Good response from just 4 months on oral finasteride and topical minoxidil
Great results from finasteride and minoxidil in a 31 y/o male in just 7 months. I was asked yesterday if balding can be reversed, you have answered the question, at least for now.
These scars reflect that your surgeon used a large punch and took it from a location that is not permanent hair. This is best treated with Scalp Micropigmentation?
The neck hair is not permanent hair so as this man gets older, he may see his neck hair disappear and so will these grafts in the recipient area that came from the neck because these hairs ‘don’t know’ that they are not in his neck.
Very nice increase in fullness from the combination of finasteride and minoxidil. I am sure that many of the miniaturized hairs were reversed with finasteride and minoxidil grew new hair as well. Congrats! Stay the course
I’m a 30 year old guy with diffuse thinning hair. I started to take finasteride about 3 years ago and to be honest I’m not certain if it did anything for me as I didn’t have any regrowth during that time. However I’ve been able to greatly regrow a lot of my hair through microneedling over the last 2 years. I wanted to get your take on wether the hair I regrew with microneedling could be permanent? I reduced my finasteride dosage from 7 mg per week to about 3mg per week about 6 months ago and haven’t lost any ground. Your educated guess? Thank you!
I don’t believe that anyone knows for sure about how long microneedling induced hair will last. I am guessing it will last about one hair cycle (Max) which in a young man could be 3 years.
I performed this surgery on this man with 1800 grafts. Note the picture on the left which is one day after the surgery. Because he washed his hair using our washing technique, he formed no scabs (crusts) on the wounds after the surgery. Note also in the after pictures, that the center forelock which was not transplanted looks like the transplanted corner hairline does with respect to density or fullness
I’m a 26 year old male, 157 lean, healthy diet, active lifestyle.
Many users may not want to hear this, but your lack of side effects may well be your ignorance of them. Finasteride affects your hormones, no argument—that is its entire purpose.
I used it for a year, and it 100% worked! Hairline strengthened, had a full head of hair, and even all grew faster. Body hair reduced as well for an added bonus. I was monitoring any immediate changes in mood/cognitive function/libido but sensed nothing different over the 12 months. This is only because they were so gradual.
I stopped taking it two weeks ago, I feel like I used to in college. It feels like I’ve always had a cup of coffee compared to needing to “wake myself up” before doing anything requiring thought or strength. I’m not sore as long after lifting, and I’ve already gained about 5 pounds of lean mass, as if my body was holding out on me all year. I’m sleeping completely through the night compared to waking up multiple times. I also am constantly horny again.
All these gradual changes I went through, I never noticed or completely rejected because I so badly wanted them to not exist. It worked, but just know you could be a better version of yourself (with less hair) if you hopped off fin.
Ignorance is bliss, however, and beauty is pain. I may start taking it again in the future, but I’m enjoying the DHT right now—it clearly serves a purpose in your body.
When you stop finasteride after getting good results from it, all of the benefits will be lost over a few months and if there was potential progression of the hair loss, you will see that too.
Have you had patients get a hair transplant while recovering from surgery? I’m having surgery on my shoulder soon and was thinking about taking advantage of the time off work to get a transplant? Not sure if this would be too much for my body.
Obviously I know my doc will have the final say. However just wanted to ask here prior to asking him, as my next appointment isn’t for a few weeks and he’s a while away
Many of my patients who have had orthopedic surgeries will do a hair transplant during the recovery period because they have the time to do it then.
The first week I took it I felt completely fine. The second week however, I experienced some ED, as well as less energy, but I chalked it up to not getting enough sleep or just overthinking it. 3rd week however was when I started seeing development of gyno and severe ED. This is ridiculous I only took it for 3 weeks.
I quit taking it right away, reported it took my doctor, who said it would go away on its own. 2 weeks later, I still feel the exact same effects, the gyno is still there, I have really bad ED, and really low energy all the time.
I literally only took it for 3 weeks, how do I have pfs already? Am I just fucked for life now, because of this? I honestly can’t live in this state in day to day life.
What am I supposed to do? The doctor I went to basically said, “Oh well, you’re fu***d” in his own words.
Honestly don;t want to continue living like this.
Sometimes it takes a few months for things to calm down and your sexual side effects to go away. Wait at least 3 months off of the drug. As far as breast lumps, that may not go away and you should see your family doctor about it if its doesn’t disappear. What your doctor told you is totally unprofessional and if he didn’t know what to do he should have sent you to someone who could help you. I hope that this posting gives you hope.
Dr. Rassman’s Comments: There is some good reading here for those interested in finasteride and the many finding of things that go wrong with this drug. One of the referenced article reflect a single case study and show DNA damage to sperm. From any single case study, one can’t conclude that the finding is attributed to finasteride as discussed by the authors. Another article address high grade prostate cancer risks with finasteride and found nothing to suggest that it is a cause and effect. Still, these articles are not authoritative and do not stand alone.
This is a follow up from
https://www.reddit.com/r/tressless/comments/f4hnuy/my_trip_to_the_derm/
Once again I am not a medical professional or giving advice.
Basically I’m in my late 20s and have had some thinning and recession, this has gotten worse despite several years of using minoxodil 5% with good compliance. I also use Ketoconazole 2% shampoo (usually daily). I think they both help, but it’s hard to prove.
So I’m looking into propecia/finasteride. I have the pills with a derm. prescribing 5mg stating that the higher dose is more effective than 1 mg.
I saw a urologist the other day about sexual and in particular fertility concerns prior to using finasteride. Honestly the fertility worries me more because I would like to have children down the road but fertility problems aren’t always known until one attempts to conceive. I feel that if one gets noticeable (like erectile dysfunction) side effects, discontinuing the drug is likely to lead to a recovery whereas keeping on the drug for years seems more likely to impair recovery. The Dr. seemed open and candid about side effects overall and discussed both sexual and psychiatric side effects. He stated that the causation of effects was hard to determine given the number of different reported effects and how many things could cause them. He seemed to think that for how often the drug is prescribed side effects aren’t super clear. He stated that fertility effects were “usually” reversible. He also felt that 5mg was too much and referred me to another derm. (who he said takes finasteride himself).
It says right on the finasteride pamphlet that fertility might be effected. I’ve read some studies that have shown a reduction in sperm parameters in some men, typically reversible. This one is probably best https://academic.oup.com/jcem/article/92/5/1659/2598215 , it states that;
” Some individuals (approximately 5% of the subjects on active treatment) demonstrated greater sensitivity to the effects of 5?-reductase inhibition, with decreases in total sperm count to less than 10% of their baseline values during treatment. “
and
“Partial to nearly complete recovery was observed during the follow-up period for total sperm count and semen volume. Of particular note, approximately 5% of individuals on active treatment showed dramatic declines in total sperm count during treatment, although they demonstrated recovery in the follow-up period. The overall impact of these findings on fertility is currently unknown. “
But even that doesn’t tell the whole story. In particular sperm can be visually (by microscope) OK but have damage to the DNA “fragmentation” that causes the cell the either self-destruct “apoptosis” (although I would think this happens early in spermatogenesis), lead to a miscarriages as the human body effectively aborts a fetus with problems, or result in a child carrying/with a mutation. The sperm (or mother through mechanisms I don’t understand well) can sometimes fix the fragmented DNA. I believe this fixing ability deteriorates with age.
DNA fragmentation is associated with older fathers and I believe is why they are associated with offspring with disorders like autism, Down syndrome, and schizophrenia. A high rate of DNA fragmentation is associated with overall difficulty in conceiving and there are at least a couple of case studies of men who discontinued finasteride and had fragmentation levels improve dramatically.
(Articles below)
So, my opinion is that finasteride might effect fertility and this effect is likely reversible. I do feel however that there is a real risk. If I’m one of the 5% with a huge drop in fertility and I take the drug for I dunno 10 years, maybe it’s not so reversible, or some of the less detectable factors don’t fully reverse. It seems odd to me that fertility isn’t a bigger concern with this drug when prescribed to young men.
https://link.springer.com/article/10.1007%2Fs11255-012-0315-9
Herein, we present an unusual case of secondary infertility after prolonged use of low-dose finasteride for androgenetic alopecia in a 40-year-old man. We detected sperm DNA damage in the patient. Despite such a long-term use, we observed that impairment in semen parameters and sperm DNA fragmentation index regressed after the drug was discontinued. Consequently, pregnancy occurred and resulted in live birth.
https://www.ncbi.nlm.nih.gov/pubmed/21292254
OBJECTIVE:
To report a case of low-dose finasteride-induced secondary infertility with associated elevated sperm DNA fragmentation index (DFI) and otherwise normal semen parameters.
DESIGN:
Case report.
SETTING:
University hospital.
PATIENT(S):
A 48-year-old man on low-dose finasteride and his 37-year-old wife with normal menses and normal gynecologic exam.
INTERVENTION(S):
Determination of sperm DFI and discontinuation of low-dose finasteride.
MAIN OUTCOME MEASURE(S):
Sperm DFI.
RESULT(S):
The sperm DFI done a year earlier was 30%. This value was unchanged when repeated 2 months later. The patient was advised to stop finasteride. Three months after discontinuing the finasteride, the DFI decreased to 21% and subsequent DFI after another 3 months improved to 16.5%. To date, there is still no documented full-term pregnancy or live birth.
CONCLUSION(S):
The significant reduction in DFI within 3 months of finasteride cessation and continued improvement suggests a causal link between finasteride and sperm DNA damage. We hypothesize that low-dose finasteride may exert a negative influence on sperm DNA integrity, resulting in increased pregnancy losses. We suggest that in infertile men using finasteride, sperm DFI should be measured in addition to semen parameters, and a trial of discontinuation of finasteride may be warranted.
Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
In these 4 months since starting dut/microneedling, I feel my hair is more dense, better quality, and I’ve noticed small vellus hairs on my temples.
Dut (0.5mg) 2x a week
Fin (1mg) 5x a week (on days I don’t take dut)
Foam minoxidil 2x a day (as per instructions)
1.5mm derma pen 1x a week
0.5mm derma pen 4x a week (immediately before applying min)
Nice improvement seen in just 4 months. I noticed that he did dermaroller 4 times a week. I see some fill in the forelock and also in the corners of the hairline. Better photos with better views would help.
I’m 43 years old I’m a Norwood 6 is my Norwood 6 pattern fully developed? my hair loss genes won’t express anymore correct? Or will I develop into a Norwood 7? Thank you!
At the age of 44, you may stabilize at a Class 6 pattern. Hair transplants can work well in men with Class 6 patterns, even if your donor density is low. First you need to have your donor supply measured and your total lifetime graft availability determined. If it is average or above average and your hair is or a medium thickness or better, then a hair transplant will work well. If your donor hair is fine or your donor density is low, then please read this article I wrote on how to get a full head of hair in these situations: https://newhair.com/wp-content/uploads/2018/11/Combining_Follicular_Unit_Extraction_and_Scalp.98621.pdf which is being heavily read by plastic surgeons from around the world. We have a travel reimbursement program for people outside of Southern California.
I bleached (at a parlor) my hair about 6 months ago and have noticed a noticeable thinning overall in my hair since then. My question is does bleaching cause permanent hair loss?
When bleaching is done improperly, there are chemicals in the bleach that can burn your hair follicles resulting in a permanent loss of hair. We see this at times in professional salons when either the person doing is new, or the person doing it did not follow a strict protocol designed to prevent such happenings. When the damage happens, it kills hair follicles at the root. Sometime, Minoxidil (Rogaine) may grow new hairs, but this is generally not a reversible thing. If it particular bad in a single area, then maybe a hair transplant can address it,
http://www.informaticsjournals.com/index.php/mvpjms/article/download/781/618
. Conclusions: Topical Minoxidil 5% is equally effective to combination of topical Minoxidil 5%, azelaic acid 1.5% and tretinoin 0.01% in treatment of androgenetic alopecia.