Author: Dr. William Rassman

June 2021 vs. today (11.2.2022), 1.5 years on 1mg fin every day, Niz 3x per week, and 1 month on 2.5mg oral min every day.

Nice improvement. Stay on your routine and it will only get better. It may take another full year to see more value of what you are doing and it is even more likely that it will get better if you add weekly microneedling to your routine. If this is not enough and you are over 25, then a hair transplant will give you a normal hairline, something to consider.

More than 5000 grafts performed in this limited space with FUE will deplete the donor area and this many will now have this huge discrepency between his donor area that was not harvested and the area that was harvested. Ther are two solutions for this type of balding (1) is scalp micropigmentation (https://scalpmicropigmentation.com/scar-covering/) and the second might be just to grow the hair he has long enough to cover the donor area. The over-harvested FUE means that he can never keep his hair short unless he has scalp micropigmentation.

The message here is that persistence pays off!

The look is great, but you have used up more than 50% of your donor supply which could be a problem if your balding pattern significantly advances. I would ask your surgeon a simple question: “Could the same results have been achieved with 3000 grafts (1500 each side)? If your hair has a medium or better thickness, the answer is ‘yes’ in my opinion.

The only way a hair transplant is normal looking after it is performed, is to transplant the natural growing groups that hair normally grows in, in their anatomical groups, i.e. the follicular Unit. The average Caucasian averages about 2.2 hairs per follicular unit and the typical human has approximately 50,000 of these follicular units on their entire scalp. So if the average hair count per follicular unit is 2.2 hairs/follicular unit, then the typical Caucasian man has approximately 110,000 hairs on their scalp. For the typical Asian, the follicular count remains at ~50,000 but the average hair count per follicular unit drops to 1.9 hairs/follicular unit for a total hair count of ~95,000 hairs. This is an average, but the range could be wide ranging from 75,000 hairs – 120,000 in any given population.

This is a picture of a 6 hair follicular unit (rare in most people) but worth showing because it shows new hairs in their growth phase. Notice that two of the hairs are shorter than the other four (marked with arrows). These are new anagen hairs growing into this follicular unit increasing the visual hair count by 1/3rd from 4 to 6 hairs. That means that possibly a few months before this follicular unit was excised, it probably had only 4 hairs that were visible. The two new anagen hairs arose from stem cells within the follicular unit. It is likely, that if we allowed this to grow (and were able to follow the hair count in this follicular unit over a year or so), the hair count may actually drop as some of these longer hairs (terminal hairs) may actually turn into their sleep phase (telogen).

Doc, i have a question, Does it happen usually that someone stops reacting to the current dosage and has to move to higher concentrated dosages. Ex, someone stops reacting to 1mg finestride and has to move to 2mg to keep seeing results. I am kinda scared of it, I started with 1mg per day, but later came across someone mentioning it, so I reduced the dosage to 1mg every alternate day, bcoz 0.5mg per day wasn’t available. Was it a smart move or me just believing in a myth?

The original Merck studies showed that the 1mg dose was the ideal dose for hair loss. Half that dose is 82% as effective, so taking a pill every other day is essentially half the dose and it should still be 82% effective in your situation.

I’ve been in fin for 5 years and maintained everything I had, even grown some back. Hairline looks great. A little thin around my right temple, but other that, great. Reason I’m stopping, is I’m having some slight pain when ejaculating and the wife and I have been trying to have another kid for almost a year with no luck. Semen seems to be hit or miss. Sometimes it looks thick, other times it looks thin and watery. Anyways,I’m 30 now, and just going to shave it all off. I’ll try to keep you guys updated if curious. I have stayed away from here from the fear mongering as it wasn’t healthy for my mental health, but wanted a place to post.

You should think twice about the decision to stop finasteride after 5 years of use. You will lose all of the hair you would have lost over the past 5 years once you stop the medication. I have seen many men regret the decision. Watery semen is a common occurrence. I am writing this to let you know the consequences of stopping finasteride.