Hand swelling might indicate you are overdosing on minoxidil. The proper oral dose should start at 1.25mg and possibly go up to 2.5mg, never higher or the risk of swelling around your heart is there if you overdose. 8 or 9mgs could kill you if you develop a cardiac tomponade.
Hair length alone can not produce such a dramatic effect in this 27 year old male. Great result. The frontal hairline is less sensitive to these treatments in this man. You would have to keep up the combined minoxidil and finasteride treatment after the hair transplant to maintain the gains you made in the top and crown of your head. Despite this, you should be congratulated for this spectacular turn around.
I’ve attached a magnified picture of my donor area that I captured; a couple of your posts I saw stated that folks can send you pictures of their donor and you can use your personalized formula to estimate their donor. The caliber of my hair follicles are 55 which I’ve been told is in the middle. Would you mind helping me estimate my donor grafts availability?
There are 29 follicular units I counted (click on the photo below), and I took the total hair count and divided it by the number of follicular units 72/29= 2.5 (rounded). This means that you have a donor density of 2.5 hairs/FU, which is 24% higher than the average Caucasian Donor density. With a hair thickness of 55 microns as measured by your micrometer, I would suspect that you can easily harvest between 8000-9000 grafts in your lifetime. Of course, the type of FUE that picks out all of the high numbers of Follicular Unit hair grafts would reduce this number substantially. That means with proper FUE performed, leaving enough good grafts behind, you can bald to a Class 7 pattern and still get hair.
You have what appears to be diffuse thinning from the view in the photo below, but to make the diagnosis, you need a microscopic examination of the donor area to quantify the degree of miniaturization that is present in the donor area directly at the bottom of the scalp in the back of your head. Drs. Rassman and Bernstein first defined DUPA (Diffuse Unpatterned Alopecia), a rare condition in men, common in women. The only treatment for this is finasteride; it works in less than 50% of men. This diagnosis must be made with a hand microscope measuring the degree of miniaturization in the donor area in the back of the head.
Now about your question. You have a very, very small, and limited donor area based on the photo you sent me. The harvestable hairs, even if you don’t have DUPA (I suspect that a good hand microscope will show DUPA), you wouldn’t have enough hair to signifier impact your appearance. Beware of any doctor, anywhere, who would offer you a hair transplant. The results of a hair transplant will be a disaster for you. A dishonest doctor or ignorant illegal technician who does surgeries at a discounted rate may feel you are a good candidate because of the money they will make from you.
25 year old male has doubled up taking both oral and topical minoxidil. There is NO GOOD REASON to do both, as this increases the incidence of side effects from systemic minoxidil overdosage. The oral alone would have given this man the same effect without topical minoxidil. I just has a patient who got cardiac fluid buildup by doing just what was done here. Risking death to get hair is not a good exchange.
I have being taking finasteride for a year with no side and I think I made some nice progress but 3 month ago I asked my doctor about trying dutasteride since I didn’t have any side with finasteride. My reason was : didn’t get side so might as well get the stronger stuff and also even if my hair got better I still feel like I’m losing 100+ hairs everyday, maybe 120/150 so I was thinking that maybe I wasn’t doing enough. Long story short I started getting some small sides 1month ago with dutasteride feeling really horny, not too bad I guess but mostly I was not as hard/would be difficult to do it twice in a row. So I stopped taking it for around 1month and started finasteride again and it’s back to normal. My question is do you think with the progress I made with finasteride I should be fine for the long run? I feel this is the smart choice but I can’t remove the small voice in my head saying to try to ease back into dutasteride. Thank you.
I take it that your side effects was an increased libido, something I see with some frequency with people starting finasteride. Dutasteride is not FDA cleared so I generally avoid it. Another reason is its long half life (4-6 weeks) when compared with finasteride (4-5 hours). The gain of 15% effectiveness reflects that its blocking impact is 85% at the 5 alpha-reductase level while finasteride is 70% effective. If you have good effects with finasteride, stick to it
You can see the new growth where the arrows are pointing
Hey doc, quick question for you. I tried making a post on the sub, but mods won’t approve it apparently. Have you had patients with blood in their semen with fin or dut? I’ve been on dut for 3+ years now, and I recently noticed blood in my semen. I feel fine, so I wasn’t too worried… But then a few days ago it was BRIGHT red. Scared the shit out of me. I’m not sure it’s the dutasteride causing it (I take it M, W, F), but I’m thinking I should discontinue anyway to be safe.
I would see your doctor. Blood in semen is not normal and I doubt it has anything to do with the drug yo are taking. Things that the doctor will look for include: an infection, such as a urinary tract infection (UTI) or sexually transmitted infection (STI)
I know this and random and you probably won’t see it but I need some help. I’m only 23 and losing my hair pretty rapidly. I want to hop on Finasteride but I’m as poor as can be. What is the absolute best and cheapest way to get Finasteride in the state of Indiana? I just want to get my life back on track and not stress about hair loss anymore. It’s really hit my confidence hard and I just want to be me again.
Costco sell finasteride for $28/year with a prescription
Generally, it usually works within 6 months of starting it assuming that the hair loss started recently (past 2-4 years).
This looks like DUPA to me. Get a doctor to look at the microscopic appearance of the hair and he/she should see this: https://baldingblog.com/do-i-have-dupa-photo/
It seems like hair clinics in the US are losing a lot of business from people traveling to countries such as Turkey, etc. Is there a good reason why they cost so much here? I’m saving for a transplant and I could technically afford one right now in one of those countries, but the task of traveling to/navigating in a country I’ve never been to get a medical procedure seems so daunting to me. I would understand if they costed like 50% more here or something, but it’s like 2-4x the price. I don’t understand it
Many of the cheap transplants in Turkey are performed by clinics owned and operated by technicians that came out of legitimate hair transplant clinics. I have been told that 95% of the clinics in Turkey have the surgery performed not by a doctor, but by a technician who was trained only in the manual/technical aspects of the treatment. They may or may not know much about anesthesia, Your risk of death is not insignificant compared to having it performed by a licensed doctor (Turkey or the US). Read here and view this video: https://baldingblog.com/seminar-hair-transplant-black-market/
DUPA (Diffise UnPatterned Alopecia) is fairly uncommon. The diagnosis is always made by examining the hair in the back of the head with a hand microscope (Trichoscope). Here is an example of what it looks like: https://baldingblog.com/do-i-have-dupa-photo/
Please look carefully at this picture. You can see that the donor density is clearly less dense than in the upper left corner, an area that was not harvested. People always ask me what is my total donor supply; well, this picture shows that with enough harvesting, the donor area becomes so thin that one can call it depleted of hair, thin enough to be visibly observed. FUE thins the donor area 100% of the time; however, there is some grafts that can be removed that will not cause significant visual depletion, as shown in this man. How many grafts can be harvested before the donor area looks depleted, like in this man? That depends on at least two major factors and some minor factors as well.
1- Major Factors:
a) Remaining hair follicles. The average Caucasian man has 27,500 hairs in his donor area or about 12,500 grafts. If the hair count is reduced by over 50% in an average-weight hair (50-micron thickness), then depletion starts to appear the more the hair count goes down.
b) Hair thickness: The coarser the hair, the more hairs can be removed from the donor area. A person with a hair thickness of 75 microns can probably lose 60-70% of their hair before donor depletion is an issue; however, if the hair thickness is 30 microns, then the loss of 50% of the donor hair will certainly look depleted.
2- Minor Factors:
a) Hair vs skin color. The closer the hair color is to the skin color, then more hair can be safely removed from the donor area; however, when the contrast is high (black hair against white skin), then the number of hair left behind must be higher than 50%.
b) Character of the hair: Straight hair may not be as good in coverage, especially if it is fine in character, while wurly or kinky hair covers well behind each single hair shaft.
Here is an example of a man who had too many hairs removed from his donor area. The only want to treat this is to (1) grow the hair longer in the hope that longer hair will act like shingles to cover the spaces where it used to be or (2) use SMP to change the color and of the spaces in the donor area with what appears to be cut hair follicles.
