I’m confused about the effectiveness of taking both oral and topical finasteride simultaneously. Please give me some insight into this practice. 

I don’t see a point in taking oral and topical finasteride simultaneously. The oral form is better as it reaches the areas the topical form can’t reach. The topical also goes systemic, so your systemic dose may be much higher than oral. The use of topical liposomal finasteride is different than the standard topical finasteride as it is designed to stay mostly in the scalp.  This liposomal preparation is used when there are side effects from the systemic finasteride. 

Will Miniaturized hair that is under Finasteride Grow back thicker and longer if it is plucked?

Terminal (normal) hairs plucked once will always grow back. Miniaturized hairs that are plucked many times may not grow back. If you are under the influence of finasteride and the miniaturization is reversing, and then you plucked your hair, I suspect it would grow back. I would like to know why you are even thinking about plucking your hair. That makes no sense.

Ive been taking minox for about 4 years now, (fin too) and suddenly in the past month the area where i apply has become incredibly itchy. It also looks like im losing denisty and hair in those areas, even though im not actually getting any hairs loose when i put my fingers trough it. Hair is pretty long now so id notice. The few hair i do get out look very thin. I find myself half sleeping scratching the area , i cant help myself.ive started using ketoconazole every day now for the past 2 weeks, it hasnt gotten better yet. Its the same brand, same amount and same place i get it from.

You may be allergic to the minoxidil or the carrier within the preparation. Ask your pharmacist for a different minoxidil brand with a different carrier.

This is overharvested.  Some areas had the grafts taken out too close.

There is often a shed when either minoxidil or finasteride is started. Other than the shed which tells you the drug will work on your head, there are no negative hair effects

If I have a more painful microneedling session, I seem to get quite a bit of baby hair growth pretty quick. I’ve even switched to doing a session every other week instead of weekly so I can go the extra mile. I use 1.5mm needle on Dr.Pen.  Have you seen this? I was previously dermarolling but wasn’t seeing much. After going 1.5mm on the dermapen, the results picked up pace. I put Minox right after.  

The science suggests that weekly is the best approach. Microneedling creates a wound, which starts a healing cascade; first comes the platelets, then the macrophages and other cells, and then, on the third day, the stem cells start activating. The stem cells we want to hit are located at the top of the hair follicle and maybe those that control hair cycling. That would explain why microneedling works. We are still determining if the hair will last the entire hair cycle (usually 2-3 years for a man in his 20s). If some maintenance program is not continued (like once a month), these hairs may go away as their predecessors did. This microneedling has arisen because young men are looking for solutions, and the medication profession hasn’t gotten the message yet. Since I speak with men almost everyone, I find that I learn more from my patients than I often teach them.

I’ve been reading scare mongering stuff online about how finasteride could harm your wife or a potential child if you were trying for one if they come into contact with finasteride which is worrying, can anyone share their opinion on this?

In the warnings originally published by Merck when they first came out with finasteride (today as well), they warned that women should not touch the pill because of the association between finasteride taken in women and fetal abnormalities (usually sexual identification issues), which were found in women who took the drug while they were pregnant. I have never been convinced that if a pregnant woman handled the drug (like giving you the pill to take), this drug could be significantly absorbed within a few seconds. Their legal team creates such statements to absolve them from any side effects.