This young man has very thin see-through hair. Near completion of the first session, the SMP procedure shows the difference between the non-pigmented scalp and the pigmented scalp as it is being performed. The first session uses lighter strokes than subsequent sessions which may be darker in the next session if the patient makes that choice as many often do. The dots are slightly lighter than his hair color. Click on the photo to see what we are talking about.
Dr William, in order to prevent hairloss and to regrow some hair in androgenic alopecia patients , can one take finsteride 5mg daily instead of finisteride 1mg?
The recommended dose for finasteride for the treatment of androgenic alopecia is 1mg daily. Taking more than the recommended dose will not be of benefit for hair.
The drug melatonin, a potent antioxidant and growth modulator, was identified as a promising candidate for the topical treatment of hair loss. The study was conducted in 2003 at the Forenap Centre Hospitalier in Rouffach, France. The drug was found to be well tolerated. Approximately 80% of people found that it reduced hair loss during the short 90 day trial. The study concluded that there was a positive effect of melatonin on hair growth in patients with AGA. The authors recommended more studies have to be done to confirm the benefits for both short and long term hair loss treatment. The drug melatonin may behave similar to a topical drug which was marketed by a French pharmaceutical company which was known as a “morning after” abortion pill (as it was/is known and marketed some 20 years ago) and no longer on the market. A topical form of melatonin is commercialized in Spain (a topical solution called Lambdapil solution) but according to a colleague there, it is weak and no better than minoxidil.
Dr. Rassman,
I’m currently preparing a Master Plan, and I’m considering the merits of combining ARTAS FUE and SMP, but I have a query: Can the ARTAS system robot differentiate between a normal hair follicle and an SMP replica follicle?
There have been patients who have had SMP first then subsequently had FUE with the ARTAS with no issue.
I have followed the finasteride-sexual impairment debate on this blog with interest and found the following review published this month in a reputable journal to be highly informative and with new information (to me). The full article, by Singh and Avram, was published in the December issue of the Journal of Clinical and Aesthetic Dermatology and is freely available to the public at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285451/
As a clinician-scientist, I have observed that the most fervent proponents of the belief that finasteride results in permanent sexual side effects do not fully appreciate the minuscule and uncontrolled amount of evidence of this phenomenon. Further, their comments (often more of a personal nature directed toward those they disagree with) usually reflect significant difficulty distinguishing between well-controlled studies, which can be done, and letters to the editor, case studies, and anecdotal reports that seem to be from the same author.
Sigh and Avram nicely summarize the current “state of the art” and the need for controlled investigations in the last section of their paper:
“In summary, the findings by Irwig et al. are quite disconcerting; however, even if the findings in these three articles by Irwig et al. are accurate, this clearly only effects a small proportion of finasteride users. As stated above in the Prostate Cancer Prevention Trial, none of the more than 17,000 participants experienced persistent sexual dysfunction or depression. In addition, the authors were able to demonstrate that finasteride only had a minimal effect on sexual dysfunction. They advised that these sexual adverse effects should not affect prescribing practices. Once again, given the data from the hundreds of randomized, controlled trials, finasteride should still be considered a safe and well-tolerated medication. It is essential that further research is performed, in the form of randomized control trials, to further evaluate if there are any unique characteristics in these individuals suffering from prolonged sexual dysfunction and severe depression after using finasteride. These future double-blind, placebo-controlled trials are necessary to conclude if these findings by Irwig et al are “a red herring” or a potentially rare but serious side effect about which we should counsel our patients.”
Thanks for sharing your thoughts!
The topic of sexual dysfunction with use of Propecia (finasteride) here on BaldingBlog as well as the Internet in general is something that will likely be a heated debate.
It is unfortunate that understanding clinical research (with randomized control trials) will be out shadowed by the “hysteria”. Interesting point about the 17,000 participants. Alas… let the debates begin…
Dr Rassman ,does side effect of weight gain always occur in all male patients who uses 5% topical minoxidil? After how many days/months of discontinuation of topical minoxidil 5%, will the patient reach to his original /actual weight?
As far as I know, weight gain is not a side effect of Rogain.
The main source of hair loss in men is genetics.
The main source of weight gain is generally over eating.
An article in Indian J Dermatol. 2014 Mar-Apr; 59(2): 163–165 States: “Finasteride is more effective for treating AGA patients who are pileous in other areas of the body.” This means that if Gorilla’s should bald, or apes should bald (which some Chimps are known to do), they may respond to finasteride better than their human cousins. OF course, not such study on balding Chimps, I believe, has been done.
What do you think is the best program for an 18 yr old who is experiencing MPB.
It all depends on your goals and expectations. You can read about the Master Plan I advocate and consider seeing a doctor. Don’t jump to do any surgery what-so-ever. At 18, you never know where your balding is going and that is why we talk about developing a Master Plan with a good doctor. Close to 100% of men your age, will go on the drug finasteride (Propecia) to slow, stop or reverse the hair loss. At the time of your visit, we will perform a bulk assessment of your hair and that will give us close to 99% certainty just how far the hair loss has gone, if at all.
Happy 2015! David (Van Halen) Lee Roth performed this past Saturday with the Foo Fighters in LA.
I was watching the clip online and when he took off his cap, he had a shaved head. What I noticed was what looked like a strip scar on the back of his head. Does this appear to be a scar from a HT? Would it be less obvious if he had SMP to help conceal it?
Just curious. I enjoy your site and have been pleased that you have answered my questions over the years.
Many celebrities have had hair transplant strip surgeries hidden under their long hair and from the photos I’ve seen circulating around the Internet it does seem like a hair transplant scar.
I wonder if he knows it can be camouflaged with SMP? If not, someone should show him this post.
nhi_smp_to scar
Sir does alpecin caffeine liquid helps in halting hairloss and stimulating regrowth in male pattern baldness patients? And can it be used with minoxidil 5%?
The only medication or treatment I know that helps (not stop) hair loss in male pattern balding is Rogain (topical minoxidile 5%) and Propecia (finateride 1mg). You will find hundreds if not thousands of Internet websites and advertisements that claim a cure, but my point has always been “buyer beware”. Caffeine or special shampoos with exotic ingredients do not stop hair loss.
