Viney

Their Facebook "About" section is quite optimistic to say the least 😅:

During my first appointment with him I asked about it. I didn't indicate a preference for it, I was just genuinely curious about it. I didn't realise he would prescribe sublingual minoxidil until I looked at the script following my appointment. Anyway since it had been working for me I just stuck to it. I believe sublingual allows you to administer lower doses and still see a good response given it's converted directly in the blood stream. I also think side effects are even less common than oral so I don't see why I shouldn't take it? Many doctors will say sublingual is actually a better method of delivery for medication, you can see this if you use the search function on this forum.

Sublingual Minoxidil: For those curious of what Sublingual Minoxidil is, it's simply a sugar tablet which dissolves below the tongue over a space of a few minutes. I'm not supposed to eat or drink anything for approx 30 minutes after taking it. I won't lie it tastes pretty good. I get the sublingual minoxidil made at a compound pharmacy. Here's a picture of it on the left next to Dutasteride (Avodart) on the right. Not sure if this is or will be available outside of Australia. Here's a 10min presentation on it, if you can sit through it. I believe it's quite similar to oral minoxidil but it bypasses the liver which could result in even more efficacy (I also hope this might also be healthier for the liver): More info: More of my experience, pictures and other stuff can be found in my other thread here for those curious. I started this thread clueless back in December 2021:

Hey all, I thought it was a good time to start a thread in the Hair Loss drugs section given I've been on medication for a while now and have a decent bank of photos and data to share. I'll probably provide more details and pictures in other posts below but here's the key stuff: Medication and Timeline: 15 January 2022 - 16 March 2022 - 1mg Oral Finasteride daily. 17 March 2022 - 24 July 2022 - 0.5mg Oral Dutasteride daily, 0.9mg Sublingual Minoxidil daily 25 July 2022 - 7 February 2023 - 0.5mg Oral Dutasteride daily, 1.8mg Sublingual Minoxidil daily 8 February 2023 onwards - 0.5mg Oral Dutasteride daily, 2.7mg Sublingual Minoxidil daily I was 29 when commencing the medication. Comparative Pictures: Here's some pictures taken from my clinic, these are taken with a professional camera with flash on and they try their best to make them as comparable as possible. The cheeky buggers made me pay extra for these photos (they post them to you in the mail via USB lol?) so I hope you enjoy.... The left is March 2022, while the right is January 2023. I can post more of my own photos if you want from more angles, but they won't be in as controlled lighting or with a camera of this quality. You can also find more in my other topic which I'll link in the post below. Side Effects: In terms of side effects, I haven't noticed anything significant, any bad trends or lingering issues. I don't really think about side effects and try not to read much online, I just focus on ensuring I take my meds every single day and so far that's worked fine for me. Everything still works as it should. I also don't recall ever experiencing or noticing a shed and I've taken my own pictures of my hair approx every 2-3 months. Donor Density: I've got comparative data from when I first saw my dermatologist in March 2022 (prior to any minoxidil or dutasteride) to now. This involves my dermatologist trimming my hair short in 3 donor areas and counting under a microscope the number of hairs per square cm. My dermatologist works at Sinclair Dermatology in Melbourne (under Rodney Sinclair) and has previous experience working at BHR Clinic with Dr Bisanga so I think he should be pretty good at doing this examination. I wanted to check if I had stopped further hairloss in my donor, given back when I had mine examined in March 2022 mine was below the average of 70-75. Please keep in mind it's basically impossible for my dermatologist to find the exact same location he counted from previously, so given this, there is obviously variability in this hair density data depending on where he counts from, nonetheless he has tried his best to count the same location. I honestly had no idea increasing donor hair count was even possible, but according to my dermatologist this is a common thing he sees in his patients and he believes it's due to Minoxidil. He says his clinic 'should probably' publish more of their data on this - I think they should - because I've tried to do some research myself but can't find much information. Back in March 2022 I was freaking out about having a poor donor for a hair transplant and now I'm apparently back around the average. Does anyone else out there have their own donor density data and experienced something similar? The only other factor I've considered is potentially I could have been experiencing a Finasteride shed as I was approx 2 months into restarting it at the time I had my donor examined in March 2022, but is fin known to shed the donor area? I also don't recall experiencing a shed on restarting fin. Next Steps: After my last dermatologist apppointment we've increased my sublingual monixidil again, now to 2.7mg daily which I will start on Wednesday. He is hopeful that we can get even more hair gains to increase my mid scalp density. I asked him if there's anything possible he thinks I could add to my routine to improve the hairline but he said he's doesn't believe there's anything else out there proven to produce good results. Regardless I'm very happy with the improvement I've gotten already. This time last year I was certain I wanted a hair transplant, now I'm still strongly considering it, but I'm no longer certain. I'm curious to see if I can get more gains (particularly around my mid scalp and hairline) out of this medication. Despite experiencing no noticeable side effects I'm still undecided if I want to commit to hairloss medication for the rest of my life and if I pull the trigger on a hair transplant I have to take medication forever. The concerns I had around my crown balding or being visible are gone and while I still have a lot of thoughts about my poor hairline, I can live with that.. for now. My dermatologist thinks that if I take the hair transplant route do not consider going beyond 2,000 grafts. He thinks 1500-1750 is adequate. This is a huge shift from the 2500-3200 grafts I was previously quoted prior to commencing medication from some of the recommended surgeons on this forum. I would obtain some updated quotes from these clinics to cross check if he's overly conservative but I don't want to waste their time. In the next post I might add some extra detail and potentially more pictures, we'll see, but if you have any questions about my experience please feel welcome to ask.

Lighting is such a big deal with hair progress pictures. This recent post on r/tressless shows just how big of a difference lighting conditions can make.

This is going to look so good!

@WhipawayI would love an update if you could be so kind. 😅

No, I didnt. I simply have (or had... 🤨?) a below average donor which would not have been known if I hadn't had an in person examination of my hair. Say if I booked a hair transplant with a surgeon overseas based purely on my pictures, once I got there on the day of surgery only then we may have realised my donor is not as good as it appears in the pictures. This could have meant less grafts available for the surgery on the day, meaning a huge change in plans and expectations, or worse cancellation/refusal to do surgery due to the risk of operating on someone with a below average/higher risk donor. These last minute changes and surprises on the day of surgery is the last thing you need with such a significant procedure, especially while in a foreign country.

I'm happy to chime in and say I am one of these people. I thought my donor appeared better (based on pictures) than it actually was under a microscope. What appeared to be an average donor was actually below average. The only reason I had it examined under microscope was because BHR Clinic required it. This has been extremely useful information for me in deciding what medication I need to take and if and how I should go about proceeding with a hair transplant. Having the detailed examination is honestly one of the best decisions I've ever made, because the medication I was prescribed following the examination is giving me results better than I could have ever anticipated or expected, even exceeding what I thought was actually possible (I'm collating some information on this which I will send to you within the next few weeks Ian 😉).

I wouldn't do anything if I were you. It looks pretty good. Just monitor it every 3 to 6 months and if you see the hairs thinning around the "bald spot" then reconsider medication.

Yep that's correct. Sorry to hear you had side effects. There are other delivery methods and lower dosages you could consider trying if you're up to it. The clinic Gatsby referred to above can tailor your regime until you find something that hopefully works for you. Whether it be topical, oral or sublingual delivery and at a lower dose. If you don't want to take medication again then that's totally fair.

Are you on medication for hair loss? Being in Melbourne you may not have access to the best hair transplant technicians but you do have access to some of the best hair loss medication, this could improve your hair.

I've been a vegetarian for 3 years and I was losing my hair long before that time. I've also experienced some decent hair gains from reintroducing hairloss medication 10 months ago while maintaining a vegetarian diet. Consider blood tests to ensure you're not lacking in any essential vitamins and then adapt your diet/multivitamins accordingly (I haven't done this but it's been on my to do list!) You should be fine.

Personally I don't think I experienced a shed phase (although I could be experiencing one now 9-10 months in 😅) . I think everyone is different.

Unexpected update. I had somewhat of a feeling in November last year I was losing a bit of ground in my hairline. It was just feeling a little harder to hide my receding points while combing my hair each morning. I thought to myself well as long as the crown and midscalp still looks good I'm doing well. However, on taking a photo today I can't help but feel like I've lost a bit of ground in this area. I might be over thinking and over analysing this but it looks like my hair is back to around September 2022 levels of thickness. It's been about 10 months since I started sublingual min and oral dut and I haven't changed my dosage or routine since back in July being 0.5mg Oral Dutasteride daily, 1.8mg Sublingual Minoxidil daily. The weather has heated up a bit the last month or two with the summer in Australia but is hair shedding over summer a thing? I know I'm still miles ahead of where I was when I started medication but I'm worried the honeymoon and growth phase might be over... I'm also worried my hair gains could be deteriorating. The crown and vertex to me appears weaker & thinner than in the December picture, and I feel like the thinning in my midscalp is more noticeable again. I know this is a pretty short frame of analysis but this is the first time I think my hair has gotten what I perceive to be worse since commencing medication so I'm a bit alarmed. I'm seeing my Dermatologist in two weeks, which will be in person for the first time since my initial appointment 10 months ago so I can ask about this, but he will be comparing me to my hair in March which is significantly different to now. Anything in particular I should ask him about or look to change/add to my routine? Do I have anything to be concerned about?

Time for the sequel 😍. Good luck Adrian!

I take 1.8mg sublingual minoxidil every morning. I believe the preference is to take it at night because of the potential side effect of dizziness (so you dont collapse while up doing things etc). However, I take mine each morning because it works better with my routine. My dermatologist said that should be fine unless I experience sides, which I haven't. The drug is working too. I've found it great for thickening and strengthening previously thinning hairs.

Okay this is pretty wild.

I got a script to oral finasteride from a Dermatologist in 2016 (I was NW1 or NW2 at this point) and I thought it was doing nothing so I stopped using it after 3-6months. 3-4 years later my hairline was gone 🤦‍♂️ Now I'm trying to catch up again with stronger medication but my hair will never be the same.

This is insane. Hope you're still not contemplating a transplant. Your hair looks perfect.

I hope you mean oral minoxidil 😅 It's positive that you have no minituarizing but the side effects don't sound good. It's only been 3 months so if the sides really are bothering you I don't think you'd lose anything by stopping now and going ahead with your surgery next month. Otherwise if you think you can stick it out taking fin for now and maybe get 'lucky' like @WhereIsMyMind above or myself in terms of the sides going away you might find you can stick with it and see a greater benefit from the fin after 6 months. I think this one might be on you to listen to your body then decide what you want to do. Understand this is probably a difficult decision for you.

Tried fin and/or minoxidil? You look like a good minoxidil candidate. I suggest trying medication for an extended period. While that's happening take the time to research hair transplant clinics.

Thanks Spring. These are minoxidil tablets specifically compounded for sublingual delivery. Not sure if they are available anywhere outside of my dermatologists clinic as the clinic owner holds the patent for the pills. It is simply a minoxidil sugar pill which dissolves beneath the tongue over a period of about 5 minutes. Drinking minoxidil sounds a little bit dangerous to me but I'm sure you know what you're doing.

Thank you. Yeah, very glad I've been patient and followed the advice of many of the great surgeons recommended on this forum. In particular the advice received from BHR Clinic (Ian & Dr Bisanga) and also Eugenix. In regards to benefits from switching fin to dut, honestly it's hard for me to tell. I did take finasteride on and off for about 5 years and not once did I ever notice it helped my hair. In saying that I wasn't strict enough and kept missing doses or I'd run out of pills then my chemist would have a 1 week delay in being able to supply more which would result in way too many inconsistencies in taking the drug. For me I found I had less sides switching to dut from fin, my sides were already very minor anyway but that's been an added benefit. I truly think the difference is the use of sublingual monixodil since March. If you haven't tried minoxidil consider giving it a go - topical or oral, just be consistent in your application. I can say I haven't missed a single dose of either drug since March. If you're comfortable answering where in Australia are you based?

Quick update. I've continued on the same medication as July detailed in the posts above. I will do a write up with proper comparative pictures in the most harsh lighting possible in February 2023, provide donor density data comparisons, and will summarise my experience with oral fin, oral dut and sublingual minox. I think I may have saved my crown for now with this medication, which was the goal my dermatologist set with me back in March this year. My hairline is still scuffed but it's improved. I comb a lot of hair forward to try and cover how receded the temples are but that was always going to be expected given how far my hair had receded before recommencing medication