I’m considering adding SMP after my hair transplant grows for more density, but the blue tint does scare me. Is there any way to solve that?
The blue pigment is created when the ink used is pure black. The inks used must also be mixed with some brown pigments and diluted to avoid this problem.
I don’t have the money for a hair transplant but I am scraping it up and it might take me another year or so. Now I wear a wig to hide my hair. I don’t know what to do. I have been worrying about this since I was 18.
A Hair Transplant is the worst thing you can do before you have a diagnosis and after good medical management. You will need to find a good doctor willing to work with you. You must have a good trichoscopy examination to see if you have Diffuse Unpatterned Alopecia. If this is the case, a hair transplant will never be an option for you, even if you were a man with that condition. Rather than a transplant, the drugs finasteride and oral minoxidil may be considered, along with more powerful anti-androgen drugs, but again, pregnancy runs risks for a child if you were to become pregnant.
3 years on fin, 2 years on min and microneedling with derma roller and switched to dermastamp, not as good results as others I saw here but I wanted to ask what you think was my problem?
Good microneedling requires a controlled amount of damage to induce the healing cascade that brings on hair growth. With the frequently used derma stamps and derma rollers, enough injury is frequently not created to get the best results. That could be the way you are using it. Try the Dr. Pen, 36 needle divide, depth 1.25 mm, and hold it in each area for 10 seconds once a week. That might make a difference.
I was recommended to have 2500 grafts from a clinic, while another one said 1500, I’m not sure which one to go with; is it better to go with more grafts in my case?
There is a huge difference between creating a good, solid female hairline versus a male one. If you are in-between the male and female decision, then designing a hairline is difficult as well as estimating the grafts required. I have done many of these on females, which usually takes more grafts if you want a classical female pattern; however, if you wish to fix a male hairline, then this will be less work.
When you and I review my photos and looked at it microscopically over a Zoom call, you said that I had extensive miniaturization on the top and crown of my head. Are these hairs destined to die off and fall out?
When there is extensive miniaturization, the hairs are destined to be lost; however, drugs like finasteride can extend their life for many years, so that is a good option for you.
Is it normal for men to develop slight thinning on the crown but not actually develop a fully bald crown?
If a microscopic examination of your crown shows uniform distribution of miniaturization, then you will eventually (over time) lose all of those hairs. It might take decades. Finasteride works wonders on the crown to reverse this process, even for men in their 70s.
Shaving your head will not make the hair grow where it is not growing well now; however, if you use topical medications, getting them on the scalp will be easier. Only 40% of men will find that minoxidil is effective because their scalp has an enzyme that will interact with it to produce its active form. When applying it, it must get on the scalp. Medication that gets on the hair is wasted.
I noticed recently that biden was ALL bald at the top (sorry for my lack of proper terminology to describe this situation) when he was competing for nomination in the 1980s. But now – come on – he has thinned but at least there are hairs on top. any ideas?
In 2014 – was 24 years old in between a Norwood III and IV, and underwent a FUE 2700 grafts to mainly cover the front. Didn’t start fin as was apprehensive of the side effects but started minoxidil which I was also inconsistent with over the years. In more recent years (last 5-6 years have been taking Nourkrin man as a supplement and topical Min 5% foam very consistently) In 2016 underwent SMP in London.
The balding area grew as my native hair started falling, while the transplanted hair also got thinner. Used to manage a nice look with the help of hair fibres over the last many years which did wonders. Finally in Feb 2024 (age 34) decided to pull the plug on another HT. Consulted with 3-4 top surgeons and mostly their feedback was consistent with c 2500 grafts available from donor area and another 600-800 from the beard. The clinic I went with managed to extract 2700 from the scalp and 800 from the beard area over 2 days. Total c 3500 grafts. They reconstructed the hairline (one thin line ahead of the earlier transplant area) and temple area along with filling up the midscalp region and sparsely covering the back scalp (the crown was mostly left untouched given the large balding area). I though you wanted to see the views on the work done in terms of look one day post implantation / distance between graft placement? I also realised my mistake of not starting fin (more mature now!) – hence have started 1mg a day and hopefully that along with min helps some regrowth along with the new HT to hopefully give a good result! Your thought please?
When you start the hair transplant process before the age of 26, you are looking at more hair transplants because the native hair and your balding pattern may advance with age, as happened in your case. I am surprised that more hair from the hair transplant hasn’t lasted the past 10 years. We see those on occasion; however, this is not that common. Most of my hair transplant patients keep their transplanted hair for a very long time. I have been doing hair transplants for the past 33 years, and some of the men I transplanted in 1992-3 have since visited me with hair on their heads. It is important to note that this man’s donor supply was significantly reduced. SMP is a good procedure, but as you can see from this man’s before picture, the SMP has faded and developed a blue tint. In addition, the individual dots from the SMP have spread out and are no longer little dots. This is common with SMP.
The average man has about 5000-7000 grafts, provided their hair is not fine. If their hair is coarse and their density is at least average, the donor area can supply 8000, possibly more, grafts. Fine hair does not produce much bulk, so donor site depletion is common in fine-haired individuals especially with FUE. For those reading this post, the message is to be sure to ask your surgeon to discuss your original donor density, hair mass, and total donor supply for your lifetime before undergoing a hair transplant. The distribution of the grafts was appropriate, with more density up front; however, considering the extent of the transplants I see, I wonder how this man’s donor supply will look in terms of over-harvesting.
I’m one of the countless who have started taking Dut and trying to figure out the best way to transition off of Finasteride to Dut daily. It seems that doctors and users do not agree on this topic. Some have suggested, and it seems in theory, that taking a loading phase of Dut is the best route since it takes 3 months of 0.5mg to reach steady state serum levels and possibly more at the tissue level. My current routine went from 1mg Fin to 0.5mg finasteride daily and 0.5mg Dutasteride daily. In theory, I’d do this for 3 months to not cause a shed from a medication gap, switch cold turkey, minimize simultaneous new medication shed, and stop fin shed. Since Fin binds to androgen receptors at the tissue level (scalp), and if finasteride is already binding to it all before dutasteride is introduced, does that prevent dutasteride from being able to bind to those receptors? And is it probably better to discontinue Fin and just keep doing dutasteride? People have great results when adding dutasteride 1x or 2x a week, which sounds counterproductive. In theory, thought would still leave Duta to block type 1 receptors, but fin still blocking type 2? I’ve seen, admittedly, just a few horror stories when people go up to 3x a week while using finasteride. They get better results once they go all in on one or the other. As much as I researched this, I’m still ignorant of how these drugs work at this level since most talk about its DHT blocking is usually blood /serum DHT and not at the scalp/tissue level.
First, you’ll need the doctor to evaluate your donor area to rule out any disease that may be there. Assuming that you are over 25, the pattern looks like you are going to a Class 5A pattern. I would need to see your hair under trichoscopy to determine that, but it means that more balding is likely to occur on a limited basis in your upper crown areas. Good doctors routinely perform trichoscopy to rule out diseases of the donor area and the metrics that I am about to discuss. It would be best to have metrics for your lifetime donor supply, including (1) donor density and (2) hair shaft thickness of the donor hairs. This will tell the surgeon what you will look like after the hair transplant, which will be shared with you. Then, a good surgeon will complete the examination by judging where your balding pattern will end up. Good planning is critical so you only expend some of your donor hair on a limited vision of where you are now. Balding is progressive, and you want to be sure that in the long term, you will always look normal and have enough hair left to follow the progressive nature of YOUR balding.
Hi! I was stupid and stopped fin for a couple of month due to travelling at that point my hair was great and after I realized what I had done, I went immediately back of 0.5mfs every other day but my hair went absolutely bad and shedded for two more months. I’m devastated right now.
When you get benefits from finasteride, you must remember that the drug and your stabilized hair loss go hand in hand. Stopping finasteride causes “Catch-up Hair Loss” which means that when you stop the finasteride, you not only go back to where you were when you started taking it, but you lose what you would have lost had you not taken it in the first place. Please, if you are on finasteride and you are not having problems with the drug, stay on it.
Some men have strong forelocks; when they start balding, as this man shows, you see the forelocks remain strong. The balding occurs around the forelock (A, B, C). A man with a strong forelock often doesn’t look like they are balding because the forelock holds the frame to the face. When I transplant balding in a patient with the pattern shown below, I leave the forelock alone, realizing that sometimes, as this man grows older, he may lose the forelock, and then he will need it transplanted; however, in my experience, when men have strong forelocks to the age of 35, they are more prone to keep these forelock, regardless of the balding that may occur over time further back in the head. These forelocks, I believe, have a genetic code different from the surrounding hair.
Any idea if ursolic acid can help with male-pattern hair loss? In the study below, it says it reduced DHT.
Ursolic acid appears to be an interesting possible treatment for a variety of conditions including an enlarged prostate, inflammatory diseases and some cancers however it is not approved for clinical use. Although it is easy to extrapolate its effects on prostate hypertrophy and its relationship to hair loss, there is no proof that this has value nor that it is safe for the treatment of hair loss.
21 y/o, been on fin for 3 months now and am seeing some new strands around the temples I think, but as the recession is already so big I wonder if it will be enough in my case. But topical min is ofc rather inconvenient (is it even sustainable long term..?), and oral min is not available where I live.
What do you think – is it worth giving fin alone a couple of more months or is it unrealistic to get this amount of regrowth with fin? After summer I will move to a new city so I definitely want to look better by then.
I have seen men who lost hair regain their hair on finasteride alone. They are usually under 24 years of age and they looked like they never were balding.