Do I need to stop saw palmetto now that I take dutasteride?
Saw Palmetto is a very weak DHT blocker while Dutasteride is a very strong DHT blocker. Yes, stop the Saw Palmetto. Many experts like me, don’t believe that Saw Palmetto works for hair loss at all
Dr. Rassman,
I’m wondering why you seem to insist upon young men trying Propecia first before pursuing a hair transplant. What with the possible side effects and the need to continually take it, a miniturization examination and possible transplant seem a far safer – and even cost effective – plan in the end.
As a doctor, I do what is appropriate for all my patients, not for my bank account. If you do not need a hair transplant surgery and may benefit more from taking a simple daily pill, that is the best for the patient.
From a side effect point of view, most men do not get side effects, so it is worth a try. Moreover, Propecia is a safe medicine. Even after or before having a hair transplant surgery, I mostly recommend taking Propecia so that my patients do not lose more of their native hair. From a cost effective point of view, a lifetime supply of finasteride is much less than a hair transplant procedure, especially if you take the generic finasteride 5mg and cut it into 1/4 pills.
For FUT I know some people have tight scalps and it’s hard to do FUT on them without leaving a wide scar. So kind of a strange question, but I know and have seen some other people who had large burns scars on their scalp or large sections of scalp removed due to cancer. In order to remove the cancer/ scar, close it up properly and make sure there was hair coverage over the area, they put what looked like silicone implants under the scalp; over the course of a couple of months, they filled it with saline to pre-stretch the skin and then took it out so when it came time for the reconstructive surgery, they could stretch the hair covered scalp over to cover the removed area of the scalp without any issues and without leaving a big scar.So someone with a big balding pattern who would better benefit from the larger graft count that FUT provides, if their scalp is tight, can they first get these silicone implants to stretch the skin before the the FUT strip is taken? Better yet, can a person with balding just get this done to stretch their hair bearing scalp over the bald area without even needing to get transplants?
2020-02-06 04:00:532019-07-17 13:32:18Dermaroller, minoxidil and finasteride got these results in a 5 months (photo)
This is a review of a 20 year old patient who started to bald after he hit puberty. He was so devastated he actually skipped going to school for over a year. He shaved his head and tried to accept his genetic fate when he found out about Scalp Micropigmentation. After his transformation, he came back and gave all the staff a big hug.
Results of dutasteride trials have been nothing less than impressive, particulary the study conducted by Olsen et al (2006) indicating that dutasteride at both 0.5mg and 2.5 mg/day generated a superior hair count to finasteride 5mg at 12 and 24 weeks. Anecdotal evidence has also suggested that dutasteride is an optimal hair loss treatment; www.twinhairloss.com is exemplary of its efficacy, in addition, the many thousands that are using it for hair loss purposes. I have also been in correspondence with one of the twins in this study. He has been on a daily dutasteride dose of 0.5mg since day one and the results are astounding.
Additionally, dutasteride has now been approved in Australia as a hair loss treatment since mid 2011. Despite not being FDA approved, is the current literature and anecdotal evidence still not enough to substantiate that dutasteride is a superior treatment to finasteride?
Thank you.
I haven’t heard of such dutasteride approval in Australia as a hair loss treatment. I can only find a public assessment report from Australia’s drug regulatory agency (Therapeutic Goods Administration) dating to January 2011 about the drug being approved for treating BPH, which is what the US FDA also has approved it for. Do you have a link handy so I can read more about the approval since mid 2011?
There is evidence that dutasteride is superior to finasteride for treating hair loss, but there are probably more complications, such as loss of libido, with dutasteride. And more importantly, the subject of sterility is still an open issue as far as I am concerned.
I generally prefer my patients to try finasteride first, and if it fails to achieve the desired goals and the patient is aware of the risks discussed above, then I have written prescriptions for dutasteride after I’ve developed a relationship with my patient. It is on a case by case basis, though.
Does a history of scalp psoriasis (assuming it is under control with treatment) rule out using minoxidil or transplants to offset hair loss?
Psoriasis is an autoimmune disease that has a genetic preference in its victim selection. It comes in all degrees of activity. Simple dandruff may be a very low active state of psoriasis and as it becomes more severe, it takes on more of the characteristics of the disease state, where scaling of the skin and red areas in the affected area can become painful. Flaking of the skin can be easily seen when psoriasis affects the scalp. Baldness is also a genetic process but it is unrelated to psoriasis. Both processes can co-exist in the same person and both can be treated independently at the same time.
People with psoriasis often ask about transplanting the disease from one area of the scalp to another. Can, for example, skin taken from the area where psoriasis is active, move the disease to areas in the recipient area that are not showing signs of the disease? The answer here is no, as the disease seems to be localized in the area where the scaling exist and moving the hair from the scaling area does not impact the normal recipient area, assuming the recipient area is normal. Psoriasis can be aggravated in the area where the disease is active by any trauma and surgery is a trauma. Some people who tend to pick at their skin and hair can develop traction alopecia (hair loss) if they persist on picking over a prolonged period of time.
I generally tell my patients to use a topical treatment (steroids) on any active area of psoriasis prior to a hair transplant so that the scaling that occurs will be less bothersome during the transplant process. I try to get good control of any scalp psoriasis prior to a hair transplant.
With regard to minoxidil, if this medication does not produce skin side-effects, then one can use it with psoriasis. If side effects should appear or the psoriasis should become worse with minoxidil, then the medication may not be a good choice.
Hi, My son, who is 23, has very thin hair on top of his head and a high forehead. He tried avacore and it’s hard to say if it helped or not. He has very thick hair on the sides-we are prone to high foreheads in our family but the thin hair on top of his head is distressing him (which I’m sure doesn’t help). Is there someone he can see to access his problem-we live in New Jersey and are a train ride from Manhattan. Thanks so much for your help.
Is your son balding now? I would guess from what you are describing is most probably genetic hair loss. Avacor is overpriced and has minoxidil as its active component; I would have been surprised if it would have worked. The marketers of Avacor do a hell of a job promoting the ‘benefits’ of their product and as a result, they have one of the most popular sales efforts ever and it appears to be priced over 10 times that of minoxidil. Propecia, which is made by Merck (pharmaceutical company), is under FDA and FCC regulation so Merck can not promote claims that are ill defined or vague. In a 23 year old male, genetic hair loss comes from the ‘workings’ of DHT on the growth center of the hair follicle. Propecia is the only substance that has been clearly documented to block the effects of DHT on the hair follicle. It has documented benefits on retarding, stopping or reversing hair loss. A competent doctor would make the diagnosis and appropriately manage the problem for you. To answer your request for a doctor on the east coast, I would recommend Dr. Robert Bernstein at 201-585-1115, who has offices in Fort Lee NJ and Manhattan NY. He is as good as they come and I would not hesitate to have my son treated by him.
2005-06-06 19:34:222006-01-25 23:24:14Early 20s with High Hairline
A while ago, Men’s Fitness ran an article about men with hair. The article noted there is a perception that men without hair were not as trustworthy as men with hair. This article was written at the time of the primaries for a US presidential election. They noted that, since President Dwight D. Eisenhower, there has never been a bald president. A while ago, I had a radio program called ‘The Inner Man”, and one of the programs focused on hair loss. I remember a call from the Vice President of marketing for a multi-million dollar company. He called in and said, “I would never hire a bald man because balding men can’t be trusted”. He did tell me that he was the exception to that rule, as he was bald himself.
Looking at Elon Musk, I would then ask: Would you loan this man money to start a business (looking at his 1999 photo)? Of course, we all know that it is not the outside of a man that is important, but the inside of the man. Elon Musk has to be one of the greatest men in the US today and his new look reflects and matches the outer man with the inner man, a man with a brilliant mind and one of the few 20 and 21st-century geniuses and great visionaries.
2018-05-25 06:13:522020-01-15 13:50:42Elon Musk Before and After His Hair Transplant (Photo)
