I have been on topical for a year and got the approval to switch to oral minoxidil. Should I expect shedding? Anything else?
My patients who switched did not report shedding to me, as I advised them to stop taking the topical when they went on the oral minoxidil.
To the people that affirm high DHT in the scalp is not a cause but consequence of AGA, why does lowering it throught medication seem to give positive results in most men?
The genes for hair loss are in both men and women; however, men produce significantly more testosterone than women. The testosterone is metabolized into DHT and DHT works on the genetically impacted hair follicle to cause loss. Finasteride blocks 70% of the activity of DHT on the hair follicle receptors, so it works well. If you gave a woman the amount of testosterone that a man makes daily, and she had the genes for hair loss, she would go through something similar to what you are now going through. The older she is, the worse the hair loss would be for her, as it might be for you if you (and she) have inherited an advanced balding pattern. For premenopausal women, their Estrogen protects their hair from the DHT effect; however, when they pass menopause, they don’t have the estrogen protection and, therefore, might see hair loss, a common finding in ~50% of post-menopausal women.
I read somewhere that 1mm depth every 10 days is the sweet spot, others, .6mm every 10 days, .5mm 3x a week. Is .5mm every 3 days as effective as 1mm every 10 days? Should I place topicals like oils or minoxidil directly before, after, or 24 hours later? Some people say you’re basically injecting the topical if you place directly before or after while others say it’s the most effective to place it directly before /after. Confused.
My opinion is different. The sweet spot is every 7 days, 1.25mm depth with a Dr. Pen Microneedling device with 36 needles held to each area you want the hair to grow for at least 10 seconds. The goal is to produce a controlled wound that kicks in stem cells to grow hair.
I’ve been on fin for 5 years now. My wife and I were blessed with the birth of our son yesterday. However something happened after he was born and the doctors went to check for any abnormalities. They said he was perfect and there’s nothing wrong with his junk! I’ve read so many random posters fearmongering over the years trying to connect a rat study that causes some issues to being a reason people should get off fin for months when trying to have kids. I spoke with multiple fertility clinics and physicians and none of them ever were worried about fin having an effect on fetal development. I asked multiple clinicians at the hospital about it as well after birth and they simply laughed it off.
I now have 2 kids that have been conceived on fin and I never took a day off. Please don’t go down the Reddit rabbit hole of listening to anonymous posters and go ask actual physicians if you’re ever worried. People try to correlate and spread fear, think for yourself and use common sense.
Today, doctors can’t advise a patient to follow your advice because, statistically, someday, some newborn baby will have some defect, and the father will blame the doctor who prescribed finasteride and the drug for the abnormality in his baby, regardless of your experience. I would rather refer men who ask me to read your post. Thanks for your openness.
Hair starting to thin on the crown, it’s not to bad yet as I am taking finasteride & minoxidil. I currently use hair fibres to hide the thinning crown but I am wondering is there any other things I can try to conceal the thinning or is hair fibres the only option? I’m always conscious if it started raining outside…
In addition to Toppik, I often recommend Dermatch. That works well for some men and women. Experiment with different fiber products. They all of limitations. For me, I had scalp micropigmentation so solve my problem, see here: https://baldingblog.com/i-just-finished-my-smp-on-my-crown-area-today-see-before-and-after-photos/
I went to a dermatologist, and he did a biopsy after examining me. When I came back to see him, he said I had scarring alopecia. I am also balding and was considering a hair transplant to address my balding crown. Can I go ahead with a hair transplant as the area he biopsied was in front of the crown, and it was very small.
There are many causes of scarring alopecia including folliculitis decalvans, lichen planopilaris, and pseudopelade of Brocq, and many others. You can expect that this small area may grow larger. Scarring alopecias kill hair follicles so transplanting your scalp is setting you up for a potential disaster. Some of these conditions can be quite difficult to treat so stick with your dermatologist and stay away from any hair transplant surgeon that offers you a deal.
Good doctors look for problems when they examine patients. Any good hair transplant surgeon should come out where your dermatologist was.
First of all sorry for my english, it is my second language. So, I have been experiencing a lot of hairloss for two years now. One thing i noticed this year when I took some trips was that my hair kept falling less. On my last trip that lasted ten days, I felt very relaxed and rarely thought of my hair and i realised that my hair was falling so much less and it felt so much thicker and when i got home it stopped falling for 5 more days and then it began again. I have a lot of stress in my daily life and also I always check my hair if it falls etc why causes more stress. What do you think is causing this?
Stress can induce telogen effluvium which is a cyclic hair loss. You need to learn how to reduce your stress at home
Hi doc, sorry for bothering you but would be thankful for a reply. Do you think there is any credence to the theory that minoxidil causes premature signs of aging in the face?
There is no evidence from various research studies to suggest that minoxidil impacts collagen anywhere in the body, including the face.
i’m only 21 so i can’t really get a hair transplant until down the line. i got put on 2.5 mg minoxidil earlier this year and i passed on using fin. i’m fine with using this pill for the future because it hasn’t really affected my day to day life in any way and my health is fine, but i was just wondering if it’d even be worth getting a hair transplant down the line if my balding is genetic and it will keep slowly spreading, wouldn’t i have to get like several transplants over time?
I make my living doing hair transplants, but I almost never have done it on someone of your age. I wait until 25-6 before even considering it. Maybe the oral minoxidil will work and you will not bald. Give the drug a chance and stay on it.
If you’re a nonresponder to topical minoxidil, are you just clogging your follicles by applying it?
Your focus should be on switching to oral minoxidil as 40% of men are nonresponders to topical minoxidil. Clogging your follicles doesn’t happen.
I would like to ask if from your practiacl experience you noticed that people who gain sexual drive from using propecia and increased their libido, do they maintain this status for as long as they use the pills? Have you seen this? Or are they at risk of gaining negative effects or going back to normal status. I know this subject is controversial but I’d appreciate it if you let me know what you saw you in your practice.
I called the one patient I remembered who spoke to me about his increased sexual drive on Finasteride. That was ten years ago. He started the drug just after he found a new girlfriend, so the increased sexual drive was very welcome at the time. He remembered that it lasted for quite a while; however, he eventually married her, and then his sex life became heavily influenced by the various stresses of work and marriage. Now, he can’t comment on the impact of finasteride because it is now a complex assessment mixed with life. The drug doesn’t, however, suppress his sexuality in any way.
Finasteride worked great for 1.5 years; now, I’m beginning to shed significantly again.
Finasteride works as long as you take it. It doesn’t always bring back the hair but it will slow or stop the hair loss if it doesn’t reverse it. Your hair loss may be accelerating, so see a good doctor.
This man worked his way up from 0.25mgs to 1mg over these 20 months. The results are impressive. Take a look at the hairline at the leading edge. It seems solid and significantly different from the photo 22 months earlier.
We have seen many mummies with balding. We have also seen mummies with wigs, going back further than this mummy. It’s still interesting to read and see this article.
How does one tell the difference between telogen effluvium or hair thinning?
The best way to tell the difference between telogen effluvium and hair thinning is to purchase a digital hand microscope from Amazon (about $35) and zoom in on various areas of the head where the hair is strong (donor area) and thin elsewhere. Miniaturization is a sign of early balding, and telogen effluvium doesn’t show miniaturization.