4chanhrn

38 minutes ago, TakeAction said:

I have to disagree, the FUT could be the difference between getting good coverage and not. With FUT (plus FUE) he could get an extra 2000-3000 grafts from his donor.

Of course nobody wants a linear scar. I would never advise anyone below a NW4 on meds to do FUT, the benefit just isn't there. But in order to maximize the donor in these high norwood cases, especially someone who's not on a 5AR inhibitor, FUT + FUE is the best way to get enough grafts. Those several thousand grafts are the difference between covering the crown and leaving it bare.

So it's either start with FUT, do several procedures and probably get good coverage over a lifetime or do FUE only, not get enough coverage over time and then have to shave.

That's my thinking. I also think Verteporfin+FUE would likely work out for better donor management. The trials are very promising. FUT now gives me the option to use Verteporfin for FUE later when it's better studied.

I'm OK with a bare/bareish crown. Looking for front/mid coverage. I don't have high expectations because of my level of loss+not using 5AR inhibitors. Also I don't think I would care as much in 40s/50s.

1 hour ago, Melvin- Admin said:

How often did you apply the Xyon? 

Got sides after single application. Tried 2 applications 3 days apart for sides to fully kick in. Sides went away after around 1.5 weeks of discontinuation. This is consistent with other 5AR blockers I have tried(topical/oral fin). Topical fin microdosing sides came in after few weeks. I stayed on it for a month hoping it would improve and had complete limp dick.

I am very sensitive to 5AR blockers. My parents are medical doctors and their recommendation was not to use 5AR blockers when my body does not like it. Every body can react completely different to medication. What works for you may be poison for you. It sucks but you can't do anything. Oral Min is complete opposite for me. It feels like it gives me so much energy and has improved my cardio.

Maybe Pyrilutamide can help. I'm waiting for it to arrive in mail.

1 hour ago, Bucky O Hair said:

Personally, I would advise against an FUT procedure.  You have many more decades of life, and you will experience further loss.  You may want to one day buzz your head (when you're in your 40s or 50s) and you'll regret the linear scar on the back of your head.  

I'm completely fine with the scar. Like you said it's a personal decision to make. I want to maximize grafts and I do not mind the scar at all. Even if I at all need to buzz it down, I don't think I would mind it, especially in 40s/50s.

1 hour ago, Bucky O Hair said:

I get that money may be tight, but you cannot cheap out on a hair transplant especially with this level of loss.

Don't get a procedure if you cannot afford one, and do not get a procedure if you're not willing to travel a few hours for a good one.  If I were you, I would reach out to Dr. Zarev for your level of loss, and do what I could to save up money in the meantime (while you are on the waiting list).

I'm not trying to cheap out, but I do not have unlimited money and would like things to be cost efficient. There are excellent surgeons(on HRN recommended list/recommended by patients) that are very good, but still not prohibitively expensive. I'm thinking I may have to get a little expensive large FUT, because there aren't a lot of good FUT surgeons(and most of them are in North America). I've listed the ones I'm considering above. And then I can get cheaper FUEs down the line. Laorwong, Nader, Pekiner, Keser, Eugenix(I often travel to India so would be easy to get done) are all good enough options for FUE without breaking the bank. There are many surgeons that charge much more, but are subpar in quality.

As for travel, it's a similar story. H&W is 4 hours drive for me. Hattigen would be a long flight+like a week worth of trip+arranging visas well ahead of time. Visas for Schengen countries can be super hard to get sometimes(depending on your passport). It adds inertia to the whole process. I can do it, but if costs, quality of surgeon aren't that much better, it is harder to justify.

Dr. Zarev is very good, there is no doubt about it. For me, his costs and availability make it a non-option.

37 minutes ago, Melvin- Admin said:

What types of topicals have you tried? I seriously think you need an effective DHT blocker before proceeding with surgery.

Topical finasteride 0.1% 0.5mg 3x/week. Tried Xyon topical dutasteride. Both give me side effects. Insomnia/nightmares, ED, loss of libido. I've tried Alfatradiol as well. No sexual sides but terrible nightmares. 

Planning to try Pyrilutamide soon.

I know medication is recommended, especially for someone like me, but I just can't tolerate 5AR blockers at all.

Hello,

I need advice on my pattern of loss and which doctor I should go for. Lighting is super strong. Sunlight+bright indoor light directly overhead.

Front view:

.

Top view:

Side view:

Back view:

Personally I feel I am diffuse NW5/6, heading towards a NW6/7. I am 27, with relatively stable hair loss since it started 5 yrs ago, although I have lost more ground recently. Family history is mixed bag. Dad, paternal uncle NW1/2. Paternal grandpa NW7. Maternal uncle diffuse like me, but has OKish hair at mid 40s.

I am on Oral Minoxidil 5mg/day, which I increased from 2.5mg/day very recently. Also on LLLT+keto+microneedling. I cannot tolerate finasteride(or topical finasteride/dutasteride). My plan is to go for FUT only, since I really need the grafts longer term as I expect native to shed. Hopefully Verteportfin+FUE by then should work out. I am planning to consult few doctors for FUT. 

• Dr. Wong - Close to me. Started consultation with rep. Quoted 4000-4500 grafts. Worried about recent misses.

• Dr. Bloxham - Honestly felt results weren't spectacular. But his methodology is good and he has good reputation for FUT.

• Dr Nakatsui - Close to me. Half the cost of Wong? Doc/techs trained by Dr. Wong. Less waiting times. Not many results posted by patients and results posted by him weren't spectacular.

• Dr. Laorwong - Much cheaper. Great results. Bit far. Not sure if he still does FUT. 

• Dr Path - Great surgeon. Expensive(especially for Thailand). Bit far.

• Hattigen - About the same price as H&W, great clinic. Hard to get to for me, would need visas.
  
  Cost is a significant factor for me. I'm open to taking a flight to elsewhere vs having to pay higher costs if results don't directly justify it. But I don't mind spending more if really needed. But I'd rather save that money towards FUE later.

What do you think? Is my donor OK enough? I feel it's thinning looking at the pics. I have extremely coarse/strong beard/body hair so those are options too. My plan is to not do much of crown, focus on front/mid, keep same hairline.

Thank you.

On 3/11/2024 at 2:59 PM, Dragonsphere said:

It does not go systemic. That is the whole reason as to why men can take it. 

If it went systemic you would have gyno, osteoporosis, muscle wastage, ejaculatory issues. 

It is an off prescription topical commonly available.  

Unlike finasteride where the side effects are real (most of the time) the worst you will get Alfatradiol is scalp irritation. 

Anyhow, it is not an extremely effective product. 

Anything you apply on your scalp does go systemic. How much and how the body reacts to it depends on every individual. 17 alpha estradiol is a non feminizing, very weak estrogen. It does need to go systemic to some extent for it to work. From my understanding, large reason it works is because your body downregulates DHT, test with exogenous use. Bryan Johnson from Blueprint applies it transdermal because it's good for anti-aging.

On 3/10/2024 at 3:51 PM, Dragonsphere said:

Have you considered El Cranell Alpha? As mentioned previously, it is topical anti androgen with confirmed efficiency and  a proven safety record. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412238/

It essentially speeds up the process of the conversion of testosterone to estradiol via aromatise which, of course, reduces DHT. It does not go systemic so the side effects are limited to irritation. 

You can buy it from Amazon.de or Ebay. 

There is more to hair loss than just DHT, I know this from my own experience and from consulting with leading dermatologists, yet some form of dht reduction is vital in any hair loss prevention regime. 

Alfatradiol seems to be a decent option and seems like lot of people can tolerate it.

However it gave me the most intense dreams ever and restless sleep even on 1.5-2ml/day. Was forced to discontinue after 4 days of use. No sexual sides whatsoever. If anything, my libido was high. I'm very sensitive to fin and get sexual sides.

Currently on oral min 1.25mg 2x/day, LLLT 3x/week, shampoo with saw palmetto and ketocanazole everyday, microneedling and zero mino every night 1ml. Planning to add oral saw palmetto 2-3x/day.

Slowly losing ground, guess I'll do a transplant at some point. 

23 minutes ago, mojones said:

Do you happen to have a link on hairlosstalk about this? I can’t seem to search on that forum. Did you try LipoFin from anagenica? And was it 0.1%? I have a liposomal rx for 0.01%

No. Just normal fin titrated down. Don't remember exact concentration, it was a while back.

Removed

There are few other interesting threads. Google and youll find them.

7 hours ago, OfficerWinslow said:

@4chanhue Where are you getting alfatradiol from? 

I placed an order on Amazon.de. Also sold on Ebay and by Anagenica.

4 hours ago, mojones said:

What are your side effects on DHT inhibitors like fin? Did you try oral and topical? Wonder if topical would give me the same effect 

Sexual sides. With oral 1mg also had brain fog. If you get sides on oral you'll also get it on topical. Topical does go systemic with continued use and very low dose is enough to crash DHT by 70%. There are many posts on hairlosstalk about this. I also tried myself with low dose low frequency topical and eventually got sides.

Just because I got sides doesn't mean you will get them however. Lot of people can handle fin just fine.

Look at mozzarella study. However there are people who haven't been able to replicate it and had to use lower doses to not have serum DHT inhibition. You can try liposomal or try super low dose.

I personally am too sensitive to anti androgens/DHT inhibitors so wasn't worth it for me. Even topical saw palmetto gave me sides. There are other options like CB,RU, alfatradiol, fluridil that you can try. I'm planning to try alfatradiol next.

LLLT does work but needs 650 nm/5mw diodes. If you dig theough studies(most of which use above spec) the results are very impressive. Most of commercial devices on the market either have too few diodes, can't power them correctly or have cheaper LEDs to save costs. The ones that derms use work but are too expensive.

There's a guy called overmachogrande(his website looks scammy lol) that has instructions on how to DIY your own for a cheap enough price(or you can get him to build one for you). I got him to build my custom helmet with the pattern of loss that I have. I'm using it since December(3 months now) and I would say I have marginal gains. You can expect as much as micro needling or little more. Fin or min would give you way more, but this is side effects free and I don't mind the 20 min 3 times/week time investment.

Mine looks same.

1 hour ago, Rasputin said:

What's your experience with oral saw palmetto? May I ask which brand do you use?

I'm planning to start it soon.

Now 320mg+pumpkin seed oil

Planning to switch to life extension ultra prostate formula once I get it. I just started it a week back. Checkout thread on HLT and other thread here. People have seen meaningful measured DHT decrease with it so it should give some results

I bought 2x bottles of trichometto. Currently on oral saw palmetto 1x/day and oral minoxidil 1.25mg 2x/day. Will add 1ml topical trichometto 1x/day at night and see how it goes.

12 hours ago, jim1973 said:

Did you ever try oral Finasteride or only topical?  I'm on oral with no sides but also not stabilized.  I'm considering topical to ensure the medication gets to my follicles.  If I didn't have negative sides on oral, I feel less likely to get sides from topical but not sure.  I just want to stabilize badly so considering trying everything.   

I tried both. What dose are you on and for how long? Are you on min as well? You can look at dut or combine with other meds like RU/pyri

Don't get desperate. You are looking for something that you can continue for a very long time with few sides

5 hours ago, Melvin- Admin said:

Some people are very sensitive. But getting sides after one application could be placebo. ED can happen for a variety of reasons, especially sleep. 

I also had sides on microdosing topical fin as well. Not even mild ED, complete limp dick. I think I'm just super sensitive to these meds. I spoke to my parents, who are doctors. They told me it's not worth it to continue when you are having sides. These are endocrine disruptive medicines and it is possible that some people are just super sensitive to them. Sucks, but what can you do.

I'm wondering if it's the estrogen causing sides due to aromatisation of free test. I'll look into a blood test if I get the time/referral for one.

5 hours ago, futureresearch said:

Are you planning to do anything to maintain hair? I have the same issue with DHT inhibitors as well but feel like I don’t really have any alternative solutions so trying to see how others deal with it.

I was on topical min since 3 yrs and that has stabilised hair loss, albeit it's slowly getting worse. Switched to oral min(1.25mg 2x/day) a month back. Let's see if it helps. I may get on Saw Palmetto because I noticed I don't have side effects on it.

Doing micro needling and keto shampoo as well. Not much more I can do. 

On 9/25/2023 at 3:57 PM, 4chanhue said:

Just got Xyon Topical Dut today. Packaging is super nice. Expiry on the package is 3/2024.

Initially was thinking of getting DHT test done, but AFAIK it requires referral from a physician here in Canada so dropped the idea.

I'm someone who had sides with both topical and oral finasteride, even with microdosing both. I'm very sensitive to finasteride and just can't tolerate it. I've not taken fin since last 3 years and have only been on minoxidil.

Planning to start at 1x/week and see how it goes. May move to 2x/week at max if I can tolerate 1x/week for atleast some time. I've stopped microneedling as well because of fear that the dut may go more systemic.

Ended up getting sides(ED related) with the first application. Lasted about a week, getting back to normal after 7 days or so. I think my body just can't tolerate DHT inhibitors at all. Planning to give up Xyon for now.

For me tretinoin has made my face look way better.

Fin should be enough, but it comes down to experimentation and what works for you. Like @Melvin- Moderatorsaid, some ppl need DUT, others can't tolerate fin(or dut) and need to look for weaker alternatives. Best treatment is one which works for you and most importantly you can stick to for the long time.

4 hours ago, jim1973 said:

I've been on oral Dut for almost a year and similar to others, never measured my DHT before (was in oral Fin for 7-8 years).  After 6 months, I measured my serum DHT and it was much lower than normal (see pic).  Having said that, I still gym every day, keep muscle, no lost libido and my Testosterone has actually increased.  I'm also on oral Minoxidil which causes some water weight gain.  My only issue is that I'm still losing hair and haven't stabilized.  I wonder if there is a chance that I'm only lowering DHT in my blood but not as much in my scalp. I was actually thinking of switching both oral Dut and Min into a compounded topical product to ensure everything works as well as possible for my scalp (to avoid the scenario I'm in, which is its affecting serum but unsure how much in scalp). I feel like my scalp Testosterone must still be high if I'm still losing hair with this level of serum DHT but not sure how to correct it or what else I can do.  Any suggestions? 

It's possible increased test is causing hair to fall out. Not sure how accurate that is, but MPMD did talk about that. DHT decrease can affect different people differently. There are people for whom small drop gives them lots of sides, while others can nuke their DHT and they still feel the same(or better). 

I guess you could see if fin works better for you?

I think healthy lifestyle, including lifting weights and eating right food should slow down progression of MPB compared to staying on the couch and eating junk.

Better blood circulation, lower stress, lower cortisol are probably good for slowing down hair loss.

4 minutes ago, Melvin- Moderator said:

I wouldn’t introduce anything until a month. By a month you’ll know if you get sides or not. 

Yea, makes sense, thanks.

1 minute ago, Melvin- Moderator said:

My advice is take it 1x per week, see how you feel. If you’re good, then slowly increase the frequency by 1x per week. I believe 4-5x per week is good enough. 

Yea, planning to do that. I would be happy with 2x/week honestly if I don't have any sides. Along with oral min should be ok to slow down or stop recession. Not particularly targetting regrowth.

I'm curious if I can combine with other compounds with less side effects like stemoxydine/fluridil on other days.

17 hours ago, consequence said:

This looks fine to you for 11 months? Looks like we found the clinic's account. 🤪

Either that or you just scrolled to the bottom of the thread and looked at the post repair pics without reading any of the actual post text.

I was saying the final result looks fine post repair.

Just got Xyon Topical Dut today. Packaging is super nice. Expiry on the package is 3/2024.

Initially was thinking of getting DHT test done, but AFAIK it requires referral from a physician here in Canada so dropped the idea.

I'm someone who had sides with both topical and oral finasteride, even with microdosing both. I'm very sensitive to finasteride and just can't tolerate it. I've not taken fin since last 3 years and have only been on minoxidil.

Planning to start at 1x/week and see how it goes. May move to 2x/week at max if I can tolerate 1x/week for atleast some time. I've stopped microneedling as well because of fear that the dut may go more systemic.

I would instead switch to DUT and try a topical with different mechanism of action like RU or pyri. Ketocanazole shampoo may also be worth a try.

Looks fine. I feel people here have a tendency to obsess over small things.