Category: Uncategorized

This patient clearly had an FUE in the past. I know this because I see the FUE scars (the missing areas) which I placed some arrow so that you can identify the scars from the older FUE this patient had. What I am seeing is that the surgeon, having already almost maxed out the FUE extractions from the permanent zone in the donor area, decided to move up outside of the permanent zone for more extractions. That means that if this man should develop a Full Class 7 pattern of balding, that he would then lose all of these new hairs. Also showed some arrow above the line I drew to show that this area was previously harvested as well. The circled area shows an FUE sites where the hair still is in the scalp as it is all over the newly harvested areas (the surgical team has not yet removed the FUE grafts). Now add to this that as he loses more hair in the donor zone where his FUEs were wrongly done, he will have terrible scars on the back of his head that everyone will see (scar-less surgery?).

I strongly believe that the FUE harvest should be restricted to the REAL permanent zone (below the line I drew) and not above the line because these guys don’t expect to lose the transplanted hair in the years to come (a real possibility).

Never (for a man) get a hair transplant before the age of 25 because the balding pattern does not declare itself until at least this age. You should build a Master Plan with a great doctor so that your hair transplant plans are carefully considered and reflect your specific short and long term needs.

Most of the topical finasteride sold today can get through the skin and its not the Liposomal preparation. if the drug gets through the skin into the body and you are known to get side effects with the pill, you will get it with the normal topical finasteride. With the Liposomal preparation; however, the measured maximal absorption for topical liposomal finasteride was reported to be rarely in excess of 18% of the total dose. I hope that language better explains what I know. But I would be happy to review articles you might have as I always keep an open mind. Last week I had a patient with the ethanol/ PG base solution and he had bad sexual side effects and that is why he came to me to get the Liposomal preparation.

A Liposomal preparation of a drug puts the active drug inside very tiny, fat-like particles. This allows more localization of the drug. Men who have measured their DHT levels found that with the topical liposomal finasteride preparations, their DHT levels did not change.

“I am almost 1 year since my hair transplant and I am very disappointed with the results”. I have heard this before. Setting proper expectation that are realistic is critical between the doctor and the patient. From what this patient told me in his email, he did not elaborate why he was disappointed so I would assume that either he did not get the growth of the transplants (reflecting some time of procedural error) or that his expectations were not realistic and his result may have been what the doctor promised but not what he expected. I always recommend that the patient return to the doctor who did the work and discuss the result, the expectations, etc… If there was a failure of the procedure to any significant degree, the doctor should be honorable and MAKE IT RIGHT to the patient’s satisfaction. I would do that if I were the doctor.

What is the long term perspective for someone who responds to common treatments like fin and min? Lets say a person starts these treatments at 30. Will they preserve their thickness into their 50s and 60s? Or they just delay the inevitable balding by 5-10 years?

I have been in the hair restoration field for 33 years and have seen it all. Men on Finasteride for life see a reduction of their end-stage bading pattern. Although the hair loss process continues, it is slowed down significantly with age. I have patients that have been on finasteride 25 years, and a few decided to stop it only to find significant hair loss occurs within 3 months of the date they stopped the drug. The same can be said with minoxidil or both in combination.

1- $60 a month is robbery. Morr F is $13 or so.: ANSWER: The FDA is a real problem for this company so that put the following disclaimer on the site: “Information, statements and products on this listing have not been evaluated by the FDA as it is not a prescription medicine and are not intended to diagnose, mitigate, treat, cure, or prevent any disease or health condition.”

The dose in More F is 25 less of a dose than the therapeutic dose required at a minimum and still there is no evidence that this finasteride in the More F solution is effective.

2- Can I dissolve my pills or crush them and then use them on my scalp: ANSWER: No you can’t because it will not get through the skin to where it needs to be

Yes, you have a mature male hairline with very early corner recession. The best way to treat this is with Finasteride

So I’ve been losing a ton of hair for around the last year. My hair has thinned out dramatically, and receded in the front a little but I have no balding areas just diffuse thinning. I have been using Rogaine and Finesteride and have seen some thickening at the crown but no benefit everywhere else. I have had a CMP done to check for any deficiencies and it was negative. I went to a hair loss clinic yesterday and they scoped my scalp and told me I had a normal amount of follicles and no miniaturization (the hallmark of male pattern baldness). When I asked why I was losing so much hair they couldn’t really help me. One person told me that I should rinse and shampoo my hair everyday because accumulated rogaine can cause hair to become brittle but other than that they just said they couldn’t help me. Does anyone have any ideas? I’m worried the finesteride won’t help either because it specifically inhibits DHT.

If you went to a clinic, you should have seen a doctor skilled in this field. I would have examined you, performed a HAIRCHECK, a miniaturization analysis and quantified your donor supply. I would have told you what to expect short and long term.

“I’m seeing a few hundred hairs in the shower drain every day. I really don’t think I am balding, but I came to ses you because I wanted to be sure that if I was balding, you could transplant my hair and keep it looking good.”

This comment reflected the comments, one way or the other, of many men who visit me, but this particular day, this 26 year old actor who just finished his first role in a major movie came to me with the above comment. He looked like a typical hairy 26 year old male and I thought that after I measured his hair bulk, that I would reassure him that he was not balding. Much to my surprise, the numbers from the tests surprised me but shock him. The tests indicated that he already lost 50% of his hair bulk in the front of his head just behind his hairline, and 40% in the top (between his ears) and crown (back) of his head. He came apart emotionally. “This can’t happen to me”, he said. “I am going to hit it big time in Hollywood, I have an interview coming up for my second film, now a leading man, and I just can’t go bald”.

I tried to calm him down. At 26, he could go on the drug finasteride and probably stop most of his hair loss, so that was the ‘good news’ I told him. But despite my reassurance, he had difficulty letting go of the idea that his career was going to be ruined. “They won’t take me on if they knew”, he said. Again, I tried to reassure him that the drug might very well buy him years on keeping his hair, but he would not, could not focus on what I said. Over and over again he said “It over, my life is over”.

Hair loss is devastating for many young men and they don’t have to be heading to the top of the Hollywood scene to feel the way this man did. Although the drug often turns out to be effective in 26 year old men, the reality is that some day he will have to face balding. Although preventive hair transplants are a terrible and improper decision for him now, if and when he starts losing his hair, this may become an option. He left very unhappy and even unwilling to consider taking the drug finasteride. I asked him to return to see me, but he was from out-of-town and not easily accessible, but I called him a week later anyway and he promised to see me in 4 months on his return to Los Angeles. I wonder if he will deny what I told him or if he will think this matter through and make the logical decision to try to slow down the balding process and fill the prescription I gave him.