j1mmy

Anyone telling you to stop finasteride before or after must know something that nobody else does, because that is wreckless. Minoxidil 0-14 days before (depends on the clinic), some of the worlds best even have 0-2 so it probably doesn't matter. 14 days after was a good idea.

I regretted clicking the video, because it is just another youtuber with an awful pluggy hairline, that he probably got endorsement for. He doesn't even know it is pluggy, nor apparently his audience, so good for him. I do however think it falsely promotes unnatural work, so his audience runs off and gets it done, until they realise they want a repair.

It may be nothing, but may be everything. Think back to when you last changed brand and when you noticed a change, and is there a link? I once changed from one generic that I got results with, to another, and went through a shed and lost ground. After hearing similar reports from others being switched around, I went on brand name Merck (the original), and got the same kicked in the nuts initial side-effect I got like the first time I started the medication. The results followed that observation. if you have ruled that out, then according to the data a 5mg daily dose (available as proscar 5mg, merck) gives a slight edge in effect over 1mg (propecia, merck). In which case, it is possible to consider taking more than 1mg per day, but take your time to increase your dose, no need to jump on 5mg immediately.

Did you change the source of your finasteride at that losing ground timeframe, or have you been consistent with the brand of finasteride? What dose have you been taking for 5 years (e.g. 1mg per day)? How is your compliance been? Same for minoxidil, what is your dose (e.g. 1ml per day, 2ml per day)? How has your compliance been?

I personally still think you should consider to try .25mg a few times per week, rather than every day. Give yourself some psychological, and potentially physical relief. When you are young, stressed (and/or depressed) about hair loss, stressed about the medication you are taking, not sexually active (right now), these are compounding any issues you may be experiencing. Roughly half of people with traumatic brain injuries experience reduced libido, a lot comes from our brain more so than our body. Any level of medication is reducing DHT, and therefore providing you significant benefits to your hair. You simply need to find a sweet spot, and if that sweet spot cannot occur at a very low-level, intermittent dose, you have to weigh up whether this is something for you. Two months is around when people might notice the cessation of daily hair fall, rather than improvements in hair count, which continues beyond 12-18 months. When I began taking treating my hair loss, a shed was making me feel itchy and play with my hair all the time. After a few months this stopped, and my hair felt more robust and strong like you could pull on it. When you are actively not so worried about your hair, then you know it has starting taking effect. It has a good effect for nearly 90% of people, so there is no question it works. Speaking from personal experience in case it helps, I started at the same age as you are now. I don't recall noticing how frequent morning erections were a thing, so it was probably not very consistent and certainly not a predictable normality. Unless you are experiencing serious issues, I would hedge that nocturnal erections are likely occurring, like you mention with having sex dreams. It is the same for me today, 10 years later. Sometimes they happen, but I am not being cognizant of when it happens or doesn't. At that age I got a lot of spontaneous erections, it was quite an inconvenience. This might well be less since taking the medication, but it was a side effect I was perfectly ok with. I think seminal fluid was a transient observation, I have no issues shooting ropes today. Degree of "hardness" was never something I noticed, nor still. My only side-effect that I cannot elucidate fully, is whether I have reduced libido. It was something I thought I noticed when beginning medication, but I was in the same situation as you with compounding stresses. I was with a girl after that for several years and questioned my libido, we eventually parted as a friends due to becoming friends rather than lovers. I am however now with a smoking hot younger girl, and my libido is fine, and better than at any point during those 7 years

So I have buzzed my head periodically over the last decade, when I have felt my hair looked particularly bad, otherwise I am mostly cutting my hair myself anyway, and living my life as a diffuse NW4A. I look ok with it, but I felt self-conscious, and it draws peoples attention to it and you are more susceptible to being the butt of a joke. There have been some people who have in a "kind" tone of voice said I suit it, though numerous women have more openly said "I prefer how you look with hair". I am an open person, so whilst it is not their business what I want to do, I respect that they were open with me. I remember I felt deeply upset when my previous girlfriend reacted that way, because she knew how sensitive I am about this issue, and when I had empowered myself again for a "final" hairstyle, she at first did not seem to accept me for who I was. Though as you can relate to, I was a little sensitive about it It is absolutely true, that shaving a full head of hair is not remotely comparable to shaving a balding pattern. This is quite honestly down to face framing, and that you do not feel judged based on not having hair loss. You are just a guy with hair, who buzzed his head. The more pronounced your hair loss, the shorter you might consider to buzz/shave your head to conceal the hair loss, whilst balancing the losing of face framing. If you are Bruce Willis bald, which was a mirror copy of my late father, then clean shaving understandably can empower you. I do personally think clean shaving any degree of hair loss is over-prescribed as the solution to hairloss by societal standards, because society creates this image that only strong balding mean clean shave their head. I think a buzz cut suits most advanced hair loss too, and is less upkeep than a shiny dome. Along the same vein, when we say "head shapes" that suit buzzed/bald it boils down to masculinity of the face shape. If you have have any of the celebrity "head shapes" that suit being bald, you probably had a squarer face, squarer jaw, more pronounced eyebrows. I would like to state, more power to guys who clean shave their head. I would simply recommend people do try shorter and shorter cuts to see what they are actually most comfortable with. Sorry for the long post!

I looked into this myself, with no clear conclusion. Everyone has a different opinion on when to stop, based on potential bleeding during surgery, stopping anything from 6 weeks to 0 days before, though 1-2 weeks seems the average. Restarting seems to be based on not harming new grafts with any chemicals or alcohols in minoxidil solutions, so grafts should be secure and scabs gone, in which case two weeks is recommended on average. I saw someone even suggest waiting until the transplanted hairs have shed, in which case 3-6 weeks. My instructions were 2 days before (so I did 3-4 to be sure since I know I bleed), and start 15 days after (think I started at 13-14 days since scabs were removed at 8). My conclusion was that you won't lose any results due to minoxidil, since even if there was a negative change after a few weeks, re-introducing minoxidil should launch those hairs back that were reliant on minoxidil. People typically say "follow your clinics guidelines, you chose them because you trust them, so why question them now?", but with every top clinic giving different answers, I logically want to get to the bottom of it myself. Hope this helps understand to decide what is best for you, rather than just confuse

Ok cool, nice to see someone from Russia! Hard to photograph I know, but try to capture the bottom of it too, so we/Dr's can see if there is any visible miniaturization at the nape.

You're the man @tripleg! Where are you based, out of curiosity? That is of course a factor with where to go should you decide to go this route, even with Europe as your net, as it was for me. Don't be afraid of online/video consultations, imagine how that has been performed and improved over the past 12 months. I don't know this for a certainty, but I think the people who you are considering have a decent idea of your donor and hair caliber from good pictures. They may not know your hairs/graft, or your donor size as a measurement but you are already equipped to gauge that. Should you be unable to meet them in person, you will have a good idea of what is the best plan and who to go with, and the plan will be fine tuned once the consultation happens in person. It also helps with a photo of the back, your occipital area is your density bullseye of your donor.

You can essentially do whatever you want, if your Dr is on board. By that, I mean that in a first procedure you could make a plan with your Dr to achieve a reasonable coverage at the hairline (you already have a hairline which is helpful), reasonable coverage in the mid-scalp, and feather in less grafts going backwards from there. Agreeing with gman, the typical advantage of frontal work is that at the very least you have facial framing and the largest cosmetic difference, when you had an untouched donor to source from. As time goes on, and the 2nd or 3rd procedure occurs, density in the mid-scalp/crown is subject to the availability of the remaining donor. That is a very logical approach, compared to if someone decided to work from the back forwards, and potentially running low on graft availability when it comes to really building the frontal third. Firstly, consider having a consultation with someone reputable to gauge a better assessment of your donor supply, the entire plan hinges on that. Secondly, understanding your concerns about a mega session, and given an average donor supply, I would favour a 2-stage approach. 1st step could be bigger and provide a significant cosmetic difference, but allow you to not feel like you just restored half of your head. Say 3000-4000 grafts with a bias towards the mid-scalp and frontal third. The second procedure, depending on your donor, address a bias towards the crown, but touch-up areas based on the results of your first procedure. I would say this is a typical approach, so you are not reinventing the wheel there.

I liked your observation about the chemist, thought it was just me that thought that At least I would hypothesise that they have a higher risk tolerance - both having multiple surgeries at a younger age. This is also interesting. "Although minoxidil is poorly absorbed through the skin, systemic doses in the range of 2.4 to 5.4 mg/day can be anticipated if application is made to entire scalp." https://jamanetwork.com/journals/jamadermatology/article-abstract/545803 I didn't think anything of side-effects when I used rogaine to good success several years ago. I weaned myself off mainly due to convenience and adherence. I started up again last year to improve my situation once deciding to go the surgery route after a relatively stable situation from finasteride for 10 years. I have however definitely experienced possible systemic side-effects - low-level headaches daily, higher resting pulse by about 5 beats (likely attributable to lowering blood pressure). If the study I shared holds some truth, along with my recent experience, there would be little difference in taking oral minoxidil at low doses. Definitely appealing based on the convenience, though with heart issues in my family, and limited access to such a prescription in my country, I don't think it is something for me right now. I also think it is worth noting that we need to understand the systemic difference between topical and oral, in order to understand the benefits vs risks. If they are indeed actually rather comparable, this opens things up to oral being more convenient.

It's important to pick a good Dr, which you are doing your due diligence with, but it helps to be as educated as you can be so that your expectations are as accurate as they can be. That way you don't need one place to tell you 2000, another place 4000, and not know why there is such a discrepancy. A hair transplant is an illusion of density, and can never look as full as a full head of hair. For that to be possible, you would probably have to remove every hair on the back/sides of your head and place them on top. If you look at for example Dr. Lorenzo on youtube who has hundreds of patient cases, positive and negative, you can find patients similar to yourself to get an idea of how many grafts can do what. This does not take into account hair thickness, colour, curls vs straight, but you will see that you usually require more grafts than you think you will. You will see that many of the higher hair loss scale patients were 3-5 surgeries, and sometimes up to 10000 grafts to get an ok coverage. You will see that often patients are most often recommended to focus on the frontal half of the scalp first, which might be 2500-4000 grafts for you, and a second surgery to focus on the crown. All of this is just to say, educate yourself to know what you want, 4000 grafts is not going to get you a head of hair like you used to have. It might get you the illusion that the frontal 2/3 is decent, or the back 1/3 is decent.

3.5 -4 euros / graft? Let's say 6000-8000 grafts over 2 procedures for coverage, with your current condition in 2021 - 25,000-30,000 euros. When you say budget is an issue, what are you talking about here? Dr. Arshad is 2.5 euros/graft I believe. Without medication, the number of grafts you would need for coverage for future hairloss is countless, perhaps impossible. 10000+ or an amount you very unlikely don't have. Sorry to tell you that. Unless you would be satisfied with restoring the frontal half of your scalp.

Well it seems from the studies Aloe has effectiveness in wound healing, for example in burn victims, for the first 10 days. I can be optimistic it helps with redness after that of course. My post-op was use of aloe from the clinic after the first wash, 4 days. I believe that was relieving from the dryness caused by twice daily washing, in addition to some wound healing/inflammatory benefits. I can't read Polish, but you haven't selected a good product, it has perfume and god knows what else. After using my clinics Aloe, I have switched to a 98% Aloe, and even that one is drying hard, not like the one I was provided which was moisturizing and soothing.

Good man. I can't see why that product wouldn't work. Note that any "novel" product carries the risk of it not being available in the future, that is one of the main reasons long-term finasteride users often recommend "get brand name propecia/proscar" - consistency and availability is not a concern as of now. I don't know how long this EssenGen-6 Plus has been on the market, or how long it will continue to be on the market. From my personal experience, I have used 1mg oral finasteride, and 5% minoxidil (on and off) for 10 years to good effect, very slow progression of hair loss. Oral finasteride suppresses DHT (scalp and serum DHT) by around 70%, thereby reducing DHT's harmful effects on hair. If I were taking topical finasteride, I would take a look at what the dose-response of it is, to know what I am taking know and for the future. According to this chart, https://fueclinic.com/services/treatments/topical-finasteride-0-025/ a dose of 0.25% (2.5mg per 1 ml) though effective for suppressing scalp DHT (comparable to oral finasteride), also suppresses serum DHT potentially more than oral finasteride. This could give a greater incidence of side effects. The lower doses (0.1% and 0.025%, 1mg/ml and 0.25mg/ml) were slightly less effective at reducing scalp DHT than 0.25%, but on the plus side did not suppress serum DHT nearly as much. EssenGen-6 Plus contains 6% minoxidil, and 0.05% (0.5mg/ml) finasteride, with twice daily application (like standalone 5% minoxidil recommends), for a total of 0.1% (1mg/ml) finasteride daily (see chart for dose-response relationship). Since you are combining two products in one, you are unfortunately not able to personalise dose of each, or know what effect each medicine will have on your hair loss, that's just how it is. I like both medicines, but not necessarily combined for that reason. Even so, you have bought this now, and as many Dr's and people have stated before, it is commonly believed that minoxidil only needs to be applied once/day, as it accumulates in your system and reaches "steady state" over some days. If I were starting my journey all over again, I would start on the lowest dose of finasteride possible in the beginning, and if I responded well, consider increasing my dose after some time. In this case, with this product, given the contents, I would definitely start at once/day. If I felt over time I wanted to use a higher dose of finasteride for a greater effect on scalp DHT, I would buy a different product, or topical finasteride standalone. Hope that offers clarity, rather than confusion!

In a sincere way - what were you thinking? Agree that you shouldn't appear "botched", but I suspect you will be unsatisfied with the density, given the graft spacing.

Yeah, sorry maybe my wording was bad, I understood that *I would have also consulted Dr Arshad*

The lower graft quote is also definitely on the "upper price range" category, and this just goes to show you how dangerous it can be to be misled by prices. That is not to say the first guy may not give you an excellent result, or he could be very highly rated for all I know. I know nothing about him, and he is significantly more expensive than someone we know is providing good work, at an affordable price.

Hey! I agree with what other knowledgeable posters said. It is often thrown out there that 1cm of hairline can be 1000-1500 grafts. I cannot see the results yet on my own surgery, but on my first day of surgery to recreate the hairline, I had around 1700 grafts for around 1-1.5cm hairline and temples. I would be very surprised if 700 grafts looked satisfactory. It is easy to feel you trust someone you have built a relationship with and they helped you by prescribing finasteride, however you have absolutely done the right thing consulting someone else for a second opinion. My impression of the first link you provided, was this "best case" example, is not very good in my opinion. If I was still living in the UK, I would have consulted Dr. Arshad. Many are reporting positive feedback as one of the few stand out there names in the UK. I would have consulted Dr. Reddy for a second opinion just on the plan, since his prices are definitely at a premium (charging per hair). I can't speak for the work quality personally of either of these Dr's, I haven't looked at their work, just familiar with what people have written about here.

Yeah hat looks like a decent match to be fair, being pretty straight. My beard is barely combable when newly washed, conditioned, oiled, due to being like a curly ginger brush. Basically means I don’t ever grow it as long as yours, becomes awful. I agree texture has more to say than colour, though mine is quite a mismatch with colour too

What SLA said. Beard hair looks like..... beard hair on your head. Might work for some, most probably not. Add in survival rates, density, it is an adjunct for few at best. Perhaps Indian patients at an Indian clinic have more compatible matches. My course dark ginger beard is decent, but will look pretty amusing blended in with my sandy blonde straight hair.

Cool, good to know. I have had some pimple looking things in the recipient area, no shedding yet I don't think. So I have been weary about sweating/getting hot too soon due to those coming and going. Definitely the grafts are safe! After 7 days if you don't have scabs, 9 days with scabs (so they say). I was feeling pretty safe at a 10 day milestone.

Agree, and same day as me too I did some lifting today You should limit sweating just to be safe, and be careful where you put your head in terms of bacteria. I just took it easy, lighter weights, longer rest times, and a disinfected mat for lying on a bench. Luckily I didn't wear a cap, that would have made things hotter! I will wait some more days before I take a jog or something. Let us know what you get up to For reference, my recommendation was "restrain from vigorous activity for 10-15 days", so if you are sensible, you can figure it out.

The dose-response curve for finasteride on DHT has always appeared to be "relatively" flat, meaning 0.2mg is not greatly different from from 1mg or 5mg. https://pubmed.ncbi.nlm.nih.gov/10495374/ That said, lower doses (0.2mg) have been shown to be less effective than higher doses. Which is a little conflicting, if lower doses are pretty effective at suppressing scalp DHT, though less effective at suppressing serum DHT. https://www.sciencedirect.com/science/article/pii/S0022202X15529357 "Initial Clinical Studies With Finasteride In Men With Androgenetic Alopecia Drake et al (1999) reported on the biochemical efficacy of finasteride in men with androgenetic alopecia (AGA), demonstrating that median scalp dihydrotestosterone DHT levels were decreased by 64% and 69% after 42 days of treatment at doses of 1 mg and 5 mg, respectively, compared to a 13% decrease with placebo. Median serum DHT levels decreased 71% and 72%, respectively, compared to a 1% increase with placebo. This study also demonstrated that at doses as low as 0.05 mg daily, finasteride significantly decreased scalp DHT, although only doses ≥0.2 mg were near-maximally effective in decreasing both scalp and serum DHT. Roberts et al (1999) reported on clinical dose-ranging studies with finasteride at doses of 5, 1, 0.2 and 0.01 mg/day in men with AGA. These studies demonstrated that finasteride treatment led to both an increase in hair count and cosmetic improvement in hair growth, establishing for the first time the proof of concept for the efficacy of finasteride in the treatment of men with AGA. The efficacy of finasteride 1 mg was similar to the efficacy observed with the 5-mg dose but was significantly greater than the efficacy observed with lower doses (0.2 mg and 0.01 mg) of finasteride. The 1-mg dose was generally well tolerated by patients, and its safety profile was similar to that seen with lower doses of finasteride or placebo. The 1-mg dose was thus chosen as optimal for further study in subsequent Phase III studies in men with AGA."

It is a relief to see the hairs so you can check if the direction and placement is what you hoped for. I think my scabs never looked like yours, so can't compare actually. Mine always swelled up with water when I washed, looking like white crusts on my head, and when dry were not as "solid" scabs as yours. Yours might not soften with water in the same way, but I'd see. At this stage as long as the shower temperature is just luke warm, and the pressure is low, I have no problem with showering directly onto my head for 10 minutes!