Is it necessary to discontinue oral minoxidil for a period of time after hair transplant. Someone said I should stop oral fin for 15 days and oral Minox for 3 months after procedure but I don’t think that’s right? Can you clarify please? Thank you Doctor.
I generally tell my patients to take minoxidil until the day before surgery and restart it one week out.
I called an office near here to discuss options to stop my hair loss. One being hair transplant and the other finasteride. They told me that finasteride is required before they even would let me consider a hair transplant. Which, fine with me, sounds fair. However, here’s where it seemed too good to be true. They told me that if I get a hair transplant and stay on finasteride, I’d keep 100% of whatever hair is transplanted on my crown and at least 80-90% of whatever is transplanted on my hairline. Is that true? They said it had something to do with how DHT affects those two areas. It felt a bit like a sales pitch but seemed a bit far fetched that finasteride would allow me to keep 100% of the hair on my crown. Can’t anyone confirm or deny that?
I have been doing hair transplants for 33 years, pioneering modern surgery, even FUE. After you get a crown hair transplant, if you are on finasteride, it is more likely than not that the native hair that is there will stay longer than if you were not on finasteride. That doesn’t mean that taking finasteride will guarantee that the native crown hair will not fall out in time, which is what will probably happen. Some doctors use salesmen to represent their communication with patients, and too often, these salesmen invent the science to meet their sales goals. The buyer must always be on guard, even in a doctor’s office.
Can you tell my why my oral minoxidil protocol is making me grow hair halfway down my forehead but not in my widows peak area towards the middle of my hairline?
This is a complication of minoxidil, not a treatment outcome. Also, the widow’s peak rarely is recovered if it is lost as it doesn’t have the classic DHT/Genetic elements that is present on the full receding mature hairline.
Transplanting near native hair should not be a problem unless that native hair is miniaturized and on the way out. Shock loss occurs when your hair is miniaturized and a transplant is performed. Taking finasteride often blocks such loss, and I recommend it regularly to my patients, especially those under 35 years of age. Men over 35 often don’t have much miniaturization present, but if they do, I again recommend taking finasteride.
I’m afraid I have to disagree. Both drugs work the same way. Dutasteride is 85% effective as a competitive inhibitor of DHT compared to finasteride, which is 70% effective; however, you pay a price for using or adding dutasteride, which is its long half-life. Dutasteride has a half-life in the bloodstream of 5-6 weeks, while finasteride has a half-life of 4-6 hours. What does that mean?” If you develop significant side effects, stopping finasteride will get it out of your bloodstream in a day or two at the most, with some finasteride sticking to the receptors for a few weeks. On the other hand, dutasteride will stay in your bloodstream for months, possibly remaining in your tissues at the blocking site for up to 1/2 year or longer. There may also be other effects on dutasteride because it blocks more than one receptor. What else could it do, this a good question to probe. Getting rid of the effects by stopping the drug is more ominous for dutasteride than finasteride.
The severe cardiac complications of oral minoxidil are very rare when dosed at 2.5 mg or less. I often prescribe 1/2 pill at a 1.25mg dose. Too many men use high doses of topical minoxidil, which get into the body and can cause cardiac complications.
Unfortunately I (21m) am gonna be unable to take finasteride for up to a week because the delivery has had issues. My hair loss is pretty aggressive (as hair loss tends to be for younger people who have it). Is the lack of fin for 5-7 days likely to affect my hair loss?
Enough finasteride is attached to the receptors to last 1-2 weeks safely, so stopping finasteride for a week is usually not a problem.
The original Merck studies showed that 1mg finasteride is as good as 10 mg dose of finasteride for hair loss. Stick to the 1mg dose.
Caucasian and Asian follicular units are straight; however, in African individuals with coarse, kinky hair, the curl seen above the skin is also present below the skin. That is the only difference between African hair and the hair of other races. Getting these out with FUE requires a lot of experience, and placing them into the recipient site could be challenging. For many experienced surgeons, that challenge has been addressed. The photo on the left is a typical follicular unit excised with FUE. Note the curl in all of them and that in this sample, they only have two hairs in each graft. The photo on the right shows Caucasian follicular units, with 1, 2, 3 and 4 hairs in the grafts shown. Count hairs in the grafts yourself.
To determine the value of the donor area, you need to measure the donor density in the donor area as well as the value of each hair in terms of donor hair thickness. These two numbers will allow you to know how good your donor supply is and how many grafts you can move safely, now and in the future. I routinely measure these numbers; see here: https://baldingblog.com/creating-a-personalized-master-plan-for-present-and-future-balding-photos/. I also have be suggesting that you purchase a micrometer from Amazon (only $22) to measure the thickness of single hair shafts in the back of your head. The product I use can be found here: https://www.amazon.com/dp/B09964YBMF?psc=1&ref=ppx_yo2ov_dt_b_product_details
Yes, what you are experiencing is normal. You are angry with your reality, while so many male friends do not have the problem. In addition, many of the posts on various forums are frightening. I always tell my patients they must learn to ignore the scare tactics many individuals post on various forums. Reach out to a good doctor and ask that doctor about these drugs and what you really have to worry about.
I’m thinking about taking Dut or Fin but I’m not having any hairloss. I made a post yesterday about being concerned about my testosterone levels. I know that Dut and Fin can raise T levels by a little and I would like to do that in combination with other natural supplements that supposedly boost T levels. So are there negative consequences if I start using Dut or Fin without hairloss?
Why would you want to take a drug that you don’t need? It makes no sense. I would never advise anyone to do this. There are always negative effects from drugs of any type, certainly finasteride and dutasteride.
This is a great result. You are to be congratulated. Stay on the minoxidil to keep the hair.
Why not get a hair transplant for the front hairline (with a reputable surgeon ofc), leaving the crown area to go bald naturally but use a hair-system to cover that. I figure that combo would be less noticable than a whole hair-system.
In theory, this works. I have done a few of these and found that all the men went back to their hair systems, which pulled out the hair transplants. They never waited out the results. If you want to transplant the frontal area and then use a hair system behind it, that makes sense, but the burden is on you to follow through properly. I have been doing hair transplants for 33 years, so I have much experience to share.
This is not a common finding. For the hair transplant surgeon, it always makes for a challenge.
