This woman presented with this bald spot characteristic of a genetic abnormality called Triangular Alopeica. It is often on both sides of the head and is best treated with a limited hair transplant, which cures the problem.
In my experience, when I put a man on finasteride, it is not uncommon to reverse this process if they have crown thinning. I have seen this happen as men in their 50-80s, who were put on Proscar (finasteride 5mgs) for their prostate, and they were considering a hair transplant only to come in and show me the of the reversal of their crown thinning from the prostate drug that they were given.
After experiencing shock loss so dramatically from my first hair transplant, would another hair transplant in the next two years cause more shock loss to happen of my current native hairs too?
Usually not. The shock loss knocked out the miniaturized hairs that were the cause of the shock loss.
I have been seeing the charts going around that a .3 or.25 topical finasteride reduces scalp DHT more than 1mg oral fin. I am asking this because I am losing density on 1mg finasteride. Before I try DUT or anything else I was wondering if you believe that this will help me. Please let me know!
The ideal dose of finasteride is 1mg. Higher doses usually are not better than then 1mg dose. Losing hair while on finasteride means that your hair loss is moving more than the finasteride is helping. The 1mg dose is ideal. I question your thinking that finasteride at higher doses than the 0.3mg you are taking, is worse for you. Adding Dutasteride may add a 15% benefit at the expense of a long half-life of 5-6 weeks, and possibly it would hang around your body for many months if you decide to stop it.
I wrote an article about hairlines and how they evolve. The word “Evolve” suggests that there is a starting point, so when women find that their hairline recedes, similar to some balding men, they are alarmed. This was the case in the first patients shown below, whose hairline had some hairline recession laterally and superiorly. She lost the lateral sides of the hairline, which resulted in losing her original concave shape. She asked me to restore her female hairline, which I did, as shown in the first set of photos below. The hairline was substantially missing in the second woman’s sides and the 1cm of the frontal hairline. In this woman, she wanted to keep the shape of the thinning hairline, which had a subtle temple peak. The third woman had a loss of the temple mounds and some frontal recession, which were addressed. I want to bring to your attention all three hairlines. They are not created by connecting the dots. Each patient had a transition zone created in front of the thicker hairline to allow for a transition zone from the forehead to thicker hair. For women and men, all hairlines should have a transition zone created to make it undetectable as a hair transplant.
Below is a schematic drawing of the various hairlines (taken from one of my publications). The female hairline (I often refer to this as the juvenile hairline) is clearly recognizable by its concave shape. Boys and girls aged 5 or 6 have this hairline, but as they grow, the hairline changes. Many fortunate women keep this concave hairline into adulthood. The classic female hairline has no temple peaks. Temple peaks signify a change from the original juvenile hairline, as shown in both the Intermediate and Mature male hairlines in the graphic. Also, classic female hairlines have no widows’ peak, which signifies that the hairline has moved upward into the Intermediate Hairline position. From a genetic point of view, the entire hairline behind the Mature Male Hairline shown in the graphics has significantly different genetics than the hairline I refer to as the adult mature hairline. The Norwood classification of balding impacts the hair behind the line, which I refer to as a mature male hairline. I have seen men develop an advanced state of balding and retain much of their juvenile hairline. I even remember seeing a patient with a comb-back that was so good that I couldn’t see his Class 7 balding pattern until he flipped it forward. By the way, he kept his temple peaks, a common finding in men with very advanced balding, suggesting that the temple peaks have a different genetic code than most of the hair on the head.
I gave this woman two choices, both acceptable to me. She chose the lower hairline because she wanted a lower hairline to reduce the size of her forehead. See the 3-year photos below.
Transplanted female concave hairline with no temple or widows’ peak, performed 3 years ago.
The shape is different from above because that is the shape she wanted.
Again, the loss of the temple mounds and some hairline loss were repaired with no temple peaks. A second set of three photos allows a close visualization of the detailed results.
Just wondering if any of you guys have done any blood or other tests to see whether the usage of topical fin can have a big impact on semen? And has anyone tried to conceive successfully while on topical fin, any issues any thing?
Yes, many men on finasteride develop a waterery semen with a decreased volume. A family member of a friend of mine took finasteride, had watery semen and a low sperm count, and made two nice babies.
Dr. Zarev transplanted 13.000 grafts in one session on this patient. Sounds too good to be true
Dr. Zarev appears to be a great surgeon. I have met him. The average Caucasian male has 50,000 follicular units on their head. Of that number, 25% reflect the rim of hair around the sides and back of the head, we call the Donor Area. If the entire donor area is removed, then the donor area will be bald in 100% of men. He could have decided to extend the donor area, which is commonly done. This is a risky decision for some men, as the hair removed from outside of the donor area may not be permanent, so some hair could disappear as they age. I suspect that the 13,000 grafts he transplanted were in a person with a very high donor density, and he removed many partial follicular units on this patient or extended the donor area. I have seen such men and have transplanted as many as 11,000 grafts on them.
Is there any truth or validity to the claim that one’s hair at age one can be used as a predictor of their hair loss later in life? Looking at a few famous people with notably in-tact hair, such as Bill Clinton, Ronald Reagan, and Brad Pitt, there seems to be some correlation. Still, I couldn’t find any formal research on the subject, and I assume the connection isn’t as direct as the rumors might imply.
Maybe one can make a business out of this as most parents would like their children to be men like those you mentioned. Some scam artists may develop a combination that will make susceptible parents take up the challenge.
It’s hard to find on google how to deal with white hair (and beard). My alopecia is being fixed thanks to the finasteride/minoxidil combo but I can’t find anything for hair whitening? is there a real solution?
At this time, dying your hair is the only sure treatment. Occasionally, I see cures posted on the internet, but when I look into the source, I don’t find it credible. Many researchers are working on a pill, but nothing I know is available now.
I’m writing this because, I keep finding contrasting opinions about microneedling Since scientific papers have already proven the efficacy of this therapy, especially when combined with other treatments, my main questions are related to depth and frequency, Is the recommended depth of needles 1.5mm, 1mm, or even lower than that? Some people say the frequency should be once every 1 or 2 weeks, while others have posted promising results from doing it every day To avoid the risk of creating scar tissue, what would be the ideal frequency for microneedling?
How much pressure am I supposed to apply if I don’t want to damage hair follicles and the hypodermis? Since dermarollers are usually not recommended, I’m considering buying a dermastamp to test microneedling’s efficacy, and I will consider a dermapen in the long run.
Microneedling works for most men. Some microneeding results parallel a good hair transplant (rare), but you will grow some hair if you do it right. For younger men, hair growth is better than in older men with long-term balding, but I have seen good results on a few men in their 50s or 60s with long-term balding, like a Class 6 pattern balding. The microneedling using a Dr. Pen device gives you control of the damage the microneedling does to stimulate hair growth. What happens is that the microneedling produces damage at the very upper part of the hair follicle where the stem cells are present. Bleeding is the first step, followed by migrating specialized healing cells from the body’s defenses. Within 2-3 days, stem cells appear at the wounding site as part of the cascade of events that occur with miconeedling. These stem cells convert to hair stem cells that control hair cycling, and with enough injury frequency, the hairs in the area of wounding stimulate the hair to commence their anagen cycle. The microneedling needs to be done once a week initially. A maintenance schedule is required, like once a month, once the hair has grown. Usually, a person can expect hair growth within 5-6 months or earlier.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4289931/#!po=35.5263
Abstract
Peppermint (Mentha piperita) is a plant native to Europe and has been widely used as a carminative and gastric stimulant worldwide. This plant also has been used in cosmetic formulations as a fragrance component and skin conditioning agent. This study investigated the effect of peppermint oil on hair growth in C57BL/6 mice. The animals were randomized into 4 groups based on different topical applications: saline (SA), jojoba oil (JO), 3% minoxidil (MXD), and 3% peppermint oil (PEO). The hair growth effects of the 4-week topical applications were evaluated in terms of hair growth, histological analysis, enzymatic activity of alkaline phosphatase (ALP), and gene expression of insulin-like growth factor-1 (IGF-1), known bio-markers for the enhanced hair growth. Of the 4 experimental groups, PEO group showed the most prominent hair growth effects; a significant increase in dermal thickness, follicle number, and follicle depth. ALP activity and IGF-1 expression also significantly increased in PEO group. Body weight gain and food efficiency were not significantly different between groups. These results suggest that PEO induces a rapid anagen stage and could be used for a practical agent for hair growth without change of body weight gain and food efficiency.
29 Years old. Been on Min (topical 5mg) and Fin (oral 1mg) for close to 2 years which has helped me maintain my existing hair but not too significant of a growth. Finally decided to get a hair transplant as I was already going on vacation to Thailand so though might as well. My biggest requirement was having natural results thus the shown hairline design. Quite a few family members and friends have told me that I should have went with a lower hairline (would love feedback on this). Am not sure if we should of went lower but I trust the expertise of the Dr. and the team at the clinic.
I am generally a believer that hair transplants should restore the normal hairline. I lecture on this all of the time when I transplant a Norwood Class 7 pattern. I almost always create a normal hairline for that person and that has thrilled my patients over my career. I would have made your hairline lower.
I recently saw a video of some guys hitting the sauna (why I am watching other guys going to the sauna is another story), and they received this kind of hat at the entrance. They said it’s to protect their hair. Been doing Sauna for a while and have never seen that. I did notice how my hair would get super hot like it could almost burn my finger. So yeah, I was wondering what is the risk there? Usually, you hear it’s good because it makes blood circulate, etc. Side question: would the steam room be better if the sauna is damaged?
No, neither a sauna nor a steam room should damage your hair. Remember, the hair on the head is not alive; only the hair-manufacturing apparatus beneath the scalp is alive.
So I start losing my hair about 6 years ago, I started taking medications of daily finasteride and minoxidil for three years. I had great results, some regrowth and slight overall improvement in density and quality and It has been stable ever since. However, up until this time, I’m not satisfied with my current hair especially in the frontal area. I visited two hair transplant doctors this week and they both agreed that I need a hair transplant of around 2500 grafts as the medications will not improve my hair any further.
Now, my concern is about the quality more than the quantity, sure I want density but and nice hairline but i want to solve the real problem of weak, unhealthy, frizzy hair that i believe is just a result of thr miniaturized hair. I wonder if the thick, strong follicles that I will take from donor area would restore the healthy appearance of my hair as it did during teenage years ? and is it true that the transplanted hair will become coarse?
A well-done hair transplant in the hands of a good surgeon and team will replicate the hair in the back of your head, where the hair is taken from. Most good surgeons don’t shoot for the original density; however, with less than the original density, it still can look great. Set your expectations correctly.
In the late 1980s, Dr. Marrit showed that if he plucked out half of the hairs on one side of the head in a person with black hair and medium-weight hair with an average density, the human eye could not see the difference between the two sides. This is where the surgeon’s judgment and his/her experience come in, as just a number doesn’t tell you what you must know about transplanting a balding area. I can’t write a book here, but I hope this explanation helps.
Should I start taking finasteride now?
First, find out for sure that you are losing hair and have miniaturized hairs and the extent and severity of it. The best way is to see a doctor or purchase a hand microscope from Amazon and then look at it yourself. My baldingblog.com has instructions on how to do it. I suspect you are not balding at all, but I can’t be sure without a hand microscope. In someone with such a thick-looking head-of-hair, without a hand microscope looking for significant miniaturization throughout the head, one can’t tell if you are balding now.
