mahhong

Hi there! The short and simple answer is nope! Transplanted hair is taken from the DHT resistant follicles around the back and sides of your hair and will not fall out. As you go into older age it may thin very slightly but only in line with the rest of your hair. If you look at older individuals (say 60/65+) quite often their hair may still be intact and they may not be balding, but the general texture and quality of the hair may have thinned slightly. For a lot of people this doesn't happen however and, even if it does, we're talking a very mild change in your hair. Fundamentally though, donor hair is bald resistant. Once it's been transplanted it should behave itself and stay put for the rest of your life.

This is a really interesting topic and one which needs to be discussed in detail. I haven't read the post which inspired this topic (but will do very soon) but wanted to add my two cents on the ideas discussed here. I think in principle it's more than just a good idea; it's really important to try and lift the common view of hair transplants from where it currently is. I'm truly amazed by how many intelligent and 'in touch' people still think the HT world is a corrupt and expensive one full of bad plug jobs and 'rag doll' results. I would argue that the general public are still largely of the opinion a HT is somewhere between a joke and a minefield. I would say that perception is slowly changing but for every world class doctor there does seem to be a pretty despicable maverick willing to make a few easy bucks and ruin some lives before jetting off somewhere else. The internet and generally increasing profile of the HT industry is slowly eliminating that - but it is slowly. The main problems I can see are really business ones. Most good doctors do good work and leave patients happy and will probably find it difficult to see how increasing their workload is of overall benefit. Similarly, most bad doctors leave patients not very happy and having to increase the documentation and explanation of why they went wrong isn't going to be of much interest to them (of course I am generalising with good/bad doctors here, but hopefully you get my point). Anyway I would feel it comes down to an issue of economics. I don't know how long it would take to really prepare these sorts of reports but whether it's one hour or a day's work, time is money. It's a harsh truth but these doctors are also businessmen with their own lives to lead and they may see the only viable way to increase their workload is to increase their costs. Of course, I can't speak for anybody, I'm just trying to be pessimistic and hoping to be surprised! The other issue which has already been mentioned is standardization. It'd be a difficult task indeed to standardize anything in this industry, especially internationally. You might end up fighting a losing battle if some doctors adopt this and others don't. To the average patient is it going to be a sellable bonus as part of their hair treatment? If a doctor puts their prices up to accomodate is the average patient going to see it as a necessary part of their treatment? I think it's a great idea, but I also think world peace is a great idea. There are problems with both! However, that's not to say it couldn't work. Anything that improves patient experience, knowledge and the overall quality of a hairloss treatment plan should really be fought for, especially by a community as pioneering as this. Whilst getting the whole industry to adopt something close to this is nigh on impossible, we do have the rather more elite and close-knit community that is the coalition. Being part of the coalition is a good thing for patients researching doctors and for doctors looking at patients, so perhaps implementing anything like what has been suggested actually starts by getting this community active in how best to document and report patients. There are a lot of enthusiastic and very experienced patients on this forum who have good relationships with their doctors and if a workable plan of action could be put forward and strongly endorsed by this community it may be possible to slowly but surely put some wheels into motion in this area. If H+W have already shed a positive light on it then that's more than a great start. I think this thread could be a very important one but the next step is to perhaps get the opinions and knowledge of the professionals and the most influential and experienced members of this community. There are a lot of factors that need to be looked at in a lot of different areas, but I think getting the coalition doctors to mull it over is the next vital step. If a way forward does appear to emerge this could be an important step forward for this community, the coalition and perhaps beyond, but it's a minefield that needs to be treaded carefully so I would imagine the wheels of progress need to turn slowly but steadily. A compromise between what is useful, what is effective and what is efficient would need to be developed. However someone in this post made the very good point that the hair transplant industry is, overall, still viewed sceptically by many. Enhancements to the patient experience and techniques which allow greater accuracy and results can only help in advertising this industry as a real and successful one (which we all know it is), It's about striking a balance and making that balance worthwhile to all parties, but this thread could be the place to kickstart real debate and development, so I think it's in the interest of all concerned to try and get the bright and best in the industry and the community to take the concept seriously and see if there is a way forward.

hi teach77, some people do report ED and similar problems months or even years after taking the drug but, as your post rightly suggests, that's not necessarily to say it's the propecia that is causing the symptoms. the truth is if you take propecia for a few months or even a couple of years and then experience ED or ED-like symptoms there is every bit (if not more) change those symptoms are attributable to something else; stress, anxiety, depression, other medication, age, physical fitness, other diseases and much, much more. i think a lot of people know in the back of their heads propecia is capable of causing sexual dysfunction (although officially these side effects are rare) so the moment they 'underperform' or maybe don't feel aroused or can't get physically aroused they assume it must be propecia. that can lead to a pattern of destructive thoughts and concerns which in turn can create stress, anxiety, depression, performance nerves - all far, far more common reasons for ED than propecia! although unfortunately no one can say for certain whether propecia caused your problem, or had any part in it, the simple fact of the matter is it's more likely] to be something else. the alcohol and your fears about performance are both much more likely candidates for the problem you encountered. of course, the difficult thing now is to be able to overcome your concerns about propecia and ED, which we all know is hard to do because once the seed of concern is in your head it's difficult to stop it taking root! my advice (which is not professionally informed and is just my personal opinion) is to continue with the propecia if you're comfortable and try (as hard as i know it will be) to relax, loosen up and not think so much about your sexual performance. from your post it's clear you're starting to question every thing you notice about yourself (and we've all been there!) and the moment you start worrying about whether your erections are weaker or arousal less enjoyable that's sure to put a dampener on things and bring about all the symptoms you worry about in the first place! if it's really bothering you see a doctor and explain the situation. they can do blood tests and other tests to try and find out what, if anything, might be causing your symptoms and may be able to shed some light on if propecia is involved. your age could also be a factor - early-thirties is a prime age to start experiencing a slow down in sexual drive which maybe does produce a few symptoms. where as most men probably wouldn't notice or not get worried, you naturally have that lingering thought that it could all be propecia related. so, try to relax, enjoy your relationship and remember that propecia has been tested and very much affirmed as a safe drug with a low occurence of side effects. if you really feel propecia is a problem then maybe take a break from the drug, see a doctor and analyse the situation more deeply. ultimately though, statistically any erectile problems are much more likely to be stress, age or health dependent than propecia related, especially if the first three months seemed to go well. hope you're feeling back to normal soon!

Congratulations! I'm hope you'll be pleased with your results! Sometimes some grafts unfortunately do not grow but I doubt you're an "oddball" patient! In the next few months you should start to see what's happening with procedure number 2 and hopefully it will be the improvement you desire! If you are worried or don't see the results you expect it might be beneficial to talk with another HT doctor to get an opinion on the quality of the work. In the meantime, however, best to let the growth begin and be positive! Regarding picking your scabs I don't think it will have had any detrimental effect! The hairs coming out is to be expected but with no blood or visible problems it's highly unlikely you've done any real damage - the grafts are resilient things so you should be fine! Are you going to keep the forum updated with your progress? It would be great to see how things go (and useful for you hopefully) and let's hope that in a year's time we can all witness your success story!

If you want to discuss the hormonal implications of finasteride in more detail an endocrinologist would probably be a better bet.

No it's not true, finasteride can work all over your hair. Generally speaking it is least effective at the hairline and temples (for reasons nobody is 100% sure of, though it's probably to do with how sensitive those areas are to DHT) but it can work everywhere and lots of people have posted great results across their entire head. To my knowledge dutasteride doesn't offer any additional benefits to your hairline so I would probably stick with propecia for now, especially if you're having no sides! You may find that the improvement to your hairline is not as strong compared to the rest of your hair but I'm sure you could see good results and, if unfortunately you don't, I don't think dutasteride (or any other drug) is going to make a miraculous improvement. How long have you been on the propecia? You usually have to give it at least 9-12 months and maybe as much as 18-24 to really see the extent of its benefits.

To get on propecia you could visit either your local doctor, a dermatologist or one of the doctors on this site. I would recommend you at least see a specialist dermatologist because whilst a local GP can prescribe propecia they often don't have the expertise to really look at your hair and see what the situation is. If you went to see one of the coalition doctors on this site they could prescribe propecia and also give you a much more detailed analysis of your hairloss and the sorts of steps you could take next, as well as give full answers to any questions you may have. I think a doctor on this site or a local dermatologist is your best next step. I would imagine a local dermatologist would be less hassle to see but a coalition doctor would probably be a bit more thorough so it really depends on your priorities! Both, however, will almost definitely recommend and prescribe propecia so you'll get the same end result either way. Also, it's my knowledge that some doctors offer free online consultations regarding hair transplants. It might be worth researching this as usually you can send photos of your hairloss and a doctor will suggest what kind of procedure you might be suitable for and what to expect. You'd still likely need a full consultation at a later date (if you get serious about having a HT) but, for free, it's probably worth looking into! So, in short, dermatologist or coalition doctor would both be more than suitable and maybe look into a free online consultation or post some pictures here of your actual hair (if you're comfortable with that) and you may be able to get some experienced or even professional opinions on what might be done.

Hi bcarbox! Welcome to the forums, which will be a great source of info and support on this issue I'm sure! The first big question regarding your hair is do you use propecia and/or minoxidil? Both of these drugs stop further hairloss and, in some cases, can regrow hair (though this is usually only moderate regrowth, so no magic bullet). It is highly recommended you use these drugs, particularly propecia, for many reasons. Thinning hair is obviously a progressive thing so having a hair transplant won't guarantee you a good head of hair back for the rest of your life; if you lose more hair over the next few years that could end up making your HT look unnatural. If you don't already take propecia I would recommend you look into it as a first step on your path. Minoxidil can also work synergistically with propecia to help improve your hair and stop further loss, both of which are essential. With regards a hair transplant, unfortunately the issue isn't very simple and there are lots of variables. Sometimes people have thick, dark hair and may not need as many grafts to look good. Sometimes people may have fine hair or other variables which need more grafts (of course it's not that simple, but just a quick comparison). Really and truly your best step is to use some of that $2,200 to book an appointment with one of the coalition hair restoration doctors. They can talk you through in detail how HTs work, what to expect, whether you're a candidate and will almost definitely advise you to get on propecia. Hair restoration is a complex subject and they will be the best qualified to come up with a plan for you. $2,200 may be able to buy you something with regards to HT but it's admittedly not a huge amount to spend when it comes to the world of hair transplantation. HTs are not really procedures you can take a punt on and a good doctor will advise you how many grafts you would need to achieve your desires whilst taking into consideration everything else. Finally, have you thought about or heard of products like nanogen or toppik? These are synthetic fibres which can cling to your hair and make it seem fuller and thicker and drastically change the appearance of some people's hair. If you cannot afford a HT or are not a candidate, getting on propecia and using these sorts of products might be a good way to maintain what you have and create the illusion of a full head of hair (or near enough). If you are only thinning in the crown/vertex you might achieve good results cosmetically with those products and give yourself some time to save up for a HT if you are a candidate but need more money. The main thing is you have come to the right place and there is a wealth of options around if you do your research properly. The priority for you, in my opinion, is to see a hair restoration physician as soon as possible to chat about where you are, where you want to be and what's available. You can come away from that with a real sense of what to do next and go from there. Best of luck!

David makes some great points. There are a huge number of things that could be the cause of ED and, whilst propecia could very well be one of them, it does seem a little odd that you had 1.5 years with no problems then suddenly develop ED. Although propecia could be the cause (and a week or two off it, in the scheme of things, won't hurt), I'd rule out the other problems David has mentioned above. Although propecia would be the obvious "go to" the fact you went for a time taking propecia without ED means other factors could be at play. Have you gotten more worried recently? Taking any new medication? Are you eating and exercising properly? Any new issues in a relationship or problems with sex life? Obviously these are not questions I'm asking an answer for, but any of those factors could be a contributor to ED. If you get off propecia and find your ED disappears then maybe contemplate taking a lower dose or slowly upping your dose to previous levels. Might also be worth seeing a doctor for blood tests and/or a general check up. Most of all try and remain pragmatic about the situation. Propecia could be the problem and, if it turns out it is, then lowering your dosage or getting off the drug is the only way to go about solving it most likely. There are many other things it could be though, so have a good think about factors that might have changed in your life and go from there. Best of luck finding a solution!

Hi trader! Your hair is very similar to mine at the moment, and we're both 27, so some similarities! I probably don't have quite as much loss at the temples but, by contrast, am slightly more diffuse across the whole hairline. Firstly, your hair actually doesn't look that bad! I understand you want to do something about it (as I do with mine!) but I would imagine the vast majority of people, girls included, wouldn't notice your hair as 'balding'. Even though you do have a bit of recession it's amazing how many people that don't think or worry about hairloss don't notice thinning or receding hairlines. I'm only saying that because, even though you're going to do more to combat hairloss, I don't think you have much to worry about with girls (so long as the personality and other stuff is intact!). Although it's difficult to tell from the photos my initial reaction was that your hair isn't that fine. That having been said, even if it is I don't think that would make a massive impact on your suitability as a HT candidate. As Future HT Doc suggested above, you should look into adding minoxidil and nizoral to your regime as these could both help to thicken your existing hair up and generally make it a bit thicker and denser. They might also help a bit more on the temples/crown, although those seem to generally be the most difficult parts to tackle. I'm sure the minoxidil/rogaine could make even bigger improvements to your hair. Regarding HTs you'd have to speak to a doctor about whether you're suitable but some things to bear in mind. Because you're young and the extent of your hairloss is not well established yet it's unlikely any doctor would risk 'restoring' your hair completely to its original density. There's no doubt they could thicken up your hairline and crown and reshape your hair but they would probably be hesitant to use up too much of your donor hair as your baldness could get worse in the next 20+ years. I'm only saying that because you mentioned the phrase "full head of hair" and, whilst a HT can work wonders, it's not going to quite give you that back and I would imagine a doctor would want to keep as much donor hair as possible in case you needed more HTs in the future. I'm not a doctor though, so don't take my suggestion as fact, just my gut feeling based on the results and procedures of others. An HT could make a big improvement to your hairline though, so please don't think I'm saying you can't or shouldn't have one! Best thing to do is speak to a coalition doctor and get an initial consultation on what can be done and if you are a candidate!

Michael5577, I appreciate what you're saying but that's business and it happens everywhere. I mean, literally, everywhere. Those who open businesses, head businesses, are the commanding executives of businesses, earn more. It's not really outrageous, it's capitalism and it's fair. Look at it this way. You have a HT done and it's not acceptably performed. Chances are you'll be taking it up with the doctor, not the techs. If a surgery falls into disrepute it's the doctor that will be demonised, and very unlikely to be the techs. In other words, doctors have to be accountable for everything that happens in their business. They also have to plan your procedure, they have to ultimately be responsible for you. As the originator of the business and the most accountable person, as well as the person ultimately response for patient plans, the doctors are the professionals and probably do earn the most money. You also haven't taken into account overheads. Rent, bills, R+D, advertising and other running costs. It's not just a doctor and a few techs - it's a whole business that needs to be paid for. I don't know what the techs are being paid or what the ratio between their fee and the doctor's is (nor is it our business, really) but businesses work that way. Everything from call centres to banks to football teams to schools are run in such fashion, where the head of the team gets paid the most. Perhaps they don't work as obviously hard as the techs on the day, but these doctors are running a surgery and the time and responsibility it takes to do that warrants the costs. Finally, even if the distribution of fees was unfair, what does that have to do with HTs in general? I don't see how HTs prey on the timid or insecure. I think everybody on here understands pretty well the sorts of results you can expect, the sort of costs you can expect and the sacrifices you may or may not need to make. HT costs are roughly in line with any other cosmetic procedure and many would consider regaining their hair much more important than a flashy car or extravagant vacation (both of which can in theory cost more). Generally speaking my experience of the hair restoration industry has been a positive one. Most reputable surgeons are very honest about what you can expect results wise, and more often than not it's a big improvement cosmetically. I haven't seen a single top surgeon boasting about restoring every hair on your head and trying to part you with $15k before you've had a chance to think. I'm sure it happens, but it does in every industry. Overall my comments on your quote would be that if you see it that way you shouldn't get an HT. If you feel there are better things to spend your money on, then there are. If you feel the results are not what you would be pleased with, then they're not. However, as a blanket statement about the industry, I think it's ultimately an unfair assessment.

As Future HT Doc said, I reckon you should stick with it! Because of the way these drugs work, particularly minoxidil, the hair must shed before stronger, thicker hair can grow back. There have been some cases of minoxidil causing hair to shed and not regrow but these are pretty rare (as in, to my knowledge, way below even 0.1% of users. Hair takes time to grow, so at least 3-4 months of hairs growing back again is needed before you really know the situation. The most likely scenario is you're shedding because it's part of the natural, necessary process of growing stronger hair. It's not nice but that's how it is! And you'll be much happier when your hair starts growing back thicker and stronger. If you throw in the towel now then the medication will not even have chance to work. Your hair would still take time to grow back, so you'd still be looking at 3-4 months before you get back to where you started. If you keep using the medication in that time there is a strong chance your results would be much improved. The best thing to go is keep up with the medication and look for signs of new growth - small sprouts of new hair where it shed, thin vellus hairs in new places etc. Chances are they will start to show within the next few weeks (maybe even already?) and if you can see them then it would strongly suggest your hair is growing back and, not only growing back, but will now be healthier, thicker and more plentiful. That of course, is not to say if you can't see those hairs something has gone wrong. If you're getting really worried go see a dermatologist. They can look for good signs and explain things properly as well as making a much better diagnosis about whether anything is amiss (which would be unlikely). Above all, no knee jerk reactions! Wait a couple more weeks and look for signs of new growth, or if you can be brave wait for 3-4 months before making a full assessment. If at any point in that time you really, genuinely feel you need better advice or a stronger assessment, go to see a doctor (dermatologist) and they should be able to help!

As most people have suggested, not an easy question to answer! I'm not a doctor so I can't talk with any authority here, but my personal opinion is that most balding men, no matter what age they are, should ultimately think of themselves as an NW6 in the making, and all treatments/surgery should really begin from that perspective. If you think about it, with the treatments we have today, no hairloss can be truly "stable", unless it's actually reached the end result of its genetic pattern. The drugs available today can halt hairloss for 5 or 10 years, maybe even longer, but ultimately they are only really slowing down the process or halting it for a short period of time. To that extent I would say the aim of any hair transplant is to add density to bald or thinning areas (in a cosmetically suitable fashion) whilst slowing as best as possible further thinning. Therefore most men may get a period of 5 or so years where the combination of a good HT(s) and drugs gives them a good head of hair. They will then likely find they need a further procedure at some point; either just because they want more density or they have to now address other areas or further loss in transplanted areas. In other words it would appear to me hair restoration is effectively a case of doing what you can with the donor supply whilst minimising the loss of native hair and balancing those two things. Eventually, however, it would seem nature will take its course. That's when your HT surgery has to come good, because when you've finally lost all your genetically susceptible hair and had all the surgery you can have, the results have to be pleasing. But that's where things get tricky I suppose! If you're young and only been losing a relatively small amount of hair for the past 3-4 years, for example, no good doc will want to pack 6,000 grafts around what's there. That having been said, what's the cosmetic or financial wisdom in having maybe only 500-1000 grafts spotted in amongst your existing hair? The results won't be easily appreciable, the cost will be comparatively high and you'll likely lose as much hair in the next 3-5 years as you gained. Overall I reckon you need to be late twenties minimum and really to have tried all the drugs for a good length of time and be in the first "stable" period from them (say a year to 18 months on). At that point, if you stay on the drugs, you can probably justify doing a good HT (1,000-3,000 or more grafts) in the affected areas (most likely start by building a good hairline). All being well if you're say 30 when you have the transplant, you might not need to start thinking about a second until your later thirties. By then you'll be older, more mature, and can take the next step with your donor hair to create additional density (or replace lost hair) and start shaping a good looking but more mature head of hair. I reckon at 33 you're a candidate for an HT, providing you meet the other criteria. If your hairloss is stable you and your doctor can probably think about making the first transplant and, with any luck, you'd have a stable head of hair for 3-5 years. It's almost a definite, however, that you'd need to commit to a further HT at some point in the future, and possibly one or more after that. If you start young you just have to think that way I guess!

I would imagine, whilst taking your situation seriously of course, your dermatologist wouldn't take you off the propecia if you mentioned your mental symptoms. She's more than likely, if anything, going to recommend you see another doctor to discuss and analyse those symptoms separately. There's no evidential link between propecia and mental problems that I know of and so your doctor is very unlikely going to jump to that conclusion. A lot of men who experienced some form of erectile dysfunction on propecia reported improvements in the following months, so there is a good chance that is the case. As your body adjusts to the lowered DHT quite often there is temporary drop in libido and sexual function that can return as your body adjusts to the new hormonal levels. Your week of propecia will do you good, if only to see how you feel. Tell your doctor what, if anything, changes when you're on/off propecia and this can only help them make any diagnosis that needs to be made. The main thing though is to stop worrying. I know it's hard but all this worry about not being able to have kids and having OCD is going turn you crazy long before propecia would! The overwhelmingly vast majority of men either have very little side effects with propecia or at least return to their normal state when they stop the drug. Those that claim propecia has permanently changed them, whilst they may or may not be right, are in the very small minority and it's difficult to make a proper diagnosis about what has really happened to them. Other factors like stress, illness, age, lifestyle, fitness or undiagnosed medical conditions may also be playing a part in their problems so it's not as easy as just blaming propecia. The first thing is to take the week off, see the doc and find out what the options are. don't worry about whether you'll be able to make babies - getting frantic about questions that big is going to make you feel worse and is unnecessary. I'm sure you'll come to a happy result with this problem!

Hi Daniel, I'm no expert or not a professional in any way so these are just opinions, but I believe there could be a scientific reason for why weight training helps. DHT is a bi-product of testosterone, it's more well known counterpart. When you produce testosterone your body metabolises some of that testosterone into DHT. I'm not sure of the ratio between testosterone and DHT but it stands to reason that if your body produces more testosterone because of the weight training, there will be more testosterone to convert into DHT. To use a very bad but simple numerical example let's say there is 1 DHT for every 4 testosterone in your body, so when there is 100 testosterone there are 25 DHT. If you take propecia it will be lowering that value of 25 DHT, let's say by 75%, so in that case propecia would lower your DHT to 6.25. But, if you were working out and increasing your testosterone levels to say 150, you'd then have 37.5 DHT by comparison. If you took propecia it would then lower your DHT but, in this case, only to 9.375, so you'd have more DHT in your body. That, as far as I can see, is a potential scientific explanation. Of course, it could be psychological as well, but to me there is a potential scientific explanation. I have no evidence to back up my theory, but my own personal theory is that men are individuals with differing testosterone levels and endocrine systems. I would say that when it comes to propecia the trick is to find the balance between having enough DHT so that it can do its job, but lowering it by enough that it has a positive effect on your hair. Propecia is given out in blanket doses of 1mg but I reckon doing a blood test before you start taking it and maybe 6 months later would be a good idea, as well as monitoring your own body and listening to it. jspence, in response to your question, I cannot say, but I would imagine you could take OCD anxiety medicine and your doctor will tell you if that's the case. Also, I wouldn't read so much of the anti-propecia stuff on the net. Propecia can potentially cause side effects but a lot of the permanent impotence and physiological symptoms stories are dubious. The truth is, in a lot of the cases, people read about propecia, take the plunge and start using it and straight away feel worried they've made some massive, irreversible mistake, and that anxiety causes them to feel many of the symptoms they were worried about. It's interesting that in the medical trials very few people reported sexual side effects and I believe a big part of the reason is because they didn't scare themselves by having anything to read on the net! If propecia is causing problems then I think the worst case scenario is that you have to stop taking it and wait a few days/weeks for the side effects to cease. There are some stories about so-called permanent problems but they are few and far between and often quite dubious (plus, considering the drug has only been out just over ten years, the word "permanent" is a bit soon!). If you think how many millions of men are taking propecia without a hitch in this world then it stands to reason whilst the drug warrants monitoring and using with caution, if you listen to your body and relax it's perfectly safe! Oh, one thing I did want to mention, although I plan to start using propecia and have done lots of research into it (both on the net and talking to professionals), I'm not using it yet (although I will be very soon). I just wanted to put that in because I felt like a bit of a fraud airing my views without being upfront about the fact I'm not taking the drug! Rest assured though I'm looking forward to starting propecia shortly and my opinions are based on honest assessment of the facts and figures!

I very much doubt it's "gone for good", but this is a good example of the problems in linking propecia to mental/sexual side effects. When men experience any kind of erectile dysfunction or abnormality they worry (obviously!) , and this in turn can cause further problems with erections and desire for sex. It's a chicken and an egg conundrum; is propecia causing your problems, or are you worrying so much about propecia that the stress and anxiety from that is causing your problems? Propecia could be causing your lack of erections but few men report this problem (around 2%, possibly a bit more) and, of course, once you're convinced you can't get it up, getting it up again is very difficult! My advice would be see your professionals and, maybe, just come off propecia for a few days (maybe a week). The way propecia works your hair won't suddenly start falling out if you don't take it for a week, so you'd be fine. If everything returns to normal and you feel better then you can make a decision on whether you want to return to propecia. Perhaps you could also try taking a slightly smaller dose of propecia? It can be a balancing process trying to find a dose that minimises side effects whilst also having positive benefits for your hair. A lot of people take propecia every other day, or half a pill every day, and still see good results with their hair. As hard as I know it is, the main thing is to try and get back to normal with your life and worry less about propecia. I cannot say whether propecia is doing these things to you or not, but there's no definite evidence to say that it is. The problem is when people see a change in their health or begin a new medical regime they often overly analys things and start to notice and exacerbate problems. To use an extreme but personal example, I know someone who had cancer (thankfully they're fine). They did a lot of reading on the internet about how and why cancer spreads around the body, and where it is most likely to spread to. Sure enough they started getting chest pains, back aches, abdominal pains etc. Every time it happened they were sure something was wrong - that they could feel something was not right. Thankfully, every time they went to the doctor it wasn't the return of cancer. It turned out that the vast majority of the symptoms were causes by, you guessed it, stress and anxiety. They particularly concentrated on the areas they feared were most likely to be affected and that's where their pains and problems were the worst. I know that's a very different situation but a lot of the underlying psychology is potentially similar. If you get obsessed about something it's amazing what your body can convince you is happening. I'm not saying propecia isn't a problem for you, but you're doing the right thing by seeing professionals. The main thing is though don't worry and, most importantly, don't start convincing yourself you have all sorts of permanent problems and irreversible side effects. That's very, very. very unlikely to be true at all but if your mind gets into that way of thinking your body can very easily do quite alarming things. See the professionals and maybe think about taking a little break from propecia. Most importantly, spend more than 80% of your day not even thinking about propecia, or hair, and just go and enjoy yourself and get on with your life as best you can. A positive mental attitude is imperative in the world of hair restoration so that's the one thing you can definitely get to work on and change by yourself!

DHCR, A lot of your arguments make sense but one thing to clarify; propecia is not supposed to block 100% of your DHT. Firstly, there are two types of DHT (I and II); propecia only blocks one type (levels of your other type are found in the brain and therefore considered by some to have a potentially important function). Of the type of DHT that propecia does block it's only able to block between around 65-80% of it (if my memory serves me correctly). It's almost definitely a fact that you do need some DHT in order to maintain a healthy sex life and that, to put it simply, DHT is an important part of your balance of male sex hormones. In my opinion the aim is to find the balance between reducing your DHT to levels where it noticeably stops affecting your hair, but not to drop it so much that you incur serious side effects. The truth is I think most men would trade a slightly reduced libido for an extra 5 or 10 years good hair, but I don't think any man would be willing to entirely lose his libido - even if they could keep every hair on their head! As David said, the ambition really is to find the happy medium you're comfortable with. Unfortunately propecia usage is not an exact science; some men see wonderful results on propecia, some moderate and some none at all. Similarly some men seem to suffer drastic side effects whilst others (the majority) suffer few or none. But I am a believer that, if you are on propecia, you should monitor your dosage and tweak it accordingly. I think a lot of men take the pill, have side effects, get a bit worried and stop taking it. I reckon it would pay to introduce a regime where you start off taking a very small dosage of the pill and work your way up to say a maximum 1.25mg (in other words a 1/4 proscar). That way your body would be introduced to the change in hormone balance gradually and you'd probably have a much better read on what dosage was optimal for you. I don't think you necessary "need" side effects for propecia to work (many men have good or better results and report no side effects), but I think you're probably right in saying that the optimal dosage is at a level where you may experience a very small reduction in overall libido but, in return, good progress with your hair. That probably indicates the maximum tolerable dose with no major effects, and therefore the lowest your DHT can go in your own personal "safe zone".

jspence, A few people report symptoms of depression and/or a general inability to concentrate and maintain mental strength when they use propecia. The difficulty is in determining whether it is definitely propecia that is causing those symptoms, or whether they may be psychsomatic or brought on by other factors. Have you spoken to a doctor about the way you feel? It would help to discuss everything with a professional before making any decisions in my opinion. I'm on the fence about propecia's reported mental side effects because whilst you cannot rule out the possibility it is propecia, it's equally possible that the stress and worry about being on propecia causes a lot of these effects. If you start taking propecia and have a bad day, then begin to believe propecia causes it and start to worry and start having more bad days... well, you can see where I'm going! That's not to say propecia can't be causing these feelings, just that there isn't any concrete evidence to support that and you should probably see a professional first. On to your other question; it's hard to say whether it's the foam or the pills that are helping your hair regrow the most. The truth is, though, propecia is far more effective in the long term than minoxidil at keeping your hair. Using minoxidil on its own can certainly give you healthier, thicker hair that possibly lasts longer, but without propecia to back that up most hair will continue to fall out eventually. So, you certainly don't have to take propecia and if you're really worried about what it's doing then you can always stop for a few weeks and see how you feel, and probably return to the propecia if you want to without much detriment to your hair. My advice, though, would be to talk to a professional and (as condescending as it sounds, I apologise) relax a little and think objectively about why you're feeling mentally not right. It's in your interests to stay on propecia but only if you're comfortable with its side effects - if you really do not want to experience them and you're sure propecia is the cause, then I guess you have to make the decision whether to stop or not.

Hi Danielkiwi, First off let me say I haven't yet had an HT, so my advice is coming from my own research and discussing HTs with others. The biggest thing you have to do is plan your HT with your surgeon. You'll find, with a good surgeon, the majority of negative comments probably come from people who didn't fully understand what an HT can do and what the surgeon had planned for them. Most people usually don't like their hairline, felt their density wasn't what they expected or generally don't see what they thought they'd see on top of their heads. You need to really discuss with your surgeon what you want and what you can expect. What should the scar look like, what sort of density to expect over the balding area, the shape of your hairline and the need for further surgeries or drugs etc. Ask the surgeon if they can show you similar patients to you to help gauge your ambitions. A good surgeon will really help you understand what you can hope for and if it's not enough then don't get the HT. Don't be afraid to ask a lot of questions; you're spending a lot of money on this and a good doctor should have both a duty and desire to give you good results and results you wanted. After research if for some reason you end up unhappy with your results then there are options. Firstly, a good coalition doctor should be willing to repair any obviously faulty work. This again comes down to lots of research and asking questions. If both you and your doc are really crystal clear about what to expect it's much easier to know if something has gone wrong. Often a patient thinks their hair is going to look different only to find out that's what the doctor intended, which causes difficulties when it comes to asking for repair work or extra procedures. If you and your doc really know what you're aiming for and you don't hit the target it's much easier for you to request repairs (which, if the doctor has made a genuine mistake, should be free of charge as I understand it). Obviously this can be a sticking point between doctor and patient sometimes so I can't stress enough: discuss your ambitions, discuss the plan, agree on the outcome you both want and you'll have a crystal clear set of goals. Repair work can be done by lots of other doctors if results weren't satisfactory. There is a guy on this site called Jojotronic who had early implants that went wrong, and Hasson and Wong did a fantastic job repairing his hair (which now looks great). Jo is not alone; lots of people have had really quite major repair work. Hopefully you won't need to go down that road but the point I am making is that good repairs can be made from quite significant damage, so have faith that there are options if things don't go right. Buzzing your hair down is another potential option, as is shaving your recipient area. Your recipient area shouldn't be very scarred but obviously it's not ideal to have to shave it down. This plan is a possibility but I think the more realistic option would be to get a bad HT repaired than to go shaving it down. If it's possible try and keep in mind the (slim) possibility that you may need some extra cash to have a repair done or (more likely) get a second procedure in the future to keep up with your hairloss. If you have some flexibility in that area you have options if things don't go to plan. I'm sure everything will be OK however. HTs are well practised procedures these days and I would guess most problems (when it comes to reputable docs) stem from patient expectation vs. patient outcome and miscommunication. Finally, make sure you really, really want it. An HT isn't something you can "try" to be honest. It's a lifetime commitment to try and restore your hair to a level that's both realistic and that you're happy with. If your ambition is just to give it a shot and see what you come out with, it's probably not for you. You'll likely have to commit to staying on drugs for the rest of your life (propecia etc.) and to further surgeries down the line as you continue to bald. It really is a long term journey and can't be viewed as a one off gamble. With proper research, realistic expectations and a good doctor, however, your results could be great and see you through the rest of your life!

I think you are getting serious replies. I'm from the UK so, in fairness, I don't know really know how salaries compare between the US and the UK, but $10 an hour would equate to about minimum wage over here, which is the lowest any adult can expect to earn per hour. As somebody suggested, the only thing you can really do is get a better job (and I know it's not that easy, but that's the hard fact unfortunately). But you don't need to be rich to get a HT. $20k, whilst being a lot of money, is not a rich man's amount. A lot of people considered working class or middle class find $20k to buy cars, refurbish houses etc. What I'm saying is that not everybody on this forum is rich, far from it. But if $10 an hour is not enough to consider a transplant then you have to find a way of getting more money somehow. Could you work a second job? Get a new job? Do you have anything to sell? A lot of people finance their HTs by making serious commitments financially in the form of loans, savings and reducing their spending. It's a delusion to imagine everybody on this forum is driving a $50,000 car and spending their weekends at the yacht club. Most people here have just worked hard and resigned themselves to using up their money on a HT. They may be earning more than $10 an hour, but you'll probably find a lot of people are not that much better off than you.

Unfortunately hair transplant is a relatively costly procedure. Most cosmetic procedures, however, are costly. I don't think hair transplants are ridiculously expensive but I do understand the frustrations people have about the sacrifices they have to make to get one. To put things in perspective, however, you could probably get one or two really good hair transplants from a reputable surgeon for the price of a fairly average car. If you smoke you could probably finance your HT on the savings you made if you quit. I guess it's about priorities and sacrifices. If you really want a HT you have to be comfortable with not having some other pleasures. Whilst I sympathise with creepingback I wouldn't share his total objection to hair transplantation. It's incredibly unlikely you'd need repair work if you spent a little extra cash and went with a reputable coalition surgeon (and discussed your ambitions in detail). It is, however, likely you'd need more than one surgery in the long term to meet your goals, so that needs to be considered. Research and planning are the key to making the most of your money however. You need to find the best surgeon, come up with the best plan and have the most realistic ambitions to realise your hopes. Cost should never be the main factor in your decision but there are coalition doctors who are well recommended that charge rates that may be more favourable to your financial situation. The unfortunate fact of the matter is, though, that HTs are always going to cost money and if you try and find the discounted places then you'll really come to regret it! My advice is to just keep saving and keep researching. Over the next few months you'll probably find some options that seem a little more affordable and you might be able to accumulate some savings. If you can finance the rest on CCs or loans (sensibly) then it just comes down to whether you want to part with the cash.

Hair cloning is difficult to define as many people take it to mean different things. Most companies aren't working on directly cloning hair at the moment but instead are looking at similar but slightly different approaches like taking stem cells from healthy bald resistant follicles, multiplying them in a dish and then injecting them into bald areas to promote bald resistance in follicles that no longer producer hair. There are other variations but most promising treatments at the moment revolve around the concept of stem cells or formulas that allow your follicles to produce hair again. This, however, technically isn't hair cloning. Strictly speaking hair cloning is actually creating new follicles from your genetic material. In principle this sounds easy when you hear of the other genetic feats that have been accomplished (Dolly the sheep being the most obvious). But the truth is hair cloning is incredibly, incredibly complex. Creating a sheep embryo isn't all that difficult because an embryo is genetically relatively simple (much like stem cells). But a hair follicle is a very specific, immensely detailed concoction of cells. To use a not so great example it's sort of like drawing. If someone asks you to draw a house any decent artist can make a good drawing of it. But if someone asks you to draw a small section of the carpet of that house it's much more difficult, because the detail required to create a faithful drawing is much bigger. Most scientists equate cloning a hair follicle with cloning a human eyeball. So, in terms of pure hair cloning, we're probably a long way off. I doubt it's a treatment many of us will see being used regularly, safely and cost effectively in our lifetimes. The plus side, however, is that it may not be the best way forward for hair restoration anyway. Cloned hair requires transplantation into the scalp to work. The cost of cloning and transplanting what could theoretically be 30-40,000+ follicles into the scalp would be pretty large. Today's treatments are focusing on making the follicles you have produce hair again, and that might be a better way to go. If we can successfully do that it may be a more cost effective and less complex way of creating a full head of hair. My own personal feeling is that the next stage of hair restoration will be combining transplants, which form the bulk of 'shaping' and designing your hair, with treatments that perhaps produce extra bulk and density in your hair, perhaps giving you 50-80% of your full density where transplantation alone can only offer maybe 30-50%. The future for hair restoration looks good but we're a long way off a magic bullet. I would imagine the cost of getting a full head of hair again will unfortunately remain fairly high (although in the scheme of things it's not astronomical, for most people it's just about making sacrifices in other areas of their lives I guess) but the range of options and the complimentary approach of those options will make getting a great cosmetic look a mutli-disciplinary approach rather than a one off treatment.

Definitely a good idea to see a specialist but I believe thinning around the bottom of the hair (neck/ears) can be attributable to MPB. My father went thin around that area (as well as the traditional crown/temples) and I've heard a few people refer to the are as the "second hairline" because of the potential for it to also thin. The tests are a good way to rule out any other potential problems but I feel it could just be part of the natural thinning/balding process. My father still has hair in this neck/ear region but it's thinner and more diffuse than the rest of his "donor region", so although I can't offer any expert advice I can say I've seen something similar happen first hand.

I think to some extent you're right. My post was a bit misleading since I was making the distinction between diffuse and non-diffuse but everybody is a diffuse thinner to some extent. I think the difference is actual DPA thinners tend to thin at the same rate over near enough their entire bald-susceptible region whereas MPB (non-diffuse) tend to thin in a more gradual, linear way, starting at the temples and crown and expanding into the middle of the head. To post links to two different examples of what I mean: A DPA thinner: http://www.babble.com/CS/blogs/famecrawler/2007/11/23-End/brenden-fraser-hair-wig-mummy-bald.jpg Non-diffuse MPB: http://www.babble.com/CS/blogs/famecrawler/2008/04/16-22/jude-law-balding.jpg You can see someone like Jude Law; it's likely where they have gone bald their hair follicles are mostly "dead" and propecia isn't likely to make them start sprouting new hairs. Brendan Fraser, on the other hand, actually has a pretty intact hairline and general covering of hair, but it's thin all over (he's not the best example as it's really thin!). My logic is if Brendan Fraser got on propecia a lot of those thinning hairs or recently "dead" follicles might start producing new or thicker, stronger hair. That overall increase in density would give him a more aesthetically noticeable improvement than Jude Law, who has a pretty thick head of hair except in his temples, where he's pretty much completely bald. Logic says to me he might get a few thicker hairs in his temple region but it's likely his cosmetic improvement would be pretty minimal.

I can't offer any help on the first question but on the second question I might be able to (though it's only personal opinion). If it is indeed true that propecia is very useful on diffuse thinners the reason may be as follows. When you have non-diffuse MPB your hair doesn't really "thin" but merely disappears bit by bit, in a way. Most people with non-diffuse MPB might not even notice they have it until a fair bit of their temples and crown have gone. In the early stages, when they're just receding and thinning in the crown a little, they might assume they're not balding or want to wait until that's the definite diagnosis. By contrast diffuse thinners tend to start noticing their whole scalp/hairline getting thinner and more see through (like I did). But, what's more than likely happening is instead of lots of hair follicles actually ceasing to produce hair, instead the vast majority of hair follicles just start producing thinner, weaker hair that creates the thin, see through effect. In short, what I'm trying to say is that there is a good chance diffuse thinners notice their hairloss before a lot of their hair follicles have "died", so to speak, where as non-diffuse will tend to notice and take action when a lot of the follicles in the susceptible areas have already stopped producing hair. So, if a diffuse thinner takes propecia there is a good chance it will start reversing some of the damage done and the hairs from the thinning follicles will begin getting thicker and stronger again. You can imagine that if this happens all over the head you get a fair amount of density back. By contrast a non-diffuse thinner might only start taking propecia when their hair and crown have thinned beyond "average" and to a point where there is clear balding happening. By then a lot of the follicles that have been affected will likely already be "lost", however, and propecia won't work for them. Instead it will only work for the follicles that haven't died or the thinning follicles. I hope that makes sense, and of course it's just a theory. Diffuse thinning is an interesting one because whilst pretty much the whole of the top of my head has thinned, no one area has really become bald. The crown and hairline have thinned the most but a good amount of my temples and crown remain. When I see men non-diffuse MPB often they have thick hairlines in the "centre" but no hair at the temples. By contrast I have much more defined temples but my entire hairline has thinned a bit. However I really know I'm balding where as a lot of those guys may not have noticed as much, or just believe it's a bit of recession and not full-blown MPB. Therefore I think diffuse thinners notice their baldness a bit earlier and when they start on medication there are lots of thinning follicles but relatively few "dead" ones, so they can possibly see strong results because a lot of those thinning follicles can be reversed somewhat and some good density restored.