Month: January 2023

Most of the topical finasteride sold today can get through the skin and its not the Liposomal preparation. if the drug gets through the skin into the body and you are known to get side effects with the pill, you will get it with the normal topical finasteride. With the Liposomal preparation; however, the measured maximal absorption for topical liposomal finasteride was reported to be rarely in excess of 18% of the total dose. I hope that language better explains what I know. But I would be happy to review articles you might have as I always keep an open mind. Last week I had a patient with the ethanol/ PG base solution and he had bad sexual side effects and that is why he came to me to get the Liposomal preparation.

A Liposomal preparation of a drug puts the active drug inside very tiny, fat-like particles. This allows more localization of the drug. Men who have measured their DHT levels found that with the topical liposomal finasteride preparations, their DHT levels did not change.

According to the attached article from Harvard Health (thanks for the reference) and a group of Australian doctors who studied two groups of about 1400 men, they found that men with bald spots at the top of their heads (vertex baldness) were one and a half times more likely to have prostate cancer than those without bald spots. As an aside, we have also known from other studied that men who have vertex (crown balding) have a higher risk of heart disease and chances of dying of a heart attack. So what does this tell us? If you have Crown balding, be careful to check your heart and your prostate.

https://www.health.harvard.edu/mens-health/testosterone-prostate-cancer-and-balding-is-there-a-link-thefamilyhealth-guide

Have you encountered patients that have had side effects that lingered for a few months after dropping the drug, like me? If so, did they get better?

They usually got better. You should think positive as the Nocebo effect is real

When you shave your hair very close to the scalp and you had a significant FUE procedure done, you will see the missing hairs very clearly, especially if your hair is dark and your skin is light as shown in this photo below. Imagine that you were the surgeon and you had to take out 3500 FUE grafts from this man’s head (look above in the normal scalp), or course you would leave ‘holes’ as shown below, it can’t be avoided unless this man’s donor density was much higher and the grafts were taken over a larger area (impossible if it must be kept to the permanent donor zone). Many people feel that FUE is preferable to strip surgery, but when you do extensive FUE as this man has, a single thin line scar (1-2 mm wide) may be better than this look. In either case, it can easily be repaired with Scalp Micropigmentation, a must to if this man wants to keep his hair on the short side. (CLICK TO ENLARGE and you can see that the surgeon did a reasonable random job in selecting the 3500 grafts to excise))

Yes, but the normal, non-balding male’s number of life cycles are not limited. In a balding male, they may be limited in the balding area to between 5-8 depending on the length of the cycle and the age that it kicks in. My grandfather, at the age of 102, had the same hairline as when he was 5 years old. I suspect, if he did not die then, his hair would have kept growing and growing.

Hair follicle life-cycles limited? from tressless

The best thing you can do is see a doctor. It would help to see a picture of where your father’s balding pattern ended up. You are clearly thinning and the drug Finasteride can work miracles on 21 year-old men with your hair loss. Do not undergo a hair transplant under any circumstance as unethical doctors will offer you hair transplants to make a buck.

See here: https://baldingblog.com/2012/08/24/i-saw-amazing-finasteride-and-minoxidil-regrowth-photos-so-will-my-hair-look-like-that/

This patient should not have a hair transplant as his disease, LPP, will kill any transplanted hairs. The previous hairs were replaced by scar tissue. This disease is evident by the shinny, scar ridden skin, the lack of vellus hairs around the hairy edge as it transitions into normal scalp. This disease is thought to be present more than most doctors realize and could be found in men in their late 20s or 30s. We have thought that women were more susceptible to having this disease in the past.