jim1973

In trying to read what would be the optimum depth for microneedling the scalp, depending on which report I read, they all have different recommendations. I've seen some that state .6-.75 is best. Others think between 1-1.5 is best, while others think it should be between 1.5-2.5. I realize that some studies are referring to a dermaroller but I'm specifically interested in the microneedling pen devices. Does anyone here have clarity on this topic?

Yes, still taking oral FIN 5 days/week, oral DUT 2 days/week (spaced every 3 days). Still taking oral MIN daily, using laser helmet twice/week and shampooing with Keto 2% twice/week. Have had 3 sessions of microneedling with my derm 3 months in a row and going for 4th session in 2 weeks. I don't really think much is left for me to try. I scheduled a HT for August but if I can't maintain what I have, I may need to cancel and concede sadly.

Same. Still losing hair daily. Scalp becoming thinner. No new hairs are replacing ones falling out.

Curious if anyone has had their DHT levels measured prior to starting Finasteride or Dutasteride and then again after the meds have been in their system long enough. Also, not sure if possible but is there a way to measure DHT levels in scalp vs serum? I've only had my DHT level tested years after I began taking meds but never before so didn't have a baseline to compare to. My last results were below normal range, which seems good but I'm still losing hair, so wondering if I'm crushing my DHT too much in serum and if I should ease up a bit and or if the meds just aren't affecting my scalp DHT enough. If there is an article or previous thread addressing this, or if somebody had experience with this, I'd appreciate feedback. Thank you.

Looking for guidance on why my hair loss won’t subside and if there is anything else I should do or look into. I began using Finasteride and topical Minoxidil in 2013, which did well for me. My hair loss subsided, and I maintained what I had through 2020. I noticed hair falling out 2020 so in early 2021, I made some additional changes. I still take FIN but also incorporated Dutasteride. Every 3 days, I replace FIN with DUT (5mg). I also incorporated oral Minoxidil (2.5mg) daily. I have no side effects from anything that I’m doing. I use 2% Ketokonazole shampoo twice/week and use a Theradome laser helmet twice/week. I’ve recently started microneedling my scalp once/month (depth of .75). Eight months ago I had bloodwork done my bloodwork showed that I was low on Iron and Vitamin D so began taking supplements to bring those into normal range. Everything else was in normal range such as hormones, thyroid, etc. I recently had my DHT levels checked (blood/serum), and the test concluded that both DHT and free were very low (below reference range – 9L and .76L), so I no longer have high DHT (although not sure how to measure DHT in scalp specifically). To summarize, I feel as though I’m doing everything possible to at least maintain the hair I have but my hair is still thinning, miniaturizing and falling out. I'm wondering if I should go back to topical Minoxidil if the oral isn't working for me. I have a scheduled hair transplant in April 2023 but am nervous about proceeding if I can’t stabilize my current hair fall. Is there anything else I can do to stabilize my hair loss or something else that may be causing it?

Everything is going fine. The good news is that I don't have any side effects from the Dut. The bad news is that I don't see any improvement yet and am still shedding, although its only been roughly 3 months so hoping to see improvement on the hair loss soon.

I have used Fin for many years (with topical Min) and everything held in place. I've been a 4a for about 10 years, not much growth but not much lost. The top is now thinning more and I'm on my way to a 5. I just began adding in oral Dutasteride about a month ago.

I did actually continue topical MIN for the first 3 weeks I was taking oral MIN because I wasn't sure if my body would appreciate the sudden change or not. Thank you for the advice. I'm done making changes. I'm going to stick with 1.25mg of oral MIN (although I think 2.5 is probably more effective) and don't plan on adding anything else. If what I'm doing now doesn't get me to a good place, I may be out of options. I forgot to mention that I have a HT scheduled in 7 months but probably won't go through with it if I can't stabilize my existing hair fall. I'd hate to shore up my frontal third only to have my top thin out and diminish.

Update: took the plunge and switched from topical MIN to oral MIN (1.25mg). I also begin adding in oral Dutasteride twice/week (every 3 days) and still take my oral Finasteride on the other 5 days. I also began taking a few products from Nutrafol (DHT blocker and probiotics) around the same time. I'm about 30-45 days in and I just noticed that the Nutrafol products contain Saw Palmetto. I'm experiencing a pretty significant shed. I'd like to think its because of this new regimen but I was already shedding well before these products, which caused me to take all of these actions recently in the first place. I'm really hoping that this shed will subside really soon as its going quick. Now I'm second guessing if my regimen of combining Fin, Dut and Saw Palmetto as DHT inhibitors is too much. No real side effects other than the hair falling out at just the touch of my head, which is concerning.

I can't tell if I'm simply beginning to lose hair at a rapid pace or shedding. I started, what I thought was a shed Summer of '21 and its been continuous through 2022 and is getting worse. In my attempt to stop the hair loss progression, I started taking Dutasteride twice/week along with Finasteride the other 5 days and am using 2% Ketoconazole shampoo. In addition, along with taking DHT and probiotic pills from Nutrafol, I also began taking oral Minoxidil (1.25mg) because the topical seemed to make my head really itchy over the years. However, nothing seems to be changing for the better and more and I see more hair fall with each passing day. I have a HT scheduled for April of 2023, which I was excited for, but if I can't seem to get my existing hair to stop falling out, should I simply cancel the HT and succumb to the inevitable of going bald? I honestly don't know what else to do. Any ideas or suggestions would be appreciated. Thanks.

After expressing my concerns of persistent hair loss while on Finasteride and topical Rogaine with my dermatologist, he gave me a prescription for oral Minoxidil (1.25mg to start) and Dutasteride once or twice/week (he left the frequency preference up to me), while also prescribing 2% ketoconazole shampoo. I've been shedding hair rapidly for the last 6 months prior to taking any of these new products and after 1 month, nothing has changed, still shedding alot. I haven't discontinued the topical minoxidil yet only because I feel as though the 1.25mg oral dose is low. Should I keep applying topical once/day until I move up to 2.5mg of oral Minoxidil or discontinue the topical immediately? Regarding oral Minoxidil, he did mention that after 30-60-90 days, I likely would need the 2.5mg dose if I didn't notice any changes and didn't have side effects. I'm curious what others experience has been on oral Min, good or bad and at what doses. Regarding Dutasteride every 3 days, is it still recommended to continue taking Finasteride on the other days of the week that I don't take Dutasteride? Or is the Dutasteride enough on its own where I should discontinue Finasteride all together?

Update: Roughly 3 weeks ago, I began adding in Dutasteride (5mg) every 3-4 days (roughly twice/week) while continuing with oral Finasteride (1mg) on the other days. I've also began taking 1.25 oral Minoxidil. I wasn't sure if that dose would be strong enough for me and how long it would take to work so I'm still applying topical Minoxidil every night. For what its worth, I also started taking probiotics (to improve my gut health) and iron supplements (my blood test showed that I was very low). I am still losing hair more than usual and can see hair fall in the sink daily, but can't tell if shedding or simply losing hair (this started over 6 months ago and is progressively getting worse). I think I may increase my oral Minoxidil to 2.5mg as the hair fall is starting to stress me out. I know that shedding can be associated with some of these treatments but since it began over 6 months ago before any new treatments, I'm concerned that it isn't the good shed where replacement hair will be coming soon. Appreciate any feedback, good or bad. Thanks.

After doing additional research, I have decided that FUT is probably my best chance for density while maintaining donor hair in case I want to have a second surgery down the road. I'm hoping that I can still keep my hair short after the surgery. I'm told that 1/2" length is enough to cover an FUT scar. Does that sound right?

Most of my life, I've had a semi-itchy scalp but never dandruff. Its likely an auto-immune disorder or some other sort of inflammation within my body that I've never properly diagnosed. There are no sores, scabs or any other visible signs of what it could be but it just always seems somewhat itchy. I probably should do a biopsy but not sure if that will actually provide definitive results or not (and for a balding scalp, the thought of taking a small chunk of scalp away where hair will never grow again, is not ideal). That said, during my hair loss journey, I have read many good things about micro needling but am worried that micro needling on my scalp could make whatever the underlying condition is, worse and cause more inflammation. Has anyone had experience with trying to find a root cause of scalp itchiness and/or tried micro needling with a similar situation?

I've heard from others that although oral FIN is better than topical FIN, that oral MIN is also better than topical MIN (but comes with more sides)

Neither were willing to prescribe since off-label.

Yes, I've been in FIN and MIN for several years. Seemed to hold everything for over 6 years but now not working.

I'm def thinking about it. Neither my primary doctor nor my derm will give me a prescription for it. I can get from Strut though.

After several years of decent results (maintaining hair) with topical Min and oral Fin, I'm no longer responding and now see my hair starting to thin and miniaturize. Also, the topical Min is making my head extremely itchy and is becoming intolerable. I was thinking about making 2 changes at once and going to oral Min and replacing Fin with Dutasteride. Because of the various side effects, I'm wondering of making both changes at once would be okay or if I should make one change before the other so looking for recommendations on the timing of these changes. Also, neither my doctor nor my dermatologist will prescribe oral Min or Dutasteride for hair loss. I respect their decisions of not wanting to prescribe off label but its frustrating since I have no history of family heart disease. Without a prescription, the only place I see that offers Dut is STRUT (oral and topical) but I don't think they offer oral Min. I'm also not sure how reputable Strut is or how well compounded their products are. Looking for some advice on how/where to obtain either of these if possible. Thx.

I hadn't thought about staying on FIN and just taking DUT once/week but that is an interesting thought. I actually saw that STRUT offers .10% of DUT and was thinking of taking that daily instead of FIN. But your suggestion is interesting so may need to think about that. If the DUT stays in your system longer though it would seem that having both DUT and FIN in system may result in the side effects we are trying to avoid.

That's intersting that the highly reputable Dr. Hasson can verify these findings. So you stopped FIN and began DUT last year. What MG and frequeny were you on with FIN and what are you on now with DUT (and are you on topical or oral)? Regarding MIN, did you replace with anything else? My scalp always feels itchy, but I'm not sure if its directly related to the MIN or not. I don't think there is a direct replacement for MIN though.

I'm at the point where my many years of taking oral FIN and topical Minoxidil aren't working and I'm starting to lose all my previous gains. I was considering going from FIN to Dutasteride (not sure if topical or oral) but also going from topical Minoxidil to oral Minoxidil. I know there are some potential side effects but one I just learned about was how MIN can cause collagen reduction in the skin. There are various threads/videos online where people have stated they feel oral MIN has aged since their collagen production has slowed down but not sure how realistic that could actually be. Is anybody here well educated on this topic?

I've been taking Finasteride for several years (along with Minixodil) and it seemed to have worked for many years in just allowing me to keep the hair I have/had. That said, I don't feel either are working as I'm beginning to thin and shed again. I've seen many posts on Dutasteride with mixed results. I was initially going to get the topical version to avoid side effects but heard that would cause more shedding so now plan on taking oral Dutasteride at .10% (thinking the lower dose at .10% will produce less sides but still could be more effective than FIN). Since I'm already taking 1mg of FIN daily, how quickly should I switch one for the other or should I allow some overlap? Should I expect to shed on the DUT even though I've been in FIN?

Over the last 10ish years, I've taken oral Finasteride and applied topical Rogaine. It seems the efficacy is wearing down and I'm no longer holding on to what I had as much. I've considered oral Dutasteride but the side effects were a concern so I did not proceed. I've read online about some people applying topical Duterasteride but there doesn't seem to be much research on it. It would seem as though there should be less side effects if applied topically but it is a concern that it isn't talked about more. I'd love to hear what others think and would appreciate any advice on the subject. Thank you.

I've all but decided that I'd prefer FUE simply because I like to keep my hair short. I also don't really care about establishing a new/low hairline since I've been this norwood 4A for about 15 years (its just started to thin again on top after stagnant for a long time). My goal now is to really maintain what I have but improve density (and probably tighten up hairline without going overboard). That said, reading the reviews, blogs, and seeing pictures, it seems my choices are down to Shapiro, Konior, Wesley and Mohebi. Based on what I'm trying to accomplish any input on which may be better suited for my desired look?