Hi Dr. Rassman, i have a couple of questions. I’ve been on fin for almost 4 years and I think I’m seeing thinning the frontal area if I get a prescription for dutasteride is it likely I will respond to dutasteride? And if I take my last Finasteride pill and then, the next day I take a dutasteride pill will dutasteride work instantly to stop DHT? Or is it over time?

I don’t have personal experience with dutasteride; however, it is about 15-20% more potent. It may therefore have more side effects as well. Dutasteride should be prescribed by a doctor as daily doses may be too much considering the half life of the drug which is 5-6 weeks.

I just scheduled an FUT procedure that is estimated for about 2500–3000 grafts in my crown, with any extra going to the corners of my hairline. About 18 days after the procedure, I have a two-week-long unavoidable work obligation where I will need to interact with clients in-person. (Aside from this obligation, I can work from home for a while, which is why I scheduled the procedure for this time). I’ve done a little bit of research and haven’t really found any crown photos at 18 days post FUT, so I am wondering what I can expect. Will the redness still be obvious? This is more of a concern if I ended up having my hairline worked on, but I would like to know what to expect nonetheless.

I am surprised that you are having any problems. I would go back and see your surgeon. By the end of one week, all of the redness is usually gone along with any swelling and most people should not be able to tell that you had a hair transplant.  Most of my patients have an undetectable hair transplant within a couple of days. Here is an example of an FUE with 3200 grafts just 6 days after surgery: https://baldingblog.com/post-op-photos-6-days-after-3320-grafts/ 

Yes, when you go down to 1 mm or 1.5 mm, it bleeds. The skin is very vascular.

Is this scalp finasteride worthy? Would the pills fill in the gaps or is it too late?

The younger you are and the more recent the hair loss, the greater the chance of benefit.

Does this look like the beginning stages of MPB? Have an appointment with a dermatologist in two weeks. Is finasteride my best option?

This could be early crown loss. Have the dermatologist look for miniaturization with a hand trichoscope. If it is, finasteride is a good drug for this

Will finasteride prevent temple recession?

In some men it will prevent recession. It works better in men under 25 and those who have not lost the hair yet or who had recession in the past year or two

By the normal 20% or below miniaturization, does this include long terminal hairs that are thinner than normal ones? Dr. Parsa Mohebi refers to this normal level of miniaturization as “recycling follicles” so these normally cycling miniaturized hairs come back as normal terminal ones eventually?