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Is shock loss after HT worse if you’re on fin and min than if wouldn’t be taking any medication? And how long does it last approximately? I’ve lost a lot of native hairs as well.

Finasteride takes time in some men. Give it a full year before drawing conclusions. I have found that in close to 100% of men, the drug will slow, stop, or reverse the hair loss. Slowing it down is common and sometimes hard to detect unless the drug is stopped, when hair loss will immediately accelerate. Stopping hair loss is less common, and reversing it is even less common (more common in men under 23). Finasteride is very effective at preventing hair loss

The hair loss patterns are inherited. The Class 7 pattern is only inherited in 7% of men and most men are there before they are 30. If you are a Class 5 and 30 years old, you are probably going to stay that way. Hair systems accelerate hair loss because the glue and attachment mechanisms produce traction alopecia.

The first sign of early recession might be miniaturized hairs that usually don’t grow to full length. I would see a doctor who can check your entire head with the HAIRCHECK test to find out if you are losing hair anywhere else. The hairs that don’t grow are most likely miniaturizing hairs that will eventually fall out and not regrow.

The appearance of thinning in the corners of a female hairline is common as age sets in. A hair transplant can easily address this as well as the high hairline and the ledge shown on the upper front of the forehead, which suggests a hairline that is higher than the normal female hairline position.

Hello,

After having a bald spot on the left side of my head for 28 years, I’d like to do something about it. The bald spot is circular in shape and 2cm in diameter, about 7cm directly above my left ear. The hair fell out when I was 2 and the bald spot has remained the same size for as long as I can remember. I am able to cover it with hair surrounding it, but it does take an emotional toll on me as I see it every day and I have to be very careful every month when having my haircut.

I saw a dermatologist about a year ago who told me it’s triangular alopecia. He was not able to locate any hair follicles under the skin, and told me the chance of regrowth is slim to none, especially as there has been no hair there for 28 years. He suggested we first try cortisone injections which did not work, and then referred me to a specialist. I went to see a specialist and he recommended scalp reduction surgery given the small area and lack of hair follicles.

I’ve done some reading on scalp reduction surgery, on your blog and others. The risks seem to be significant (stretchback, slot scaring, hair angled incorrectly, etc.) and it’s clear you’re not a proponent. I’ve also been unable to find any success stories/testimonials online. I’m going to ask the specialist to share more information (# of surgeries he’s done, before/after photos, # of surgeries I’ll need, risks, type of incision, etc.), but before doing so I’m hoping to get your advice.

Given the small area (2cm in diameter) and being able to cover with existing hair, do you think this is a case for a successful scalp reduction surgery? If not, are there any alternatives you’d suggest (e.g., Rogaine, hair transplant)? Both my dad and grandpa have full heads of hair, so I’m not really worry about the hair on the left side of my head receding back to the site of the bald spot.

Thanks for your help!

Scalp reduction surgery, in my opinion, generally carries more risks than benefits. Small scars such as you describe do not do well with scalp reductions, as I have seen many patients for consultations over the years with failed scalp reduction / scar revision surgeries and difficult scars that result from the surgery.

Triangular alopecia is best treated with hair transplant surgery.

For a better assessment diagnosis and treatment options, please follow up with your doctor. Or if you are in the Los Angeles area, you can also visit me for a consultation.

Minoxidil will have no value to the transplanted hairs. Minoxidil’s has value is in the non-transplanted areas. I performed a study where I had patients apply minoxidil to 1/3rd of the transplanted area (to manage overlap) and then compared both the speed of growth and the thickness of the end result. There was no difference between the treated sides and the non-treated sides.

I am a 28 year old single female. 3 years ago I started losing a lot of hair, my my estimate almost 70% of my hair. Now I have started multivitamin for the past 3 months and the hair stopped falling out and some regrowth has happened. Shall I get PRP added to what I am doing?

If you have seen value from taking multivitamins, then you may have a Vitamin deficiency and you should get the various blood tests to document which type of problem you have rather than treat it blindly. Doing PRP is just grasping for straws and does not make sense in the absence of a diagnosis and you may be wasting your money or worse, losing hair while you fail to get the right treatment for your ‘unknown’ condition.

In September, I had a virus that closed my throat, or at least that’s what they thought happened. I was intubated for 22 days and was in the hospital for 30 days. I was prescribed blood pressure medications: Amlodipine (10 mg) and Losartan Potassium (50mg). I always had really thick curly hair, but about 3 weeks after I got home, I noticed a lot of hair on my pillow and in the shower. Now, I can’t even put my hair in a ponytail; what’s left of it is straight and stragglers. My doctor said that hair loss isn’t a side effect, but I have read hundreds of the same stories. She told me that any kind of trauma will cause temporary hair loss and she won’t change my meds. Instead, she wants me to go to a dermatologist. My insurance sucks and I don’t really have the money to pay for a specialist. Anyone know if this is true or of any BP meds that don’t cause this?

Between your protracted and traumatic illness and the various medications you were on, it is impossible to point to any single cause of your hair loss. Although Losartan is known to have rare hair loss side effects, I think that the long-term stress you went through is as much a cause of your hair loss than any single medication. By the end of a year, you might see improvement. Good luck.

If my sperm count is reduced, does it go back to normal if you stop the drug to have a child?

If you have a fertility problem related to your sperm count from finasteride, you can expect that it might take months to return to normal. In the following publication: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205531/, the authors state: “A patient on finasteride (1 mg) for 1 year, diagnosed with oligospermia (impaired spermatogenesis) 5 years earlier, was found to have increased semen volume immediately after cessation of finasteride and his sperm concentration improved to more than 10 × 106/ml about 4 months later.” You should read more of this publication.