Curious25

On 7/26/2023 at 2:38 PM, Bertie said:

I've just watched a YouTube video ("Nizoral Shampoo For Hair Loss - THE TRUTH"), which recommends 2% Nizoral, rather than the usual 1% variety, which is apparently standard. I have been using Nizoral in the UK, but am not sure if it's the recommended 2% variety. In the UK, all it says on the bottle/packaging is Nizoral - Ketoconazole 20mg/g, and I buy it in 100ml bottles for greater economy. Is the the right stuff? Any recommendations on where to get it at 2% in the UK for a good price?

20mg/g = 20/1000 = 2% 

This Dr has been producing the most astonishing results within the industry for the last few years now - there is no competition.

Amazing so far , well done. 

You currently have no dilemma, you are just waiting for Dr Bisangas response. 
 

You need minoxidil my friend. 

Looks good. 
 

Are you going to return with the aim of solidifying the hairline and temples of you are keeping a short buzz cut ?  

Regardless of the definition of TRT - an increase in your personal levels of testosterone compared to your currently lower levels, has the potential to heighten the risk of hair loss. 

It will likely come down to; 

1) your follicles sensitivity to testosterone as an androgen

 and

2) how much of the additional testosterone will convert to DHT;

For example if you have a current test level of 400 - and propecia is currently blocking a 70% conversion of this to DHT, assuming propecia maintains its 70% block rate, and via TRT your T levels are upped to 800 - all variables stay the same eg. the excess T that remains free, aromatises and 5ar reduces at the same ratio - the remaining 30% of DHT will still be a higher value than what it was before. 
 

Could wreak havoc - could not. Depends on your sensitivity. 
 

As Melvin says - perhaps upping your regime to dutasteride may be of consideration between your and your dr, to increase the percentage inhibition factor - however you still have the potential issue of  testosterone to address.

This is where some people’s desire for utilising topical anti androgens comes into play. 
 

None of this is medical advice. 

Great Work ! 

That’s a heavy dosage ! 
 

But yes, you are correct - the studies point towards a correlation between the highest efficacy shown from the patients taking the higher end dosages. 

The Nike tick was so ingrained on my ankle last night that my gf thought I had a tattoo. 
 

Stopping this poison immediately. 

Finasteride is predominately used to maintain the remaining hairs on your head that are susceptible to DHT miniaturisation (by saying maintain, it refers to dramatically slowing down the balding process). 
 

So simply put - it becomes more so of a necessity to those with larger amounts of remaining hairs that are prone to miniaturisation via DHT, in which a Dr can check for early signs of miniaturisation during a trichoscopic examination. 
 

Some people face miniaturisation of the traditional donor area, therefore if they opt for the hair transplant route, it would be highly advisable for them to consider medication, otherwise their transplanted follicles will eventually start to thin out and miniaturise away. 
 

Others may witness their balding halt at a NW5 grade, in which a successful transplant should be able to gain full coverage with donor hair that is unaffected by DHT.
 

There is no exact way of knowing - so it’s important to consider family history, and go for regular check ups with a reputable hair loss Dr to continually check for signs of miniaturisation.   

7 hours ago, Rossybop said:

- Might experience any side effects from dut; advanced shedding for a few weeks etc?

- Should I expect awesome results with dut? A lot less hair loss? Perhaps thicker hair?

- If I use dut 0.5mg x 4 weekly will that be strong enough, seen as it has a long half life, or should I just use it every day, or maybe even 5 days a week?

 

- Potentially. Which will be a good indicator that you’re responding better to dutasteride compared to finasteride. 
 

- No. You should set the benchmark low and hope for maintenance (drastic slowing of hairloss) and let anything additional be a bonus. A higher dosage frequency will lead to a higher likelihood of benefits. 
 

-Using 0.5mg daily is optimum - especially if you are aiming for regrowth. You could taper yourself onto that dosage - however if you’re going from 1mg daily fin with no sides - swapping that to 0.5mg daily dut, you should be ok. 

If by full density you mean, native density (the same fu per cm2 as non balding areas of your scalp) - then yes, the Dr is correct by saying this is not feasible because 

1) the low end average of native density is around 70FU per cm2 and most Dr’s cite this as being impossible to implant in one sitting - I have only ever saw one particular Dr who claims to transplant at this density in one pass during the last 15 years. 

2) That level of density is not actually required to provide you with a full looking head of hair. 
 

3) You would probably utilise all, if not more, of your available grafts from your donor zone if you were to pursue with this plan. 
 

If the Dr is referring to not being able to get you to a point of looking like you have a full head of hair in the front after 1 pass, then he could be correct, however others might feel differently. You really need to go for in person consultations to get the most accurate assessments on your situation - uploaded photos are more times than not heavily deceiving of the reality of the situation.  

Temples are appearing a lot more closed than what we are used to seeing in his recent pictures with the Prince. 
 

Bit of a strange temple closure - which makes me ponder whether it’s just a hair taken from his hairline brushed across to hide the recession. But I am leaning towards it likely being a surgery from around 4 months ago. 
 

11 hours ago, FinallyHT said:

When you start a new medication, how many months does it take to grow back the hairs that shed? Could it take 6 months or more? 

After a hair physically exits , I believe the usual time frame for it to ‘sprout’ again, is 3 months. 
 

When it becomes visible depends on the length of your hair, and the strength of that individual follicle - if it was severely miniaturised, chances are it will take a few shedding cycles for it to regain any sort of substance to make an impact visually. 

$785 for a pack of 30? That is unbelievable - what the hell is the reason behind that? 

Do you mean you were prescribed 5mg of oral Minoxidil, and you are taking 2.5mg of it. Because 0.5mg and 0.25mg are extremely low doses. 

You could transplant the front as that area is already bald - and then hopefully the medications will help strengthen your thinning in the vertex and crown.

In your own time, and if you are comfortable - aim to increase the dosages to 1mg daily finasteride and 5mg daily minoxidil to really give yourself the best chance of benefiting from them. 

How much has it increased by? 

Im terms of efficacy (and convenience) 

Oral > Topical 

Always. 

Some theories suggest that testosterone can also play a role in androgenic alopecia, albeit to a lesser extent than DHT. 
 

Or - you could just have follicles that are extremely sensitive to DHT, and the ~70% reduction finasteride provides isn’t quite sufficient in halting your hair loss. 
 

There are some anecdotes online of people incorporating dutasteride once or twice a week, in replacement of taking finasteride on that particular day/s - could be a good way to start tapering in to it. Because of the extremely large half life of dutasteride, some people feel that daily consumption is unnecessary anyway.

I myself I take fin 6 days a week, and dut 1 day a week - I started that regime three months ago in the hope of experiencing some further regrowth - so i’m hopeful to see some benefits towards the end of the year. Let’s see. 

However I echo the above sentiments, if you are fine on fin, you will likely be fine on dut. 

7 hours ago, hairison_ford said:

Yes, been there. Most docs don't seem to report seeing this but I've definitely experienced this 'cyclical shedding' myself and I've seen plenty of online anecdotes from people who have too. 

Been on fin consistently for 3 years and took photos every time I had a monthly haircut to track progress for the first 2ish years, so I knew I wasn't just imagining things. Had a huge shed over the first 3 months that took me to below baseline, got a ton of regrowth for about 3 months afterwards that took me to above baseline, and then went through several sheds/regrowth cycles over the next couple years at roughly that same cadence, though with reduced degree of shedding/regrowth each cycle. I also messed around with minoxidil on/off during this time, so that may have contributed a bit as well. I'd say it's been pretty stable over the last year with only minor sheds that I notice every now and then, but I ended up stabilizing at about pre-medication baseline -- which is fine for me as long as it's maintaining.

The 'theory' that I've seen floating around is that the medication synchronizes your hair follicles' growth/shed cycles when you start taking it. So a bunch of miniaturized hairs shed all at once, then they regrow back all at once, but because they're miniaturized they have a shorter growth period and will shed again within a few months, and so on. Eventually they become desynchronized and the shedding/regrowth cycles become less obvious. If the hairs were miniaturized enough to begin with, they may not be able to become terminal again even with medication, and so they may get 'stuck' like this for a long time/indefinitely. Again, that's just a theory I've seen floating around on the internet so take it with a grain of salt, but it makes sense to me and aligns with my experience.

Thanks. 
 

Yea that does make sense to me - miniaturised hair that is recoverable will likely need multiple cycles of a reduced DHT environment that remains consistently reduced for a sustained time period, as opposed to shedding at the first instance of a reduction in serum DHT and then miraculously growing back to their former glory right away. 
 

Probably why the studies allude to final results after 2 years. 

Yep, no unwanted sides from anything. 

Any one else experience this? 
 

I’m currently on all three -

ORAL MINOXIDIL

OM 5mg daily since Jan 2022. 

FINASTERIDE
Finasteride 0.5mg EOD Aug 2022 - Nov 2022
Finasteride 1mg daily Nov 2022 -March 2022 

Finasteride 1mg 6x a week March 2022 - present 

DUTASTERIDE

Dutasteride 0.5mg 1x per week March 2022 - present

I’ve been making really nice progres , however over the last two weeks I’ve noticed an increase in shedding and I actually thought that I looked like I have regressed to pre medication baseline this morning when I woke up. 
 

Most doctors and online info just refer to the initial shed that meds often times incur, however I’ve read a few anecdotal accounts of people saying they experience multiple phases of shedding, to then return better than previously - and I have two notable  periods in mind (November 22 and Jan 22) where I felt I had less density than the prior months, only to then seemingly make more ground following on from this. 
 

This recent shed has been a kick in the teeth, because as I say, I was feeling really great about things only a few weeks ago, to then go on to feeling very underwhelmed today at what I was seeing in the mirror. 
 

I guess logic would point to the introduction of dutasteride 1x a week being within the last 3 months, so it very well might be an initial shed from that . . It’s just annoying to think it could potentially be a continuous phase of shedding and growing for the foreseeable, if that’s how it works for diffuse thinning ? 

1 hour ago, Rafael Manelli said:

What exactly do you mean about the temple closure? 

The rounding of the angle in which the hairline meets the temple.  

I want to add - it would be far better if you let your hair grow out for another 2-3 weeks from this length to give better judgement of the current state of your donor (short and fair coloured hair makes it hard to ascertain the density). 
 

From these pics - I would hedge a bet that you are in the transition between a NW5 going onto NW6.