Lane604

The new delivery methods available (HPCH spray, liposomal gel) are mainly designed to reduce systemic absorption (and side effects) but I wonder if they also offer a better safety profile in regards with accidental contamination compared to the standard compunded solutions. Ideally, we want the solution or gel to penetrate the skin without leaving any residue on its surface and especially on the hair. Sub-cutaneous/intradermal injections could allow just that but as far as I know there are only two studies on this method.

The liposomal gel was introduced by two Canadian doctors, it is compounded by a pharmacy in Italy and one in Canada, the one in Canada has a web page about it so it is easy to find, the one in Italy does not. EDIT: Just found a note from one of the doctors from which it is not clear if the Canadian version is a liposomal gel or simply a gel.

Interesting to know about another liposomal formulation, is there a link or can you provide more information? Meanwhile I found out that the version compounded in Milan was indeed designed to minimize systemic absorption and aims to do so through the use of what are referred to as silicon particles. EDIT: silicon particles enhance liposomes for delayed delivery Also, there is a third gel version compounded in Florence Turin which was also designed to minimize systemic absorption and uses a lower fina concentration.

What's ridging? Scar tissue in the donor area?

Wow, I hadn't thought of that. I am currently considering both starting finasteride and having a BHT but now I guess I will have to choose between the two... Do you know if CB (clascoterone) is safe for body hair?

The liposomal gel was reportedly developed to reduce systemic absorption but it has been argued in another forum that the primary use of liposomes is to increase penetration. In theory this could allow a lower concentration to be just as effective, however the concentration of the gel was originally set at a rather high 2.5%. Some buyers have requested versions with lower concentrations like 0.2% and 0.1%. The gel is more expensive than the solution.

I have been looking into topical fina for a while now. There are at least three versions: solution, liposomal gel, and the Polichem one. They all seem more or less effective but it is very difficult to figure out which dosage will prevent or reduce systemic effects. Concentrations and studies are not comparable, so the best (most detailed/recent) studies we have (from Polichem) are not applicable to anything that is currently available (gel and solutions). Maybe things will clear up when the Polichem version will hit the market.

You mean 0.5 mg? I never took finasteride before but I could consider such a small dose, if effective...

If you posted it, could you add a link here? I recentely heard dr Bauman saying that topical finasteride seemed the obvious way to go but the FDA would never have approved it. I'd be curious to know why? My only speculation is that it would pose a danger to someone touching your hair...

Interesting line of products, I wonder what is the percentage of Ketoconazole in the shampoo and why is minoxidil not listed (as such) in the ingredients of the lotion?

topical

Didn't read it either, only skimmed through but from what I gather they have shed some light on how minoxidil works. They found evidence that it does act at the hormonal level but in a different way from finasteride. Rather than altering systemic levels of hormonal compounds, it would target local receptors which suggests to me that (1) it does counter the effects of DHT and (2) it does so without possibly causing systemic side effects.

I was wondering what you think of this study: Minoxidil may suppress androgen receptor-related functions https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039155/ It's from 2014 but I just came across it and my first impression is that it should have challenged the generally held view that minoxidil complements finasteride but is less effective when used on its own, especially after a few years, but so far I haven't found many reactions in this or other HT forums/websites... What I am really interested into is how effective can minoxidil be, alone or combined with something other than finasteride, at slowing down hair loss in the long term.

I am also interested in any opinions on Nioxin products, beginning with the Scalp Renew treatment, which the lady at the local hair salon has offered me the other day. I am 1 and 1/2 year post HT (and very happy about it) so my first question would be about safety. I haven't researched them thoroughly, but my first impression is that Nioxin products are just cosmetics, possibly effective at giving some thickness to hair, in which case they would be useful, and could be used alongside Nizoral (rather than as an alternative). Nizoral is the only hair loss treatment I have been using regularly post HT. For hair care, I am still experimenting with products that are supposed to make your hair thicker.

I began to notice one at about 9 months post-op. It's smaller than pea-size, but not sore, only somewhat itchy (at first I thought it was a mosquito bite). It's more or less near the scar (haven't tried to see it in a mirror yet), right in the middle at the back of the neck. It may have something to do with the fact that I often read in bed with my neck curved and the back of my head pushing against the pillows, which may perhaps stretch the area a little bit (but I thought that by now there was no more risk of stretching the scar?), though I am not really sure. Anyway now I'll try to avoid that. I don't think it's a pimple because of the stinging, and a mosquito bite would have gone away in a few days while this one I had it for at least a few weeks. I wonder if after all this time from the procedure it could still be an ingrown hair? A tiny piece of suture does seem possible, since I think there was a knot more or less in that area, and the removal was done by someone quite capable but not a HT surgeon. @Gillenator, did it eventually disappear? Do you think it would have if you had not been digging at it? I wonder if it wouldn't be easier to have it removed by a dermatologist... maybe it could be a good solution whether it's an ingrown hair or a tiny piece of suture, as long as it comes off with it...

Thanks everyone, I'm waiting to get a new set of pics before to create my results thread. So far so good though.

Hello everyone, I had my HT at the end of last year with Dr. Scott Alexander in Phoenix, AZ. I had cold feet the day before but I am so glad I went through. I can't say the surgery isn't challenging, in a way, but everyone at Biltmore Surgical helped to make it go as smooth as possible. The good thing about strip procedures is that the worst part comes first, and the easier (for the patient) at the end, so once you're through the first step you easily get relaxed and mostly only need to be patient. The strip incision was done very carefully, I didn't see or feel even a little blood. The injections for the second step were painful but that only lasted a few seconds. The cutting of the slits felt uncomfortable on the scalp, for some reason, but not painful at all. In the other room four assistants were preparing the grafts. ACell (recommended by the doctor) was used in this phase. The final step was carried out by two assistants, one of which seemed very experienced. The number of grafts was lower than expected so I guess the plan was adjusted accordingly. The doctor and the helpers were all friendly and carefully talked me through all the steps. In the end I received a kit and written instructions which were very helpful all through the first week. The difficult part for a patient comes when you get home as you need to be extra careful and learn how to deal with your new situation. I recommend taking a week off especially if it is your first HT. Overall I had a great time in Phoenix. The accommodation included in the package was amazing, an historical resort located in the Biltmore area. The natural scenery when you move around Phoenix is breathtaking, with low mountains in sight everywhere you go. The airport is also quite comfortable. I usually like to walk or go by public transport but the streets in Phoenix are so big you really need to get a taxi or a car every time you go out (you get to know taxi drivers from all over the world). I recommend doing some shopping on the day before the surgery, including some headwear that will feel comfortable and will keep your head as cool as possible. I had a light and oversized cotton beanie but still it was not suitable, so I bought a summer running hat online. A set of sterile towels would also have been handy but I didn't had the chance to get it. The kit I received had two pillow covers but I never lost any blood while sleeping. Soon I'll post photos in the patient results section...