This is an excellent result from using finasteride and minoxidil for 7 months. It is not unusual for the crown to respond to these two medications.
Dr. Wrassman, to clarify, are you expecting that this is a normal outcome? I get bleeding and worry that I am going too hard and perhaps should consider less time or a shorter needle length? Quite frankly, it’s been tough to pin down an optimal needle length in the literature. I was considering restarting at 1mm with the dermapen assuming the 1.5mm rollers prevalent in literature only penetrate 1 – 1.25mm.
The stem cells lie under the epidermis which is 0.5mm below the scalp surface. The 1 or 1.5mm reaches this depth. Either should be fine. The key is to get wound healing that reaches the stem cells.
Hi Dr Rassman I don’t know what to do I keep my Finasteride bottle in a cool place always at temperature around 72 to 74F but now that I have moved to my new temporary home it’s set to 72F but the humidity is is what I’m really worried about it keeps going from 49% to last time I checked was 54% Relitive humidity I keep a desiccant in the bottle but I’m just nervous I don’t want to destroy Finasteride effectness. I looked up humidity level for Finasteride but the FDA only mentioned the temperature no mention of humidity. Should I be concerned?
Use an airtight bottle. The pharmacist near you will supply you with one. and if he doesn’t just give one to you, ask to purchase one from him/her
I smiled when I saw these illustrations. Men often grow hair on the face and sideburns in many different iterations when they don’t have head hair. These photos are a look back in history over the past 150 years.
This young man went to Turkey 3 months ago for a hair transplant because the fee was much lower than quotes near his home. He had a medium level balding crown and very small frontal corner recession. When he went to the clinic, the building was beautiful. He came in on the first day for the surgery evaluation and they suggested 4200 grafts. The next day he had the surgery and found the entire surgical crew unprofessional, ignoring him, laughing and chatting and not focusing on his surgery. He found out that many of them were hired recently, “just off the street” and they were being trained on his head. That day, he counted more than 20 patients having surgery at that facility. He knows that this was a terrible mistake and I am going to work with him after he gets to the 8 month postoperative date when he sees where he is. I am concerned about his donor site, which he believes has been damaged.
Girlfriend just said to me “what if you started balding by shaving your head first” immediately followed by a “hair transplant”
This is not your girlfriends head, its yours. You should decide what you want as if she didn’t exist because whatever you do or don’t do, you will have to live with it.
If you decide to shave your head after a FUE hair transplant, will it look stupid/horrible (owing to all the scars in donor and recipient regions) and, if so, can this be countered with SMP?
You might see the white scars from the FUE punch. That would call attention to your hair transplant.
I’m taking dut and oral min daily, and I’m waiting till I’m a bit older to get a transplant (age 21 nw3). In the meantime, I thought it would be a confidence booster to wear a hair system (wouldn’t stop taking meds). I’m trying to figure out if that would accelerate existing hair loss but I can’t seem to find any info online. Thought some of the guys here who’ve been wearing systems for a while might have some Valid input.
Yes, the glues and clips used to hold the hair system in place produces traction alopecia most of the time. These glues will produce a more advanced patterns of balding by the time you reach the hair transplant age. I would think this through carefully and maybe have a talk with your parents before you act.
I’m 24 and I want to get a hair transplant, so how many grafts will I need?
You need a Personalized Master Plan: https://baldingblog.com/go-why-do-we-need-a-master-plan/. You need to lay out what your worst case balding is and balance that against your available donor supply capacity before starting the hair transplant process. You will find many doctors willing to quote you 1500, 2000, 3000, 4000 grafts for your problem. Is your hair fine, medium or coarse in thickness? Could you respond to medications or other treatments such as microneedling and avoid a hair transplant and still get your hair back? How do you tell which is right and when you should tackle it?
I have seen these unusually low hairlines for a mature male. They are common in children but usually disappear as the male matures. These hairlines are found more in the Latin and India countries than in Caucasians of European decent. Even for a juvenile hairline, this is low. Note that there are no temple peaks because they are incorporated into the rounded hairline.
I started out 1.5mm, but now I’m concerned about scar tissue. I’ve heard 0.6mm might be better, but the redness goes away pretty fast. I started out doing once-a-week needling, but then I’ve seen people who did it twice a week at a lower depth followed by minoxidil that had great results
Microneedling depth should be able to reach the stem cells at the top of the hair follicles which lie about 1mm below the skin so 1 of 1.5 mm microneedles are about right. These stem cells have some cells that specialize in hair cycling so that when stimulated, the command goes out to the other stem cells to kick in the anagen cycle (theory at present).
I know you suggest finasteride after hair transplant to prevent shock loss. How long would you use finsateride after a hair transplant to prevent shock loss?
I generally like the man to be on finasteride at least 1-2 weeks before the transplant and until the transplanted hair has grown out. That applies to men under 35 as a rule, but what finasteride protects, is loss of the native hair with miniaturization present. As men get older, they may have less miniaturization and as such be less likely to get shock loss.
Anyone ever notice the balding spots are hot to the touch? Way more so then other parts of the head?
The scalp receives, second to the brain, the highest blood flow of any organ in the body. If you are recently balding and the skin of the scalp has not become atrophic, then this area may feel hotter than other parts of your scalp. Usually, if complete balding in an area occur, the skin become atrophic and cooler to the touch.
I have written to you before. Will minoxidil give me enough hair to avoid a hair transplant?
Traction alopecia from the use of a turban is usually permanent. You will know this because if the hair doesn’t regrow without the tight turban in 6 -9 months, it is gone. This is caused by traction. Unfortunately, only a hair transplant will solve the problem. Minoxidil might bring on some weak hair fuzz, but not real hair, worth a try though if you want to delay tackling a hair transplant