This is a remarkable video of Dr. H Mohmand performing FUE at a rate of over 3000 grafts per hour at his clinic in Islamabad, Pakistan. Very commendable skills.
Pharmacology and therapeutics
Female pattern hair loss: a pilot study investigating
combination therapy with low-dose oral minoxidil and
spironolactone
Rodney D. Sinclair1,2, MBBS, MD, FACD
Abstract
Background Minoxidil and spironolactone are oral antihypertensives known to stimulate hair growth. Objective To report on a case series of women with pattern hair loss (PHL) treated with once daily minoxidil 0.25 mg and spironolactone 25 mg. Methods Women newly diagnosed with a Sinclair stage 2–5 PHL were scored for hair shedding and hair density before and after 12 months of treatment with oral minoxidil 0.25 mg and spironolactone 25 mg. Results A total of 100 women were included in this observational pilot study. Mean age was 48.44 years (range 18–80). Mean hair loss severity at baseline was Sinclair 2.79 (range 2– 5). Mean hair shedding score at baseline was 4.82. Mean duration of diagnosis was 6.5 years (range 0.5–30). Mean reduction in hair loss severity score was 0.85 at 6 months and 1.3 at 12 months. Mean reduction in hair shedding score was 2.3 at 6 months and 2.6 at 12 months. Mean change in blood pressure was 4.52 mmHg systolic and 6.48 mmHg diastolic. Side effects were seen in eight women but were generally mild. No patients developed hyperkalemia or any other blood test abnormality. Six of these women continued treatment, and two women who developed urticaria discontinued treatment. Limitations Prospective, uncontrolled, open-label observational study. Discussion Once daily capsules containing minoxidil 0.25 mg and spironolactone 25 mg appear to be safe and effective in the treatment of FPHL. Placebo-controlled
On topical min for 1.5 years + topical fin for 6 months with great results. Started oral min and seeing a ton of shedding. Is this normal? Topical min was great when I started it 1.5 years ago but all it did was slow the hair loss down. So 6 months ago I started topical fin with great results, and saw almost all loss stop within a few weeks. I still have a few thin patches so almost a month ago I decided to add oral min (1.25mg) to the mix after reading about how effective it can be. Almost immediately after starting oral min I began shedding again pretty heavily, and its continued on now about 1 month after starting.
Shedding indicates that minoxidil is working. The shedding will pass in a month or two. Then hopefully, you will see some new growth to solve your problem.
I went to the doctor today and was prescribed 5mg finasteride orally per day. i was kind of surprised by this because most people seem to take 0.5mg to 1mg per day from what i’ve seen. just want to know if this is considered dangerous or anything. i’m 22m and relatively healthy otherwise. also my hair loss isn’t too crazy mostly just some thinning and temple recession. any input would be appreciated.
In the original Merck studies on finasteride, they showed that the maximum effective dose for hair growth was 1mg. Going up to higher doses did not improve the results but may cause more side effects. Not a good idea to take the 5mg dose.
It takes time to get this type of result. The corners filled in nicely but there is still some mild recession.
Yes, SMP doesn’t last as long in scars as it does in skin.
This is called a ‘J’ haired graft which came out after the hair transplant was done. This indicates that was folded on itself as it was placed (implanted) into the recipient area. Most doctors believe that these fail to grow. I am not sure of this; however, this shouldn’t happen with a good surgical crew.
This is a good photo after microneedling that goes down to a depth of between 1 – 1.5mm. This is where the stem cells are targeted. There is going to be some pain but most men who do this once a week put up with the pain for the gain.
What should I do?
See a good doctor and find out where your hair loss is going. It does not look promising; however, this may be treated with medications alone.
A family member was on finasteride for 15 years and had a baby when he went off of it without incidence. The original Merck study suggests that not enough finasteride goes through the semen to harm conception. Many Redditors, challenge this view.
Your hairline shows early erosion which will lead to recession if that is not already there. See a good doctor to address the problem before your hairline goes up.
Should I treat this?
I try to caution young men not to start medications until the hair loss is real and significantly detectable because medications for hair loss are lifetime commitments which are not something that is casually made. What I see is a short haircut on the sides, not balding
Age – 28M. Hairline started receding since I was 18, but nothing crazy. Visited dermatologist and I was diagnosed with Male Pattern Baldness. I am currently between NW2-NW3, with M shape hairline. I was prescribed finastride 1mg, Topical minoxidil 5%, PRP sessions, and kit of multivatims. I refused for minoxidil, ’cause i wanted to wait for atleast 6 months to see the results of fin can provide on it’s own. No to monthly PRP sessions cause it was costly and provided temporary results. No to multivatims, cause I believe they don’t have significant impact, and will opt for natural way to get my set of vitamins. My question: Am I good with fin alone in the beginning? Should I consider multivitamins? I know this is subjective, but when can one expect to notice results of fin?
I like your thought process and think starting with just finasteride and giving it 9 months to see if you respond is a good approach. You might add microneedling as a good adjunct to kick-start the follicles.
ALSO LOOK AT THE DETAILS OF THIS BREAKTHROUGH DISCUSSED BY THE PRINCIPAL RESEARCHER, DR. PLIKUS: https://www.youtube.com/watch?v=suGzbbNreD8
If I read correctly, Fin is not linked to cancer? This was just a misconception? Are there any other long term health side effects aside from mood and ED?
You are correct. Most focused side effects have been focused on sexual side effects from finasteride. There are also depression, anxiety and cognitive complaints (brain fog) reported as well. Many of these symptoms go away when the drug is stopped; however, it sometimes takes months for full reversal. There are reports of Post Finasteride Syndrome where these side effects never go away. In more than 10,000 prescriptions that my group has written since the drug came out, I have never seen a case of Post Finasteride Syndrome in a normal person. There is also no cancer reported from this drug. In fact, there is a reduction in the risk of prostate cancer from me on this drug by 25%.