The miniaturization doesn’t exceed 20%, which is, therefore, by definition, normal or marginal. To be exact, repeat the photo with the hairs cut short against the scalp so that an accurate count can be made. Vary the location as well so we will be looking at more than one place. Also map it against a photo so I know where the photos is coming from.
I take minoxidil, finasteride, and tretinoin and want to add microneedling. Will I have to continue miconeedling if is works on my head?
If microneedling produces hair, it is likely that microneedling will have to be continued on some maintenance schedule for your entire life. So, for example, if you start doing it once a week for 6 months and get the growth you wanted, you could step back to once a month, which might suffice. I certainly will not guarantee this.
My situation is that I used minoxidil for 1.5 years, so imagine all that time I wasn’t a responder. Can it make my hair worse since I’m just applying alcohol all the time? I’m asking about my situation cause I have been on fin and min and my hair is worse.
If you used topical minoxidil, only 40% of men have the enzyme in their scalp to convert minoxidil to minoxidil sulfate, the active form of minoxidil; however, if you have taken it orally, 100% of men should get some response to the drug because the liver creates minoxidil sulfate, the active form of the drug. If you had no response to the oral, then you are not a minoxidil responder.
There seems to be a lot of different opinions floating around regarding it’s long term effectiveness … With consistent use, does it maintain it’s therapeutic effects, or does your genetically predetermined Norwood level eventually develop as you age despite taking it? I’ve seen some people state that it continues to have it’s effects for as long as it’s taken but then others state that it only delays the inevitable and if you are let’s say genetically programmed to be Norwood 5, that you are going to eventually go there despite finasteride use? What is the actual case? (I know there’s different variables and there’s a small percentage of people who are non responders, but I just mean in general).
Finasteride always works to (1) slow hair loss (2) stop hair loss or (3) reverse hair loss. The aggressiveness of the body’s genetic hair loss is a variable. Apoptosis (cell death) occurs with genetic alopecia. We believe that each hair on the head is programmed to grow only a certain number of hair cycles. Once those cycles are reached, the hairs die. Finasteride seems to alter the duration of these cycles, possibly the number of hair cycles you can achieve, but this is just a guess. Good question.
Hair loss has nothing to do with nutrition and this man proves it.
Weight loss doesn’t mean starvation. This man likely had achieved a good balance with fewer calories than he usually took and kept good nutrition. It is wrong to think that because this man didn’t lose his hair, others may not have been well managed during the weight loss routine. Also, this man most likely didn’t have the genes for genetic alopecia, which might have precipitated hair loss.
Fin at a young age, 18, 19, 20, etc. Should you do it? Messing with your hormones at such a young age doesn’t seem like a good idea. Does it mess with them as much as people say and would you advise someone of that age to take fin if they’re balding?
I routinely prescribe finasteride to young men as I find it is often very effective. The time the hair loss is caught has much to do with its effectiveness. The earlier the hair loss or even before hair loss while the hairs are miniaturizing, the more the hair responds well to finasteride. Few men have complained about hormone issues to me. I have prescribed thousands of men this drug (all ages), and I notice those who lost hair within the past 2-4 years get the best response, while men who lost hair ten years or more only sometimes responded with hair regrowth. Even men in their 40s, if they start finasteride just after their balding starts (late balding men), should get a good response to finasteride.
Clogged pores is an old wives tale and does not cause hair loss
You know how with senile alopecia or DUPA, the hairs miniaturize but don’t (usually anyways) actually shrink to the point where they fall out and stop growing altogether? They miniaturize to a certain extent but then stabilize in a miniaturized state and are still retained (hence why you don’t see people with DUPA develop totally bald scalps because the hair is still there, just much thinner). Well, can the same thing occur with patterned hair loss? Where the hairs in the thinning areas of the scalp (vertex and/or hairline depending on the Norwood level) miniaturize to certain degree but then stabilize at that point and don’t continue to miniaturize to the point that they fall out and totally stop growing altogether? Or in patterned hair loss, miniaturizing hairs in a thinning area of the scalp will most definitely shrink to the point of no more growth?
You are drawing a lot of conclusions about DUPA. DUPA may be another form of Senile Alopecia or just a variation of genetic hair loss? I don’t know, but I doubt it. DUPA might progress over time, possibly leaving very little hair on the head. i have seen this in women but never seen a man with such advanced DUPA that his entire head became very thin. DUPA is different because it impacts the Donor area and every other place on the head. Someone can have genetically patterned hair loss and then develop DUPA, which I have seen. These men are in a tough spot, as their patterned hair loss may progress to full balding, leaving a fragile donor area.
An Article published in the British Medical Journal in September 2016, based upon “two populations of men free of risk factors for erectile dysfunction and other sexual dysfunction or its treatment: men aged 40 or more with benign prostatic hyperplasia who received a prescription for a 5-alpha reductase inhibitor (finasteride or dutasteride) or alpha blocker, or both, and men aged 18-59 with alopecia”, suggests : “The incidence rate of erectile dysfunction was lowest among users of 5-alpha reductase inhibitors only (15.3 per 1000 person years, 95% confidence interval 14.3 to 16.5), and similar among users of 5-alpha reductase inhibitors+alpha blockers (19.2 per 1000 person years, 17.4 to 21.1) and alpha blockers only (20.1 per 1000 person years, 19.6 to 20.7). Compared with users of alpha blockers only, the adjusted incidence rate ratios for users of 5-? reductase inhibitors only and 5-alpha reductase inhibitors+alpha blockers were 0.92 (95% confidence interval 0.85 to 0.99) and 1.09 (0.99 to 1.21), respectively.” Of further note: “cases of erectile dysfunction were more likely than matched controls to be overweight or obese (as measured by body mass index) or to have a diagnosis of non-erectile dysfunction sexual dysfunction, hypertension, diabetes, hyperlipidemia, depression, orchitis, or alcohol misuse before the index date.” Of course, this study was done in an older population that is prone to Erectile Dysfunction
https://www.bmj.com/content/354/bmj.i4823#:~:text=The%20risk%20of%20erectile%20dysfunction%20increased%20with%20increasing%20number%20of,odds%20ratios%20were%20statistically%20significant
Comment: The risks of ED rises with age, so the groups tested were clearly at a higher risk of ED than younger men. The statistics reported by this article suggest that in this higher-risk population, the risk of ED was 1.3%, less than was reported in the original Merck study or in the Propecia ED risk factors brochures. I am wondering why so many younger men are reporting ED, considering the above statistics?
I have published on the genetics of the persistent frontal hairline. This man could bald and yet keep his frontal hairline. For a hair transplant surgeon, that means that he will not have to get the leading edge of his hair transplant, saving the patient money and donor grafts. For him, it means that he will retain a frame to his face with a good comb-back of his hair for styling purposes.
Can you please expand on what you mean by saying hair transplants accelerate balding, especially in younger men? Thank you
Younger men often don’t see their final pattern, but it is often there if they look through a hand microscope and see a lot of miniaturization present. A hair transplant causes many of these miniaturized hairs to fall out, and they RARELY come back. Remember, miniaturization doesn’t necessarily mean thread-like hair, as it could be hair that has lost only 30% of its thickness, not easily seen without extensive hand microscopic evaluation. With a 30% loss of hair thickness in most men, they will not see thinning or balding. I have seen many 23-year-old men who get hair transplants and never knew they had significant miniaturization with a miniaturization pattern that suggests a more advanced balding pattern.
Young men (under 26 years of age) who have hair transplants may see a Class 3 pattern, but they might have a Class 6 or 7 pattern, which would be a surprise. I don’t like surprises, nor should the patients. So many young me are going to Turkey, where technicians are in charge of the business. In most of these clinics, such evaluations seldom occur except for less than a dozen good doctors that I know personally. Shame on the doctors who do these surgeries without looking for and quantifying the miniaturization before they collect your money and do the surgery. Too many of today’s doctors, even in Western countries, are in it for the money and forget the oath they took when they became doctors, which states: ABOVE ALL, DO NO HARM.
I recently met with a 23-year-old male who came to me after having three hair transplants in the US at different clinics by less-than-honorable doctors. His entire donor supply was depleted, and so was his bank account. The hair transplant doesn’t even look normal to me. All of these transplants were in the first 3 inches of his hairline. When I examined the hair behind the transplanted 3 inches of his frontal area, I saw signs of miniaturization that went back to the crown. The miniaturization was very early, possibly too early to have fallen out with the transplant. He was lucky because he took finasteride, which often stops the loss of miniaturized hairs associated with a hair transplant. As this was a recent visit, I can’t tell you how it will turn out. I suspect he will live with the transplants, even with the defects of an imbalanced hairline and a lot of 2-3 hair grafts seen in the frontal edge of the hairline.
What’s the consensus about microneedling/dermarolling without using minoxidil? Does it help or is it just a waste of time (and tears)?
Microneedling works on its own. Recognize that it works by creating a wound near the stem cells in the upper part of the hair follicle that may control hair cycling. It produces a healing cascade that stimulates the stem cells as part of the cascade.
Yea doc said just not to use it. My father used minoxidil as well and he got lots of side effects just as I did. Very disappointing considering there’s barely any other options
If that was topical, he and you might be one of the 60% of men who will not respond to topical but will respond to the oral.
Post-menopausal women (50% of the feml population) often develop hair loss or diffuse thinning. Finasteride works well in some of these women; however, when a pre-menopausal woman has this condition, it may not work very well. In addition, pre-menopausal women have significant risks with this drug if they become pregnant so they should not take it with that risk over their head.
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