Your biggest enemy is the progressive thinning leading to a balding pattern that is not evident at this point in time. The degree of thinning that you are experiencing would suggest that you should see a doctor who most likely will get Bulk Measurements of your hair to determine the degree of the thinning that you are presently having. If the diagnosis is early genetic hair loss (the most common cause of hair loss in young men), then the best treatment would be the drug finasteride which is highly effective in men of your age and may not only stop the hair loss but possibly reverse it. If you are developing a more advanced balding pattern the best test to get will determine the Bulk Measurements of your hair and this will show, over a one-year time frame, how effective the treatment will be. Once you know this information, then you and your doctor need to develop a MASTER PLAN which will define what you need to do over the years to come.
Breast pain and nipple pain has been reported with people using Propecia (finasteide). If this continues, you should see a doctor if that is why you are asking this question. Some people develop small painful breast lumps so an examination of a doctor is a good idea. When this happens (it is rare), the drug often needs to be stopped.
Depression is a known potential side effect from Propecia (finasteride). There are actions of the 5AR enzymes in many parts of the body and as it blocks the effect of this enzyme, the effects can be seen everywhere the enzyme exists which does include the brain. The dose of Propecia (1mg) is low so the effects elsewhere in the body is minimal. We see this drug used in the 5mg dose for the treatment of benign hypertrophy of the prostate (BPH) and most of the information we have on side effects come from the men treated with BPH. There are, of course, many causes of depression and depression itself needs to be addressed independent of the use of this drug alone.
As you get older your testosterone drops along with the DHT and then the finasteride is often less effective as you get older. What hair you have has stood the test of time which is an indication that much of it might stay; however without seeing you, I can’t make such a judgment.
In the 26 years since I practiced hair restoration surgery, I have never seen the drug finasteride make the hair worse. I have, however, seen the hair loss accelerate in what I believe is its normal loss process in some men with aggressive hair loss.
Almost all Caucasian males develop a maturing hairline. When recession occurs, it usually is associated with hair loss elsewhere on the head and scalp and that is why I perform a HAIRCHECK if I have any doubts on the distinction between a receded hairline and the appearance of a maturing male hairline. The HAIRCHECK instrument will show hair loss behind the hairline which always occurs when the hairline is receding. The picture of me below shows a V Shaped mature hairline that is 100% mine since it changed from the rounded hairline of my youth. This hairline was not transplant but my entire crown was transplanted with 2700 grafts. The second picture shows early hairline recession that was transplanted along with a replacement of the temple peaks. You can see that this hairline was ‘ratty’ in appearance which is essentially what often happens when the hairline starts eroding.
The official number is 2-3% but the placebo number are almost 2%. In my practice I think that the numbers may be higher, 4-5% range. The reason that you see a lot of complaints on the internet is possibly because you are only hearing from those that have the negative sexual side effects. One of my own family members, got an increased sex drive, a complaint I do here on occasion but seem to never read about it on the internet. The testosterone levels often do go up when this drug is taken. For those that need/want to take this drug it is a matter of choice for many of them. To paraphrase William Shakespeare, “To take the Pill of not take the pill, that is the question?” Balding may be the only alternative.
Crushing finasteride is ok, but dissolving it in a solution will not guarantee that it will work and you may inactive it by doing so, especially if you don’t drink it immediately.
I really do not know if finasteride can stop the maturing of a hair line in men. I have never had the opportunity to use it for this purpose, but I would expect that a maturing hair line will evolve even if you are on this drug. The reason I believe this, is that maturing hairlines usually reflect a process called apoptosis (cell death) which is, in men, tied to the number of hair cycles that the hair goes through. It is probably triggered by testosterine and maybe DHT. If a hair cycle is 3 years in length and let’s say that apoptosis is scheduled for 7 cycles, that person will lose the hair at the sage of 21. If you are committed to try this, I, as a doctor, would agree to prescribe this drug for you if you were my patient.
I don’t like to invent new scrips when there is an excellent review of this condition here: https://www.dermnetnz.org/topics/lichen-planopilaris/. “Lichen planopilaris is a rare inflammatory condition that results in patchy progressive permanent hair loss mainly on the scalp”
The Norwood patterns that were published by Dr. Otar Norwood were genetic patterns that were developed by people directly. Contrary to popular belief that one evolves from, let’s say a Class 3 pattern into a Class 5 or Class 6 of Class 7 pattern, no such evolution occurs. People born with a Class 3 pattern of balding will not evolve into a Class 5 pattern of balding and will remain with a Class 3 pattern of balding
This is a condition that is reported when a young man was on finasteride and developed sexual and other side effects that did not go away. This syndrome is highly suspect because of the litigation going on with Merck and two important observations: (1) The drive to profit from a Class Action law suit is present in some of the people complaining about the side effect and (2) the frequency of erectile dysfunction in men is 30% in 30 year olds, 40% in 40 year olds, 50% in 50 year olds and so on. Some men just lose their sex drive and their ability to get an erection with age and that is why drugs like Cialis and Viagra are so successful. Most men using these drugs were never on Propecia.
“The test is to wash your hair vigorously for three days and then in the morning when you wake up, comb the hair and count hairs.” I don’t like this test as it is not as accurate as looking for miniaturization and I spoke about in previous posts. Total cost about $20 on Amazon (https://newhair.com/digital-microscope-examine-hair-balding/). I will be happy to interpret it for you by sending me a copy on my email
We do not have any heavy metals or any type of metals in our pigments. Our pigments are purely organic and as a result you don’t have to worry about an MRI which can pull on the pigments and cause redness and pain or have your body react to substances it can not absorb. Many SMP doctors, cosmetologists and tattoists use pigments that contain some dangerous looking stuff in the solutions. We did an analysis of a ‘competitors’ pigment and after it was burned in the lab, the lab found the following material left in the remnants. You judge if this is what you want in your body, not me. This is why we use only organic pigments in our SMP pigments.
If you are correctly wondering why the FDA does not control such substances with potential harm, the answer is that the FDA has told congress that they do not have the funds or the staff to investigate the tattoo industry. Within the United States, 22% of adults have had a tattoo with the type of materials shown in the chart below.
Yes, if you have hair in the areas you want transplanted, you can do it in stages, slowly changing the look. Most men get away with less surgeries not more by doing it all in one session and then ask yourself, do you really want to undergo many surgeries when you can do it once and probably no one will ever know? I usually suggest that if privacy is a real issue, for the patient to grow out a beard if they do not have one, or take it off if they do. People focus on the face and not the head. You can also use the hair you have to style around the recipient area, but if you want to do it incrementally, we offer what I call ‘Lunch Time FUE” so you can come in for 2 hours at a time and get 200-300 grafts in each session until you achieve your goals.
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