Men shouldn’t get forehead reductions because of the risk of more balding or recession which would leave you with a scar in the front of your head. A hair transplant lowering surgery is the best approach to this problem
2019-12-06 07:06:392019-11-28 10:48:2141 year old male wants Forehead Reduction for recession of the frontal hairline
Enough for what? The recommended dose is 1mg and 0.5mg is 80% as effective. Your call
2021-01-11 02:43:112021-01-11 09:51:21Is 0.5 mg of Finasteride per day enough?
Hey doc, I have just found your website and have enjoyed it tremendously. I am 23 and have noticed my hair thinning since I entered college at 18. I tried Propecia but grew impatient. I wish I would have stuck with it but I chose to stop. I have lost enough hair now that I am fairly thin on top and towards the front. I was curious if you would recommend a transplant for someone so young. I am on the bubble about this, but I think that for my mental well being and career that really it is my only option. I am constantly unhappy with my looks and miss dating a lot. Truly the only real thing holding my back is the price, I would do it tomorrow but I just truly do not have enough saved. I think I would need extensive graphs to restore what I have lost. I have only looked into Bosley because it is the most popular and respected name. Would you recommend them or should I look elsewhere? I am very afraid of a poor surgery where I come out looking like a fool for the rest of my life because of some doctors weak job on my head. Thank you so much for your time.
You must be careful that you are not body dysmorphic. Dating and hair loss relate with regard to self-confidence certainly, but losing your hair should not be an excuse to stop living. Your points about career, mental well being, dating, happiness, (I can go on and on) are good reasons many people try to either hold on to their hair, or if they can not or have lost it, they can get it back with good medications or hair restoration surgery. Now with that said, you need to first get a diagnosis established, your scalp mapped out for miniaturization and the pattern of hair loss that you may develop. Many good medical hair restoration practices, such as Bosley or NHI, can supply a good working diagnosis for you. It is important that you find a hair restoration clinic that you feel comfortable with, and that you feel will give you the results you are looking for. I would not go somewhere based solely on marketing. Do your research.
There is much in this blog about how to shop for hair transplants (my lengthy post from earlier today, The Truth About Cheap Hair Transplants, is a good start), because budget minded people need to understand the entire shopping experience. With a diagnosis in hand, you may find out that you can reverse it (if you have it) with something as simple as Propecia (one pill a day), which works well for many young men. Be careful of the sale pressures to make you buy a hair transplant before you do your comparative shopping and before you know what is wrong with your hair. Knowledge is power, and you as a buyer are very powerful in determining your fate and the status of your hair for much of your life.
Hello. I have been balding for around 4 years (started when i was 17 unfortunately) and I have searched for solutions for my hair loss endlessly to no reward. I have used multiple shampoos, different types of minoxidil (spectra-DNC and more recently rogaine foam- had to stop rogaine foam because it seemed as if i was shedding ridiculous amounts for way to long ~1 month) and still nothing.
I feel like have no where else to go besides into the realm of anti-hormone therapy. By that I mean finasteride (propecia) or Saw Palmetto pills. My question now is, is the herbal route (saw palmetto) that much different than the pharmaceutical route (finasteride)? They both inhibit 5-alpha reductase leading to lower levels of DHT so what makes one drug better than the other?
Another question I had was, after testosterone is inhibited from becoming DHT, what happens with the extra testosterone? Does aromatase convert it to estrogen (-> leading to gynecomastia)? Does it have the same effect as steroids whereby exogenous testosterone leads to smaller testicles and decreased sperm count?
Thank you.
For starters, peer-reviewed clinical studies about saw palmetto as a DHT blocker do not exist, making it difficult to make any comparison. It’s a catch 22, I know — it’s a natural herb so it won’t be able to have any patent protection, thus no company will put up the funding to get a good study done. Still, Propecia (finasteride) does have such studies, meaning there is real data to look at and make judgments on. If you don’t want to go the pharma route and would rather go with saw palmetto, that is entirely up to you. I don’t think the results will be there with saw palmetto, however.
Much of what you state has bits of truth to it, but it’s not a complete picture nor is it really helping you understand things. Hormonal pathways are very complicated and you cannot narrow things down to explain things to suit your needs. I am not going to explain all the biochemical pathway of testosterone to DHT to aromatase, etc. It’s a bit too abstract for this site, and honestly I don’t want to teach a course in college biochemistry.
So lets start from the beginning… and by that I mean, what are your goals? If your goal is to find a cure for hair loss, then you will not find it. There is no cure for hair loss. If your goal is to slow down male pattern hair loss then the only thing that I know of that really works is finasteride and topical minoxidil. These medications do not stop hair loss per se, but will help slow down the loss before your genetic predisposition eventually wins over (this could be many years). Everyone responds to the medication differently, and ALL medication have side effects.
Propecia’s side effects have be beaten to death on various web forums, much of it being false or blown out of proportion. Take note, Propecia is not the only medication that has side effects. Just look up any common medication on the Internet and I am sure you will find loads of false (as well as true) information and their horror stories. My guess is that Propecia is a sensitive topic to most, because words such as “erectile dysfunction” and “decreased libido” are key issues for any male patient. If you look up medications like Prozac or drugs used to treat high blood pressure, you will also find “erectile dysfunction” as one of the many side effects.
The patients who are considering Propecia should be aware that side effects exist, but in reality (from my personal medical practice with actual patients I see at my office) the incidence of “erectile dysfunction” is as stated in the medical literature — 1 to 2%. Those patients with these issues can stop the medication and the side effects reverse within a week. The incidence of gynecomastia is about 1 in 300 to 1 in 500 (I am not sure of the exact published number), but I only remember one patient reporting sensitive breasts about 3 years ago. He stopped the medication and he was fine afterward.
One last thing I wanted to point out — Propecia does not give you small testicles or decreased sperm count.
2010-10-25 14:58:002010-10-22 15:30:47Is Finasteride Really That Much Different than Saw Palmetto?
You have a Class 4A pattern of balding with a persistent frontal forelock. The balding is behind the forelock, and the forelock looks strong. Forelocks that persist after the age of 35 often stay, and there is a strong family history in balding families with strong forelocks. For instance, a man can lose almost all of his hair and still keep his forelock. Since you reported that you are 42 years old, I think this is the case with you, but I would need to examine your forelock to see just how permanent it is and to see if there is any miniaturization in it. Weak forelocks show miniaturization, while strong ones do not. I would transplant the area around your forelock to complete the frontal hairline if your forelock is strong in addition to the area behind the forelock.
Australian Times:
Jack was 16 when he first noticed that his hairline was receding, as he checked photos his surfing friends had posted on Instagram.
“I’d look at pictures of me when I was 14 or 15, see the hairline and then look at pictures from a year later and say, ‘Oh, that’s changed’,” says Jack, a bashful but athletic high-school student.
Last week Jack, still just 17, underwent hair-transplant surgery to move 3,000 hair follicles from the back of his head to the front to re-create the hairline.
His parents, worried about the impact on his self-confidence, paid dollars 22,000 (pounds 14,000) for the surgery.
Jack is one of thousands of American teenagers turning to surgery for a follicular fix.
“We live in a world where you are judged by the pictures that you take – particularly by the opposite sex,” he said.
“In our age group, most of what you do is going towards appealing to the opposite sex. We’re just fixing something that, by genetics, we just didn’t luck out (on).”
Dr Keith Durante, who is treating Jack, claims that a growing proportion of the 200 hair-transplant procedures he performs in a year in West Islip, New York, are for men in their early twenties or late teens.
Thanks to the barrage of high-resolution pictures on social media, young men are spotting their retreating hairlines and thinning crowns at a much younger age.
Many of the patients Durante treats are diagnosed with clinical depression and are beginning to isolate themselves socially as a result of paranoia about their baldness, he claims.
“You will spend more money on psychiatry bills and medications than you would if you just gave these kids some hair and let them enjoy it for 5 to 10 years,” Durante said. “If they need (the treatment) done again, we can do it.”
Hair-transplant surgeons have been reluctant to treat men until their balding has plateaued, fearing treated hair could end up as an island of fluff if the balding continues. Durante says he can offset the hair-loss process with a mix of treatments.
Nonetheless, some rival surgeons believe it is irresponsible to begin treatment at a young age.
“You’re not creating new hair – you are just moving hair,” said Dr Spencer Kobren, a hair-loss expert.
“You have a finite amount of hair you can utilise. Most experts in the field would say that not only is that medically inappropriate, but it’s unethical.”
Dr Rassman
I recently had transplant surgery at a reputable office to combat thinning hair on top and a receding hair line. I am 48 years old. I was suprised by what I believe was a fair amount of shock loss around the graft areas given my age. I was not on propecia pre-surgery but began taking it a few days following the procedure after reading your column. Now I believe propecia can also cause shedding in the early months. Could you explain the difference between shedding and shock loss and what you believe I am experiencing. Maybe a combination of both.Thank you
It sounds like you experienced shock loss and if this is in the miniaturized hair, the hair may not come back. Treating thinning with transplants is not something I do often. In many people with miniaturized hair, transplanting into that ‘unhealthy’ hair does little to really increase the fullness. I believe that for most people like you, any benefit you will get in the long term may be lost in the short term, making transplants a poor decision. I would think that Propecia should have been used in advance of your hair transplant procedure just to minimize this risk. The transplants done may offset the hair loss and the Propecia may bring some of the hair back. Only time will tell. Once the glass of milk falls and the milk spills out, it may be impossible to bring it back.
2006-05-19 12:36:262006-05-19 08:58:1948 Years Old With Shock Loss After Transplant
Hey there Dr. Rassman. I’ve been reading through your site here for a few months after I noticed some thinning at the front of my hairline. I’ve been on Propecia for over a month now and I feel better about the situation but obviously have not had any results yet. The reason I’m contacting you is because, frankly, my hair is very, very important to me and it’s hard for me to effectively convey that to my primary care doctor. Is it unusual for patients to travel cross country to seek your treatment or would I be better off finding someone here in Memphis? I am not in a current financial situation that would allow me to come see you but some day I might really want intensive care for my hair. I can tell by reading your material that you are wise man who cares about people. I would appreciate any correspondence and advice you have to offer.
Our practice is not a typical hair restoration practice in that a good number of our patients do travel a long way to see us, though more than half of our patients are local to California or surrounding states. For those patients who are not local to one of our offices, you can set up a “virtual consultation” with us to get an initial opinion. Some things can be managed without a face to face meeting, but we often direct those potential patients to at least have a phone call. We encourage the use of photographs to help us understand the problems at hand. Hair is very important to our audience and many of those we do a virtual consultation with over the phone have developed questions from reading this blog. If you’d like to request additional info or setup a consultation, check here.
With just a month on Propecia and without knowing more about your hair loss situation, I couldn’t begin to guess if you’re a candidate for hair transplant surgery. Hypothetically though, you should choose the surgeon that can best fits your needs and that you feel most comfortable with. I wouldn’t suggest basing your decision on convenience. For those coming from out of town for surgery, we do offer a travel program.
2009-06-19 14:36:142019-03-12 00:26:33Is It Unusual For Patients to Travel Far to See a Hair Doctor?
