In the early 1990s when I pioneered small follicular units in large sessions, many doctors could not place the grafts with forceps in these tiny holes, so they purchase NAILS from a hardware store, and used them as dilators to open these little holes so that they could get the grafts into the balding area.  This was barbaric, but the doctors who did this, did this because they had to. Their patients wanted large sessions of small grafts because it became the new Standard of Care that everyone wanted.  I hope that they sterilized the nails before they use it. Dr. Brad Wolfe sent these to me as a reminder of things done in the past (not by him but by others).

Yes, oral minoxidil can produce facial hair, but I doubt to the degree shown in the photoshopped photo below.  For women who use minoxidil, facial hair to some degree is common.  This is something women must know about before taking this medication; however, if it happens and the woman stops taking the drug, these new facial hairs will fall out. 

Great response to the drug in just 2 months. The viewers can see the small hairs growing in the frontal hairline. 

What would you recommend?

I suspect that you have been balding for sometime.  You appear to be leaving some of your hair longer so that you can use it as a combover.  Men in their 40s. are best treated with a hair  transplant.  Have you considered a hair transplant. They have gotten so good today, you can’t tell it is a hair transplant. 

I have been getting thinner and thinner.  I am a woman age, 34.  Any suggestions?

Women with progressive thinning require a trichoscopic examination where the doctor magnifies the hairs on the scalp and looks for miniaturization.  Some women just develop premature Age Related Thinning where there will be no miniaturized hairs on the scalp.  In ART, the best treatment is to use thickeners iin your shampoo and conditioner which will increase the thickness of the hair shafts as it is forced to absorb water.  An alternative is to use either topical concealers (like Tokkik) ot Scalp Micropigmentation (a tattoo of the scalp make to look like cut hairs).  If your hairs are miniaturized in some areas, you need a hair specialist to assess that for you.  

I am sorry if I add to your problems, but this is what I try to get guys under 25 to understand. The risks of hair transplants could be devastating, even if you took the drugs finasteride to minimize shock loss. It doesn’t always work. How many grafts did you have? How much hair remains in your donor area? Do you have a doctor with a lot of experience that understands how to manage a problem like what you have? It MPMD your surgeon? You can reach out to me if you wish.

MPMD subject model loses all his hair, holy cow…! from tressless

Pharmacology and therapeutics
Female pattern hair loss: a pilot study investigating
combination therapy with low-dose oral minoxidil and
spironolactone
Rodney D. Sinclair1,2, MBBS, MD, FACD

Abstract
Background Minoxidil and spironolactone are oral antihypertensives known to stimulate hair growth. Objective To report on a case series of women with pattern hair loss (PHL) treated with once daily minoxidil 0.25 mg and spironolactone 25 mg. Methods Women newly diagnosed with a Sinclair stage 2–5 PHL were scored for hair shedding and hair density before and after 12 months of treatment with oral minoxidil 0.25 mg and spironolactone 25 mg. Results A total of 100 women were included in this observational pilot study. Mean age was 48.44 years (range 18–80). Mean hair loss severity at baseline was Sinclair 2.79 (range 2– 5). Mean hair shedding score at baseline was 4.82. Mean duration of diagnosis was 6.5 years (range 0.5–30). Mean reduction in hair loss severity score was 0.85 at 6 months and 1.3 at 12 months. Mean reduction in hair shedding score was 2.3 at 6 months and 2.6 at 12 months. Mean change in blood pressure was 4.52 mmHg systolic and 6.48 mmHg diastolic. Side effects were seen in eight women but were generally mild. No patients developed hyperkalemia or any other blood test abnormality. Six of these women continued treatment, and two women who developed urticaria discontinued treatment. Limitations Prospective, uncontrolled, open-label observational study. Discussion Once daily capsules containing minoxidil 0.25 mg and spironolactone 25 mg appear to be safe and effective in the treatment of FPHL. Placebo-controlled