I have Afro hair

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

I have Afro hair, would the FUT approach be the best? What’s your experience regarding FUT scars for African patients? Thank you for any thoughts

FUT scars are fine with African hair types provided that you don’t have a Keloid history. There are other factors that determine the scar including (1) laxity of your scalp, how the wound is closed (I prefer staples and leave them in 20 days for half and then 1 week for the other half), and (3) the use of deep sutures for a two layer closure. These are technical details not clear unless you are a surgeon yourself.

Can I have a hair transplant without finasteride?

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

Finasteride does two things when you are having a hair transplant:

1- It prevents shock loss (loss of the hair you would have lost in the coming two years which is accelerated)

2- It stabilizes the progressive nature of genetic balding

So yes, giving up these benefits is not uncommon and you can have a hair transplant without finasteride.

Frustrated with hair loss technology

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

doctor it is hell of frustrating, let me tell you from a customer side. The whole hair loss/hair restoration situation is 100% the same for 30 years now. It is like fighting a dragon but if you cannot tolerate Finasteride, your shield broke, but the shieldsmiths are either charlatans or always postpone the delivery for another 5 years. People are out here on Tressless taking oral Minoxidil for hair loss, a lot of them having heart papilations, ppl accept finasteride sides and try to combat it with viagra, some people even start to take trans gender drugs, all of that because it seems impossible to deliver a finasteride without side effects for 3 decades. Please try to convey the desperation of hair loss sufferers at one of the conferences you are attending, where once a year hair transplant surgeons and hair loss researchers meet and announce proudly “We still have two medications, topical Minoxidil and oral Finasteride”, or the 2022 version “You can now also use topical Finasteride and oral Minoxidil, what a BREAKTHROUGH!”

I empathize with you and your comments. Oral minoxidil in doses of 1.25mgs doesn’t have many side effects. Microneedling has made a huge difference in many men now using it with significant gains. New breakthrough medications are soon coming to the market. Last but not least, a hair transplant done by an experienced surgeon works and holds for decades, possibly to when you will be older than Joe Biden (he had his hair transplants in the 1980s) before they were repaired to look better. Conclusion: it is not a bleak as you make it to be.

Do I have to take finasteride for life after transplants?

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

Been losing hair slowly from forehead sides and it’s depressing since father and grandfather both went bald I have no hope looks like , I used some minoxidil bottles for 8 months but it’s super expensive in my country so I gave up I won’t buy it anymore so I did read about finasteride and that it has so many sexual side that can be permeant so It’s not an option for me I don’t want to risk it at all . Had the hair transplant plan on my mind for the next 5 years maybe but I head you’d still lose your hair and you need to use finasteride for the rest of your life if you don’t want to go bald again , I used to think a hair transplant is enough ?

Hair loss is progressive. Finasteride clearly will hold onto hair that otherwise would fall out. Just look at this data: https://baldingblog.com/10-year-japanese-study-of-finasteride/. There is no doubt in my mind that the hair loss gap with finasteride will continue for many years past the 10 year study.

Taking topical min whilst partner is pregnant

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

This is an interesting question. You can decide to take it in the morning and go to work, showering when you return home.  This way your wife can touch your hair without fear. It needs to sit on the scalp at least 8 hours to get the impact of the drug; however, even the topical liposomal finasteride can go through the skin into the blood stream so you can’t 100% protect her from this drug.  Using condoms is a solution that absolutely will keep her and her baby away from the finasteride.