Before considering a hair transplant you might want to be evaluated by a dermatologist, possibly getting a biopsy to be sure that the cause of this loss will not also impact any eyebrow hair transplant. The loss of the lateral eyebrow is often a target for a variety of skin and autoimmune disorders. I would need to see your entire hairline looking for problems there as well, such as a loss of vellus hairs in the frontal hairline.

This 10 year study of finasteride in Japanese men is very significant. (1) it revealed improvement and prevention of disease progression in 99.1% of the 532 Japanese men with AGA treated with 1 mg/day finasteride for 10 years, (2) younger patients show more improvement than that of older patients with AGA treatment [24,25]. In this study, AGA patients at the early stage of N-H classification showed more improvement than patients at the later stage did.

https://www.oatext.com/Long-term-(10-year)-efficacy-of-finasteride-in-523-Japanese-men-with-androgenetic-alopecia.php

We evaluated the long-term (10-year) efficacy and safety of AGA treatment with 1 mg/day finasteride in a large study population (532 patients), as the first study of this kind in Japan, to our knowledge. A high objective efficacy was demonstrated by the MGPA, which revealed improvement and prevention of disease progression in 99.1% of the 532 Japanese men with AGA treated with 1 mg/day finasteride for 10 years. Furthermore, the outcome was similar to or better than that reported by other studies in Japan [8-10,13,17]. Differences have been known to occur in the progression of AGA symptoms between Japanese and Caucasian men [8,18]. This efficacy of the investigated treatment in Japanese men exceeded that reported in other studies in Caucasians. The superior response of Japanese men with AGA was reported to likely be attributable to their hair characteristics (greater diameter, black color, and lower density), which facilitated the detection of slight changes [10,19-23]. A novel finding observed in this study was the significant difference in the improvement of AGA following finasteride treatment between the N-H: I/II/III and N-H: IV/V/VI/VII groups at the first visit. The ROC analysis revealed a similar difference, that was performed to classify patients with improvement (MGPA?5) and deteriorating (MGPA<5) condition at year 10 of treatment; the cut-off point was N-H: III (AUC: 0.746). Furthermore, the MGPA of the total study population and the N-H: I/II/III group at the first visit significantly improved from treatment year 5 to 10 (P<0.001). This efficacy was different from that of a 5-year study in Japanese men, which reported that the efficacy began to plateau after 4 years of treatment [10]. Several studies have reported that AGA progresses in N-H classification with age, [7,11,12,18] and that younger patients show more improvement than that of older patients with AGA treatment [24,25]. In this study, AGA patients at the early stage of N-H classification showed more improvement than patients at the later stage did.

I was wanting to know if you have any information/clinical observations concerning worsening of side effects for patients who continue to take finasteride?  I ask this as I am experiencing watery semen. In addition to this, I have an extremely high libido that’s way too high for my own good. In regards to such, I have a very minimal, almost non-existent refractory period after ejaculation.  After having sex the first few times around, my erection quality isn’t quite what was pre-finasteride. But this is a side effect that I can very much live with.  In your clinic, what observations have you made concerning patients who have manageable side effects? Do they worsen or get better with time? Or is there a general consensus that they stay the same?

Good questions. When the water semen occurs it seems to stay until you sop the finasteride. Some people report it takes 3 months before the water semen goes away. I have seen an increased sex drive from some of my patients, even my own son experienced it. He loved that side ffect.

Most people find either (1) they get accustomed to the finasteride and the side effects eventually reverse, or (2) the side effects continue or even get worse. For those who have a reduced sexual drive or ED, some doctors, including me, feel that the longer the ED on the drug, the more likely that the irreversible PFS becomes a problem (although still a very small number of people fall into this category). For doctors like me who tell the patients with significant ED that can’t mange it on the drug, I tell my patient to stop taking finasteride. As a result, of the thousands of finasteride men I have given the drug to, I have never seen a case of PFS in my practice as many of my colleagues who have similar approaches to such problems.

Generally, the dermaroller (the microneedling device) induces Anagen, a single hair cycle and it should be sustained for the duration of the growth cycle. After the hair goes into telogen (about 2-3 years for men and 3-5 years for women), the pre-treatment state should return so you would have to go through the entire dermroller treatment all over again. Microneedling induces wound healing and the release of inflammatory molecules that can stimulate hair growth bringing hairs that have stem cell present back to functioning and into the anagen growth cycle.

Cutis verticis gyrata describes a scalp condition with convoluted folds and deep furrows that resemble the surface of the brain. Cutis verticis gyrata is a progressive condition. It is mainly troublesome due to the cosmetic appearance. Rarely, it can be complicated by malignant melanoma developing within a melanocytic naevus. Cutis verticis gyrata occurs more commonly in males. The primary form of cutis verticis gyrata has a reported male-to-female ratio of 5:1. The incidence of cutis verticis gyrata may be reported as lower in women because longer hair may camouflage the condition (Ref: Dermnet NZ).

This is a cosmetic issue for those who have it. As you can see in this photo, styling the hair can be a problem.

This is my idea!

1. Use minoxidil for beard growth

2. Wait till new beard grafts become terminal

3. Use the grafts for a hair transplant

4. PROFIT!

The beard makes for good grafts, usually taken from under the chin. Minoxidil induced beard growth is usually not thick and certainly not permanent as they depend upon the drug minoxidil for their existence.