I mean why is it so frizzy and all over the place. Used to be super straight
That is strange. Usually hair changes with age and gets a finer hair shaft and more straight.
That makes no sense to me, as adding topical finasteride while you are taking oral finasteride at the 1mg dose, will add blood levels of finasteride. With topical finasteride, the drug will come across the scalp and go into your body. There is therefore no reason to add topical finasteride once you are on the proper dose of oral finasteride.
How do you tell if you have DUPA vs Diffused thinning MPB? I’ve searched online, and haven’t really found substantial answers. I have diffused thinning across the top of my scalp, with it being noticeably thinner at my crown. Some hairline recession as well. I got a scalp biopsy done and derm said MPB, but I don’t think he took a close look at the sides and back of my hair. I’ve deff noticed some thinning and hair loss there. Is it over for me? So is the difference of DUPA that you also lose hair in donor area ?
Diffuse Unpatterned Alopecia (DUPA) impacts all of the hair on the head, even the areas around the sides and back of the head. What I do, is count miniaturized hairs in the “donor” area to see if miniaturization exceeds 20%. Some doctors require a higher threshold. Unfortunately, your doctor didn’t biopsy the proper area. Here are some examples of DUPA, early and late stages with explanations on how to make the diagnosis:
- https://baldingblog.com/possible-end-stage-dupa-in-class-7-patient-photo/ (grossly evident)
- https://baldingblog.com/is-this-dupa-photo/ (Early DUPA with subtle changes including depigmentation of hairs)
- https://baldingblog.com/do-i-have-dupa-photo/ (A great view of a Classic case of DUPA)
I hope this helps you understand the DUPA diagnosis. Never get a hair transplant if you have DUPA as the transplant will usually fail at some point in the near future.
In evaluating this spot, a knowledgable surgeon will know or want to find out:
1- This location is not typical for Triangular alopecia as it is too far back from the temple peak.
2- What does the trichoscopy show as there are hairs within the bald spot that might shed light on the diagnosis (will rule in or out alopecia areata)
3- Most likely that this is not genetic patterned balding as it is not located in the patterns for such balding
4- This is a clean scar sitting inside normal hair, likely a form of alopecia that has a clear “cut” border
It turns out that this lesion was biopsied, and the diagnosis was definitive for Citrical Alpecia (scarring alopecia). This man had this for many years, and it was stable, suggesting that the disease had already done its damage and could be, therefore, transplanted as was done with good immediate results. The problem with such diseases is that:
1- It could return at the site and kill all of the transplanted hair
2- it could appear at another site and do the same damage
3- if the disease was active during the transplant, it would either immediately kill the new hairs as they started to grow or slowly kill off the new hairs over time.
Can you help me?
The photos reveal what I would expect: a healthy donor area with no evidence of DUPA. There is a slightly better-than-average hair density; however, I suspect your hair is fine in thickness (I suspect in the range of between 25-35 microns (just a guess, but it should be measured with a micrometer) because I can see through the donor area to the scalp. The rest of the photos show widespread miniaturization (not shown microscopically), which should be treated with finasteride, or you will likely lose all of the miniaturized hairs after any hair transplant surgery. Finasteride will not only reverse some or many of your miniaturized hairs, but if or when you get a transplant, you will have the protection of finasteride, so you experience minimal shock loss. Men with fine hair and a large potential balding pattern will need at least two surgeries to address the pattern, as the hair bulk transplanted with one surgery may not be adequate. The higher-than-average donor density helps but is not enough to offset your fine hair thickness. Before considering hair transplantation, I would start you on finasteride and wait at least 9 months and then re-examine you. A transplant should not be a foregone conclusion for you.
When I transplant men like you with fine hair and an advanced balding pattern, I often discuss a good frontal reconstruction from the hairline to mid-head as a first step. One or two sessions might be indicated, followed by SMP, which makes for a fuller-looking frontal head of hair, especially in men with fine hair. I would delay the crown reconstruction after reassessing the donor area and after the frontal area is fully stable to the mid-head. I have performed surgeries like this frequently with excellent results, but men with fine hair often don’t have the expectations of someone with coarse hair because they only know fine hair, even as a teen. Men with fine hair may have to make compromises on their goals.
Many articles have discussed the attractiveness of hairy men over balding men. The most notable was a Mens Fittness article many years ago that stated that to be president of the United States (after Ike), you must have had hair. Hair makes men appear more trustworthy, according to that article.
These researchers fond some unique stem cells in the upper part of the hair follicular sheath that could lead to hair growth in a bald man, so they suggest.
Minoxidil is not the right medication for some people. With swelling of the face as a known complication, I would ask your doctor about stopping your minoxidil. If you also have swelling in your feet, it could produce swelling around your heart, a hazardous complication called Cardiac Tamponade (https://en.wikipedia.org/wiki/Cardiac_tamponade)
There are other medications, so just speak with your hair doctor.
I’ve been on Fin 1.25mg for about 1.5 y, but for several reasons am hoping to stop taking it soon. How long after stopping it will I begin to notice my hair loss restarting? Thank you for your help
Within 3 months, you should see “Catch-up” hair loss when you stop finasteride.
24 years old. Started oral min and fin almost 8 months ago. My hair is not getting better at all. It honestley works worse at this point. I still lose over 200 hairs every day just like i did before I even started using the drugs. Was a NW2.5 when i started. Feel like I’m bout to reach NW3.5.
It would be best if you got an expert to evaluate you. I have heard many similar comments, but when I examined the person with those complaints and took a careful history, I found the solution to the problem. There is no substitute for an expert with years of experience; even the collective Reddit.com/r/tressless community doesn’t necessarily focus on YOUR problem.
What some men call a Norwood Class 2.5 pattern, they need the correct diagnosis. Your hair loss may be from all around your head or, without disrespect, in your head. The average Caucasian male loses 100-150 hairs daily and regrows that same amount. You never sent photos, so I will work in a Black Box scenario.
I’ve been on 1mg finasteride since early august so over a month now. I’m 18 years old and I stared seeing results within weeks of starting it. My hair felt more full and thick and it showed clear signs of improvement.
Why do I feel like the effect has stopped. It feels like my hair reverted back to how it was before I started fin. Is it possible for fin to work well in the beginning and then suddenly lose effect in the span of a month? Am I doing something wrong?
Finasteride always works to slow or stop hair loss. Reversing it is another issue; however, if it looks like you are losing the benefits of finasteride, it may be that your genetic balding is accelerating. Finasteride is a competitive inhibitor effective at about 70%, so that action at the 5 alpha reductase level, doesn’t change as your hair loss gets worse. Dutasteride blocks the same enzyme at better than 90%, but that might or might not make a difference, so switching to dutasteride does not guarantee that your hair loss problems will be solved. Alternative medications such as oral minoxidil sometimes help as it is a different mechanism of action
Im acting a bit dumb in the title. I know that you should stay on medication after a hair transplant because otherwise the remaining hair might thin and fall out leaving you with patches of hair. But I also often hear that the transplanted hair will also fall out. Now this does make a little less sense to me when you follow the common opinion that the hair on the back of your head is more resistant to DHT. If that’s the case, shouldn’t they last forever like they do with most people (even with aggressive hair loss there remains the beloved „horseshoe“). This would only make sense to me if there was indeed another difference between the back and top scalp. Not to indulge in bro science but it seems to me that DHT sensibility isn’t the only thing here. Am I missing something?
Although the hair around the back and sides of the head is generally thought to be lifetime hair, that may not be correct as people age. This lifetime hair often reduces in numbers with age and hair thickness (Age-Related Thinning). Now, from a practical point of view, the problem is not the hair transplants in a 10-20 year horizon for a young man having a hair transplant; the problem is with the residual hair as hair loss is progressive, so medications treat your remaining hair that may be impacted by the progressive nature of hair loss.
Does the water beading on the hair suggest something unique about my hair?
No! The observation may indicate that there was a conditioner or something waterphobic in your shampoo.
I’m age 38 and started to use minoxidil 2 times a day as well as 1 mg Finasterid daily. I also do derma rolling with 5mm needles 2 times a week and take keratin vitamins daily. I wear my hair long and made huge progress.
This is an amazing reversal. I congratulate you for your persistence. For my readership, pre-menopausal women must not get pregnant if they choose to take finasteride, or their baby may have sexual identification issues. I would advise you to reduce your dermaroller depth to no longer than 1.25mm. Longer, like the ones you are using, will likely cause deep scarring in the dermis.
Amazing reversal to his normal, solid, mature hairline.
