Patient Kept Hairline with Propecia, but Density is Poor (with Photos)

The photos below are of a 24 year old man who started taking Propecia (finasteride) at the age of 18. At 21, he switched to Avodart (dutasteride), but on seeing no improvement or reversal of his hair loss he switched back to Propecia, which he has maintained through today. His donor density is 25% less than the average Caucasian, which obviously means that his supply of donor hair is limited. Plus, he has black hair and very white skin and he is miniaturized to 90%.

 

I suspect that the hair he has is only there due to the Propecia routine he has followed strictly over the past 6 years. Starting hair transplants at this time would be the wrong thing to do, as it most certainly will accelerate the remaining hair loss. With thickening products and the use of Toppik, he does not look balding and I suggested that he continue that approach until it fails to work. Only then can the transplant option be used, but he will have to give up any thought of crown hair and accept only a frontal hair transplant.


2007-04-11 15:35:19Patient Kept Hairline with Propecia, but Density is Poor (with Photos)

Could Lawsuits Against Big Pharma Prevent Them From Working on a Hair Loss Cure?

Dear Dr. Rassman,

I’m very concerned over the article regarding the law suit being launched against Merck. I’m 31 and have been using Propecia for the past two years, which reversed crown thinning and has maintained a mostly full head of hair for me. I stay hopeful however that a better medication or procedure will come along for maintenance/regrowth over the next decade. Do you think that law suits like this are going to kill the efforts, funding, and motivation to continue research for creating more options for hair loss sufferers?

Thanks for your time

There’s around 7 billion people in the world, about half of those are men… and in general, hair loss affects about 50% of the male population to some degree. So with such a huge potential market measured in billions, if there is opportunity the drug companies will likely work it. These companies are in the business of making money. Lawsuits won’t stop them from their research and development.

We live in a very litigious society and a lawsuit against Merck does not mean they’re guilty or at fault.

I Have Patterned Thining, What Can I Do for It? (From Reddit)

Background: I’m 34, 35 in May. I noticed that I was losing hair when I was 27. Crown first, then hairline. The hairline isn’t noticeable unless taken at an overhead angle as attached. I lose hair in a pattern, but it’s also thinning. I have the same hairline as when I was in my early 20’s, but it’s thinned out. My hairline has not moved upwards, meaning I don’t have a V shape. The crown is obviously thinning but it is only extremely noticeable in bright pictures. In some pictures, I just look as if I have a blonde spot in the midst of my dark brown hair.

The consensus is “wait, you may lose more hair,” but it has been the same if not a bit better (cause treatment) for probably 5 years. So I’m starting to think: if I do lose more, it will be a long time from now, or very slowly and I can react to it— so why not go for the HT now?

I dermaroll 1.5 weekly, minoxidil daily, 2% niz. I have tried finasteride 3 separate times, splitting pills in half, taking them every other day. I experienced side effects every time -brain fogg and low libido. Finasteride’s side effect profile for a cosmetic drug is not a good trade off in my opinion. I won’t be trying it again no matter the consequences.

I was going to post this on RealSelf, but the doctors seem to tend to reply with a lame copy and pasted response.

Thoughts on HT in my position?

You are correct to stay away from finasteride. One good option is that you get Scalp Micropigmentation which will create a thickened, much fuller look. You must be prepared, however, that over time the thinning MAY lead to balding, so a plan must be created to address your next step. I am big on a Master Plan for anything you do (see:https://scalpmicropigmentation.com/thinning-hair-gallery/)


2019-02-20 08:46:54I Have Patterned Thining, What Can I Do for It? (From Reddit)

Could SMP Fill In My Donor Scarring?

I have had some extensive hair surgery done, and it looks quite good. Still I have some scars from the 90’s transplant days and thinning in the crown. Could some SMP be done to fill in just the scars and in-between the grafts for illusion purposes? I’m afraid if I shaved it completely, there is just too much extensive donar scarring from before. I’m afraid I might be stuck at the mercy of Topik or Couvre, but the mess really is a hassle. Thanks!

If you look at our SMP site, you will see examples of what you are asking about. Micropigmentation is not as good as Toppik for thickening up areas in the crown the way you described your present problem, but if I examined you, I might be able to tell you what benefit you could get. Without examining you, I can’t guess what will happen with the pigment in the crown area where you presently have hair.

Percocet and Hair Loss

Percocet causes your hair (and eyelashes) to break and fall out. I’m 56 and have always had TONS of hair. “Enough for three people,” my stylist always commented. I had been on Percocet for 4 years due to severe Hip Dysplasia and my hair was coming out in little chunks. My beautiful, long eyelashes kept breaking until it looked like I barely had any. I thought it was because I’m in my 50’s. I had a full hip replacement last year and am finally off the pain meds. I’ve been off them about a month and, to my astonishment, my hair is growing back as thick as it used to be and my eyelashes are long and beautiful again! Those rotten pills! I don’t know how I would have gotten along without them as I was in severe pain, but I’m glad I’m off them now. My hair is recovering, so the hair loss doesn’t seem to be permanent.

Give your hair time and eat healthily. It should recover. Good luck!

Counting Hairs in the Shower

I am not sure if you have been asked this, but could you explain the hair counting thing? Does counting the hairs that come out in the shower really tell you anything? Thats not really a good indicator of anything is it?

Counting the hair in the shower (hair by hair) would mean that you are likely obsessive about hair loss. It would be logical that if you are losing hair, the hairs lost in a single shower would vary by time of day, the vigor of your washing and massaging, the number of times you actually apply shampoo in a single shower, etc.. Generally all non-balding people lose about 100 hairs a day. If you see a change in number of hairs (a gross change) over a long time frame and keep all of the things you do constant, you may be losing hair.

PFS from Saw Palmetto

I want to inform you that after 7 months, I am still experiencing genital numbness, shrinkage and rely on cialis to achieve erection. Libido is almost completely gone. All after quitting Saw Palmetto, which I tool for a year. I’ve done excessive testing (urological, neurological, endocrinologist…) and everything turned out fine. Yet, I am suffering from these extreme side effects. I seem to be one of the unlucky ones who got hit with PFS because of Saw Palmetto, which I didn’t think was possible at all. I’d ask for help but I don’t think anyone can. I only hope this information might be helpful to you about the dangers of 5AR-i.

This is the second time I have heard about Saw Palmetto as a cause of PFS type symptoms. I never personally met these patients but connected over internet forums. See a urologist as there are many causes of your symptoms that may not be tied to the Saw Palmetto

CRISPER pigs could dotate organs to us

Using animals for organ donors have been tried for years, but cross species transplants have done very poorly over time. Now the use of CRISPER can tolerate organ donation much like Dolly the Sheep. Genetic material are used in pig cells in the early embryo and implanted in sows. The plan is to create pigs that have also been altered to make them more immunologically similar to people. In theory, this should mean transplanted organs are less prone to attack by a recipient’s immune system. This work is being done by Robin Weiss of University College London as reported in the New Scientist August 19, 2017 issue.

More pictures of depleted donor area (photo)

This is a man that again went to Turkey had developed this donor area problem probably reflecting either shock loss or direct donor site depletion

depleted donor 52


2018-05-31 16:41:07More pictures of depleted donor area (photo)

Cutting My Propecia Dose in Half Eliminated the Side Effects

Hi Dr,

I tried Propecia about 2 months ago and got sides (could not maintain full erection during sex after a week). I stopped for a month and have now take .5 propecia for the past 2 weeks with no problems. I am 25 and have a bald spot in the back forming with diffuse thinning down the middle of my scalp.

What do you advise as my plan of action for re-growth, would you recommend me to up the full dose soon? Rogaine? Have you seen good results with adults my age range?

thanks for you help

If half the dose of Propecia works, you will get about 80% of the value of the drug, on average. That may be enough to accomplish your goals. You can try increasing the dosage up over time, but I really don’t want to give dosing recommendations for someone that isn’t my patient. This is a prescription medication, so you should go over your options with your physician.

You can try adding Rogaine to your routine, which is sold over-the-counter.


2010-01-15 09:54:18Cutting My Propecia Dose in Half Eliminated the Side Effects