexual side effects from finasteride can appear at any time. It may be caused by the drug. See your doctor and discuss this with him. I generally tell my patients to reduce the dose to one pill every 4th day for 3 weeks, then one pill every 3 days for 3 weeks and then end up with one pill every two days and stay on the lower dose if that dose helps the side effects.
“If you’re going to loose all your hair eventually there is no point in treating it, you will be bald anyways, that’s how God wants you to be.”
A relative of one person gave him this comment. This was my answer: God gave us genes that cause hair loss. God did not say that one had to accept these genes and that is what I make a living at, helping people like you manage or cure your hair loss cosmetically or otherwise. If God intended that hair loss should not be treated, God would have stopped the science of hair restoration from growing like crazy. If God gave you cancer, heart disease, smallpox, measles, etc.. would you accept it or try to cure it?
The question I ask is: Is this shock loss or donor site depletion?
How many grafts have you had? This is likely donor site depletion. At 8 months any shock loss will have reversed. If this does not reverse, the only treatment for this that is effective is Scalp Micropigmentation (https://scalpmicropigmentation.com/) which, although it is not hair, will make the donor area look normal. This is something we do all of the time.
The diagnosis of Diffuse Unpatterned Alopecia (something I defined in the medical literature) can be made with a hand microscope which shows an abnormal amount of miniaturization in the sides and back. I think that you need to have such an examination
I am now 5 months since my surgery and I think that the surgeon went high on my donor area and may have over-harvested in this area as I can not see-through my scalp when I cut my hair short.
Your donor area may very well be over-harvested and the area on the left side looks lighter than the permanent zone below it. The harvested area appears above the permanent hair zone so speak with your surgeon about your concerns.
I’ve been thinning since the age of 16. Now I am 23 years old. At first it wasn’t anything I thought was serious. After a few years it got super aggressive and I didn’t do anything about it like an idiot. Now I stand a Norwood Class 5. I will be going for multiple transplants and getting on Fin very soon. I’m going to buzz my remaining hair for easier application of Min. Any positive suggestions?
See a doctor and develop a Personalized Master Plan for your future fight against hair loss. Don’t rush to start the hair transplant process until there is no real better alternative. Men with genetic balding continue to bald no matter what we do to try to stop it. If we are lucky, we can slow the time line down enough never to face the end stage balding we are genetically programmed for, even with the use of finasteride (best drug to slowing and possibly reversing hair loss). But to be safe, you must assume that you will not be the lucky one and figure out a worst case scenario with your doctor. Think about this and its meaning. Best to find a great doctor and then develop a long term relationship with that doctor working according to a Master Plan that this doctor will put into writing for you, something I do on every patient at your stage of genetic hair loss.
I had diffuse thinning for 2 years, and now my hair is suddenly regrowing, will miniaturized hairs on right side of my hairline get thicker?
Miniaturization in genetic hair loss reflects an early stage of hair loss. Miniaturized hairs can be seen in various stages of miniaturization. For example your normal hair shaft is 70 microns in thickness, a miniaturized hair could be any thickness less than 50-60 microns on any particular individual. So in the earliest stage of hair loss, it might be 50 microns in thickness and over time come down to 40, then 30, then 20 microns and at some point it might just be like a tread with almost no thickness to it at all. All of these are miniaturized hairs. When people take the drug finasteride, it often reverses the degree of miniaturization such that a 30 micron hair thickness which is less than 50% of its original value, may thicken to 90% or at times 100% of its original value. That is why I like finasteride as it works both to reverse miniaturization and to stop the hairs from both miniaturizing and falling out directly (another manifestation of hair loss).
Young man started treating balding in the old days (15+ years ago) first with scalp reductions trying to cut out the bald spot, eventually getting transplants into the bald spot. He continued to bald and ended up with an oasis of hair surrounded by a bald scalp. This is the way it was, thankfully, not today. In those old days he rushed to get a hair transplant in the front, getting the old type of plugs transplanted into his head yet he continued to bald leaving him with terrible looking plugs, like a corn field on his head. The more transplants he did, the balder he got. His doctors made a lot of money out of him with multiple transplant sessions and three scalp reductions (where the bald spot was removed surgically for the thousands of dollars) never thinking of any Master Plan which would accommodate his balding progression. In the old days, Propecia/finasteride was not on the market so he could not slow the process down.
What can we learn from this and let’s compare the 1980’s to today.
1- The balding progression time-line has changed because of the use of finasteride today and this drug will absolutely slow hair loss down so that many people may not reach their final balding pattern in the youth. A balding man who might develop a Class 6 pattern without surgery in 1985, might develop that pattern before they are 30, but today on Propecia/finasteride, they might not develop that balding pattern for 10 or 20 years later, but it can happen sooner and it may be safe to assume that it will happen sometime in his older age.
2- If you have a 2 inch round balding spot in the back of the head and get it transplanted, you may lose hair around it to a 3 inch round bald spot in 5 years, it will look like you have an Island of Hair with surrounded by your normal hair. This is why I don’t like to transplant the crown, particularly if the drug finasteride can restore the hair. If the hair is not restored by the drug (with or without minoxidil) and the density of the hair in the donor area is average or better than average and if the frontal balding pattern has been addressed with transplants, then the crown can be transplanted provided there is enough hair to finish what was started (worst case planning is critical) and the patients final balding pattern can be defined by the surgeon. Only an experienced doctor who is not after your money but cares about your long term look, can make this judgment. Today, many doctors will transplant the crown without regard to this Master Plan I am talking about here.
3- The same rules apply to frontal balding. What is the worst case scenario? Finasteride does not usually work to reverse frontal hair loss but it will slow down the frontal balding process. So when you get your frontal area transplanted, ask your doctor what is his/her thinking about the progression of your frontal hair loss. If there the doctor has no good answer to this question, get the hell out of his/her office.
Why am I discussing this with you today. Because even today, we continue to bald no matter what we do. If we are lucky, we can slow the time line down enough never to face the end stage of balding that we are genetically programmed for, even with the use of finasteride. But to be safe, you must assume that you will not be the lucky one and figure out a worst case scenario with your doctor. You and a good doctor can build a Personalized Master Plan for your short and long term hair loss. Think about this and its meaning. Good planning is always the right way to go in managing your hair loss.
This is a wonderful response to microneedling, finasteride and minoxidil over a 6 month time-frame
I’ve done a lot of research on here. I love how I’m not the only one dealing with this. Father went bald at 22 and my grandfather is bald as well.
I noticed hairloss around my sophomore year of highschool. Pretty mild crown bald spot. Had a person come tell me my crown had no hair and that I should move it. Little did I know there was nothing to cover the spot with.
I have very curly hair from my mothers side. I took a lot of her genes from some reason but it seems like the big gene I took from my father is hairloss. Around a year ago I started to use Shea moisturizer curling cream since again I have curly hair. I didn’t realize that the curling moisturizer itself was doing something to my hair until I stopped using it during quarantine. My hair started falling out quite rapidly. ALOT of dandruff which it itched a lot not sure because it was amount of showers I was taking or what. Then again still unsure. I never went outside during this period so my body was all over lol. I returned back to Cantu curling and my hair looks a lil better after a week I don’t know if there’s something in the cream that helps my hair. Anyways besides the point.
I knew I was going bald. My hairline has be receding. There’s nothing but single strands of hair across my hairline that was once there. The top of my head is also. I can pretty much see a lot more of my scalp. But the back of my head has perfect hair. I want to try fin. I’m not to worried about the whole beard and facial hair issue. I have a thick full beard at 18 and seems like I’ve hit the peak of my puberty I guess you can say. I see there’s a lot of side effects going on with ED and stuff then again I’ll just stop taking it if it’s severe. I wanna get this discussed with a doctor first but I would like to hear from the other teens here since I know there’s much more commenting then posting.
-how was fin treated you ? -how bad are the side effects if so how long did they last? -should I really take this at this age?
If your father went bald at 22 and you get his genes, the only possibility to hold on to your hair is the drug finasteride. Men who get a Norwood Class 7 by their mid-20s have never been studied with finasteride at an early age like 17-18. With the HAIRCHECK instrument, the diagnosis may be much easier when the hair loss first starts along this path, possibly as early as 18 years old. This type of balding is aggressive so the treatment with finasteride has to be timely and consistent.
I understand thank you once again. I was simply asking if oral min was generally considered safer in the long term then fin? The answer for the drug finasteride and oral minoxidil is that if you don’t develop complications from the drugs, then they are safe for you. For example, oral minoxidil has a very […]
Finasteride, when it brings back the hairline, it is usually in a younger man (under 25) but I have seen it in a 33 year old as well. This is not common and the published literature suggests that it is rare and not to expect return of frontal hair with finasteride.
The doctor recommended 10 sessions of PRP at $500/session. I would guess you might purchase a good used car for that $$ amount. So if you were shopping for a car, you would research it, right? Doubt that you will stop your hair loss with PRP and reversing it is another story! Some doctors are […]
I was wondering if you have an opinion on hair systems, or if you ever recommend them to patients with advanced balding? I know that most people prefer to keep their natural hair, but I feel like people with very advanced balding (NW5+) would look much better if they just wore fake hair rather than […]
I have a scar from my hair transplant, why did it happen, did my doctor do something wrong and what can I do about it? (photo) You had a strip surgery and clearly scarred worse than many people do. I had three surgeries in the same place and have no significant visible scar. It is […]
The sexual side effects from finasteride can appear at any time. It may be caused by the drug. See your doctor and discuss this with him. I generally tell my patients to reduce the dose to one pill every 4th day for 3 weeks, then one pill every 3 days for 3 weeks and then […]
“If you’re going to loose all your hair eventually there is no point in treating it, you will be bald anyways, that’s how God wants you to be.” A relative of one person gave him this comment. This was my answer: God gave us genes that cause hair loss. God did not say that one had […]
The question I ask is: Is this shock loss or donor site depletion? How many grafts have you had? This is likely donor site depletion. At 8 months any shock loss will have reversed. If this does not reverse, the only treatment for this that is effective is Scalp Micropigmentation (https://scalpmicropigmentation.com/) which, although it is […]
The diagnosis of Diffuse Unpatterned Alopecia (something I defined in the medical literature) can be made with a hand microscope which shows an abnormal amount of miniaturization in the sides and back. I think that you need to have such an examination
I am now 5 months since my surgery and I think that the surgeon went high on my donor area and may have over-harvested in this area as I can not see-through my scalp when I cut my hair short. Your donor area may very well be over-harvested and the area on the left side […]
I’ve been thinning since the age of 16. Now I am 23 years old. At first it wasn’t anything I thought was serious. After a few years it got super aggressive and I didn’t do anything about it like an idiot. Now I stand a Norwood Class 5. I will be going for multiple transplants and […]
I had diffuse thinning for 2 years, and now my hair is suddenly regrowing, will miniaturized hairs on right side of my hairline get thicker? Miniaturization in genetic hair loss reflects an early stage of hair loss. Miniaturized hairs can be seen in various stages of miniaturization. For example your normal hair shaft is 70 […]
Young man started treating balding in the old days (15+ years ago) first with scalp reductions trying to cut out the bald spot, eventually getting transplants into the bald spot. He continued to bald and ended up with an oasis of hair surrounded by a bald scalp. This is the way it was, thankfully, not […]
This is a wonderful response to microneedling, finasteride and minoxidil over a 6 month time-frame
I’ve done a lot of research on here. I love how I’m not the only one dealing with this. Father went bald at 22 and my grandfather is bald as well. I noticed hairloss around my sophomore year of highschool. Pretty mild crown bald spot. Had a person come tell me my crown had no […]