You need your donor area examined with a video microscope and get a hair count and a measurement of the thickness of your hair. You want to make sure that you don’t have DUPA which can be diagnosed with the hand microscope. If you want to know your original donor density and your Hair Mass Index along with your total available donor graft supply for your lifetime, see an expert in the field. I wrote extensively about this here: https://baldingblog.com/donor-density-is-counting-hairs-with-macro-lens-on-cell-phone/
Amazing response!
Hello doctor, thanks for your time. Doctor a question, in YOUR clinical experience, NOT in studies, only in your experience… what percentage of your patients get side effects from Finasteride that you suspect is NOT Nocebo?
I think that the sexual side effects in my patients over the age of 30, is about 4%. Many of the younger men are getting their information from forums and blogs that emphasize sexual side effects as almost expected. In these younger men, the incidence is higher.
Will starting minoxidil worsen my natural hair? Do the minoxidil supported hairs steal nutrients from weaker non minoxidil supported ones – meaning if you stop minox you’ll be bellow starting baseline or am I mistaken? I am already on 1.25 fin EOD so in theory my existing hairline should maintain/not effected by MPB.
Thank you in advance!
No. Minoxidil works to grow hair because it is a known side effect of the drug. Originally the drug was marketed for hair blood pressure but found not reliable as better drugs came to market. Women notice that it grew facial hair and didn’t like that side effect
From what I’ve seen, it seems like hair miniaturization progresses over several hair cycles and happens after a hair sheds. Is this the only way that it can occur? I have semi-long hair and I’ve noticed that the hair I shed appears to get thinner over time, as in it tapers from thick to thin towards the root – is this hair miniaturization? If so, what makes this different from “normal” miniaturization?
Yes, a miniaturized hair can regrow again and then undergo further miniaturization. I have seen single hair shafts that are thinner at the exit point in the scalp then they are at the long end.
I see a lot of people who use derma rolling/stamping. Creating small holes in my head feels like it mainly creates damage. Can somebody explain me what it is used for and how it should improve the hair situation?
Reddit posted a full ‘How to Do Microneedling’ here: https://www.reddit.com/r/tressless/wiki/microneedling/
When microneedling is done correctly (controlled damage performed at least 10 seconds in each spot you need the hair to return). The Dr. Pen device offers the best product (see Amazon) as you can get the 34 needle type, length 1.25mm and use it from place to place until you cover your entire area that you are hoping to get your hair back. Once a week seems to be the most effective timing. The wounds that are created, are near the stem cells that trigger hair cycling. These cells don’t like the constant wounds, so they react with wound healing, a component of it impact the stem cells to trigger hair growth as part of the cytokine response by the body to the healing process.
So I started oral min like a week and a half ago. After like 10 months on topical min. Seeing tons of new hairs around my eyebrows and even some baby hairs on my hair line. Does this mean my hair in my head is also growing ? Can you get new body hairs but no regrowth on ur hair ? I can’t tell but I’m seeing a ton of growth everywhere hopeful for my diffuse thinning problem?
Did you take before photos to compare now vs 10 months ago? How bad was your balding? If it was only some thinning, maybe you might not have recognized hair growth. The fast that you got hair growth elsewhere suggests that you should have seen in in the scalp.
I’ve been relatively stable on oral fin and topical min for past 6 years but noticed increased temple and hairline recession in the past year. Thought dut was next best step but not only did I have testicular pain (which I had on fin) but pain in penis which I’ve never had before on fin so it scared me considering the strong half life of dut. Is oral min my next best step? I have no idea if topical min has been effective for me since I started at same time as fin.
Treating yourself doesn’t sound good to me. Now with dutasteride on board (that is what I think you said), it may take 4-10 months to lose the side effects, unlike finasteride which is much less time to reverse as the half life is only 4-6 hours rather than 5 weeks as with dutasteride. A reasonable alternative may be oral minoxidil, but the real oral minoxidil, not taking drops of the topical and sallowing it. You might consider getting a real doctor to manage your hair loss.
Not a good idea as the pill can absorb water out of the atmosphere.
How long after stopping finasteride did it take to recover from sides?
Everyone seems to take a different amount of time to reverse finasteride side effects when stopping the drug. The range in my experience relates to how long you have been on the drug. The range is between 2 – 16 weeks.
Some people see regrowth from microneedling coupled with finesteride. If somebody’s hair loss is not entirely related to dht then would just microneedling have a better chance of working then for somebody who has dht related loss? For example some women experience this trichotillomania related hair loss issue and they most likely don’t have dht related loss. Do you think it’s worth a shot to try only microneedling? I already started but I wanted to know what you think.
At the end stage, trichotillomania causes traction alopecia and it is usually permanent. IF the person still has growth potential, all they need to do is to stop picking on the scalp and then wait for 6 months, when the hair will usually grow back. Adding microneedling to this might accelerate the growth of hair that is not ‘dead’ but will come back normally after 6 or so months
I’ve been using finasteride and minox for years and it saved my hair. Ofcourse I am happy with that, but comparing it to earlier, when I was super obsessed with my hair, it seems less important today. Do you think you’ll continue treatments for a long time, even into old age, or at one point not really care anymore?
I just did 3000 grafts on a wealthy and successful businessman who actually didn’t want to do the hair transplant; however, his best friend who I transplanted last year, looked so good, he got pressured into it by this friend. Now that the surgery is over, he told me this story and also told me that the procedure was a delightful day away from his pressures at work and home. He was happy that he did it.
In my experience, with thousands of hair transplants under my belt, I found that 100% of the men who underwent the transplant, found that they felt better about themselves when they look into the mirror, regardless of marital status or independent wealth.
I have have a really bad, receding hairline with dense hair and no crown problems. I was going to start minoxidil and add finasteride in 2 to 3 years since I still haven’t finished my puberty. I really want to try to recover my hairline, the thing is, I am okay with getting a HT in a few years.
I often prescribe finasteride to 18 years old men. This drug often works very well with a high degree of reversal. If after one year it doesn’t reverse, add oral minoxidil to your routine and worst case, add microneedling 6 months after than it it doesn’t work. Actually, I don’t think that the first or second will fail. A hair transplant is out of the question for at least 7 years and by that time, if you don’t treat it now, you may bald far more than you see now.
This is an amazing result in just 4 short months. I believe that teh microneedling really helped accelerate the benefits shown here
