I Just Turned 40 and Have Some Hair Loss

Hi,
I have been on minox for the last 10 years when I noticed my hair started to thin and have managed to keep it fairly well. About 1-2 years ago I started on Dutasteride (I know you don’t recommend this) as I felt I saw an increase in thinning of my hear, especially in the crown region).

I have seen a few times that you have indicated that hairloss may be less aggressive after you are 40+.

As I’ve just turned 40 and have some hairloss, I’m of course curious if I maybe statistically have an increased chance to keep the remainder of my hair?

Kind regards

It is true that in general men’s hair loss tend to slow down as they age (after 40 years old, etc), but the cause of hair loss in the great majority of men is due to genetics. So while you might be an exception to the statistical rule, you could find that these statistics don’t apply to you.

I Just Started Finasteride. Should I Start at 1/4th of a Pill First?

I began using fin (1mg) today and want to avoid sexual side effects. Do you recommend starting out by taking it only a few times a week then progressively taking it more often until it’s 1mg per day? I saw you’re comment saying that this is a reasonable strategy to avoid side effects

Generally, since the risk of sexual side effects is less than 4%, it is best start at a full dose. If you are the 1:25 people, then change to the routine I referenced in a previous post.


2019-12-05 13:00:26I Just Started Finasteride. Should I Start at 1/4th of a Pill First?

Dutasteride dosing with a long hair life?

I just started Dutasteride. What’s this about the half-life allowing you to take it less often than fin?

The half life for dutasteride is 6 days (this is in the blood), but the tissue life (at the hair follicle itself) lasts much longer-possibly weeks or even a month. Less frequent dosing is ok, in my humble opinion.


2020-02-07 08:49:14Dutasteride dosing with a long hair life?

I Just Saw a Bald Spot — Do I Observe It or Go Right to a Doctor?

I’ve only just noticed I have bald spot after someone mentioned it, it is in an awkward place to see in the mirror. The bald spot is only at the crown area and I haven’t noticed any other hair loss anywhere else. However I do think my hair has thinned recently (last year or so). Do you have any suggestions as to what I should do next -see a GP, observe for a few months etc.?

I’m only 21 years old and I’m quite self conscious now that I’ve had comments about it.

Thanks in advance for any help.

You can consider a visit to our office in Los Angeles if you’re local or planning a trip out this way (the consultation is free). Otherwise see a good doctor, perhaps your family doctor, who will be able to determine what you have and what you can do about it.

If you think it is the beginning of male pattern baldness, you certainly want to see about starting treatment early… but I don’t know what is causing your bald spot at this point. I often mention the Master Plan when considering future hair loss. Educate yourself.

I Just Moved and Now I’m Losing Hair

I recently moved to US (bay area) and have been noticing a lot of hair fall. Slightly pulling my hair causes them to come out. I have no serious illness etc. What could be causing the increased hair loss?

Thanks!

It could be a variety of things. Perhaps it is your genetics and the timing was coincidental to the move… or it could be stress-induced (moving can do that)… or it could be allergy… etc, etc. I really have no way to know based on your email with limited information. You should see a doctor if you’re concerned.

I just had 4000 grafts for my Class 3 pattern, is this a good number?

4000 grafts are likely 60% or more of your donor supply. Have you considered what you would do if your hair loss pattern evolved into a more advanced balding pattern? If you are under 26, this is a significant question; however, if you are over 35, the risk of developing a more advanced pattern may not be substantial unless some male in your family line developed a later pattern of advanced balding. Who do you take after in your family line? Do you have a worst-case plan? I think 4000 grafts for a balding Class 3 pattern male is mal-practice.

My SMP on my crown area today (see before and after photos)

My medical hair history: I entered the Hair Transplant business in my private practice forming New Hair Institute in late 1991. With a partner who had done thousands of hair transplants at Bosley, he and I worked together. My crown was balding and my wife told me that it was bad business to have a bald crown and then talk to patient about treating their bald crown areas while I had one. So my partner recommended Scalp Reduction Surgeries (I had three of them, one every 2 months completing the sequence of surgeries in 6 months). What happened was historic. By the last of the three surgeries, my bald crown came back and my scalp was scarred badly. As soon as I realized I was deformed, I picked up the phone and called the worlds expert in the field at that time (no name here because he is still alive) and told him about my problem, asking him how often he saw such problems (I was thinking it was rare). He said it was very, very common, in fact, most people had their bald areas return. I followed up with: “Why didn’t you publish these results and stop the surgeries from being done?“. He responded: “It would have been bad for business!” I felt sick and disgusted with him and his comments as now I was both a victim of this horrific surgery (the removal of the bald area in the crown) and a doctor who had already started doing them on my own patients (6 surgeries, one on my own first cousin and best friend). All 6 people had the same thing happen to them, so I tried to make amends with them by giving them hair transplants to solve their bald crown area. I also started a campaign to DEMYSTIFY this horrific surgery and expose it for what it was, a deforming surgery. I published against it and spoke before the largest hair meeting in the world telling the audience: “That I would volunteer my services for all victims of the Scalp Reduction surgery as an expert witness in any malpractice case brought against anyone performing this surgery with the resulting deformities that it produced” . I was blackballed for about a year by other doctors who made a good living doing this surgery, but what happened was almost immediately after my announcement, the doctors that performed the procedure stopped doing it. Now, it is rarely, if ever, performed. To fix my problem, I had three hair transplant surgeries of about 900 grafts each over 25 years. Still, my crown was not as thick as I wanted it to be, so today I took the last step and had Scalp Micropigmentation performed on my crown. My before (the first two photos) and after pictures (the last ones) are below. Now any thinning that has remained is gone! I practice what I preach! Comment: I don ‘t think I look balding in my crown now, the first time in years that the problem is solved. The last picture was taken 6 weeks later (I think I got more salty color in my hair over the past month or so).


 

 

 

 

 

 

 

 


 

 

 

 

 

 

 

 

 

 

 

AFTER

I just congratulated an older man on keeping all of his hair. He smiled and said, I have been on “Propecia” for years.

I saw him on my walk and I have no idea what came over me, but I just had to tell him that he had great hair. I’m shedding at 24, and this guy was well into his fifties with a full head of glorious hair.
This is not uncommon, but this may not be your story as everyone responds differently to this drug. The drug has only been out since 1997.


2020-02-03 10:56:12I just congratulated an older man on keeping all of his hair. He smiled and said, I have been on “Propecia” for years.

I Just added finasteride to my routine 3 months ago

I have been on oral minoxidil and been microneedling for a year or so, then I added finasteride just 3 months ago. What do you think?

I suspect if you continue with this routine, you will get the results you are hoping for. Finasteride works well in the crown, more than the frontal areas. Your frontal areas have filled in nicely and I would expect the crown to follow. Keep it up.