hair4tomo

That's a good point, but I don't feel as if I'm someone that's vulnerable to the placebo effect.

I know I won't get an unbiased population sample in this poll, but it's just something to take into consideration.

For the person who voted "Minor negative side effects which are still persisting for months or even years despite not taking the drug any more", can you describe in more detail please?

I'm soon about to begin taking Finasteride, and would like some more reassurance before I start, so I created this poll.

I've learnt that when using Regaine/Rogaine (minoxidil), that if you have success (or merely no change in hair loss, which is sort of success), but then if you go off it, your hair loss shortly afterwards will have been as if you never took Rogaine in the first place. In other words, worse than when you first started (even after shedding recovery). This seems a shame - I was hoping that it would act as a "pause mode" where your hair cells stop deteriorating whilst you're on it. Can someone confirm this?

Attached here is a picture which neatly illustrates what I'm trying to say. I'm hoping for Loss Pattern A, but I expect that Regaine would cause Loss Pattern B if I stopped taking it:

I was wondering if other treatments were like this too, or if they acted as more of a true "Pause" function (Pattern A in picture). For example, does dutasteride (Avodart), finasteride (Propecia and Proscar) also act like this whereby halting treatment means a gradual natural steady loss FROM the point of any regrowth obtained (Pattern A)? How about using a derma pen/roller to microneedle the scalp? Or how about shampoo like this which contains DHT blocking chemicals?

I want a "pause function" for the next few months/years, whilst I consider hair transplant treatment further down the line.

Thanks all, saw this Dr Pen A6 product, but it only got 3.9/5: https://www.amazon.co.uk/Certification-TopDirect-Microneedle-Cartridges-Rechargeable/dp/B07JJ7YCFD

Would something like this pen be suitable: https://www.amazon.co.uk/Titanium-Cartridges-0-25-2-5mm-Koi-Beauty/dp/B01J7PSSOI

Allows 0.25mm up to 2.5mm I think. Looks like the product's just for women, but I'm sure that doesn't matter. It also says it's both a pen AND a roller, but then so did Dr Pen A6 product.

22 hours ago, Shifty said:

I use the Doctor Pen A6. I do not use minox and pen on the same nights as Mycroft stated, you increase chances of side effects. 

What sort of side effects are we looking at? Just greater chances of the existing Minoxidil side effects, or new?

2 minutes ago, Mycroft said:

It's because applying it after the needling increases the absorption, which in turn increases the possibility of it going systemic (and you experiencing systemic side effects). Having said that, I haven't been getting any sides, so I don't worry about it at all and it's probably helping.

Interesting, thanks.

Can anyone else chime in on using these two almost simultaneously (2mm needles + minoxidil). I might be a bit braver with the longer needles if others can corroborate Mycroft's technique.

On 6/19/2019 at 9:23 PM, Mycroft said:

I apply minoxidil right after needling, though I do clean my scalp of any trace blood that may have come out first.

Why do you think they warn not to use minoxidil and these stamps together? Also, why not simply skip minoxidil the day you have the stamp done?

On 6/13/2019 at 6:23 PM, RecessionProof said:

Minox works well in most cases too, but keep in mind you'll have to rub that stuff into your scalp at least once a day for the rest of your life (or until you stop caring).

Wouldn't that apply for Finasteride too? (every day for life)

On 5/31/2019 at 10:29 PM, CosmoKramer said:

Great article Melvin.

I purchased a Derma Pen recently after seeing some impressive  “results” on the tressless reddit page and have just started microneedling myself, hoping to better fill-in my mid/crown area. After a couple uses, already I see some improvement.

The pen is great I gotta say, much better and more efficient than the roller (I’ve used the cheap roller a couple years ago but not really consistently.

Any further progress with the pen? How often do you use it?

42 minutes ago, Mycroft said:

Most of the studies linking significant hair growth to micro needling utilized a 1.5 mm needle. Consequently, most laymen I've seen trying it out at home are emulating that.

You had good results with the pen you spoke about? How many times a week do you use it and where did you get it from - can you give a link?

1.5mm needles sounds scary and painful. The same Amazon web site said up to 1mm is okay if not using minoxidil. So I'm a little wary about going higher than that.

22 minutes ago, Shifty said:

1.5 but with the derma pen I vary between 1 and 2 depending on how much it hurts lol

Looking at a derma roller product on Amazon, it warns: "NEVER use a needle length longer than 0.5mm with minoxidil.". I know you used them on different days, but I'd be wary even if the two weren't used on the same day. Thoughts?

Do you think 0.5mm would be as effective? Also, why did you switch to the pen if you were getting such amazing results with the roller?

Ah thanks. Amazing results you have there. What mm size needles on the roller did you use? 0.5mm? 0.3mm?

Do you have a link to the Nizoral product? If I were to go for one, should I pick the Nizoral one or the "HAIR RESTORATION LABORATORIES' 2019 PROFESSIONAL STRENGTH" one?

Hi Shifty, Just wondering why the derma roller isn't part of your "big three" (to make a big four) if it gave you such success?

Thanks all. Replies to some of you below. If/when I reach peak restoration where no more regrowth is going to happen, which of the two medications (if either) would be most appropriate to discontinue? 

On 6/13/2019 at 6:23 PM, RecessionProof said:

If you're pretty sure there's more hair loss to come (I would guess there is), you should definitely try finasteride first. It addresses the root cause of balding and will usually make the biggest difference in keeping your hair over the years. 

Minox works well in most cases too, but keep in mind you'll have to rub that stuff into your scalp at least once a day for the rest of your life (or until you stop caring).

Instructions say twice a day, but maybe if I see no improvement after a certain period, I can reduce it down to once per day?

On 6/13/2019 at 6:29 PM, Dr Blake Bloxham said:

A lot of patients start them simultaneously. The argument for starting both at the same time would be: overlapping the initial shedding phases (each drug carries a 3-4 month initial shedding phase) so you do not need to go through this twice, and increasing the strength and efficacy of your preventive regiment. The argument against this would really be that if you did experience some sort of negative effect, it is difficult to tell where it is coming from and how to make adjustments if you started two medications at the same time. 

If you are looking to stagger them, I think most patients would start with Propecia -- which will likely be the most effective as well. 

Shedding? Glad you warned me - that's sounds scary. Is it unlikely, likely, or guaranteed? If I do experience negative effects from either, would those effects surface within a week or two? I can certainly wait that long and just use one for a couple of weeks before I start using both together.

I've recently bought Finasteride (Propecia - 1mg tablet per day) and Minoxidil (Regaine, a foam to run in scalp twice a day) from my local chemist, and was wondering how should I go about trying them out to see which works best.

Options are: Try Finasteride for now, then Minoxidil later. Or alternatively, maybe do Minoxidil now, and Finasteride later. Or as a third option, maybe just start both treatments now simultaneously. I think the last option will have the best chance to produce the most regrowth/stabilization, but then I'm less likely to see which option is most beneficial. Perhaps one will have no effect, whilst the other does all the work, but then I'm paying for two things instead of one.

Any advice appreciated. I'm also thinking of having a hair transplant in around 6-12 months as I have level 2-3 (vertex) on the Norwood scale.

10 minutes ago, Sean said:

Dr Keser is really really good too when it comes to hairlines.  He is based out of Turkey.  He does manual extraction and does smaller procedures per session to maximize graft survival.  

Any idea what percentage extra of hairs can be saved with shorter procedures? Also by shorter, do you mean around 1000-1500?

Thanks Fozzie, I've added any of your new recommendations to the totals. FUE is definitely my favoured choice for HT.

Where's Dr Keser based?

Thanks both for the suggestions. Yes, both of those were on my shortlist.

After trawling through several posts in this forum (searching for European/UK surgeons), I collected a list of all the surgeons who were mentioned by users in this forum, and have sorted them by how many times each surgeon was mentioned (with the users who mentioned each next to them). Results are below (note that they are not all from the UK) :-

14 recommendations: Dr Feriduni (Belgium) : Bill - Managing Publisher, spex, RCWest, Blake Bloxham Forum Co-Moderator, HARIRI, England, JohnnyDrama, Melvin-Moderator Forum Co-Moderator, Dutch, Rootz, Mickey85, alix, snowman, fozzie
11 recommendations: Dr Farjo (UK): mikeyhwk, hairthere, fozzie, thanatopsis_awry, spex, Guest donald, RCWest, aaron1234, HairsGone, Melvin-Moderator
11 recommendations: Dr Bisanga (Belgium) : Topcat611, spex, HARIRI, Cant decide, JohnnyDrama, Melvin-Moderator Forum Co-Moderator, Dutch, Mickey85, Rootz, delancey, fozzie
10 recommendations: Dr Lorenzo (Spain) : mikeyhwk, Jessop, Mickey85, HARIRI, HairsGone, Dutch, FUE2014, Rootz, Melvin-Moderator, fozzie
6 recommendations: Dr Reddy (UK): fozzie, fueBobby, HairsGone, Mickey85, FUE2014, Melvin-Moderator
5 recommendations: Dr Koray Erdogan (Turkey): HARIRI, HairsGone, Dutch, FUE2014, Mickey85
5 recommendations: Dr Devroye (Belgium) : spex, RCWest, Blake Bloxham Forum Co-Moderator, Dutch, Bill - Managing Publisher
4 recommendations: Dr Ball (UK): mikeyhwk, fozzie, HairsGone, Sean
3 recommendations: Dr Mwamba (Belgium) : spex, JohnnyDrama, Mickey85
3 recommendations: Dr Keser (Turkey) : mikeyhwk, Maines, Sean
3 recommendations: Dr Couto (Spain): mikeyhwk, fozzie, Sean
2 recommendations: Dr Bhatti (UK): itxrd , mikeyhwk

FWIW. Bear in mind, there are thousands of posts I DIDN'T view, so this will be error-prone and restricted to posts where I searched for "best UK hair surgeon" or similar. I'm sure there are many excellent worldwide surgeons missing from this list.

I've spent hours browsing the forum and the closest match to the question was from three years ago here

So I'd like an update if possible. Personally at age 40, I have a Norwood stage 3 or 4 right now, so I'm trying to narrow my search down further before I commit to a decision. I am apparently suitable for (and frankly, prefer) FUE, so that may influence my focus for this topic.

"Best" is subjective, but we can take into consideration factors such as: Symmetry, least chance of shockloss, least unnecessary loss from donor area, yield rate for transplanted hairs, equal spacing between transplanted hairs, appropriate feathering, hair angle accuracy, appropriate hair texture, and I'm sure a few other factors I'm forgetting.

Which UK or nearby surgeon ticks all the boxes?

I don't want accuracy, just a very rough approximate.

Nah it's fine. I'll just go for a more expensive one.

I was just wondering about the success rate for the average one, but if you don't know, that's fine, no worries.

Thanks for your feedback both. What are the odds (as a percentage) for permanently losing significant (noticeable) existing thinning hair under an 'average' surgeon, versus a top 20% surgeon versus a top 5% surgeon?

Say if I went with an average or below average hair transplant surgeon using the FUE technique, and I had hair from the back of my head transplanted to my thinning temples. Now, I already have existing hair around my temples, but it's quite thin, so I'd like some more hair there. What are the chances that transplanting hair to that region will damage the EXISTING hairs that were already there?

I'm thinking of going for a somewhat cheaper surgeon, but I'm worried I'll lose existing hair in my temples. Is there any chance of that? Or is the 'danger' simply only that a good percentage of the newly transplanted hairs may not themselves succeed.

I'm approximately at stage 3 on this chart, and I want to improve matters: https://i.imgur.com/NX8SJ7z.png

There seem relatively few reviews of Dr Camilo Diaz compared to many, so I was wondering if any of you could share experiences of this particular surgeon. He seems pretty well qualified being an expert in dermatology and is listed at the gmc-uk . org site (GMC Registration Number: 4684985), so I know he's legit.

However, I am curious to see results of his work, including immediately post surgery, and after twelve months or so.