I understand thank you once again. I was simply asking if oral min was generally considered safer in the long term then fin?

The answer for the drug finasteride and oral minoxidil is that if you don’t develop complications from the drugs, then they are safe for you. For example, oral minoxidil has a very rare cardiac side effect that is dangerous and must be picked up early (fainting, heart palpitations, allergy).

these are known complication of this drug so should you eliminate taking it because of this potential, even if it is rare? If you get sexual or other side effects from finasteride, then speak with your doctor and see if you should still take it. A few people believe that if you get sexual side effects and you stay on the drug, these side effects will continue (Post Finasteride Syndrome)

The doctor recommended 10 sessions of PRP at $500/session.   I would guess you might purchase a good used car for that $$ amount. So if you were shopping for a car, you would research it, right? Doubt that you will stop your hair loss with PRP and reversing it is another story! Some doctors are just not honorable. I can tell you that I would doubt that you would get much value from this PRP package.

I have a scar from my hair transplant, why did it happen, did my doctor do something wrong and what can I do about it? (photo)

You had a strip surgery and clearly scarred worse than many people do. I had three surgeries in the same place and have no significant visible scar. It is not that I had a better surgeon, I just healed better than you did. I am sure your surgeon did the surgery right. The best way to deal with the scar is to have scalp micropigmentation which covers up the scar nicely.  Your picture is on the left, a worst case scar is shown on the right before and after scalp micropigmentation (https://scalpmicropigmentation.com/).  There is hope!

“If you’re going to loose all your hair eventually there is no point in treating it, you will be bald anyways, that’s how God wants you to be.”

A relative of one person gave him this comment.  This was my answer: God gave us genes that cause hair loss.  God did not say that one had to accept these genes and that is what I make a living at, helping people like you manage or cure your hair loss cosmetically or otherwise. If God intended that hair loss should not be treated, God would have stopped the science of hair restoration from growing like crazy. If God gave you cancer, heart disease, smallpox, measles, etc.. would you accept it or try to cure it?

The diagnosis of Diffuse Unpatterned Alopecia (something I defined in the medical literature) can be made with a hand microscope which shows an abnormal amount of miniaturization in the sides and back. I think that you need to have such an examination

I’ve been thinning since the age of 16. Now I am 23 years old.  At first it wasn’t anything I thought was serious. After a few years it got super aggressive and I didn’t do anything about it like an idiot. Now I stand a Norwood Class 5. I will be going for multiple transplants and getting on Fin very soon. I’m going to buzz my remaining hair for easier application of Min. Any positive suggestions?

See a doctor and develop a Personalized Master Plan for your future fight against hair loss. Don’t rush to start the hair transplant process until there is no real better alternative.  Men with genetic balding continue to bald no matter what we do to try to stop it. If we are lucky, we can slow the time line down enough never to face the end stage balding we are genetically programmed for, even with the use of finasteride (best drug to slowing and possibly reversing hair loss). But to be safe, you must assume that you will not be the lucky one and figure out a worst case scenario with your doctor. Think about this and its meaning. Best to find a great doctor and then develop a long term relationship with that doctor working according to a Master Plan that this doctor will put into writing for you, something I do on every patient at your stage of genetic hair loss.

Young man started treating balding in the old days (15+ years ago) first with scalp reductions trying to cut out the bald spot, eventually getting transplants into the bald spot. He continued to bald and ended up with an oasis of hair surrounded by a bald scalp. This is the way it was, thankfully, not today.  In those old days he rushed to get a hair transplant in the front, getting the old type of plugs transplanted into his head yet he continued to bald leaving him with terrible looking plugs, like a corn field on his head. The more transplants he did, the balder he got. His doctors made a lot of money out of him with multiple transplant sessions and three scalp reductions (where the bald spot was removed surgically for the thousands of dollars) never thinking of any Master Plan which would accommodate his balding progression. In the old days, Propecia/finasteride was not on the market so he could not slow the process down.

What can we learn from this and let’s compare the 1980’s to today.
1- The balding progression time-line has changed because of the use of finasteride today and this drug will absolutely slow hair loss down so that many people may not reach their final balding pattern in the youth. A balding man who might develop a Class 6 pattern without surgery in 1985, might develop that pattern before they are 30, but today on Propecia/finasteride, they might not develop that balding pattern for 10 or 20 years later, but it can happen sooner and it may be safe to assume that it will happen sometime in his older age.
2- If you have a 2 inch round balding spot in the back of the head and get it transplanted, you may lose hair around it to a 3 inch round bald spot in 5 years, it will look like you have an Island of Hair with surrounded by your bald scalp and your hair around that area. This is why I don’t like to transplant the crown, particularly if the drug finasteride can restore the hair. If the hair is not restored by the drug (with or without minoxidil) and the density of the hair in the donor area is average or better than average and if the frontal balding pattern has been addressed with transplants, then the crown can be transplanted provided there is enough hair to finish what was started (worst case planning is critical) and the patients final balding pattern can be defined by the surgeon. Only an experienced doctor who is not after your money but cares about your long term look, can make this judgment. Today, many doctors will transplant the crown without regard to this Master Plan I am talking about here.
3- The same rules apply to frontal balding. What is the worst case scenario? Finasteride does not usually work to reverse frontal hair loss but it will slow down the frontal balding process. So when you get your frontal area transplanted, ask your doctor what is his/her thinking about the progression of your frontal hair loss. If there the doctor has no good answer to this question, get the hell out of his/her office.

Why am I discussing this with you today. Because even today, we continue to bald no matter what we do. If we are lucky, we can slow the time line down enough never to face the end stage of balding that we are genetically programmed for, even with the use of finasteride. But to be safe, you must assume that you will not be the lucky one and figure out a worst case scenario with your doctor. You and a good doctor can build a Personalized Master Plan for your short and long term hair loss.  Think about this and its meaning.  Good planning is always the right way to go in managing your hair loss.