What is the effect of minoxidil to the hair follicle? How can you tune the dosage to manifest the effects on hair?
I fear I may have developed DUPA. My sides and back have become transparent and I am approaching an NW7. I have added oral fin, oral min, and topical pyrilutamide which I believe has helped and the oral min has regrown some hair and increased thickness a bit. But the density is still poor. I still experience some itching and tingling along my hair line, even for my beard which is patchy. I am wondering if there are natural anti-inflammatory treatments I can add to my regimen to combat loss from inflammation. Is there a such thing as a natural JAK inhibitor that may be gentle enough to help my DUPA?
I have read that for DUPA sufferers, inflammation is the cause of hair loss, where the immune system attacks all the hair follicles of the head. This seems relevant to me because right after a shower if I have scrubbed and dried my skin a lot, I notice a lot of puffiness, redness all over and tingling and itching and hair fall from my scalp and even beard. So I fear inflammation is attacking my hair. I have also suffered skin conditions like eczema resulting from inflammation in the past. I am afraid to try JAK inhibiting drugs to combat inflammation because they come with high risk of potentially deadly sides.
Your discussion was interesting to read. Please make sure that you have DUPA. This is what it looks like, so get a hand microscope and see if this is what you have: https://baldingblog.com/classic-case-of-dupa/
21, ftm transgender man, got double mastectomy at 19 and telogen effluvium from the surgery triggered ongoing hair problems. ive been on topical minoxidil for about a year and i think it’s helped somewhat (i didnt take progress pictures because i was incredibly embarrassed about my situation). my dermatologist is thinking about oral minoxidil, especially since i’m going through my first finasteride shed rn. but i know that oral min can cause body hair growth and that’s causing a lot of hesitation for me. i really prefer to be androgynous irl (dunno why exactly, i just feel most comfortable that way) and hate being too hairy, i got my beard lasered off when i turned 18. i have dark hair on my legs and arms and a trail on my stomach but that’s really it and i’m happy with that amount. i really don’t want chest or back hair. i value having a mix of masculine and feminine traits and i feel like too much hair would tip the scales too much. but at the same time i obviously want to get the best results possible for my head hair. so i’m just trying to weigh my options. will oral min cause new body hair growth or just thicken hair thats already there? or is it a case-by-case basis? would keeping it on a low dose be worth it? i know for a fact that i’m an outlier on this sub, i’ve never seen any posts approaching hair loss from a similar position of wanting to maintain some femininity, so i don’t expect to hear from very many people in the same boat if at all. but info from people who know more about oral min than me, or just any advice or encouragement, would be really helpful.
This is a real concern that you have. Small doses of minoxidil might cause an increase in your body hair. If you try it, these hairs will be dependent upon minoxidil so when you stop it, these hairs should fall out. It is a real risk, but I doubt a permanent gain in hair will be the result of any experimentation you do. there are many good alternatives for preventing hair loss on your head, so this should be managed by a good, knowledgable doctor.
I’m thinking of starting weekly microneedling, but my hair is buzzed down to about a 3 and the hair on my crown is super thin so my scalp is quite visible. I’m concerned about having visible redness or scarring while at work. If I needle on Saturday morning, would it heal by the time I go in on Monday morning?
Everyone reacts differently from microneedling in terms or the pink color of the skin. Some white person’s skin may be ultrasensitive to redness, and in these men, the redness can last weeks or months. Most white people will see the pink color disappear in a few days. The darker the skin, the less noticeable the color distortion; for example, my skin is tan and doesn’t show redness very well
let’s say you bald at 20 (nw2) and so on needlessly to say you start taking finastride, fast forward 10 years, you become 30 with a wife you are trying to impregnate, you don’t know if fin will cause any problems so you stop taking it. anyhow what i’m trying to ask is, what would happen to your hair if you stopped taking finasteride – would it continue to bald at the same rate as if you were 20 years old and never started taking finasteride, or would the accumulated hair loss over ten years result in a more advanced stage of balding, possibly Norwood 4?
The answer to that question is that you will play “Catch up hair loss,” which means that in 3-4 months, you will have the amount of hair loss you would have had if you never took finasteride. That means, of course, that your results will reflect your genetics
https://pubmed.ncbi.nlm.nih.gov/12647000/
It is difficult to project these rat studies to humans on finasteride. I would only mention the findings in Group C of the Rats with the report that there was a “reduction in smooth muscle fibers in the trabeculae of corpus cavernosum”. I would like to see some clinical documentation in this area which is probably very difficult to obtain. I look at this as just a rat study for the moment.
My grandfather had his juvenile hairline at the age of 102, and it was black, not gray. I am bragging, but my hair is now salt and pepper so at least on the color side, I will be more like the man in the photo than my grandfather.
This is a very unusual balding pattern in a 23-year-old male, but nevertheless, he succeeded with two medications oral minoxidil and finasteride
https://www.healthline.com/health-news/microrna-breakthrough-hair-loss-treatment
I am always skeptical. This is a new idea, that stiff hair causes balding, and softening the hair can address the balding problem. The hairs above the surface of the scalp, are already dead. Treatment below the skin, as the new hairs are being formed, would be necessary if this theory made any sense. We have seen developing hairs that are miniaturized, most of these hairs become soft because they lose bulk. I have oversimplified the premise, but you should read it to draw your own conclusions.
For men that experience AGA, does every single hair follicle in the respective balding area (based on their Norwood level) always eventually miniaturize and stop growing, leaving that area total hairless and bald? Or, in some people, can just a percentage of the follicles in those respective areas be afflicted while others in that same area are DHT resistant and never miniaturize? So like, for instance, let’s take someone with a Norwood 3 Vertex pattern; in the crown area, is it always a guarantee that every single follicle in that area will stop growing and leave a totally slick bald crown? Or can some of the follicles remain unaffected based on the person’s genes leaving just a thinned looking crown as opposed to a completely bald one? I ask because usually when I see receded or bald men, even elderly men with a Norwood 7, their bald areas usually aren’t totally hairless and slick bald. There’s still some remaining terminal hairs to various degrees in those spots.
You are astute in your observations: Some men with Class 7 patterns may have a few remaining hairs right in the middle of the balding area. I remember one man I transplanted who actually knew that there were 7 hairs in his balding pattern and gave names to each one of them. Those with a Class 3 Vertex pattern may not develop complete balding of some of the crown, but most do, not necessarily enlarging the balding crown with a complete “Friar Tuck” look. If I remember correctly, OJ Simpson’s attorney had a small completely Friar Tuck bald spot, seen from behind. These Norwood patterns described are usually complete, but it may take years to get there.
With Dupa and Age related thinning, does every single follicle on the scalp miniaturize? And do the miniaturized follicles in these conditions eventually miniaturize to the point where they fall out and stop growing altogether like in AGA, resulting in a totally bald scalp (including the donor area)? Or do they miniaturize just to an extent but then stabilize and continue to grow at that level?
The best insights I have into this great question are from women who have it. They are often older, and they usually do not bald from it. I believe that these DUPA patients tend to be stable; however, since I interfere with the normal course of the disease with drugs like finasteride, I don’t frankly know what would happen if we just did nothing for these patients. I remember one woman who came to me with almost complete balding (donor area as well as the rest of the head), and she had DUPA’ however, since I never saw her when she was younger, I can’t comment on her disease progression. She did report that the thinning was noticed after menopause. There is, of course, no comparable analogy for men.
Infection is very common when synthetic hair is placed into the scalp. This process has been outlawed by most Western Nations, but somehow the companies that sell it get someone to put them in the scalp on some balding men. I am told that initially, the implants look great and can make a bald man look like he has a full head of hair, but in time, these artificial hairs get infected. The infections are persistent and don’t respond to antibiotics. These or foreign bodies and the patients develop severe scars. Even if these hair could be removed, which is very, very difficult, the infections often remain. In this man, the infection went down and exposed his skull.
Getting 2500 grafts from an FUE doesn’t mean that it will be aesthetically pleasing or successful. This is an example of a failure on both ends of the FUE process from a Turkey clinic. To make matters worse, 2500 grafts that were taken from the donor area are lost for future hair transplant work. When needed. Fortunately, this can be fixed, but there is no bargain when you pay for it twice.
I was on finasteride for 5 years when I stopped it and then lost all of my hair. Fortunately, I restarted it and it all came back.
Some men who stopped it and waited too long were not as lucky as you were in getting all the benefits back. I hope others learn from you but don’t expect the same result.
Some men inherit a strong forelock and then bald around it as is the case in this man. The forelock was not genetically sensitive to his DHT but not the hair around it nor behind it. He is lucky that these impacted hairs responded to finasteride and minoxidil.
