Day: January 1, 2023

Hi doctor, just a question, do you have hundreds of patients on Fin without any sides? And if they do have any do they just call you? And what dosage do you recommend, Im thinking of 0.25mg

I have thousands of patients on finasteride without side effects. Usually, I start at the recommended dose, unless the patient is unusually concerned about the sexual side effects. If that be the case, I might start with 1/4 dose and slowly over weeks increase the dose until it reaches the 1mg dose provided that there is no deleterious side effects reported.

Most were happy that they were on the medication and few had complaints of side effects. Not everyone saw benefits.

Are you happy you took fin? from tressless

I have a questions about finasteride. Is it something I could add to help with my balding? I already take 100mg of spironolactone daily. I have gone on/off spiro afew times d/t having kids but now haver had a hysterectomy so do not have to worry about any teratogenic concerns.

Finasteride has been shown to work on some women but because of its unpredictable action, most doctors don’t prescribe it for women. It works better when women have gone through menopause. For women who can have children, as you seem to understand, the impact on the baby in pregnancy can produce abnormal sex differentiation.

I own a digital microscope and while there is miniaturization in the donor zone it’s not past the 20% threshold, yet at least, I would think the current pattern tends to point towards diffuse patterned alopecia. If I can bother you again, what I do want to know since information is somewhat scarce on the internet, is if there are any other causes, besides DHT, that would cause diffuse miniaturization of hair follicles? (deficiency, thyroid, allergy, mold exposure, a disease of some sort, etc.) I know most of these usually present as telogen effluvium though. Essentially, what I’m desperate to know is if miniaturization means you 100% have DHT sensitivity? I’m ready to start finasteride, but want absolute confirmation that’s what I’m dealing with before I mess with my hormones at 19. Thank you for your time.

Everyone one has less than 20% miniaturization which is normal. Each person will lose and replace up to 100 hairs per day. you have listed the many causes of diffuse thinning so check each one out with blood tests as needed, best through a doctor’s office

Hey all, I am soon going to start using topical minoxidil. The only brand (Linn Minoxidil) I could get a hold of somewhat easily where I live (the Netherlands) is a spray. The manual says to spray six times on the balding spot. But I am a norwood 3.5-4, and hence would like to spray both on my diffusing crown and receded temples. The manual however does not specify how to treat multiple areas, i.e do I just do three sprays on the temple and three sprays on the crown? Or do I have to use the spray on i.e the crown alone? Was wondering if anyone here has faced this issue/knows the answer.

First, you must be aware that only 40 % of men will respond to the topical minoxidil. On the other hand, the oral form is 100% effective because it is metabolized in the liver into its active form. I generally prefer to agree with the manufacturing instructions; however, with the topical minoxidil that I am familiar with, one good application a day works well. I recommend applying it after a hot shower on a damp scalp to increase absorption. If you do not get a good response to the topical, you may assume that you are one of the 60 % of men who do not respond to the topical form. If you are committed to going the minoxidil route, the oral form requires a prescription. I have seen wonderful results from oral minoxidil.

Recently, I got a prescription for oral finasteride from my dermatologist. I’m a bit nervous to take the oral route due to the side effects that appear to be somewhat common and the possibility of the post-finasteride syndrome. I have learned that my pharmacy is able to compound 5% minoxidil with 1mg Finasteride into a topical solution. I was wondering if you had an opinion on this?

Keep in mind that topical only works where you put it. So, if you have hair loss where you don’t see it (like many people do when I perform a HAIR CHECK test), then these areas will still lose hair. Also, Post finasteride syndrome, I believe, doesn’t happen if you stop taking it after you find that even staying on it a month or so does not solve the ED problems.

I’m 32yr old male who has been using Rogaine 5% for about 8 years. It has been working well to save me from going completely bald, but my hair is definitely not as thick and dense I would like (especially with direct light).

I am planning to get a hair transplant because of that and because I am tired of Rogaine commitment.

My question is: Is it a good idea to stop Rogaine before getting the transplant? I know that hair will go with it, but I want the surgeon to assess the actual state of my hair without Rogaine and maximize the transplant results without Rogaine. Does this sound logical at all?

Just wanted to ask you a question about dosage. Most drugs become more effective when the dosage is increased. I assume that’s why doctors start their patients off at a small dose and increase it if the patient isn’t responding to treatment.

However, I believe you’ve mentioned that increasing the dose of finisteride wouldn’t give better results. Wouldn’t that statement contradict the fact the as dose increases so does effectiveness? For example 5& minoxidil is more effective than 2%. So it would follow that a 5mg dose per day of finisteride would give better results than a 1mg dose.
Please correct me if I’m wrong.

Drugs are not always more effective with increase in dose. So your presumption is wrong. There may be a maximum effective dose and anything above that is a risk for unwanted side effects.

Propecia is finasteride in 1mg strength. It has been determined by studies that 1mg is just as effective as 5mg. Taking more will not improve its efficacy on treating androgenic alopecia. Increasing the dose will likely cause more side effects.

I’m having an FUE procedure and i’ve seen plenty of people on youtube who are able to rock really short fades, pretty much bald fades after getting one of these procedures done (the haircut where you cut really low on the sides and back and gradually up it a little more), and I was wondering, in case I happen not to be able to pull it off, is it a possibility to get SMP (Scalp micropigmentation) over the punch holes (the FUE scars) so it blends in better?

Yes, SMP works wonders for FUE scars, when done properly. I wrote most of the medical literature on this ( https://scalpmicropigmentation.com/ ). Also read this extensive article: https://newhair.com/wp-content/uploads/2018/11/Journal-of-clinical-and-aesthetic-surgery-Article.pdf

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.