I’ve noticed that my dad has had the same semi-receded hair line for like the last 15 years. It has only slightly thinned out on the top since.
We are born with a patterned hair loss (inherited from family) that we will reach and then stabilize. That is most likely why your dad’s patterned hair loss is stable. Let’s stay that he had a Norwood 4A pattern genetically programmed, that means he, most likely, will never progress further to a Norwood Class 6 or 7 pattern.
Hair system for someone who still has hair but diffused thinning like me, will they work well?
Hair systems work well, but they almost always accelerate the hair loss because of the various attachments that are used. Men who use hair systems find that they get balder by the number of years they use them.
Have your patients reported to you that their life improved was improved from getting a hair transplant (E.g. Confidence, more time etc)? I’m thinking about getting it done and I’m really worried about the first day travelling home.
Almost all of my hair transplant patient regret not doing it earlier. The average age for a hair transplant in my practice is mid-thirties. The older the man is, the more they regret not getting a hair transplant and living with balding. Almost 100% tell me hair transplants were a life changing process. I started doing large session transplants in 1991 with follicular units back then. I never did a ‘plug’ surgery
This is a predictable response for finasteride. This drug works best on the crown and it is more predictable with response in the crown when compared to the frontal area. The older you are, the less responsive the frontal reversal will be.
One pictures shows it all. This man is a good responder to minoxidil.
Nice post on your blog. I’ve always wondered why some people’s HT don’t always take.Questions this brings up:– should one go to a dermatology clinic instead of a doc to get this done?– perhaps in the same way one can take fin to mitigate shockloss, would it be wise to take corticosteroid pills say leading up to and after a HT?Just trying to gauge how to put this information into practical use :-DThanks again! Love your work!
Hello doctor, I was wondering if you could help me with a conundrum I’m thinking about: I see some people start taking fin for a solid 6 months to a year, see if hair loss stabilizes, and then are advising people to take min. My derm prescribed me a compounded fin / min topical , and I’m a little worried about taking fin/ min together in case I stop just the min, and want to continue taking the fin. Would it be wise in any instance to insist on taking both at once, or would taking fin first then waiting for min always be a safe result?
Both may work better in many men (the majority of men respond to oral minoxidil but only 40% will respond to the topical form). These two drugs act differently, so taking them both gives you the best shot at addressing the hair loss
This is a very good result from finasteride alone. The frontal area is not as responsive usually to finasteride as the crown is.
Not a 3A, of course is not balding. A Norwood 3 might be balding. That’s a mature hairline means. A presentable hairline that is basically the final pattern of hair loss for a man.
The maturing hairline is not balding. The Norwood scale at a 1 or 2 show some form of the juvenile/maturing hairline. Balding starts when corner recession appears when the hairline takes on a gentle V shape as in a Class 3 pattern where the corners and possibly the entire hairline rises up. It can also be detected when or if crown thinning appears. The correct incidence of balding in the male population is about 50% of men believed to have inherited some form of balding in their lifetime. My grandfather died at 102 and he had his 5 year old hairline when he died. His hairline never went through maturation. Bill Clinton is another example of a mature male who kept their juvenile hairline.
Dr. Christine Shaver and other dermatologists are picking up diseases of the scalp in young balding men. These men present with itching, inflammation and hair loss. Upon biopsies taken by Dr Shaver, she identifies about one young male patient each week with a condition called Lichen Planopilaris or Frontal Fibrosing Alopecia, both autoimmune diseases of the scalp. In some men who eventually get a hair transplant, the hair transplant is likely to be rejected by the body. It may also reduce the growth or prevent growth in a hair transplant. If you have itching and inflammation, seek out a dermatologist and have two biopsies, one in the frontal where the inflammation and the itchiness is most prevalent and then a second biopsy from the Donor area in the back of the head. A biopsy read by an expert, will make the diagnosis and then special treatments are required. Catching it early is critical for everyone who has these diseases.
I was reading up on a few dutasteride studies and was curious what your thoughts were about the recommended dosage of dutasteride given it’s rather extended half life.
https://academic.oup.com/jcem/article/89/5/2179/2844345 for example.
Clark noted that the DHT suppression in patients after drug cessation for .5mg dutasteride only had a minor deteriation after 2 weeks with greater DHT in the following weeks, and I’m just wondering what the medical benefits would be from continuing on the recommended .5mg daily when there doesn’t appear to be a specific clinical benefit?
Just curious, not taking this as medical advice. I just have questions and no friends in medicine to ask.
This is a complex issue. Do you really want a 94% or high reduction of your DHT? The article indicates it is possible with dutasteride. The recommended daily dose is .5/day, but I suspect that same benefits might be reasonable at a dose of once a week but since I do not prescribe this medication, I would rather not weigh in on the dosing issue. Most articles I have read indicate that the DHT block is 85% with dutasteride and 70% with finasteride
I’ve been on finasteride for half a year and I’ve just started topical minoxidil (regaine) about a week ago, I’ve been applying it on my temples because that’s where my hair is thinning and receding, I don’t have any hair loss on other parts of my head. I found that using a few drops on each side already covers the whole balding areas and using any more makes it wet and drip down my forehead, so is it fine to just use enough to cover those areas even if it’s less than 1mL? Thanks
You don’t have to flood your scalp. Using the liquid, put if on the scalp in small drops and rub it in. Do it best after a hot shower before you go to bed