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Please read and comment: Propecia (Finasteride) has been available since 1997 and is the first oral medication to ever be approved by the F.D.A. specifically for the prevention of hair loss. A physician’s prescription is required. The overwhelming majority of men using this drug experience some benefit from its use, sometimes dramatically. It takes a full year before the full benefits can be fully seen and appreciated. The recent 5-year research studies show that, for most patients, there is a substantial increase in the number and quality of hairs growing on the patient’s scalp for around 4 years. After that, the patient’s overall hair mass on top very gradually starts dropping ever so slightly each year, so that at the end of around 10 years, the patient is back to where he started 10 years earlier. So, in effect, for most patients it holds off the hereditary expression of hair loss for around 10 years. There also are many clinicians and investigators who believe that finasteride works nearly as well when administered in dosage amounts substantially lower (and cheaper) than that recommended by Merck.

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Much of my opinion is projection and conjecture. Propecia hair loss curves show that hair loss continues, albeit slower, with the drug than without the drug after an initial gain in hair volume, but Propecia is still not the magic bullet for hair loss. After 5 years, the hair may return to the level that it was at prior to starting the drug, but that varies with patients. I had a discussion some years ago with researcher David Whitting, who told me that the Merck studies showed that Propecia was just as effective at 1mg, 5mg, 10mg and higher. The effectiveness dropped by 20% at ½ mg. So all I know is what the 7 years data shows (hair loss continues at a slower rate) and that lower doses than the recommended 1mg level are less effective. You are using generalities on what may happen at the 10 year mark. It may or may not happen. Avodart may be more effective than Propecia, but as of this moment, the data is not in my hands and the FDA has not ruled on safety and effectiveness issues.


As i am concerened by hairloss, I have looked at your site and read some useful information. The one question I had was, while going through the Horror Stories link [note: on our sister site,], are there any horror stories which have occured after about the year 2000, and the development of FUE and FUT. I can understand that an operation which cuts a large chunk of skin out of a persons head is going to run the risk of causing a large scar and other related complications, but has the development of new techniques like those above which allow the removal of single hairs got away from these problem or has got other ones? Also why do so many people choose to keep the name of a bad doctor to themselves?

Thank you

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You are correct that fewer and fewer horror stories are appearing because today’s techniques are much better than those of the 80s and early 90s. Certainly, the quality of the work of the top notch surgeons has improved to produce virtually undetectable transplants. The focus of those surgeons is now on improving the growth of transplanted hair. There are still some failures with these modern techniques because today’s FUE and FUT techniques require exacting methods which, if not followed, will cause the transplant not to grow.

Well trained doctors using modern techniques should produce not only undetectable transplants, but a very high survival rate. Still, there are some doctors who do not know what they are doing, and I still see some terrible complications which reflect a doctor’s lack of training, skills or ethics. I am also seeing more and more patients who are being transplanted that should not have been transplanted and those who being sold more grafts which are put in beyond the balding area and into the permanent hair zone, just to increase the fees. Find yourself an ethical doctor who uses modern techniques and be sure to meet with some of his patients before you take him/her on.

I often ask the same question that you did in this email: “Why are the names of bad doctors kept secret?” The answer here is that men are generally not confrontational, and they do not like to be reminded that they made a mistake. They do not want to relive a bad experience over and over again. Just sharing their stories to prevent others from making their same mistakes is not a pleasant experience for these victims.


I am 20 years old and very nervous about losing my hair. Since about my senior year in highschool ive seen the front of my hair line recide. This is a very stressfull and private thing for me so I only talk to my family members about it. When I ask if it looks like im going bald the answer is always no. But my hair line from my senior pictures to now has deffinately changed. Its seems to be going back on the sides, right above the eyebrow.(im sure you know what im talking about. So I do have a couple of questions.

  1. Am I to young to get a hair transplant?
  2. How much hair do I have to lose to actually be able to get one. Im always reading different sites and all kids my ages ask almost hte same questions but everyone always says wait till you go more bald… Well I dont want to wait, I want to prevent it before it starts. I dont want any sign of thining hair or a reciding hairline. Its like my petpeve.
  3. Do hair transplants look like real hair, or can you tell the difference? Ive seen about 2 people in person that got them done..and one person It was pathetic he had like 3 strands of hair growing out of one section. Then about a 1/4 inch space and then more hair. If I get a transplant I want it to look so real that even I cant tell it was doen.

Also I was reading a question that someone posted on your site. And I read an answer by some John Doe. He said that there were scars from his transplant. This is the first time that ive ever heard anyhting about scars. Can you tell me more about that?

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You have many questions, all good ones, but not easy to answer without writing a book. I actually wrote a book, The Patient’s Guide to Hair Restoration, which you can get by clicking here. The entire book is available in PDF format, but you can also order a complimentary print copy complete with photos at the Request Additional Info page. Many of these questions will be answered by the book or even in the previous blog questions from other young men about your age. No matter what I tell you, you must have a visit with a competent, caring doctor. Although I have performed hair transplants on patients as young as 18 years old, it is not my usual case, but before I would do this, I would want to know what is happening to you. Make an appointment with a good doctor who specializes in hair loss treatments. Dr. Robert Bernstein in New York is such a doctor, if you can handle the 5 hour drive to visit him. He is at (201) 585-1115.


I am menopausable, early sixites, and experiencing extreme hair loss. My once thick, course hair is now fine, thin and receding. Many dermatologist in the area do not consult on hair loss. Can you recommend someone in Jacksonville Florida who specialized in women’s hair loss? Thank you

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The ISHRS (International Society of Hair Restoration Surgery) membership shows two doctors who are members of the society. I would look to this society as those who are members have focused heavily on the learning process made available through them. Marina Pizarro, 904-246-2024, may be worth interviewing as she has a website at which will give you some information on her background.


I have been using the hair laser for 3 months and it has made my hair much worse. What is happening?

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Chances are that your hair loss is progressing on its own. If you are not taking Propecia, you should probably be on it, but you need to see a good doctor to understand what is happening.


I am going bald, but after reviewing the several sexual side effects from Propecia that are in the drug warnings, I am afraid to take this drug. Is this a real concern or am I over-reacting?

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I believe that like most men, any potential threat to your manhood should scare the hell out of you. There are many ways to answer this question. The official FDA studies show that the difference between the placebo group and those that actual took Propecia, is less than 1% of men are impacted by a reduction of libido (sexual drive). There is also a very small percentage of men who have ‘sexual dysfunction’ (I hate this term because is implies that something is ‘broken’) which can be made worse by Propecia. The risk for worsening sexual dysfunction is in the order of 5%. So the proper answer to this question is that there is a very small risk of some type of libido or sexual performance impact by Propecia.

Men are highly suggestive, so if a man thinks that he is going to be the one out of a 100 men who have a decreased libido or sexual performance, men can easily talk themselves into this side effect. If the problem is one of sexual performance (unable to have the penis work the way the man wants it to work), then there may be issues that need to be treated with drugs like Viagra, Cialis, Levitra or the like. There is no need to sacrifice your hair just because your penis does not work as well as it did when you were 16 years old. Hair loss, libido and sexual function have one thing in common in that they are impacted by male hormones. If something is wrong with any of these three, please see a good doctor and fix the problem. I believe it is possible to have a good sex life and get your hair back or prevent it’s loss, so get a doctor involved with your problem if you have one.


I received this letter from a patient that we did two procedures on, totalling 1584 grafts. It is the knowledge that we can change lives, that makes my day that much better.

Thank you very much for the work you did on me. It has completely changed my life. You guys are so professional and courteous. You go above and beyond to make people feel comfortable. Your work is flawless and undetectable. I have had two surgeries and people I work with (which is quite a few), have never noticed anything.

The beauty is in the illusion. If anyone reading this is contemplating surgery, just go ahead and book the appointment. I give you permission to look at my before and after pictures. Notice how much younger I look and how different my face is framed. It is the You, You’ve always wanted.

Best of luck and thanks again.

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The first two photos were before hair restoration at NHI, and the photo on the right (in black and white) is the final result. This patient is an actor, and the photo was scanned from his headshot. Click the photos to enlarge.


I am 45 years old and I came to your office 1 year and one month ago. I have a bald spot about the size of a silver dollar in the middle of the back of my head (I believe you call this the crown) which did not go away when I used the drug Propecia for the past year. When we met last month, you suggested that I get the dollar size area transplanted with 700 grafts. I am a careful buyer, so I went to [Note: Doctor’s name removed – let’s call him Dr. X] office for a second opinion. Dr. X told me that I needed between 2500 and 3000 grafts, 1500 in the back of my head and the rest in the front. I was shocked by the difference between the two opinions. Is it possible that you missed any hair loss I had in the front? Even though I did not see any problem in the front, I have been looking at my hair a lot lately, and I am now starting to think that maybe I have hair loss there too. If you are right, then where is Dr. X going to put 3000 grafts? If he is right, will you be chasing my hair loss every few months? Who do I trust? Should I keep getting more opinions?

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First, you should see me again and let me review your examination. Although I would be surprised if I missed frontal hair loss, there is no great mystique to the diagnosis of genetic patterned loss. We can mutually review this on the video densitometer which will absolutely show the existence of any hair loss one way or the other. I just met with another man who had a similar story to yours. He had frontal loss and no loss anywhere else, but when he got another opinion, he was told to transplant his entire head. Integrity and medical ethics should prevent doctors from transplanting men who do not need it. The buyer must always beware and is ultimately responsible for such decisions.

With regard to your comments about thinking that you may be losing your hair after staring at it day after day, just make sure you are not talking yourself into something that is not there. You have the power to control what is about to happen to you, use that power wisely and do not get sold on something that you do not need.


Dear sir
I am 28 and for more than 6 years I have consumed FINPECIA tablets ( dosage which is 1 mg per day )which is made in India for preventing of hair lost.In this regard I would like to know that wehether this tables has any side effect such as sexual tendency,etc.

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The pill you are taking appears similar in name to the drug Propecia (finasteride) made by the US drug company Merck. If it is finasteride (controlled by US and foreign patents), the side effects are four:

  1. An initial increase sex drive in 10% of men taking the medication
  2. An initial decrease sex drive in 1-2% of men
  3. Breast swelling in less than 1% of men
  4. Some decrease long term impact for prostate cancer

If the drug is not finasteride, then I have no way to know what the side effects or the effectiveness of these drugs might be. For whatever reason many people in the United States promote the idea that drugs made in India are not quality controlled like drugs made in the United States. I think the correct statement for this should be that the United States FDA has not verified that the generic drugs made in India meet the strict standards required in the United States.


Assuming that I am a candidate for FUE procedure, will the institute perform a surgery of as little as 100 grafts on the side of my head(temple region). I want to try it out first before committing for bigger session. /money is no object ,with in reason. Thanks for the quick reply of my previous question (Resuming Physical Activities After Surgery).

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Performing a session of 100 FUE grafts is not a problem. I will assume that the area that you want to try will stand alone if you decide, for any reason, not to do more?


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