Friedman

So, i have continued with the "big 4": Topical minoxidil and finasteride, microneedling, and plasma therapy for my hair. I think my hair is fine-ish (I still wish were a bit thicker). However, I think the topical minoxidil and finasteride has caused my face, particularly on my temple, to age a bit and get wrinkly and leathery. I think what happens is that when I sleep, the solution gets on my pillow and then to my face. I'm contemplating what to do about this. Someone else who just used minoxidil also reported this. Some steps I'll take are: 1. try to change my pillow-cases almost each night. 2. Maybe wear a nightcap when I sleep so that my hair doesnt' directly touch my pillow 3. Do a better job of applying the liquid in a way so that bits don't end up on my face. 4. do microneedling on my face 5. A friend who is 50 with no wrinkles swears by using facial cream to prevent wrinkles. 6. I may look in to botox...

^I guess the other three things you can do are: (1) don't drink that much (2) eat lots of fish & seafood (3) get lots of natural sunlight, & take vitamin D tablets in winter. (4) don't do things that impair your sleep. Don't stay up super late. go to bed and wake up at the same time each day. dont' stress yourself out. However, none of these are going to have a noticeable impact on your hair but you should do anyway for other reasons.

^Ah, also, there are a couple other things I do. One, I noticed that my minoxidil tends to just make my hair look thicker. So I tend to add that in as well. Lastly, sometimes I add Caboki. Just a powder which makes it appear like I have a fuller head of hair than I do. These are also two nice tools in the arsenal. Am I missing anything?

My topical Fin is MinoxidilMax. It's minoxidil and finasteride. So, I've now added PRP to my regime the past 3 months. So, its Minoxidil, topical finasteride, Microneedling, and PRP. This seems like the "big four". I seem to go back and forth on whether I see progress or not. Certainly, it's not like the obvious progress of getting a hair transplant, but often I suspect I see some progress. Or at least I'm keeping my HT gains from 2018. Also, it's too soon to see any additional benefit of the PRP. I'm still planning another HT this fall/winter. I'll probably do Belgium. I don't want any developing country BS.

Well, I cannot leave Russia, so that limits me quite a bit... Was thinking now is a good time to do, given social distancing, closed-down nightlife, etc. etc.

For those interested (not sure there are), I no longer think my current treatment regime: -- topical finasteride + minoxidil + microneedling -- is going to see any noticeable results. I was quite positive at first, but I seem to think I've seen some hair thinning. This may just be my paranoia. I now have given the topical finasteride + minoxidil about 10 months, and can't say I see any benefit. I fear I might have regressed a bit even. Even before, I had been doing minoxidil + microneedling. Thus, I'm going to look into another transplant.

^Wow, I thought everyone was microneedling by now... Cheap, safe, relatively effective. No reason not to do.

Cheddar, why not also add minoxidil plus microneedling, and see if you can get some growth/improvement?

^as this poster said, the shed might have been a good thing. How long did you give topical fin? Why don't you try fin + minoxidil + micro-needling and giving it all 9 months? Also, your hair doesn't look that bad.

Switch to topical fin, and hit the weight room. Lost 20 pounds if overweight.

Why not do topical fin instead? And add in microneedling?

I am using it. I have been for a bit over three months. So far, so good. I feel like I'm seeing results. I also do aggressive microneedling. The one major drawback is -- don't touch your hair and then touch your face, and keep away from your eyes! Also, I change my pillowcase every night to keep them clean, and even sometimes wear a nightcap to keep the minoxidil from my hair from getting onto the pillow where I rest my face. You don't want this stuff on your face or hands. Same goes for minoxidil. All told, my initial results are very promising. I'm going to give it a few more months and see what happens.

I would have tried topical Finasteride plus my minoxidil + microneedling regime and given it at least six months first. This seems to be working for me. A HT also helped, and I'm glad I did, but perhaps had I tried topical Fin first, I might have needed fewer grafts, or even none at all. What treatment regime are you using? The other thing is to talk to a handful of surgeons and choose the one you feel most comfortable with.

Why not try topical fin? That's what i'm using now...

Blonde bearded bro here. Definitely give topical finasteride + minoxidil + microneedling a go for 6 months before trying a HT. It's way cheaper and could be a permanent solution.

So, it's not totally clear yet, particularly since I've gone a long time with no hair cut thanks to quarantine (long hair papering over my lack of thickness perhaps), but my sense is that this treatment regime -- topical finasteride + minoxidil + microneedling -- is working. You might consider giving this treatment regime 6-9 months before trying a hair transplant. It's been a bit over 3 months, which was preceeded by a one month break from any hair treatment. Is this too soon to see results? I'm only about 85% sure I see improvement. And, I'm not yet to be where I want to be, but at this point, I'm willing to wait until June or July to gauge progress before I think about another HT. Compare to pre-ops and pre-treatment, it's night and day.

Unfortunately, no results yet to report for my topical finasteride. The reason is I couldn't get the stuff until September. In November, my dose ran out, and I was travelling, and even forgot to bring my minoxidil with me, and went 3 weeks with nothing. Everything I read suggests this should be a major setback for my hair, as you have use this stuff continuously. Since around Jan 15th, I've been using this treatment regime religiously -- topical finasteride + minoxidil + microneedling. One issue is that you really don't want this stuff to get in your eyes. I wear contacts, and so sometimes it does. I had to switch to using glasses. This is a real downside of this treatment regime. I'm only patient enough to give this stuff until May to work its magic. After that, I'll do another HT.

Why not switch to topical finasteride? Less chance of sides, but also effective. Why not use a dermaroller?

^Why don't you try topical propecia?

It does look like nice progress. Keep it up. My dermatologist told me to use the dermaroller daily. Is there any hard evidence (I.e., a RCT) that suggests you should just do once a week? I typically rest or forget to do it about 1-2 times a week. I think you should also try topical finasteride. Do this stuff for one year, then go for a hair transplant to fix the front.

Do you take oral propecia, or the topical propecia?

The reason not to use topical finasteride alone is because these different treatments work in different ways, they are complimentary, and different people will respond differently to different treatments, and no single treatment is going to work on everyone. The best chance of a good result is to use all of them. Randomized trials do show benefits of topical finasteride alone. I'm not going to be using it as part of an RCT. However, I'm going to add that, but probably not do the PRP. Reason not to is that the cheapest PRP place is about a 30 minute taxi ride away for me. That's 90 minutes I lose, plus about $50 a session. Overall, that makes a cost of about $200. Doing 3 times is fine, but then what happens when you quit? I'm going to do this every month for the next few years? It's too much hassle. I am a bit suspicious though -- I don't think this will end up doing much for me. I expect some tangible but modest benefits. The doctor I talked to was not a fan of laser therapy, btw. He did not believe it works.

Update: I just did an online consult with a doctor. He was raving about the benefits of the topical finasteride/minoxidil combo. Suggested also doing 3 months of PRP to start off. He told me some doctors have been prescribing the topical finasteride/minoxidil combo for years with results. What is unclear to me is why this isn't widely known. In any case, I'm going to give this a go. He said this only lowers overall DHT levels by 1/18th as much as the pill. He did warn it might darken my hair a bit, but I am fine with that outcome.

Not true that only Finasteride & Rogaine are the only clinically-proven treatments to regrow hair. Microneedling (also called a "dermaroller") and PRP are also proven to be effective in randomized trials. Microneedling is also cheap, you should add that at the very least, whereas PRP is a bit of a hassle and costs money. I think either give this stuff 8-10 months, and then think seriously about a HT or just do a HT now and then do this stuff on top of it.

Why take the oral fin when you can use the fin cream? And still get 90-95% of the results?