cut my dose of finasteride by half and the sexual side effects went away

/by William Rassman, M.D./0 /

I posted a while back asking if anybody had any anecdotes for taking smaller doses to alleviate sides. Well I bit the bullet and bought a pill cutter last Thursday and from then until Monday took 0.5mg fin every day. It was by the Monday that I woke up with proper morning wood for the first time in weeks and had the horn all day. At this point I noticed more hair in my hands than normal after washing, so went back to 1mg Monday night.

You should probably stay on the half dose as it is 80% as effective as the full dose.

 

Man had problems with his SMP (From Reddit) – with photos

/by William Rassman, M.D./0 /

If you have no idea what SMP is then you’re probably not going to find this interesting but I wanted to start a thread chronicling my experience of lightening/removing my scalp micro-pigmentation (hair tattoo). I had my first laser session yesterday.

My hair story is a bit of a long one but I’ll try and explain it as best as I can. Pretty much been bald since my early 20’s, always had a high forehead and it really shook my confidence (and still does unfortunately).

My GP put me on Finasteride and after trying it for a few weeks and dealing with bad sides I stopped it. In my early 20’s I went to see numerous transplant doctors who all told me that I need to wait a few years to see where the balding would end up. They also said that I probably wouldnt be too happy with the outcome of a transplant because of how much hair I had lost and having a so-so doner area. I then started to look for other solutions. I came across Scalp Micropigmentation (hair tattoo) and researched it heavily. This was 5 years ago. I had heard of ‘Tricopigmentation‘ which was branded as a semi permanent SMP option. At the time Milena Lardi in Italy was the best clinician in this field so I travelled to Milan and had 3 sessions done (after shaving my head all over for the first time).

The tricopigmentation gave me a nice shadow but I wanted more so I decided to go down the ‘permanent’ SMP route with a UK company. Again I had 3 sessions but this time it was much darker and overall I was pretty happy with it. I was not as self conscious about my shaved head as I thought it looked like I was shaving out of choice and not out of need. It was high maintenance though as I had to shave everyday and also use alot of anti-shine. Some people noticed and others didn’t. In hindsight Im not sure I was fooling anyone as I do think that many people can spot a ‘too perfect’ hairline. The eyes are naturally drawn to it, which isnt good.

Once I got to my late 20’s I decided to get a transplant to compliment the SMP. Again I researched this for quite sometime and ended up having a 4300 graft hair transplant in Turkey. This gave me texture on the scalp and also massively reduced shine (which I was delighted about) but its way too thin to grow long. The recovery was horrific and dont think id ever get another one. While the idea was that the transplant would compliment the SMP (and vica vearsa), I was left with transplant hair I cant grow very long because it makes the SMP on the scalp stand out like a sore thumb! Furthermore it really made the hairline look even more fake.

Fast forward to 2019 and I was left feeling really self conscious about my head. I do notice when people talk to me they linger just a second too long on the hairline and scalp, plus i do see some people do a double take on the street. In the end I decided my only option was either to live with it (not happening) or get the SMP lasered off (without damaging the hair). After a few months of research I went with a laser removal technician who has alot of experience with SMP.

I had my first session yesterday and so far Im pleased with the results — although it was really f***ing sore. It will take a number of weeks for the fading to happen (it doesnt happen right away) but already I’ve noticed the hairline looks a little more natural and while its still red (it looks worse in photos) I think I will be happier with it gone or faded. Less really is more.The actual hair stands out now rather than the SMP dots.

Happy to answer any questions you guys might have. 3 words of advice if you’re thinking of SMP or lasering it off for that matter:

  1. If you’re thinking of getting SMP go with someone who has ALOT of experience and can show you photos of their work. This is very important.

  2. LESS is more when it comes to SMP. Try and keep things as natural as possible (broken and receding hairline) — not a lego man hairline. Its really difficult to get a natural hairline, especially for lighter skin tones.

  3. If you’re thinking of getting SMP or indeed removing SMP — Research, research, research and ask questions before committing.

Photos:

Upper left photo = SMP + Transplant hair a little longer than buzzed (before laser)

Upper right photo = 1 day post laser and buzzcut (today!)

Bottom Left = SMP before laser and transplant hair buzzed

Bottom right = 1 day post laser and buzzcut (today)

 

This man offers good advice. I keep mentioning the idea of a Master Plan and that is something that is critical. Had he found the right doctor at the onset, he would have been able to tackle a hair transplant when and if he wanted one. Here is a man who had the worst balding pattern possible with hair transplants followed by SMP. The photos speak to the result:  https://baldingblog.com/72-year-old-surfer-still-surfing-and-he-has-hair-photo/

I am trying to find out if I have enough hair to be a good candidate for a hair transplant. How many grafts do I have total?

/by William Rassman, M.D./0 /

Close to making a decision about a transplant, just unsure about whether my donor area might be too thin. I have always had messy/forward hair and would like to keep this style, is this possible with a HT? In most results I’ve seen, the hair seems to be placed facing upwards.

See the photo below. Left Box has 33 hairs and 16 hair groups = 2.1 hairs per Follicular Unit. The Right box has 38 hairs and 18 groups = 2.1 hairs per Follicular Unit. Both of these man have an average hair count reflecting about 110,000 total head hairs and a donor supply equal to about 6-7000 grafts in their lifetime. I purchased this from Amazon to do this photography:  Xenvo Pro Lens Kit for iPhone, Samsung……….

 

24 year old female with corner hair loss and some hairline early elevation

/by William Rassman, M.D./0 /

This is a common finding in some women, although it is more common as women get older. I have treated many of these women with a hair transplant to put back the rounded hairlines typical of the female hairline. You should be look at my an expert to make sure that you don’t have an autoimmune disease like Frontal Fibrosing Alopecia. a diagnosis that is easy to make when your doctor is skilled in the examination of a female hairline

I’m looking at getting hair transplanted to make the size of my forehead be reduced

/by William Rassman, M.D./0 /

I was wondering if anyone has any tips or things to look out for when searching for a surgeon?

Check out the doctor on various websites such as Yelp, Realself and look for places where the doctor got a bad reputation. When you meet your possible surgeon, make sure that you are meeting the surgeon not a salesman or saleswomen. Check out if he/she does the surgery or delegates it to technicians (including the actual cutting, FUE, anesthesia) as it should be done by only the surgeon. Ask to meet his/her patients one-on-one so that you know for real, what the scoop is. See if you like the surgeon (if he is an Ass, skip him, if he loves himself or herself, skip that doctor). The good doctors can be found by researching them.

How to build a comb-over and how to live with it (Photos)

/by William Rassman, M.D./0 /

For the bald man that wants hair cover, he should let the side hair grow long enough to be able to sweep the hair from one side to the other.  Once that is done, the center part of the long hair is pulled forward to the eyebrows. The final product is the last picture, a damn good covered hairline very common in many men who slowly bald over time.  The problems occur when the bald area becomes too large and the amount of hair that is grown from the sides is both too low on the fringe area and too short, and you get the failed comb-over shown in the last picture. Note that the comb-over just doesn’t last as you can see in the gray hair suggesting that this man let his comb-over go on too long.  The last set of photos I found on Google images which shows how creative some people can be to get their hair covering their bald area.  This photos is not as outlandish as it may appear as this is called a Bouffant  and is not infrequently built from scalp hair.  In my 29 years of practice, I have seen such Bouffants on a number of men. I remember one man who got up at 2:30 am every morning to build the Bouffant hair by hair (a three hour process). His Bouffant looked good enough to fool me when we first met, but when I unwound his hair, he was fairly bald. He had two hair transplants and told me that these transplants changed his life. He now slept to as long at 7:00 am without worrying about his hair and was able to engage in activities with his children, including swimming and vacations in places that he never thought he would travel to.