Used Estradiol patch, minoxidil & Bicalutamide in 4 months

/by William Rassman, M.D./0 /
The use of Bicalutamide and an Estradiol patch in this treatment plan is an extreme approach for men.  The Bicalutamide and Estradiol are not in the Standard of Care so we don’t have a side effect profile on this drug in young men, but we do have side effects when used for prostate cancer.  The Bicalutamide is a very strong anti-androgen which almost certainly will bring on ED and sexual dysfunction and the Estradiol is a feminizing hormone which might further impact a man’s sexual function.  The minoxidil and dermaroller is standard in this approach. I would not recommend that the average guy go this direction in his treatment despite the remarkable results from these drugs. Do you have good sexual function? Is it worth giving up a sex life for the return of your hair?

 

Why do doctors prescribe finasteride after a hair transplant?

/by William Rassman, M.D./0 /

Why do MDs suggest taking finasteride post transplant to keep the hairs? Just for keeping the non-transplanted hairs from falling out and having lower density? Nothing to do with the new hairs, right?

Finasteride after a hair transplant prevents the miniaturized hairs from falling out permanently. This is particularly important in men under 30 when their hair loss is most active.The new hairs in the recipient area do not need the finasteride to grow, just a good surgical team.

 

Is the research that shows stress accelerates balding?

/by William Rassman, M.D./0 /

Is there scientific research behind this? I searched pubmed but couldn’t find anything

I have years of experience where patients developed stress and precipitated the balding process that they inherited. I have also seen acceleration of genetic hair loss with stress. I remember a man who lost a child and he went completely bald to his Class 7 pattern in a matter of months. He was 29 years old.

Will transplanted hair miniaturize?

/by William Rassman, M.D./0 /

Is it possible to transplant hair form other parts of the head so that it will eventually miniaturize once I get of finasteride? I want to avoid a bad hairline once I stop fin so would it be possible to use hairs from my scalp that would eventually miniaturize and disappear?

If the transplanted hair is taken from the 3 inch high donor area from the back and side of the head, it will not miniaturize and should be permanent unless the donor area produces a thinner hair as your get older and develop ‘Age Related Thinning’

Finasteride not working after 1 year

/by William Rassman, M.D./0 /

So i started January 2019 with 0,5 mg finasteride until june 2019. Then upped to 1,25 since then. I am still shedding more than 100 hairs after showering (i shower every two days). My right temple area has receded. I do comb my hair so it is not visible. However, my question is will this receded area (so no hairs are there anymore) grow back or is it lost?

There is a good chance that the hair loss is slowing with the finasteride. IF you should stop it, you might even see it accelerate. Some men’s genes are just to strong for balding and even finasteride might not be able to reverse the process, only a hair transplant works.

Can smoking reverse minoxidil?

/by William Rassman, M.D./0 /

Can smoking mitigate the effects of Minoxidil since min is a vasodilator and tobacco/nicotine is a vasoconstrictor? I know there was a study in Taiwan that showed hair loss was more common in smokers, though this was only with men who had a pack a day which most smokers don’t have. Also was told by a hair clinic doctor that smoking has no effect on hair loss.

There is no evidence that smoking reverses the effects of minoxidil. Minoxidil’s benefit is not from the vasodilation, but from a drug side effect.