I have seen great initial growth with finasteride in some men 18-22. It works best when the hair loss is recent. See the photo collection from Dr. Robert Bernstein’s office here: https://baldingblog.com/dr-robert-bernsteins-library-of-finasteride-results/
Diffuse thinning should generally NOT be treated with a hair transplant. Why do you have diffuse thinning would be my question? Did someone give you a proper diagnosis? A good doctor might do a HAIRCHECK test (https://baldingblog.com/haircheck-test-how-it-is-done-video/) as well as miniaturization analysis of your hair and look to see patterns of hair loss.
One doctor told me this story as he believes that PFS is totally a nocebo effect. This is how he proved it to himself.
His brother was going to have a second hair transplant and believed that the finasteride caused him sexual side effects the first time he took it. So he refused to take the medication in preparation for a second surgery a few months down the road. His sister-in-law (the man’s wife) put two finasteride 1mg tablets into his daily shake which she prepared after he went to the gym without telling her husband.
So he took 2 mg per day for 3 months and told his surgeon brother that his hair miraculously was thicker and laughed that he didn’t have to take finasteride and experience side effects. At the three month mark, his surgeon brother told him that his wife had put double the dose of finasteride into his daily shake without telling him, in other words 2mg of finasteride per day. Not knowing that he was taking the finasteride, he had no side effects at all. So the idea that you can talk yourself into side effects was raised here. I know that there are sexual side effects with finasteride and I have seen that with my patients, so I am not suggesting anything to the contrary; however, there are some people who are just highly suggestive and worrying alone, can bring on side effects. No surprise.
June 10th marks 6 months since my 1200 FUE graft HT on my temples (lowered hairline as well slightly). The transplant hair is growing in slowly but surely. Unfortunately, I have significant shock loss on my native hair surrounding the transplant hair. Much of this has not grown back yet. Specifically, I have shock loss in the front hairline area and behind my right temple where grafts were placed.
I met with my doc last month, and she boosted me from Fin to Dut to help with growth (I have no sides from either-yay!) She also remained steadfast that all my shock loss hair will grow back, it just takes time. However, part of me wonders if I should really believe her, if she thinks it will really grow back or if she is just saying that.
Finasteride is best taken before the hair transplant as it often prevents the loss of the native hair. Unfortunately, after you lose your native hair and then take finasteride, the effect is heavily muted. I always offer my patients finasteride before I do a hair transplant to avoid this problem. You should wait a full 8 months to see the results of the transplant and then reassess your situation.
Yes, usually hairy people who take finasteride are early in the hair loss process, so that is when finasteride is most effective. At the end of the hair loss process, large balding areas rarely respond to finasteride. Everything else is in-between.
Is it rational for me to think that either a forehead reduction or a hair transplant at 24 is a good idea because my forehead bothers me?
I never TELL patients what to do, I just educate them. At 24 for a male, it is rarely a good idea to do any hair work unless you have certainty about your balding pattern, have a HAIRCHECK test to help you determine that pattern, sit down with a very good skilled doctor who cares about you and not the money he will make from giving you some type of surgery. Get it?
a little more info about the doctor, he’s from Istanbul/Turkey. even though he has license, his assistants will do the actual operation while he supervises. do you think this is a huge red flag? most hair clinics in Turkey operate in the same way and there are so many of them to choose from.
The question is really is he really over-viewing the surgery and the details of how it is being done, Who determines the distribution of the FUE grafts as they are taken out one-by-one. I’l bet he is not involved in that level of granularity and that is where the problems arise with the terrible photos I posted here: https://baldingblog.com/?s=over-harvested+photo . In my office, only the surgeon is doing the FUE so 100% of the decision are made by the surgeon as each graft is excised so we never they the type of problems shown in the reference here.
HAIR UNAPPARENT The celebrities and pop-culture icons to the left have been Photoshopped to remove some or all of their hair. Can you still recognize them?
This man had his hair wash this morning. There was no crusting on his head. I recreated his natural swirl which doesn’t show up well in these photos. The tape was placed to minimize any swelling that would follow a procedure of this size (which would otherwise produce swelling in the forehead and possibly the eyes within 3 days of the surgery). He slept well and drove in this morning feeling completely normal and pain free. He will now starting doing his own washing. That is not blood you are looking at below his head but a flower on his shirt. I told him that he could begin exercising in two more days.
The third picture was taken a day 6 and as you can see he looks much better. He is having no difficulty washing his own hair and has resumed full activities
I Have Heard That in Bald Men, Their Head Is Hot and They Lose Their Hair Because It Creates an Environment That Is Not Good for Hair Growth.
There have been many jokes from bald men that hair doesn’t grow on a busy street. So they rationalize that they lose hair because they are smarter than those that keep their hair. Tell that to Albert Einstein who had a lot of unruly hair. It’s not true!
Since there is no hair on a bald man’s scalp, if you feel it, you may feel his body temperature which is warmer than typical room temperature and perceive it as hot when it is not.
What If the Donor Area Is Not Particularly Dense Though?
I always measure the donor area density and total supply and then match the donor area to your ‘worst’ case possible hair loss. I always create a Master Plan individualized for each patient so that they always know what is going to happen to them. This is critical in hair transplantation because both doctors and often patients rush to use up all of their donor hair before the balding pattern is complete, leaving the patient stuck with an incomplete job.
I had a patient that went to India for 6 months to treat his hair loss. Center to their treatment was standing on his head many times a day. They did massage and gave some magical potions. Nothing worked so he came back and got a hair transplant and in one session he got his hair back.
The best test to get is the HAIRCHECK test ( https://baldingblog.com/haircheck-test-how-it-is-done-video/ ) to get a good baseline for your hair loss so you know, when you repeat the test yearly, if you are controlling it or losing the war.
This proves my point that young men (under 25 and especially under 20) have a higher benefit from taking finasteride than men over 25. Good job and stick to it and maybe you can avoid more hair loss for many years. The photo shows that the miniaturized hairs in the front seem to have become thicker ‘terminal hairs’ which are essentially normal growing hair.
