Bertie

I've just watched a YouTube video ("Nizoral Shampoo For Hair Loss - THE TRUTH"), which recommends 2% Nizoral, rather than the usual 1% variety, which is apparently standard. I have been using Nizoral in the UK, but am not sure if it's the recommended 2% variety. In the UK, all it says on the bottle/packaging is Nizoral - Ketoconazole 20mg/g, and I buy it in 100ml bottles for greater economy. Is the the right stuff? Any recommendations on where to get it at 2% in the UK for a good price?

My interest in women remains both emotional and sexual. I do still have erections/ejaculations, but unfortunately less so than in the past. I'm aware of Viagra and it's good to know I have that to fall back on. Yes, having a reasonable head of hair does make me feel more confident and losing a significant amount would make matters worse. I take your point about ruling out other factors and will proceed cautiously.

Thanks for all the helpful advice. Whilst the 20 years on minoxidil and Propecia have helped, I should also add that I had two transplants by Ron Shapiro (in 2013 and 2015), so I can't evaluate these treatments separately. Unsurprisingly, the transplants showed the most dramatic improvements, but even so were not as impressive as I'd anticipated. They really just thickened up my hair, which had become very thin. As a teacher, I had the transplants done in the summer and only ever told one other person. Remarkably, while I have had compliments on retaining my hair, no one else has ever said anything - not even close friends and family! Following the helpful advice here, I will look into topical finasteride, 'maca for libido', and also consider the options of cutting down + a trial discontinuation to find out if it improves my libido. My interest in women remains as strong as ever, but I am currently single and am concerned that should opportunity present itself I might fail to rise to occasion! Interesting to hear that 'hair loss generally accelerates in the higher age (after 65 or 70)'; helpful to have the facts, even if I'd prefer to hear the opposite.

I take both Minoxidil and Finasteride (via Proscar) and have been for 20+ years. I'm considering stopping taking Finasteride as my libido has dipped in recent years. As I'm now 60, I realise that this is sadly probably age related, but I think it's worth stopping finasteride to see if I get any positive results, something I've never done before. But my questions are: 1) Is it better to stop completely or phase it out gradually? 2) I'm worried about quickly losing all my gains of retained hair for 20+ years. The book 'Hairloss for Dummies' says "If you stop using the medicine, you can expect to lose all the hair that you may have gained from this therapy as well as any hair you would have lost while you were on the therapy, but luckily not more. After about six months your hair will look as if you’d never used the medication, and you’ll resume losing hair at your natural rate." - I interpret this to mean that I would lose all my gains of 20 years in a matter of months, almost like a damn bursting, and I don't suppose I could restore my hair to its present state if this happens. On the other hand, perhaps the minoxidil would hold things in check and prevent further loss. Moreover, perhaps being 60 means that hairloss proceeds at a slower pace (? I'm hoping). I seem to recall reading something about side effects of stopping finasteride, which is a concern. Any advice would be appreciated.

Thanks for the advice. I'll work on my hand-held mirror technique, but I'm tempted to buy and fix one of those extendable wall-mounted swivel bathroom mirrors so I see well enough to apply the concealer powder to my crown. Yes, Matt also told me about Fill-in powder, but I believe this works directly on the scalp like Dermatch, which may not be great, i.e. theoretical possibility of clogging up pores and affecting HT growth. But since I would only need to use it for two half days + one full day per week, I'm quite tempted to give it a go.

Well, I got to week 7 and with the school holidays over and teaching work about to resume, I dyed my hair - one week short of the 8 weeks advised by SMG. I assume this won't be a problem as I have noticed that most HT surgeons don't recommend as long as 8 weeks wait before dying the hair. As I am quite grey I used permanent hair dye. With the dark brown hair colour I can better see the extent of my growth. I’m not sure but I think I may have suffered some shock loss, although my hair was quite thin in the crown before which is why I had the transplant. I realise it will be months yet before this area fills in, but until then I will need to use a concealer. I have been using Toppik. However, I find it very difficult to apply it as I can't see the crown area where I am shaking it onto. I am using a mobile barber to avoid the embarrassment of visiting a salon full of young gossiping girls. My barber very quickly applied the Toppik, but I'm sure I must have used 3 times as much powder as him just because I couldn't see the crown properly; applying it was very much hit and miss! I have a hand-held mirror and even tried a camcorder but I still think I need a better system to help me see where I should be applying the powder. Any advice would be appreciated. I am also interested in trying Nanogen as an alternative to Toppik. I have read that it works well on large crown areas (perhaps because the powder is thicker) and doesn't have the dulling effect on the hair that can be experienced with Toppik. I don't know if this is true, but I'll give it a go. Meanwhile, can anyone advise me on the best place to purchase Nanogen in the UK; I would like it to arrive quickly.

I have just had my second HT with Ron Shapiro. I had my first HT with Ron Shapiro in July 2013, which consisted of 3632 grafts. This greatly improved my hair’s overall look, but frustratingly I still had thin areas at the temples and crown. Ron had implanted most of the grafts in the frontal core of the head, explaining that this would enable me to brush my hair down to cover my temples, which would work with my fringe hair style. I had hoped, perhaps naively, that a single transplant would attend to all areas, but I understood why he gave priority to the frontal core area; the result looked very natural. However, I now wanted more and fortunately had enough donor hair for a second op. I arranged my HT at the very beginning of my long school summer break; I’m lucky in being a school teacher as I have 7-8 weeks time for the HT and recovery. I flew out (from Heathrow-London to Minneapolis) for my HT scheduled for Mon. July 13, staying in the same hotel as for my previous op., ‘Country Inn and Suites’, which was very comfortable and situated only a 10 min walk away from Shapiro’s. However, on the day of the op., I awoke with an awful migraine. As a frequent migraine sufferer, I knew it would stick with me for the whole day, and the thought of having my head operated on during a migraine was daunting, to say the least! Nevertheless, having flown half way across the world, I couldn’t allow myself to be put off by mere illness and decided I’d just have to tough it out. Fortunately, Ron and his staff were very understanding and when it became clear how ill I was, my HT was shifted to Wednesday, the day before I returned to the UK; luckily, I’d arranged a four-day trip and was very grateful that Ron adjusted his timetable to fit me in. As expected, my migraine lasted only a day, and on the next day (Tuesday) I visited Shapiro’s to discuss my HT requirements. The discussion, which continued during a photo session, lasted over an hour. In addition to work on my crown, we discussed my wish to have more hair at the temples to give me less of a receded look. Ron explained how he would bring the temporal hairline forward while also building up the hairline, but emphasized that I didn’t need to have it brought forward very much; to illustrate this he showed me pictures of male models (including David Beckham), to show that there is typically a straight line from the front edge of the side-burn to the ‘temporal point’ (top edge of the temporal hairline). I also pointed out that I’d like to have the option of parting my hair on the left side, and remarked that I had some thin areas at the side where I would part my hair. Ron said it was common for men to have thinness in the side ‘allies’ stretching up to the crown and said he would insert grafts in these areas if he saw any gaps (especially on the left side where I parted my hair). We also discussed ACELL, which he recommended, and I agreed to have. He then drew in his proposed hairline which I was happy with. I had the HT operation on Wednesday 15 July, and everything went smoothly, with little pain or discomfort. I was quite concerned about my back as I’d had recent problems with a herniated disc and thought that lying in one position for so long could aggravate the problem. For this reason the nurses gave a me a few Valium pills, which made me sleep through most of the operation. After the op. I was pleased to see that much of my frontal hair remained (vital to help disguise the op) and that the hairline and crown looked good. I made sure that I applied ice to my forehead as I’d swollen up a lot in my previous HT. One of the nurses also placed a plaster band across my forehead, which was supposed to help against swelling; fortunately, I didn’t have any swelling on this occasion. I also slept quite well considering, although the staples were quite uncomfortable until I had them removed 12 days later. I visited the clinic on the following day for a hair wash. Later in the day, I caught the 10pm flight back to London-Heathrow. I had no problems whatsoever, and was able to apply the ATP solution in the plane’s toilet and also ice my forehead with a bag of ice provided by the plane staff.

I am surprised that this subject never seems to come up. Like many others, I am very grey/white at the sides and back of my head, but remain largely dark brown in the front of my head. However, I ensure my hair colour matches as I dye my hair an even dark brown all over. I am about to have my second transplant with Ron Shapiro on Mon July 13. As transplanted hair retains it colour, this means that my hair taken from the back of my head and moved to the front will remain naturally largely white, which will contrast with my largely largely brown hair at the front. This means I would look very odd if and when I stop dying my hair. Basically I'll have rather comical tufts of white hair at the front of my head, which won't match the rest of my frontal hair colour. I am 54 and mean to continue dying my hair for a while yet, but what if I choose to stop in a few years? Why does this subject never come up on this forum? I would have thought it a common concern and a common occurrence. Any thoughts from anyone? I'd love to hear from others who have experienced this issue following a transplant.

I think he's a lucky man, Carlene. You sound very nice and considerate!

Few if any people in a relationship disclose everything about their past life etc. That doesn't mean they're being necessarily dishonest, just choosing to keep certain things back. Like we all do, I guess, although your boyfriend will find it hard to keep it hidden indefinitely if he has a wig. If my girlfriend was wearing a wig and chose not to tell me, I think I'd stay clear of the subject, unless she brought it up. Also, girls have a tendency to divulge details about their boyfriends to their friends, in a gossipy, 'Sex in the City' type way that men generally don't. So he may be thinking that you may inadvertently blurt it out to one of your friends and make him a laughing stock. And another thing that occurred to me, if you've been telling him how lovely his hair is, it might make him even more nervous about you finding out. The very thing you've complimented him on, something you say you like, is not even real! If it was me, I'd think, 'Oh no, perhaps she'll go off me if she discovers my hair is not real!', or at least think a lot less of me. That would be quite a rational thing to conclude.

in Nov 2014 at a consultation with Hasson, he thought I'd require 2,500 -3,000 grafts including 500 grafts in my crown. Ron Shapiro says he suspects I'll need somewhat fewer grafts than this, but he says he'll only know for sure when he sees it up close.

(Please visit my 'Bertie' blog by clicking link at the bottom of this post, as I have just added loads of new photos on my blog to accompany this post) I had 3632 grafts from Ron Shapiro on 7 July, 2013 I chose to wait for my hair transplant to mature completely before updating this blog. Two years on from my op with Ron Shapiro, I am now planning a second procedure with him, having booked an op. for July 13, 2015. I am posting up photos of my hair taken at monthly intervals from after 6 weeks. The pictures tell their own story, but I do judge the transplant a success and am grateful to Ron Shapiro for improving my hair. I am pleased that the general thickness in the central area is much better than before my op. However, I am disappointed not to see much improvement at the sides and only a little difference at the crown. I had hoped to have only one transplant. It's quite a thing to have to go through another transplant, but I understand that it's common for patients to have a few transplants before they are happy. In the pre-op discussion, Ron advised me not to bring the hairline down at the sides, saying that the increased thickness of hair would address my concerns. Had my hair grown thicker at the sides, I may not be considering a second op., but unfortunately the area is still thin. The overall look is much better as I can comb my now thicker hair in a fringe over my thin areas, but this means that I need to keep my hair quite long at the front; a shorter haircut reveals the temple recession which is not flattering to my rather long face. I also had a consultation with Victor Hasson last November, who offered very helpful advice and suggested a treatment that would involve adding another 2500 to 3000 grafts (including 500 in the crown). I seriously considered Hasson as an alternative to Ron, but eventually decided to stay with Ron for the second op. Ron says his main concern in the first op was to address the central area and core, and he thought that bringing down the hair at the temples would risk sacrificing density in the central area, leading to a more see-through, unnatural look. He now proposes to bring the temporal hairline forward, to have a slightly less acute angle going back to it and to start the bend a little further out. This will also involve building up the hair a little more in the area right behind this. I’m having the op at the beginning of my summer break, and as a teacher am lucky to have about 7 weeks before needing to go back to work. But I want to keep this HT a secret, so wonder how I’ll look after the op. I don’t think I’ll need to shave down this time so can comb my fringe down to hide the work done, but I’m not sure how effective this will be. As my crown will need to be cut short (or shaved?) to have about 500 grafts inserted, it may mean the whole hair will need to be shaved, so I may end up looking like Friar Tuck! Last time I suffered a lot of shock loss, and it took 6 months before I felt OK to go out without a hat. That was tough, and I hope I have a much easier experience this time round. I’d be interested in anyone’s thoughts, especially those who have had a second transplant with work done mostly at the temples and crown, as I’m about to have.

Thanks for your interest. It's 31 weeks now since my transplant and my hair is continuing to grow/improve and I'm waiting to see how it develops. I had a lot of shock loss and it's taken most of this time, about 6 months, to get back to where I was before the transplant, which has been pretty tough. It's now at 7+ months and am pleased to report that my hair is looking generally better than before than my transplant op. - slightly thicker and better quality overall. However, I'm concerned that there hasn't been much improvement at the temple area and in my crown, which were my main areas of concern. However, I still feel stubble/new hair coming through (although not really at the temple area) so am hoping that I'll be one of those patients who have good growth at a later stage. At any rate, it looks as though the final result will be an enhancement on my pre-op condition, but I do find myself looking in the mirror and wondering whether all the 3632 grafts have come up or not. I don't want to make premature judgments, so I think it best to wait until a whole year has elapsed before posting up a thorough review with pics included. I hope by then that my concerns and anxieties will be behind me and I can post up a positive review.

Seems odd. It may have been a typo. Double check and ask why 8 months is recommended when most of the top surgeons only recommend 4-8 weeks. Shapiro also recommended me to use Toppik rather than Dermatch to mask scalp show through, which is another issue you are likely to encounter at some stage.

Are you sure it wasn't 8 weeks rather than 8 months? Shapiro Medical Group advised me not to dye it for 8 weeks after my op. in July 2013 (other surgeons seem to think a shorter period is fine, perhaps just a month or less). When I began to dye it, I used temporary dye (which has less harsh chemicals, e.g. ammonia and peroxide), which is kinder to the scalp. Now, at 6 months, I use permanent dye once again.

This will give you a good post-operative breakdown of what to expect: http://www.youtube.com/watch?v=BoWsGsI3JGE I didn't find the first two weeks that difficult. You have to spray on the grafcyte spray, take the meds (pain relief and prednisone for anti inflammation), not exercise, wear a hat, wash your hair (I did it once a day). The staples/sutures come out after 10 days and then you just wait, and wait, and wait.... You won't be winning any beauty contests for a while. I'm at week 15 and had a lot of shock loss so I'm still wearing a hat. The hair lost to shock loss should mostly grow back, but I think it will be Christmas before I can feel OK to go out without my hat, and some time after this until my hair looks better than the day before my HT (if it all goes to plan!). Here's a good website page to explain what to expect after a hair transplant: After FUT Hair Transplant Surgery & Post-op Instructions | Bernstein Medical

Fortunately, I have a patient nature, and I realise that the "3 month period is really the earliest potential point for new growth". Nevertheless, it would be interesting to know the first signs of regrowth experienced by others and whether it is "is usual to feel it before you see it". I'm quite surprised that no one has responded to this question.

I've just passed 14 week post up with Ron Shapiro and don't appear to have any regrowth as yet, and am dealing with a lot of frontal recipient-area shock loss. But if I run my hands through this area I fancy I feel some stubbly growth, although neither my eyes or my camera can confirm this. I'm hoping this is the first sign of regrowth and wondering whether it is usual to feel it before you see it.

An interesting question to which I hope you receive an answer, as I'd also like to know the answer.

I am also at 2.5 months with 3625 grafts and have no new growth yet at all as far as I can see, only substantial shock loss! It's tough but from what I've been told and read, the new hair doesn't start growing until around the 3 month stage, which is average. It's possible that I (and you) may take longer than average, awful though that is to contemplate. And the hair is thin vellus hair when it first comes through so may not even be apparent for quite awhile. So you and I are just going to have to hunker down and be patient. We've both chosen distinguished surgeons so have every chance of an excellent outcome. Meanwhile, we'll probably have to stick to the hats and scalp concealers (I'm using Toppik) and just try to stay positive. I look forward to comparing our magnificent heads of hair in the coming months. :-)

Thanks for the advice. My scalp condition has improved recently, although not entirely gone. If it's gets worse again and definitely bear your advice in mind.

For my next hair cut, this weekend, I should be able to even the hair up to look equally short all over, which should help. I wonder how 'Mane' compares to Toppik. Does it have any advantages? Ron Shapiro advised me to use Toppik rather than Dermatch and it is excellent, but it can't do anything at the temple area, where I have no hair to fortify so inevitably end up with the unfortunate 'widow's peak' look. Is there a method to disguise this aspect? I suppose Dermatch could colour/pigment the scalp itself, but with no hair in situ it would probably look a bit weird.

This is the week I have to return to school, where I can't wear a hat and my hair is on view to everyone. I have grown back about an inch of my own untransplanted hair since the HT, which is what I'd anticipated. Unfortunately, at least half of my untransplanted hair seems to have gone missing, leaving me looking substantially bald at the front (compare today's pics to my pre-op pics). I knew I had a 20% chance of getting some shock loss and unfortunately the dice have not rolled as I'd hoped. Unlucky, eh – shock loss is quite shocking! I've used Toppik to cover as much scalp show-through as possible and it's quite an amazing product, but the contrast between pre and post op is still profound, like I've been thrust forward by at least 5 years to see how bald I'd have become had I not gone for a transplant, the very thing I wanted to avoid and a bit of a nightmare scenario. I've been getting quite a few comments and double-take glances. One teacher asked if I'd had some kind of accident, and I must admit it does feel a bit like that. But I do realise that shock loss is quite normal, so I just have to get through this period as well as I can. If cornered I'll say I'm suffering from temporary hair loss – or telogen effluvium, which sounds impressively medical as well as being actually true – and hope that my hair will soon start to grow. It's supposed to be about 3 months before the new hair starts to grow so hopefully not too much longer to wait. But it also takes about 3 months before hair lost to shock loss starts to reappear, so when I do start getting new hair it may be difficult to know if it's tranplanted hair or simply my own untransplanted hair growing back. I just want to see any hair growing back. At the moment it feels like I'm waiting for the cavalry to arrive!

3632 graft FUT with Ron Shapiro: 9 weeks post op

I looked at Blackrock clinic's website. The results look good but why is it so expensive? I traveled to the US from England 2 months ago and got a transplant with Ron Shapiro for much less than I'd have have been charged at Blackrock. And Blackrock's reputation doesn't, as far as I am aware, begin to compare with Shapiro's. Blackrock may be fine if you have the income of Louis Walsh, but why don't you do as I do, go to one of the top doctors in the US, save yourself a lot of money, and have an enjoyable holiday too? Blackrock prices seem a bit on the greedy side to me, which naturally arouses my distrust.