Balding Blog

Comment by William Rassman, M.D.: I have been prescribing this drug for years. The problems that is discussed below have generally not been seen in most of my patients. Any drug, ANY DRUG, runs some risks when it impacts your body function like hormones, mood, etc… When you take any pill, you must recognize that this is a man made item and although the FDA may clear it for safety and effectiveness, there is no guarantee that you will not develop some unusual problem like the many discussed below by this very knowledgeable person. I felt that this comment was important to make. You should know that I am now taking finasteride and my son has been on it for 15 years and neither of us have seen any problems with this drug in our system.

The fact that this poison is still being regularly prescribed undermines the legitimacy and perceived objectivity of the American medical system and the pharmaceutical industry. There have been plenty of publications that have come out over the decade that have shown 5-alpha reductase inhibitors to be dangerous, even to those who appear to respond well to them, which I’ll link at the end of this comment. I am glad that the FDA was objective enough to deny the approval of these drugs as chemo-preventative therapies – who knows how many lives would’ve been destroyed if they’d been approved for that – and that they decided to finally label the drugs with serious warnings, but it’s not enough.

The risk of full-blown Post Finasteride Syndrome, while apparently low, is not something to dismiss. Additionally, the odds of developing side effects increases with time. These drugs have been shown to chronically lower neurosteroid levels, the most significant of which being allopregnanalone, which is responsible for anxiolytic, anti-depressant, pro-sexual, and other important effects. And as it turns out, DHT isn’t useless after puberty like many people seem to claim. There is no way to screen for who is at risk for post-5ARI syndrome and who isn’t. Even if the odds are low, you’re playing with fire. And many men who don’t develop the condition will still eventually have milder side effects, like a loss of morning erections, weaker erections, lower libido, increased anxiety or depression, etc. all to save a few thousand hair follicles. How do physicians justify this? It’s one thing to prescribe it for a hyperplastic prostate (and even that’s questionable), it’s quite another to prescribe it for vanity. Any physician that considers prescribing this drug for hair loss, as far as I’m concerned, should never be allowed practice medicine again, and should be sued for malpractice and negligence. Clearly they’ve never considered “first do no harm”.

Many physicians’ ignorance of what they’re prescribing is astounding, and the denial of a very real condition when it happens is, at the very least, cruel and pathetic. This sort of science-denial is akin to climate change “skeptics” or evolution deniers. I don’t think I need to explain why this is a terrifying trait to see in a licensed physician. The science is in and has been for years now.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4064044/

https://www.sciencedirect.com/science/article/pii/S0960076017301024

https://www.researchgate.net/publication/308996540_Exploring_the_neural_mechanisms_of_finasteride_A_proteomic_analysis_in_the_nucleus_accumbens

https://www.ncbi.nlm.nih.gov/pubmed/28289563

https://link.springer.com/article/10.1007%2Fs11930-015-0061-y

There is a risk with any medication and Propecia (finasteride) is no exception. It is hard to surround the statistics on the permanent negative side effects reported here by this reader. Some say that the negative sexual side effects that are permanent are as frequent at 7,000 out of the millions of men taking the drug. That is a small number, but if you are one of them, it is 100% for you. Every medication has risks and I always inform my patients of these risks and never push any medication on them. Those men with great results from taking the drug will argue with this author, but everyone is empowered to make their own decisions once they know the facts.

Not every complaint about permanent sexual side effects are real. One of my patients took finasteride and reported impotence in 2 hours, before the drug peaked. Although I told him to stop the drug immediately, he refused and said he preferred impotence to hair loss. His call! Not what I would recommend.

The growth is just starting. Hopefully, in the next 3 months, you will see 80% of the growth to styling length. With 1950 grafts in that area, the results should look fairly thick.

5 Months AFTER my Hair Transplant from tressless

A picture is worth 1000 words. This is a nice result from a hair transplant in just 6 months.

Ask a family member or a friend for an opinion before you jump in and do something that you might regret. There are many things that can be done for this. If you are a male over 25, a hair transplant works great. However, I always tell young men like you that “A GOOD DECISION TODAY IS A GOOD DECISION TOMORROW” so if you are under 25, be patient and wait until you know how much balding you will develop.

The “I look fine in the mirror/horrible in photos” effect — what is it?! from tressless

Unfortunately, deforming or failed transplants take a big impact on people so such a story doesn’t sound outrageous. I am aware of three men who committed suicide because of hair loss, so the emotional impact of hair loss can be very severe for many men. Most men who get very emotional about their hair loss, get depression. In the days when the large plugs were put into bald men’s head, their hair transplants were deforming. Prior to the early 1990s, these large deforming plugs had no cure short of a hair system, a common solution for the time period between 1960-1990. Hair systems is something that doesn’t work for everyone but if the deformities were soo bad, a few men were driven to suicide?

Today, with the hair transplant technology commonly available, hair transplants that go wrong can be treated with a success rate of 100%. Men who find themselves in this situation, should seek a modern hair transplant doctor to help manage the deformities and a good family doctor to manage the depression. The good news is that almost 100% of men with hair loss today can get their hair back. Hair transplants are today’s miracle.

See: https://www.hulldailymail.co.uk/news/uk-world-news/man-47-killed-himself-after-7724486

If you have no idea what SMP is then you’re probably not going to find this interesting but I wanted to start a thread chronicling my experience of lightening/removing my scalp micro-pigmentation (hair tattoo). I had my first laser session yesterday.

My hair story is a bit of a long one but I’ll try and explain it as best as I can. Pretty much been bald since my early 20’s, always had a high forehead and it really shook my confidence (and still does unfortunately).

My GP put me on Finasteride and after trying it for a few weeks and dealing with bad sides I stopped it. In my early 20’s I went to see numerous transplant doctors who all told me that I need to wait a few years to see where the balding would end up. They also said that I probably wouldnt be too happy with the outcome of a transplant because of how much hair I had lost and having a so-so doner area. I then started to look for other solutions. I came across Scalp Micropigmentation (hair tattoo) and researched it heavily. This was 5 years ago. I had heard of ‘Tricopigmentation‘ which was branded as a semi permanent SMP option. At the time Milena Lardi in Italy was the best clinician in this field so I travelled to Milan and had 3 sessions done (after shaving my head all over for the first time).

The tricopigmentation gave me a nice shadow but I wanted more so I decided to go down the ‘permanent’ SMP route with a UK company. Again I had 3 sessions but this time it was much darker and overall I was pretty happy with it. I was not as self conscious about my shaved head as I thought it looked like I was shaving out of choice and not out of need. It was high maintenance though as I had to shave everyday and also use alot of anti-shine. Some people noticed and others didn’t. In hindsight Im not sure I was fooling anyone as I do think that many people can spot a ‘too perfect’ hairline. The eyes are naturally drawn to it, which isnt good.

Once I got to my late 20’s I decided to get a transplant to compliment the SMP. Again I researched this for quite sometime and ended up having a 4300 graft hair transplant in Turkey. This gave me texture on the scalp and also massively reduced shine (which I was delighted about) but its way too thin to grow long. The recovery was horrific and dont think id ever get another one. While the idea was that the transplant would compliment the SMP (and vica vearsa), I was left with transplant hair I cant grow very long because it makes the SMP on the scalp stand out like a sore thumb! Furthermore it really made the hairline look even more fake.

Fast forward to 2019 and I was left feeling really self conscious about my head. I do notice when people talk to me they linger just a second too long on the hairline and scalp, plus i do see some people do a double take on the street. In the end I decided my only option was either to live with it (not happening) or get the SMP lasered off (without damaging the hair). After a few months of research I went with a laser removal technician who has alot of experience with SMP.

I had my first session yesterday and so far Im pleased with the results — although it was really f***ing sore. It will take a number of weeks for the fading to happen (it doesnt happen right away) but already I’ve noticed the hairline looks a little more natural and while its still red (it looks worse in photos) I think I will be happier with it gone or faded. Less really is more.The actual hair stands out now rather than the SMP dots.

Happy to answer any questions you guys might have. 3 words of advice if you’re thinking of SMP or lasering it off for that matter:

1. If you’re thinking of getting SMP go with someone who has ALOT of experience and can show you photos of their work. This is very important.

2. LESS is more when it comes to SMP. Try and keep things as natural as possible (broken and receding hairline) — not a lego man hairline. Its really difficult to get a natural hairline, especially for lighter skin tones.

3. If you’re thinking of getting SMP or indeed removing SMP — Research, research, research and ask questions before committing.

Photos:

Upper left photo = SMP + Transplant hair a little longer than buzzed (before laser)

Upper right photo = 1 day post laser and buzzcut (today!)

Bottom Left = SMP before laser and transplant hair buzzed

Bottom right = 1 day post laser and buzzcut (today)

 

This man offers good advice. I keep mentioning the idea of a Master Plan and that is something that is critical. Had he found the right doctor at the onset, he would have been able to tackle a hair transplant when and if he wanted one. Here is a man who had the worst balding pattern possible with hair transplants followed by SMP. The photos speak to the result: https://baldingblog.com/72-year-old-surfer-still-surfing-and-he-has-hair-photo/

I have been asked how this can happen. We are now doing extensive research into wound healing and the appearance of hair after a wound has healed. This man grew hair from the sides of his burn wound (my assessment of the photos) and this new skin brought along with it hair follicles that clearly were different than his balding follicles which had disappeared prior to the burn. In our experimental work, we have created such wounds and found hair growth not-infrequently. This is the theory behind microneedling that is now performed regularly by many men with good results. The wound created by the microneedling go down to the depth of the stem cells (1-1.5mm below the skin) and with persistent wounding, hair is stimulated through the impact on the stem cells reached by the needling. This was shown in the previous post on this blog.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351888/pdf/bmjcred00266-0059a.pdf

It is wonderful when someone allows us to watch the progress of

their hair transplant and take the time to do it with such intention to detail.

The hair transplant changed his look!

I took a picture every day after my Hair Transplant last year, I compiled the footage in a time lapse video. If someone wishes to see how my transplanted hair grew in a year. Here’s my head 🙂 from tressless