Leftwithrope

Just a quick question for people who've used Minoxidil: how long did it take for Minoxidil to fully exhibit its strengthening effect?

I'm 5 months in on 5mg OD oral minoxidil and my miniaturized hairs have become noticeably more robust. The thing is, I am contemplating increasing the dosage to 2x 5mg daily for better results, but may postpone the idea if I still have much to reap from my current dosage.

Would appreciate any advice from ex/current minoxidil users.

Hey Legend, could you post a picture of your hair right now? Am curious as to whether your weaker areas have filled in/thickened up.

4 hours ago, Yaro said:

What about a haircut to combat this? My understanding is that from month six onward it is possible to have a regular cut

 

That's cool, man. Rep for clarifying!

A haircut helps a lot in terms of tidiness, though hair around the 6 month mark is usually 1.5-2 inches long, so you will be limited to hairstyles that are tighter on the sides. 

Personally, I think transplanted hair really only start to blend in with native hair after a year; the unevenness in graft maturation does prevent your hair from looking as robust as it should.

That being said, 6-9 months is around the time when you'll be able to regain a pre-balding appearance, even if it doesn't look as great as it should yet.

Good luck!

Transplanted hairs will look like a clusterfuck because of uneven length and thickness until past the 12-15 month mark.

5 hours ago, jjsrader said:

I'm a very white guy w/very little body hair or arm or leg hair.  As I've gotten older all the hair on my lower arms & all of my legs has decreased by probably 40% at least (or got lighter/more fine).  I do have a hereditary minor skin condition that looks like freckles but are actually light red discoloration dots on my lower arms and on my legs that killed off alot of original hair.

I've noticed just a little bit more hair around my eyebrows & fuller eyebrows and some vellus hairs around my temples.  I'm 52 so having fuller eyebrows (somewhat) makes me appear younger - even though about 25% of them are grey now.  I've noticed fuller temple point growth as well - even though I had 400 grafts (200 on each side) added to these areas in March '17  via FUT + FUE surgery megassesion.

So, compared to normal guys I am about 80% less hairy as a baseline.  For me then, upping my dose over time hasn't been an issue whatsoever.  My beard seems about the same or maybe just somewhat more robust (marginally) - but I have average beard hair - haven't noticed it growing faster.  But I only shave down to stubble 1X per week anyways.  I don't have to shave for my regular day to day - so I can't really guess if it grows in back faster.

Everybody's different - genetics dictate one's results.  If you are responding well w/5mg 1X per day in only 4 months - w/just a few minor inconveniences - it's a win/win in my book.  I personally don't think increasing your dose over time will make you twice as hairy (5mgs X's 2 daily) w/your already established side effects.

Just means you are a good responder and would probably do better at a higher dose over time.  I've noticed no difference other than what I described going from 5mg once a day to 10mg 2X's per day over the last 19 months or so.

I plan on staying on oral minox.  In 19 months my crown has gone from slightly thin (keep in mind I've had 8.5K grafts - I'd be a NW V without hair restoration & a NW VI without medical therapy) to basically no cosmetic appearing thinning.  My midscalp vertex has thickened every so slightly.

I have added a 420+ diode laser hair helmet regimen that I use religiously 4 days on/1 day off/3 days on/1 day off for 22 minutes a session in the last 21 months - this has made my existing transplanted & native hair more robust & is an 'additive' treatment modality in my opinion. 

I can wear my hair long again and it appears healthier (less breakage) & my donor hair seems of better quality as well (much better). 

So, I've stayed on Avodart (Dutasteride) since 2002 & since full maturation of my last hair transplant (by 05/18)  - the only thing I changed was going from 30% custom-compounded minoxidil cream I applied 2X's per day to oral minox (05/18) & added the hair helmet (03/18).

I can see the difference - it is not a monster difference - but there is improvement over time.  That's about all I could ask for.

 

Thanks for the informative reply, JJ. 

Going from 5mg to 20mg without any noticeable increase in sides sounds pretty insane. Correct me if I'm wrong, but it sounds like you're saying that once side effects have been established, an increased dosage is unlikely to compound them (taking 10mg will not make you hairier than 5mg does). 

I was always of the opinion (and fearful) that increased dosage would simply worsen any side effects you were currently experiencing.

Congratulations on your new look too. How long did oral min work for you before its results started to peak? Also, which laser cap are you using? I was thinking of getting one myself, but am not wholly convinced of their effectiveness

@jjsradar Man, how do you cope with the hypertrichosis. Have been on 5mg 1xdaily for 4 months, and I've had tiny vellus hairs pop up below my hairline. The hair on my arms are significantly darker and longer. I also need to shave my moustache and beard every 3 days now instead of 5 days before (am Asian). 

That said, I'm very satisfied with how it's made my miniaturized hairs stronger and thicker. Oral min and finasteride seem to work together well. I was contemplating upping my dose to 5mg twice daily, but am mainly concerned with whether an increased dose would mean increased hypertrichosis. Would appreciate if you could share some of your experiences with upping your dose from 5mg.

First of all, if you aren't already on finasteride and minoxidil, get on it. Your scalp seems to be mostly contain miniaturized hair instead of completely dead follicles, so you stand a good chance of restoring their thickness. 

Secondly, only look at India and Thailand for hair transplants within Southeast Asia. That being said, I think most people here would agree that you're not an ideal candidate for a hair transplant. Your hair loss pattern is diffuse, which means that a hair transplant might do more harm than good because all that miniaturized hair that you currently have would be gone from shock loss from the surgery. Go visit one of the many dermatologists in the Orchard/Somerset area; Dr Tyng Tan seems to be a common choice for many. The cost of hair loss medication in Singapore can be prohibitive, so look at online pharmacists if you need to get them cheap. 

Go visit Dr Tan and find out what she has to say about your condition. I think she'll also agree that your condition would be best managed by finasteride and minoxidil. You actually stand a good chance on these 2, buddy.

4 hours ago, Greg_Swanson said:

Hey brother,

Yeah man, all up it contains: zinc, picolinate, biotin, tyrosine, vit-E, Zinc, fin 0.5mg, and minox 1mg.

Though, I'm really not sure how effective oral minox is. Admittedly, I haven't researched much about oral minoxidil. 

Derm has an in-house compound pharmacy, and the whole concoction is really quite cheap.

Mate, how long have you been on that pill? You mentioned having a shed on your own thread and it's known that minoxidil can cause a dreadful shed phase before it works its magic. Oral Minoxidil (brand name Loniten) is known to be a potent alternative to topical minoxidil. Users and anecdotal evidence from doctors have claimed that oral minoxidil is superior to topical in regrowing hair, but do not recommend it to majority of their patients because it has not been FDA approved. 

I'm bringing up this old thread so you can learn more about oral minoxidi

Doctors who prescribe it usually advise their patients to take a maximum of 5mg as this stimulates hair growth while keeping the risk of side effects at a minimum. I myself am looking to give oral minoxidil 5mg a try soon. 

27 minutes ago, Legend007 said:

Listen to Lenny , he makes sense ..  but yeah , don’t cheap out on urself n ur hair .. it will cost u more in the long run .. n don’t waste time on marketing shampoos n nutrients .. if u losing ur hair . N it’s aggressive . Don’t mess around n waste time .ur hair is thinning n aging each year while u trying new products.. u know what u got to do .. u have to prevent  free testostorones  from turning to dht n attaching  ur hair follicles .. It shrinks the root of the hair , then the shaft n hair itself , so it falls out easier . So if ur body don’t go grow hair faster than u lose them . U going to be balder faster than u want .. so take them meds . N don’t feel bad about it .. when we balding, we have a hairloss issue .its a chronic progressive issue .. u can only slow it down .. its part of the aging process .. but do nothing , it gets worse faster . 

 

 

I'm actually running out of finasteride and the next batch of it that I'll be receiving from overseas will only be here 4 to 5 days after I've exhausted my current supply. Is it possible to temporarily go down to 0.5mg for a week or so and resume 1mg after. I have only been on fin for 1 month.

On 5/15/2019 at 7:01 PM, Greg_Swanson said:

I'm having trouble committing to a transplant, and can't pull the trigger.

I'm a NW 3, 28 years old, and it's really affecting my life, but I'm so concerned with the "what if's".

What if the transplant fails, what if my recession progresses to the point that getting more transplants isn't an option, and so on. Every surgeon I've spoken to says I'm a candidate, but this is simply from a few photographs, with no way of knowing what the future holds.

How did everyone get over the hump, and overall, are you happy that you had the procedure?

It's such a weird place, to be so desperate to fix your hair, but still so cautious about the future.

Thanks all.

Take it from a 24 year old who's just gone from a Norwood 2A to a Norwood 1 from a single hair transplant. I'll tell you about the things I've overlooked in my quest to restore my hairline:

1. I probably could have avoided getting the HT if I had got on finasteride and minoxidil. As mentioned, I was a norwood 2A then, which means I had a wispy forelock and very receded temples. I was so afraid of the shedding phase and having to remain on drugs for the rest of my life that I did not consider how effective they could have been for me. I probably would have completely regrown my forelock and a small part of my temples, making me a norwood 1.8 or 2. 

7 months after my HT, I had results that I was happy with, but realised that there was a straight line of about an inch running across my head behind the transplanted area which contained mostly short and miniaturized hairs. Imagine my horror when I now had a full head of hair but was still receding from behind the transplants. Looking at pre-op photos, the hairs that got miniaturized mostly provided cosmetic coverage, but a more informed person would have been able to tell that they were not perfectly healthy terminal hairs, and so would be prone to shock loss. Shock loss I did get, and they came back thinner and weaker than before when they finally regrew. I am now on finasteride and soon, Minoxidil, in hopes of saving these miniaturized follicles. If I could restore them to terminal hairs, my transplant would then be considered an astounding success.

Shock loss WILL happen to weak hairs around the recipient sites (even if these hairs still provide cosmetic coverage), and a good surgeon will make sure you are aware of this risk and plan your transplant accordingly. If I had gotten on fin and minox before the surgery, the hairs around my transplant would probably have been strong enough to resist the trauma of the surgery.

2. Waiting for the transplants to grow out was hellish for me. I am by nature a neurotic person, so the anxieties of waiting for my transplant to grow out, coupled with the fear of having people find out really did a number on my mental health. I had extremely bad depressive phases and anxiety attacks because I actually looked worse off than before the transplant due to shock loss.

Consider how mentally resilient you are and make plans about how you are going to deal with others and yourself while waiting for the transplants to grow out. It is only around the 6th and 7th month when you will receive significant cosmetic coverage from your transplants. Having used to be a model, actor and college heartthrob was what made this journey so painful for me. Some people on this forum get by with honesty and vulnerability. It's up to how mentally resilient you think you are.

3. Hair transplant results will never look as good as when you still had hair. This is especially true for the hairline, which is immediately visible to everyone. Hair transplants are meant to give you a dense look, not actual density, so while it may look good in almost all social situations, it will actually feel different and less dense to the touch for you.

Frontal hair loss is usually treated by dense packing at the hairline and then reducing density as the surgeon moves back to conserve your donor. This means that preservation of the hair behind the transplanted area is extremely critical to an aesthetically pleasing result. You do not want a wall of hair at the front with weak hair behind it (try and imagine looking at a skateboard ramp from the side. Flat and weak hair that gradually gives rise to a wall of hair). 

4. Manage your expectations. I cannot emphasize the importance of this. I went into  my HT believing that my results are going to be like Armani patients (the original Armani lol) and that I'll regain a semblance of my former glory. Thinking back, this was probably just wishful thinking on my part because I was still in shock over my hair loss, and I wanted to convince myself that this would be the easiest path to getting my hair (and all the things associated with my handsome looks) back.

What I actually got was a result that nobody could tell was from a hair transplant, and which other surgeons whom I've met locally, call 'good work'. When I look in the mirror, I notice all the imperfections (differences in density between a natural hairline and a transplanted one, patches of lower density behind or around the hairline, how different lighting can affect the perception of density) but it seems like noone but me is bothered by this. 

Would I have gone ahead with my HT were I to have known all of these? Probably, but only because the area requiring transplantation would be a lot smaller and also because I could have stood a chance against shock loss.

In other words, Greg, only consider a HT when you have exhausted all your options of medical treatment, and when you are aware of what a hair transplant will do, can do, and cannot do for you.

All the best mate.

On 5/15/2019 at 5:24 PM, Greg_Swanson said:

Hey mate,

Yeah I am. I am on a compound tablet which contains fin, minox, zinc, and some other vitamins, etc. 

My initial result with both seemed to be a pretty strong cessation of recession, and some minor, minor regrowth in the temples.

They still receded a little, so it didn't halt the MPB, just slowed it. Mind you, I know of people to which have had their MPB completely halted, so I think it's more person-to-person. 

I will be consulting with my derm in a week, and see what she thinks about upping it back to 1mg.

Hey mate,

Woah your tablet contains min? Exactly how much min is in there? You mentioned a strong cessation of recession; did you manage to thicken up the hair follicles that were miniaturized? I just saw your thread and will share my opinion there.

This question probably doesn't deserve a thread on its own, but I feel it's pretty important for me and anyone else who wants to have their expectations managed when it comes to hair loss treatments. I've recently hopped onto Finasteride and pretty soon, Minoxidil. I see two words being thrown around quite often when people talk about them - regrowth and thickening. For example here is an excerpt from ForHims' website:

"In one clinical study, 26% of men reported moderate to dense hair regrowth after using a 2% minoxidil topical treatment for 4 months. This shows that minoxidil does work if you’re patient and willing to use it consistently."

My question is: is there any difference between what the two terms actually mean for patients? Personally, it seems like regrowth refers to the emergence of new hairs where previously there might have been none (visually or physically), while thickening refers to the fattening up of miniaturized follicles. I have a band of hair  behind my transplants that has been miniaturized. They're not vellus yet but they're short, weak and don't offer any cosmetic coverage at all. As such, I'm hoping to hear whether these two terms mean the same, as it will be disheartening to know that the chances of thickening up these existing hairs are as slim as the chances of my personal assumption of what regrowth means.

Thanks guys.

2 hours ago, Legend007 said:

If u want to lower the dosage.. that’s fine .. anything is better than nothing in the hairloss battle .. but really though ? For cost cutting ? The recommended and most effective dosage is 1mg.. why would u want to go into the hairloss battle with a sword when u could of had a gun .. myself personally .. I’m 1.5 years in .. n I will do the full 2 years before I consider lowering my dosage .; the first two years of finasteride at the recommended dosage will hopefully put ur hair back Into a good state . My hair has gotten a little thicker , it felt like straw n very fragile before . So it’s an improvement . But I wish it be better .. 

Correct me if I'm wrong, but isn't there research proving that lower doses of finasteride work just as well as 1mg? 

Congratulations on recovering some of your hair. Around when did you notice an improvement? Are you also on Minoxidil?

2 hours ago, Greg_Swanson said:

Hey dude,

I had been on 1mg for about a year and a half, or so, and switched to .5mg for the past 6 months.

It's hard to say, but I think my recession progressed. I underwent a pretty heavy shed recently, and my temples receded further.

Now, this honestly could have had absolutely nothing to do with the change in dosage, and may have been external factors, my MPB progressing, and so on. Could it have impacted my hair? Sure, but I really cannot say.

I have read studies in which patients had experienced positive results as low as .2mg, so you can definitely still have a good result.

 

 

Hey Greg,

Are you also on minoxidil as well? You should probably speak to your doctor and find out if you should get on a higher dose of fin. What were your initial results with fin? Did you experience regrowth/thickening or did it only stop your MPB in its tracks? 

16 hours ago, Dr Blake Bloxham said:

Rope, 

I have seen many "good responders" to finasteride continue to enjoy the benefits at doses as low as 0.5mg daily and even 0.25mg daily. It does not mean your body will respond the same way, but it is not uncommon to be on a lower than recommended daily dose. However, you should ask the doctor who prescribed the medication and follow his/her advice to the letter. 

Hope this helps. 

Thank you Dr Bloxham.

You mentioned good responders so I assume there will be poor responders or non-responders. I'm wondering if you have ever in your career, seen cases where MPB actually accelerates when the patient gets on finasteride. Also, I'm wondering how finasteride actually causes regrowth for some patients as I understand that it only inhihits DHT and that minoxidil is the drug responsible for regrowth.

I have started finasteride for 2 weeks and am wondering if it's okay to cut down to 0.5mg for cost-cutting measures. My main concerns are that the sudden reduction in dosage would result in adverse effects for my hair. Would appreciate if anyone could lend their input on this.

Thanks

Thank you for your reply, Dr Sethi and Dr Bansal.

I understand that density often has to be limited due to the complications you mentioned. However, if the goal of achieving high density is split into 2 sessions, will these complications be avoidable? Also, are there any complications for a second hair transplant surgery that isn't widely known?

Thank you.

Hey guys,

It's been 7 months after my op and I'm rather satisfied with my results. I now have a hairline that frames my face but still find myself getting disheartened when I critically examine the density in a mirror. From a social distance, I appear to have a full head of hair but up close and in a mirror, it appears gappy especially when I view it from the bottom up.

I'm a perfectionist and I've also heard several times that a single procedure is unlikely to give you a very dense result. My question is; assuming you've had a densely packed result from the first procedure, how significant of an impact can a second procedure make when transplanting into the same area? I know native density is unrealistic because of donor availability, but for my age (23), I am really hoping for a result that is as dense as possible.

Thanks

Hey Jean,

Did adding more density to the previously transplanted areas add any significant coverage? Kinda hard to tell if it's your new hairline or the increased density that's giving you a dense look.

Dr Bhatti is a highly recommended doctor based in India.

2 hours ago, hairlinehelp said:

what clinic did you went to ?

Sorry, can't reveal here. PM me for more details.

Quick question. Does anyone know whether the using and subsequent disuse of minoxidil on native hairs will cause them to fall out? I am thinking of using it on the shocked areas to encourage growth.

Hello,

I promised to upload a picture of my results on another thread, so here we go.

I am 23 years old and am Southeast Asian, so majority of my hair has fine caliber with the exception of hair in my donor area, which is really coarse/thick. I decided to undergo a hair transplant at such a young age because it was psychologically too painful for me to be a norwood 3A at such a young age AND being asian. Even though it is only 7 months after the procedure, I am already beginning to feel the positive effects that a full head of hair can give. The transplanted hair is now 1.5-2 inches long while my native hair on top is 3-4 inches, so it'll take some more growing out for me to achieve a more seamless blend.

I experienced shock loss of terminal hairs above the transplanted area at around month 3, which is really causing the overall result to suffer.  You will not be able to see the shock loss here because I layered my native hairs over it. It's almost month 7 for me and I do see some signs of regrowth, so fingers crossed.

Statistics:

Grafts: 2500 (Doctor added in a free 100 grafts to offset any transection, so that makes it 2600)

Density: 50-55 grafts/cm^2, with lesser going further back

Hair characteristics: I had no measurements done for this, but when a trichologist used one of those magnifying tools on my scalp, my donor hairs seemed to be really fat and black, in contrast to the rest of my hairs, which is fine as is typical of Asian hair. This is probably why I managed to have good coverage. My hairstylist actually asked me if my surgeon transplanted at a higher density than my native density. Asians having lesser native density than other races + coarse donor was a huge help for me in this area.

Donor area is a bitch to photograph, but if scars are not visible even at a 1 guard buzz, then it's pretty good.

I will not name the doctor or clinic because he has explicitly stated that he does not wish for his results to be posted online without his discretion. He does not belong to any coalition and is practically unheard of in this forum.

6 hours ago, pkipling said:

Agreeing with BeHappy. Any hairs that shed due to the HT will come in fine and wispy at first and then thicken up and mature over time. I also encourage you to go ahead and post pictures if you believe it will serve you. We may be able to put your mind even more at ease if you post pre-op photos and some current ones. 

Alright, I will post pictures soon. I'm a young Asian (23 years old), so I believe there'll be a niche crowd who'll it be helpful for.

11 hours ago, BeHappy said:

New hair always starts as thin, fine, wispy hair. It's no different whether it's a transplanted hair or a new hair from a follicle that recently shed the previous hair. If you had shock loss late, then expect the hair to grow back late. It's going to be about two months behind the transplanted hair if you figure the transplanted hair fell out after one month and the other hair fell out two months later.

 

This is really interesting! So even the hairs on healthy non-balding people start off their growth cycles as fine, wispy and colorless hair?