Do you believe that it stays effective long term? (Say more than two years) Or will it lose effectiveness compared to the oral form? I am 22 years of age and considering taking topical instead of oral. Let me know what you think.
If you are asking me if you continue to apply it for 2 years or more, will it still be effective. The answer is yes!
2021-03-06 02:58:432020-12-16 11:00:24How long can topical finasteride be effective?
i am 20 yrs old,and my dad is bald,although he started losing his hair only when he was 37 yrs old,i just have the fear that i may also get bald like my dad,so far now,my hair is ok,just that i have some dandruff .is there any specific age that i wil start balding,or how can i keep my hair healthy and ever long lasting.is it mandatory that i may also lose hair as well as i grow old
Balding almost never hits men under 18, so I have set up a model for the balding process to give some insights into men on the balding process. If you imagine that we are born with different types of baby hair that changes as we get into our first year. Then it changes again through childhood and then again around puberty (11-13). I suspect that these changes are influenced heavily by the hormone DHT. The hair undergoes another change between 18-29 years old.
The changes are two fold. The first part of the process is the advancement of the frontal hairline into the mature position. The typical juvenile hairline of the 12 year old boy is no different than the hairline of the 12 year old girl, but as men (typically 95% of Caucasians) move into a mature pattern with the central area rising about ½ – 3/4th inch above the central crease and the sides move up about 1-1½ inches, giving a slightly receded corner. A small percentage of men (Bill Clinton and Ronald Reagan) keep their 12 year old hairlines through life. Many young men mistake the mature changes in the Caucasian hairline for balding. Such changes are normal, but for the soap actors who must retain their baby face, such changes are devastating, so on rare occasions I have restored this juvenile hairline on famous actors.
Secondly, the balding process may start anytime after this change starts (about 18 years old). Since real balding starts at about 18 years old (caused by the impact of DHT on the susceptible genes associated with genetic hair loss) the faster the fall out occurs, the worse the prognosis. There is some protection against DHT that holds until 18, but when that protection is gone, the faster the fall out, the more is the indication that balding will be severe. On a visit to my office, I will put the hair of the patient on a TV, so that they can look at the hair shaft diameter variability. Normal (non-balding) hair has equal diameter while genetically impacted hair starts to become finer and finer, reducing the diameter to smaller and smaller sizes (miniaturization is the term that doctors use) until it becomes threadlike and just disappears. The drug Propecia blocks the impact of DHT on these impacted hairs, often slowing, stopping or reversing the process over time. The best way to change the course of this hair loss is to take Propecia which means that you must stay on the drug for life. Short of that medication, there is no effective proven medication or treatment. There is no doubt that the hair loss will still pick up again (even on the drug) but it will be a slower process.
I am a 27 year-old male from Toronto, Canada. I have a family history (faternal family and partenal family) of MPB. In the summer of 2005, my stylist informed that I was thinning at the top/front. I was in denial as I have used lots of gel or similar styling products and have been able to see my scalp. I later noticed the front thinning a little, but did not really care as it did not seem to be serious. In late December 2005, my uncle asked me if my hair was thinning (which he has always done b/c of the gel) and my aunt said that my hair was thinning from the crown….my sister said she noticed it as well. The next day I asked my barber not to use styling product and he said that would be good b/c of the thinning on the top (the first time he has mentioned it since the summer!!!). Needless to say I am no longer in denial BUT I WANT TO TAKE ACTION AS QUICK AS POSSIBLE.
I am going to speak with my family doctor about propecia/proscar. I have bought rogaine (2%) but will wait to use it, as I would like to see the doctors say and b/c of your advice to start out with one remedy so that I can know what is effective. I have also bought nizoral (2%). The rogaine seems like a pain to use. I am a very very busy young professional.
I have a few questions:
- do you have suggestions for a good doctor in Toronto, Ontario, Canada (preferably downtown core) where I can get miniaturization done?
- how long does the balding process take? I am concerned that I will lose a lot more hair before any medication kicks in. I would BE QUITE HAPPY IF I COULD MAINTAIN MY CURRENT HAIR for the next 8 – 10 years as I love my locks.
- Is avodart available in Canada?
- do you recommend any particular thickening shampoo and styling product? I want to avoid the revivogen and stuff like that.
Thank you for your help.
It sounds like genetic balding is the diagnosis, but I couldn’t properly determine that without an examination. As you know, we tend to follow our family patterns, which also includes the rate of balding. Find out who you take after, and you will have a better idea of what may happen if you do not go on such medications as Propecia.
2006-01-09 09:36:482006-01-09 09:37:15How Long Does The Balding Process Take?
What is the difference between FUE and FUSS – strip surgery? Which is better? I am confused. Doctor tells me that the strip surgery is not done anymore and it’s an old fashion surgery. That the future is the ARTAS. How is the ARTAS different than the FUE? There are so many choices it is confusing to decide how to choose a hair transplant surgery method.
Dr. Pak was an engineer working with me (Dr. Rassman) in the mid 1990s before he went off to medical school to be a doctor . We worked to invent a system or robot which would use cameras and special optical sighting system to target a hair follicle to automatically take out a follicle using the FUE technique. This work became U.S. Patent 6572625 that we licensed to Restoration Robotics, the company that sells the ARTAS robot. Dr. Pak and I since worked on many U.S. Patents used in the ARTAS as well as other hair harvesting and implanting devices.
Dr. Pak performs FUE at the New Hair Institute with a special FUE instrument he designed. He has at his disposal the ARTAS, or even NeoGraft. Even with all the technology (ARTAS, etc), his manual technique with his instrument is faster and just as precise (if not better).
He is just as fast and precise at the FUSS – strip technique. He can harvest a donor strip and close the wound and clean the area all under 5 minutes. There is a video of this on the Internet. Speed does not necessarily make you a better surgeon, but he has the experience and accuracy. Our experienced techs can dissect each FUSS strip into exact precision perfect grafts.
My point is that you should choose the type of surgery based on the merits of the doctor (not technology). Dr. Pak and I are very familiar with the FUE, ARTAS, NeoGraft, and all forms of harvesting hair follicles. We also offer all method of harvest. In terms of graft quality between FUE (ARTAS, Neograft) versus FUSS strip, the FUSS strip harvested grafts are generally better (which means better results). The exceptions are the doctors with unskilled staff. Then the ARTAS grafts will be better (or rather up to par or standard).
Many doctors push FUE or Neograft or ARTAS claiming “no scar” or “minimally invasive”.
Many doctors dissuade patients from strip surgery asking “why would you want a big scar”.
The focus should be on RESULTS. Not how a doctor takes out the grafts. From a donor scarring perspective, if you are ever going to shave your head or cut your hair really short, you should probably get the FUE. That is it! Line scars are not an issue for most men and women with long hair (minimum #3 or #2 hair clipper). Just remember a 4000 graft FUE scar is like having a collective open wound hole the size of a baseball on the back of the head. There is nothing minimally invasive about that. We end up performing Scalp MicroPigmentation (SMP) and fix horrible FUE scars routinely. These is nothing “scarless” about FUE. DR Pak has performed surgery on me and my family members using the strip technique. The linear scar on me is a pencil thin line you probably will have a hard time finding. It’s not that Dr. Pak is a better surgeon, it is because my body heals well. The point is, a strip surgery scar is not as terrible as the Internet makes it out to be and there are also terrible FUE scars.
Again, the focus should be on RESULTS.
A bad hair transplant result from FUE or Strip is like Herpes. You’ll carry it with you for life.
Hi DR,
i have been through all the entires in the blog and find it quiet useful… here is my problem/question…I am almost 26 yr old male and experiencing considerable thining. This probably started 7 months ago although it was not that noticeable and there was considerable self denial on my part. My frontal hair are thinning althogh my hairline is maintanied and now even the crown area is thinning considerably. It a very emotional rollercoaster for me and i’m feeling depressed. today I started on propecia and saw palmetto and maybe i ll use nizoral shampoo too. I want to know how long will it take to see a complete stoppage of hairloss and regrowth of new hair ? I may be a BIT late in starting but the thinning started occuring 6 months back and considering that I had a head of full thick hair until october last year… I was in total self denial that my hair was thinnnig. My dermatologist confirned its a case of MPB since my dad started losing his hair in his very late 20s. I am not even married and its very emotionally distressing :(. What are my hopes ?? Also will a sinus surgery(with local IV sedation) cause any further hairloss on me or contibute ?
Please write back. Thanks
With a 7 month history of hair loss, there is sill a possibility of controlled loss or reversal of some or all of the hair loss within the first two years you are on this medication. You must wait this out. I would recommend against taking Saw Palmetto with it, as there may be competition for the DHT enzyme sites between the two medications making the Propecia less effective. Any added stress can impact the rate of hair loss, and sinus surgery is no exception. Still, if you need the sinus surgery, do it and continue to take the Propecia regularly.
Good luck.
Dear Doctor,
I am losing my eyebrows hair (23-male).
- Can dandruff be a reason for it?
- Do you always recommend scalp hair for translpanting to eyebrows? Can chest hair be used? Or armpit hair?
- I have always heard about scarring at donor site. Are there scars or marks at recipient site ever?
Thank You very much indeed.
There are many reasons for eyebrow hair loss, including hypothyroidism, plucking, trichotillomania, psoriasis with scratching, dermatitis, infection, any inflammation process, and a series of autoimmune problems including alopecia areata/totalis. Using hair at the occipital area to transplant by single strands to the eyebrow areas is the best way to do it.
2006-03-15 08:36:472006-03-14 14:33:26Why Am I Losing My Eyebrow Hair?
I hear that question all of the time. The answers often vary from 1000 to as high as 6000 grafts, sometimes regardless of the balding pattern. We focus on the number of grafts because more grafts move more hair into the balding area. But the real numbers depend upon
Note that I am putting in a time factor, because balding is a progressive process and how bald you are today, might be distinctly different than how bald you will be tomorrow.
Some young men fly to Turkey, get 5000-6000 grafts for minimal cost. Then they come home to wait and watch it grow. Assuming that the clinic did it right (not the case in many Turkey clinics that don’t have a doctor but sell grafts (like potatoes were sold to the Irish at the time of the famine in the 1800s), they may run out of grafts (or potatoes) before they finish balding.
Hair transplants need to be part of a Personalized Master Plan that incorporates how you are going to manage fixing the balding problem against a progressive balding process. If you use up all of your donor hair before the balding is complete, you may end up looking freaky for the rest of your life. I hear the young man tell me that they are not worried about their hair loss when they get to 30, or 35 or 40. I speak with many 30, 35 and 40 year old men and they ALL CARE about what their hair looks like. Poor planning is almost always a disaster for sometime down the road. All doctors are not equal. Some doctors are in it for the money, so selling more grafts means making more money. You have to identify those doctors and make sure that you don’t get one of them. I always say that a good decision today is a good decision tomorrow.
So to answer the basic question “How many grafts do I need?”, take it easy, digest what you read above and the look to some of the following links below:
2021-10-18 13:52:482021-10-18 14:39:16How many grafts do I need?
Am I the only person questioning why there isn’t a big market for this? Scientists all around the world are cloning hearts, lungs, and other organs in a glass box without a body. Yet these scientists cant just clone your hair follicles and transplant them or something – and just “cure” baldness? Or is this once again just the trillion dollar hair corporations refusing to let this become a thing because they will lose millions on selling imaginary hairy growth products to the gullible masses?
Good questions. Cloning was done in the late 19802 when Jahoda cloned hair from he and his wife. They were only a few hairs and it has never been something can can be done commercially. In the 1990s, hair cloning was successfully done on mice, but the the hair which was cloned in a petri dish, when transplanted into mice, killed them because the hair grew wild in every direction causing massive infections. What most people don’t realize is that a hair is a complete organ system and each follicular unit, as an independent organ, has be be developed that it grows like a complete organ, in the correct position and direction. For this reason, most people have tried to work with stem cells to grow the organ from scratch, which would then have a direction and each stem cell might produce a hair organ (follicular unit). We have not gotten there despite now almost 30 years after the first hair was cloned.
Plan on getting a HT I have an autoimmune disorder called LPP & the top of my head started thinning really bad about a year ago hair falling out in clumps flaky I’ve tried meds and everything there’s not much they can really do . It’s killed my confidence but I’m looking at getting a hair transplant to correct my hairline how many grafts would I need? Its just the top of my head thats needs to be filled in I have a really good donor area and I’ve been thinking about a HT for awhile now if anyone could give advice thanks
Having LLP (Lichen planopilaris) is generally a contraindication for a hair transplant, as the odds are that the disease will kill the grafts.
I ‘ve been taking propecia for the past 4 years but now I really wish to donate blood at least once in my lifetime.
As you know Finasteride users are not allowed to donate blood. According to one of your previous posts Finasteride is cleared from the blood stream within 48 hours.So I planned to stop taking propecia for a week, donate blood and resume taking the pill. A week seemed a reasonable
amount of time also because according to the information I found on the internet, DHT levels take a whole week to be
back to normal once you stop taking it.Unfortunately, however both on the Red Cross site and other sites, they state you need to wait at least 30 days after
the last dose of Finasteride.Why do I need to stop for a whole month if Finasteride is cleared from my blood stream within a few days? Wouldn’t say,
two weeks be safe enough?
You need to wait a month because that is the policy of the Red Cross. Two weeks may be “safe” but you have to follow the organization’s policy.
