NikosHair

I agree with the other posters that commented it looks 'clean'. I see other positives too. Your hair characteristics look favorable for the illusion of density. You went bold with the lower hairline based on the number of grafts. There is a good argument for choosing a lower density followed by a 2nd HT to top up. The grafts will not have so much competition for blood supply, which may yield better growth. A 2nd pass will allow the surgeon to finesse the results and add more density where it is required. The one caveat is, working between grafts is highly skilled and you will need to ensure the doctor you choose has proven results of adding density. Don't worry now about this, it may or may not be required. In summary, No disaster and lots to look forward to (growth)👍

Hot off the success of 'Are topicals just hype and fancy marketing?', I thought we might share our thoughts on the different delivery systems for topicals and if it makes a difference. While the poll is open to everyone it would be useful if you could provide evidence that supports your response. I know this is a bit demanding but I'm keen to move the conversation and shed some light on the subject. Happy Voting!

Topical fin breaks the skin barrier and goes systemic. The key selling point is topicals somehow target the dht receptors in the scalp without going into the blood. Which as the pitch goes, you stop your hair loss in the scalp without the sides. In top fin, as you have found out it's not the case, and with top dut no one has provided clinical results of hair growth and sides. I'm not against people spending money on topicals, it's their choice but compounding medicine is unregulated, and lacks the standards of quality control we would expect.

So logically, get the highest concentration (it's most likely the best bang for your buck too) and use once a week to start with. No sides after several weeks ... then try twice a week and so on. The bigger issue is 'does topical dut even work?' I suspect NO, as very little of the drug breaks the skin barrier. Despite some enthusiastic supporters of Top Dut no independent clinical results have been provided.

Your starting point should be the dosage you've seen that gives the most impressive results. You won't know the sides until you try it.

I'm sure others will pitch in but to get an objective opinion you need to try and take the photos in the same location with the same lighting. If you look at the comparison Melvin posted we see much more light in the 1st photo, even to the point it looks like you have a different hair color. Additionally, in the 1st photo, you have tilted your head so the crown is fully exposed. In photo 2, less tilt, and less crown. Easily corrected and you should be able to get a better appraisal of your progress. 3 months is still early days so if you afford the cost, it would be interesting to see how you get on by month 6. Have a look at this thread for more info.

@FinallyHT Great hair pre and post Top Dut! I'm struggling to see 'improved immensely' You dropped a fair whack of wedge on the product. How do you feel it's going so far?

Holy moly!

Thats the correct and measured approach. You may well dodge a bullet, but it is still unacceptable for the doc to take the risk with your donor. The only explanation I see is laziness. It's easier to punch out FU's that are next to each other, rather than distribute the harvest across the donor.

😁

You raise an excellent point. The problem with compounding pharmacies is real and a problem, as highlighted in @Melvin- Moderator discussion with Dr.Vaño. TimeStamp 3:02

x2

No contradiction - the efficacy for topical was less. Similar but less. This raises an interesting question that was discussed earlier in this thread. Could 1mg be overkill? That makes an interesting case for micro-dosing oral fin. You're making the assumption the efficacy vs DHT reduction is linear. That's not what I said. (see above). Side effects were statistically similar is not what you want to read if you're hoping topicals are the solution. You need to understand why 'statistical significance' is significant. The difference was so small that the researcher could not eliminate the possibility the difference was purely due to 'chance'. To emphasize the point, 2.8% of the placebo group reported side effects ... They didn't even get any drug! (again, this was highlighted earlier in the thread). Agreed. I specifically referenced fancy marketing in the question. If you want a discussion purely on effectiveness or safety you can create your own question in your own poll😉 'Possible' isn't acceptable if you sell a topical product that claims to grow hair by reducing DHT locally in the scalp. It can be tested very simply (described earlier in this thread) but the companies producing the topicals do not produce the results. I say that's unacceptable and perhaps they have results that don't support their product🙄 I appreciate you're late to the thread but this stuff has been covered earlier. Give topicals a try and let the community know how you get on👍

Results are the only thing that counts (Results = High efficacy/Sides). It doesn't matter what the packaging looks like or what is written on the bottle. To use an example, we have all seen the bottles of ketchup labelled 'New Improved'. It may taste better it may not. The label means nothing it's the results that count. It's just another way to justify an increase in price/encourage you to purchase their product. If I come round and offered valet your car. I tell you I'm using the latest cleaning products with nanotechnology and microspheres sounds great but do you really care? It is all about the end result (and the bottom line). The bar is much higher for meds they need to prove with clinical/phased studies they do what they say and get FDA approval. Compounds manage to avoid that level of scrutiny as the FDA does not approve compounded medicine. Companies ensure their product has a USP (even if it makes zero difference to efficacy).

For topical, the results were less, the sides were less, and the serum DHT reduction was less (Patients showed higher DHT levels in the topical cohort Vs oral fin). The only thing the study can tell us is the more you reduce DHT, the more hair you grow and the greater the potential for sides. Nothing we don't already know. Critically, it only demonstrated rubbing stuff on your head was just another method to get the drug in the bloodstream, albeit a less effective way than taking low-dose oral fin.

Delivery vehicle, concentration of active ingredient, packaging etc are just fluff. Results are what count - Pick the product that has demonstratable, repeatable, independently verified results.

I haven't seen any studies that count hairs on micro-dosing. Studies are often funded by pharma companies and there just isn't any money in the micro-dosing results. If you go down the super cheap micro dosing route you can try crushing a 1mg pill and mix it with a filler eg. microcrystalline cellulose. Then cap it (gelatine capsules).

This has been covered earlier. The researchers concluded the sides on topical vs oral produced 'similar' levels of side effects. Based on the data they couldn't find statistical significance. In lay terms, they couldn't predict the outcome if they re-run the study. It was just too close to call. Not what you would expect the pharma company that funded the study wanted to hear (they produce a topical fin). Some studies measured the reduction in DHT at different levels of fin. As you expect, there is a correlation between dosages, although it seems to top out at 1mg per day. A dosage of 5mg per day only marginally reduced DHT more than 1mg. The other interesting finding was you can take a fraction of a 1mg pill (0.2mg), and it still has a significant effect on DHT. Proving if we didn't already know, fin is a very potent drug,

Don't encourage him😄

Both lower systemic DHT serum levels and cause side effects. With topicals, the skin acts as a barrier so less fin gets into the bloodstream, but it also shows less efficacy in growing/maintaining hair. I haven't seen a study demonstrating topical fin is better (efficacy/low sides) than micro-dosing oral fin. That's the real question you need to ask before dropping $$$ on topicals.

Oral Fin is proven to increase hair count but doesn't work for many due to sides. The holy grail for topicals is getting comparable increases in growth with limited/no systemic reduction in serum DHT. The study demonstrates the fin does go systemic and does reduce serum DHT. This may explain why many people on the forum complain of sides with topical fin.

I won't re-hash the discussion in the first couple of pages. Have a read and draw your own conclusions. Define 'work' in the context of topicals

Great! What did you learn from the study cited in the opening post and subsequent discussion? Did you vote or still undecided?

That's great news and an all-around health benefit. Not only have patients had successful implantation into scar tissue, but studies have shown the activity of the new hair may regenerate the scar tissue. Have a look at a previous thread.

There are 5 pages of discussion into all aspects of 'Are topicals just hype and fancy marketing? You've chosen to talk about subscriptions. What would you like to share with us on the efficacy of topicals? Which studies have you read that convinced you either way? What products have you used, and how did they work out for you? The floor is yours ....