Hey, Dr. Rassman. Thank you for checking in. Unfortunately (or, perhaps, fortunately, in that I have an answer) I was diagnosed today with lichen planopilaris. It seems worst case in a way, but again, I’m relieved to have an answer. Starting injections soon. I’ve finally found a good dermatologist that was willing to take a biopsy and didn’t just prescribe finasteride at the first mention of “hair loss.” Thank you for perusing this subreddit and helping people out. If we’re here, we’re miserable, and it’s good to have someone here who will listen and give actual advice. All the best, and happy holidays to you and yours
This is becoming more and more common in younger men and men of all ages. We used to think that this was a woman’s scalp disease and now we know better. You must get a good doctor when you treat hair loss, as this man struggled to get the proper diagnosis. If he was to be transplanted by some over-zealous hair transplant surgeon, it would have failed because the disease that took his hair away would have done the same thing to his hair transplants.
Can “end stage” miniaturized hairs be salvaged with medication such as Finasteride/Dutasteride/Minoxidil. Or are those a lost cause once they reach that stage?
We tend to look at these hairs as lost causes; however, microneedling may have changed that perspective. We don’t really know as proper research has not been done. I have seen finasteride reverse miniaturization on a limited basis, possibly when it is early.
Do you apply minoxidil right after dermarolling? If so, why? Is it more efficient or just personal preference? Also what is the perfect derma roller size? 1.5mm or less/more. And how do you clean your derma roller? Sorry for all the questions, im just cautious
If you apply the minoxidil immediately after dermarolling, then the medication may go through the skin directly making it more effective
I am using finasteride and me and my partner had unprotected sex whilst she was in her infertile stage of the menstrual cycle. This may sound stupid but I am worried that having unprotected sex whilst on finasteride will cause damage to the female’s reproductive ability / any egg cells. Is use of a condom specifically recommended if your partner is pregnant or could get pregnant? We are not looking to have children for another few years at which point I will quit using finasteride but just worrying myself that there will be damage caused by unprotected sex in the present
If you are using any birth control, not a problem. The use of a condom is recommended if she it tying to get pregnant. Timing fertility (the actual point of ovulation by taking body temperatures) is not always accurate unless she is regular on her periods.
Hi doc, in your experience, is finasteride less successful for people who are lifting weights in the gym? Currently on 3mg/week for almost 2 months and still lose some hair.
I don’t see going to the gym as reducing the impact of finasteride
Hey, so I’m planning to get a DHT test to check out the levels before starting finasteride. I’m wondering whether it is the amount of DHT or the sensitivity that matters when it comes to balding or other effects? Basically is it a waste of money to measure DHT levels if they don’t correlate with anything?
I personally think that it is not worth doing. What you want to know is: will the drug work for me? Changing drug blood levels doesn’t tell you that information
At this point, I want to let it go. There are several reasons for that.
All my male relatives have male pattern baldness. So one way or another, it’s going to happen. Feels like I’m fighting a losing battle.
I feel pretty vain acting upon hair loss. Especially when you see others not caring at all. I want to feel good without being attached to my looks. Looks fade.
The time invested in combating hair loss could be used for more productive stuff, especially knowing since my hair is ought to go anyway.
Many men want hair because they are more attractive to themselves and more confident in themselves. I have performed hair transplants on many celebrities who all tell me that it improved their self-confidence. You would be surprised by this if I revealed their names.
My question is; does finasteride and dutasteride lost effectiveness over-time in the body? Like, say in decades, would my body become used to dutasteride and it will lose its effectiveness and hair loss will resume or can I preserve my hair forever (until I’m a senior, theoretically) just from taking 0.5 mg of dut everyday for the rest of my life?
Another question, will the hairs that grew back become thick like how they were before they fell out? Is there anything I can do to make them thicker or do I just have to keep taking the drug and wait longer?
It is not the blood levels of these drugs that are important, but the tissue fixation that occurs after taking the drug. The tissue fixation of finasteride is about 7-9 days while the tissue fixation of dutasteride is about 6 weeks. These drugs generally do not lose effectiveness but the balding pattern is tied to apoptosis (cell death) which these hairs undergo over time. These drugs slow the process down but will not prevent the outcome, which is inevitable.
In the early stages of use, when miniaturization is high and newly formed, the probability that these drugs will reverse the miniaturization process, making these hair stronger and less miniaturized, will be good.
I just watched the Andy Irons documentary (A Pro surfer) with Andy and his brother who are known to have used hardcore drugs and are perfect Norwood 0’s. David Bowie, Bob Dylan, Robert Plant, Comedians like Richard Pryor, Joey Diaz. Do you think hardcore drugs lower your Testosterone and DHT levels? When ever I hear people saying hair is a diet thing I think absolute bullshit. David bowie lived off of cocaine in the 80s with like a can of tuna fish and some peanut butter or some shit and had perfect hair.
These guys are public. I doubt that their hair has anything to do with hard drug use.
I am strongly considering a transplant, since I really am sad about my balding situation.
It is such a slow progression and at the moment It is only frontal part that will need transplant. I am 27 now and cannot tolerate the AR5 inhibitors (tried everything, including all different dosages). Crossing fingers for future treatments !
BUT I am afraid of the FUE scars (even with micro) if I eventually will have to shave it all off to the bare skin (if the balding continue, even on the side and back of the head). Can you share pictures of the FUE harvest area after a head has been shaven?
Most of those men who shave their heads after hair transplant either had: (1) poor or no growth, or (2) poor planning without a Personalized Master Plan and with unrealistic expectations that result. Also, if you shave your scalp very close after an FUE, you will see a lot of white dots, the scars left from the removal of the grafts which happens in 100% of FUE surgeries. FYI: any cut into the skin any place in the body will cause a visible scar.
The safety of dutasteride in young men with hair loss has not been determined as this drug is not FDA approved. Start with finasteride which is almost as effective (70% vs 85% of the competitive inhibition at the hair follicle level)