Balding Blog

The photos show a lot of miniaturized hairs behind the hair transplant. I would expect to see hair loss behind the hair transplant unless you had been prescribed finasteride. Even with that, your hair transplant probably didn’t extend far enough back to cover the area of what appears to be advanced thinning. Hair loss here will not come back.

I’m 18 and I’ve had diffuse thinning for the past 3 years. Yes it sucks but it’s slow and still have decent amount of hair. I’ve noticed for the past 3 years that when ever I get a hair cut, my hair is easy to pull out. Same with sides and my back. Is this DUPA? I’m really worried because I hope it isn’t. I took pictures with the flash and it’s still thick. Also when my sides grow out, I try pulling on it and it doesn’t come our. WTF.

I am the doctor who defined DUPA and it is rare. You need to have a microscopic examination of your donor area if you want DUPA eliminated as a diagnostic possibility. Most hair transplanted doctors offer this.

Hello fellow baldies. I’ve finally decided to take the leap and go get a hair transplant. I’ve been quoted on the price and scheduled an appointment in Istanbul. The clinic is Esteliv if anyone’s wondering or if anyone has underwent a procedure there I’d love to hear how it went. About the procedure: *Extraction of follicles with micro motor using stemcell technique and Sapphire FUE. They will be extracting between 3000 and 4000 grafts. Hopefully this’ll be game changing for me. Wish me luck!

Do you need 3000-4000 grafts? You have a donor bank that only has withdrawals and the typical Caucasian has between 6000-7000 grafts, only half of which can be safely harvested from the donor area without getting over-harvesting. If you are Asian, Middle Eastern, or family from Southern Asia (India, Thailand or Vietnam) then usually limits are substantially less than Caucasians. Do you actually believe this Stemcell and Sapphire FUE stuff? You should realize it is all promotional stuff.

I’m going to talk to the doctor about my type of hairloss and why I am thinning on Dutasteride. I’m going in for a free consultation and I’ll see what they have to say, whether I have normal MPB, DPA, or DUPA. I’ll keep you guys posted.

DUPA (Diffuse Unpatterned Alopecia) was first published by me in 1996. When it occurs in men, it impacts the donor area and as a result makes these patients poor candidates for hair transplants. Back then, doctors transplanted these men when they were balding and most of the time the transplants were failures, often leaving these men with scars and hair transplant deformities. The diagnosis is made with a hand microscope looking for miniaturization in the hair in the back and sides of the hair which is generally immune to balding. It can sometimes respond to finasteride, but it is not predictable. The cause is unknown.

People who develop minoxidil dependent hair will lose that hair if they stop the minoxidil. The same is true for finasteride. That decision, of course, is yours.

Lady here who’s been on Min and Fin for a year now, how do I quit? from tressless

I am 25 years old. I had a couple of questions I wanted to ask and I would really appreciate if you could help me out since I’m really distressed these days cause of my excessive hair shedding.

I started finasteride one month and 20 days ago after extensive research. I had a full head of hair but i could feel my hair density especially at the top of my head and my hairline going down. I also see i lost hair at the top of my temples.

I started finasteride very reluctantly since I didnt wanna lose any more hair and i didnt go on minoxidil because it caused hair to shed. I wasnt aware then that finasteride also causes a shed.

Before starting finasteride, i used to shed around 60-70 hairsin the shower if i took a bath after 2-3 days. But after starting finasteride, almost 2 weeks in, i started noticing around 250-300 hairs in the shower which i take after 2-3 days.

Im really stressed since this started happening. I noticed after this excessive shedding that I lost a bit of density on the front of my hair and the temples.

I read that shedding is common after starting any treatment since alot of hairs go into resting and I accept that.

The thing that is freaking me out is that:

1) How can i identify if this is a normal shed (250-300 hairs in the shower after 2-3 days ) or a bad reaction to finasteride?
2) Whether the hair that is shed would grow back, especially in the front of my head?
3) How long can i expect this to go on cause at this rate, im losing hair fast.
4) Have you ever had a case where the initially shed hair didn’t grow back?

I would be grateful if you could ease my mind. I dont know whether to continue with finasteride or stop it.

Thank you very much.

Despite what you may read on the Internet, shedding is not very common after starting Propecia. You must also understand Propecia does not stop or cure male pattern balding. Male pattern balding (MPB) is a genetic trait. Propecia is a medication to treat androgenic alopecia. (not cure it). Thus, you may notice hair loss even if you are taking Propecia. You must also note that it takes about 6+ months to start noticing the effects of Propecia but this does not always mean you will not lose hair.

If you are having further issues, you need to discuss this with your doctor who prescribed you the medication. You may have a false impression or expectation of what Propecia can do for your hair loss.

I had 2500 grafts done one year ago and the results are not what I expected. Will more hair grow if I wait another year?

At 12 months you now have 98+% of what you will end up with. I would not expect substantially more growth than what you presently have. If you had a competent and ethical doctor, go back to that doctor and discuss your disappointment. If I were the doctor, I would want you to be happy and would do my best to make it happen, even at my costs to redo the surgery.

I use 3 pr 4 ml daily of minoxidil and I am scared of developing cardiovascular sides. I am young and it has been 3 years that i have been taking it.

Does low dose oral min ( 1.5 mg ) is safer?

Like all drugs, there can be side effects and one of the many side effects can be dangerous to the heart. If you take minoxidil, as any drug, and you get side effect, speak with your prescribing doctor or if it is not a life altering drug like minoxidil, just stop it. Are you taking it orally now? If so, what dose are you taking? Generally, the 1.5mg oral dose is safe, but there are exceptions and that is why you need to see your doctor.

I’m considering to get a procedure done and was wondering if there are difference between FUE procedures or are they all about the same? What are some important questions to ask when deciding on a doctor besides ‘how long have you been doing this’?

FUEs vary between doctors because each doctor uses a different type of hand ‘punch’ and smaller ones (up to a limit), leave smaller, less detectable scars. The problem with FUE is that the number of grafts removed safely is absolutely related to the density of the hair in the back of the head. The higher the donor hair density, the more FUE grafts can be taken, while in a person with a low donor density (a typical Asian, Indian or middle easterner) might have a normal lower hair density than a typical Caucasian from Northern Europe. This rule also applied to the Hair Mass Index of the hair, the higher the index, the more FUE grafts can be safely removed. If a doctor takes too many hair grafts out, then you can get balding in the back and sides of your head from the FUE (see here: https://baldingblog.com/collection-victim-photos-internet-harvested-depleted-donor-areas/ ) which is something that the doctors don’t have to live with, you do. Worst, 90% of the people doing the FUEs in Turkey are not doctor so that certainly with an non-professional person doing your surgery may be VERY common in people receiving surgery in Turkey.

I was the person who pioneered the FUE in 2002 when I published the first paper and presented it at the first meeting all in the same month. I gave out 600 DVDs showing what an FUE looked like. Then, within a week, doctors from all over the world started doing it and doing it very poorly. My video was only 2 minutes long and it was not made to teach the doctors all of the nuances of the FUE. Even today, many doctors don’t understand it well. I, with my partner Dr. Pak, also invented the robot that does the FUE holding two patents for the technology. We licensed it to the company that made the ARTAS robot. Here is our original article that opened up the FUE business: https://newhair.com/wp-content/uploads/2018/11/mp-2002-fue.pdf

You must find a doctor who is skilled in the process and you can tell by asking to meet some of his patients and then look carefully at the donor area for the type of scarring that is evident (my link above shows it). Ask your doctor for his measurement of your original donor density and his assessment of how many grafts he believes you can support in your lifetime. Too many doctors take out too many grafts with FUE causing the problems I demonstrated above.