calvinmd

-- Maintaining your current hair from age 24 until death with propecia is probably not realistic. Many users seem to report a "falling off" of its effectiveness after several years. There's debate about whether the drug is actually losing its effectiveness over time, or whether it's just evidence that it never truly STOPS hair loss but rather just drastically SLOWS the loss. But either way, finasteride is probably not going to be a decades-long solution to freezing your hair's condition exactly where it is right now. Can it hold you where you are for years? Yes. Can it give you decades of less hair loss than nature had intended for you? Yes. But decades of NO MORE LOSS AT ALL? Probably not. -- There's also the safety issue with finasteride. Some (many? most?) people have side effects with it, as I'm sure you know. But what concerns me most about Finasteride (at least in regards to HT planning) is this: Sometimes people are still feeling those side effects starting and/or worsening several years after they start using the stuff. So even if you tolerate the stuff acceptably for the first few months, or even a couple of years . . . I'm not sure if there's EVER a point when you can really be assured that you will be "safe" on it for decades to come. I honestly think you must ALWAYS assume you could possibly have to quit the stuff eventually, even after a several-year track record of tolerating it okay. ------------------------------------------------

-- Most hair loss is genetic. 90% or more. -- Most genetic hair loss slowly keeps getting worse for the rest of your life. -- Most genetic hair loss is irreversible. Once a hair follicle has been dead for a few months or a year, it actually gets a little bit of scar tissue in it. By then, that hair is never coming back. Don't believe anyone or any product that claims otherwise. -- Most products advertised to help or prevent hair loss are worthless. 98% of it does not make a very noticeable difference, and 95% of it is total ripoffs that do nothing at all. -- Propecia, Avodart, Minoxodil, and Nizoral are the only drugs/products that will do much of anything at slowing down the rate of hair loss. (But all of those drugs/products need to be researched a little before you jump in and start using them, though. For exmaple, Propecia & Avodart can have sexual side effects that may even be PERMANENT in a few people.) Hair transplants are a more permanent fix. They won't bring your hair back but they can at least help to make your hair loss much less noticeable. Transplanted hair basically "works." It almost always keeps on growing normally, and it won't go bald again later like the original hair in that spot did. But . . . Transplants WILL scar up the skin on your head. No matter what kind of transplant, you will see some kind of scarring if you shave your head later on. The vast majority of the doctors/businesses that do transplants are not good at it. Many are flat-out unethical and they will lie to you and scar your head up much worse than if you never did anything about the hair loss at all. Be VERY wary of any place you see on a TV infomercial. Getting a transplant needs A LOT of research before you do anything. And many people still decide never to do it at all because of the scarring & other issues. Some people are better transplant candidates than others. ------------------------------------------------

This Curis thing has been in the news off & on for a while. What would the hedgehog thing do, anyway? Does it stop the DHT from binding to the follicles? Is it a glorified anti-inflammatory? --------------------------------------------------

I'm 28 now. Didn't use any MPB drugs until these last few months. I'm a NW3 with a thinning front/top. If the rule of thumb is that it takes 50% loss to start being visible, then I'd guess I've lost maybe 60-70% of my original hair volume in the front/top affected areas. My hair loss probably started as early as 21 but there's no way in hell that anyone other than me would have known it. At that age most hair/skin doctors would have laughed at me for being a hypochondriac if I'd gone to them asking about hair loss. But I already sensed that something was different from the hair I was growing 2-3 year earlier, even though my hair at 21 still looked great and I would get unsolicited compliments on it. I was thinning VERY slowly in front/top. With almost no MPB in the family, I honestly thought I was just abusing my hair for several years. It took until about age 24-26 before it was anything visible. Even then it was only about 1-2 centimeters of actual front hairline recession. But at age 26ish, the overall thinning on the front/top was finally too much to chalk up to my rough lifestyle & inconsistent hair care. That's all I can tell you. It's not very comforting, but I'm 28 years old now and I'd still love to have a better idea about my long-term hair loss situation just as much as you would. The fact that there's so little hair loss in my family leaves me without much to go on. ------------------------------------------------

Thanks for all the responses everyone. I've already done enough research not to let 95% of the HT industry anywhere near my head (and I'm not done researching yet!). I guess it's just more of a concern about what's achievable even in the best docs' hands. I mean, almost every patient I see who was over a NW3 to begin with . . . seems like they ALL end up wanting to deplete their donor area as much as their money & long-term hair loss plans will possibly allow. That tells me that almost NOBODY is getting as much hair density/coverage as they'd really like, not even the HT patients who look great in their grown-out "after" pics. ------------------------------------------------

I see what you're saying about the various NW cases, Bill. The reason I bring up discontinuing meds is because I keep reading more about DHT suppression and I'm not liking it at all. I'm not gonna abandon finasteride without giving it a decent shot, but at the same time I'd probably drop it in a hot second if they ever release HM or a truly effective DHT-blocking topical. I'm not unduly obsessed with the "all-natural" mindset some people have, but my gut-reaction is that finasteride is risky. Way too many people seem to quit this stuff for way too many of the same reasons. And at least some of the people report that the side-effects are still starting/worsening many months & years after they started, so when can I ever really begin to think I'm "safe" with this stuff? And just in general, it's my own history. There haven't been many medications that I've ever kept taking for more than a few months or years. (Antidepressants, sleep meds & ADD-related, etc.) Everything just seems to have primary effects that diminish over time and side-effects that don't. ------------------------------------------------

If finasteride flat-out SHRANK a lot of penises, I really doubt Merck could keep it quiet. The stuff has been out there for about a decade already. Is is possible? I suspect it is, theoretically. Maybe a combination of a too-young user with a natural DHT level that was already on the low end of the bell curve, and then a high fin dosage for years . . . if it'll do it to rats, then I don't think it can be ruled out. But realistically, how many dudes could lose much penis size without realizing it immediately? Some of the complaints are about guys losing entire inches off their weiners. I have a hard time believing finasteride could really knock an inch off anyone's wiener before they noticed, discontinued the fin immediately, and then called a class-action lawyer. ------------------------------------------------

I like the idea of transplanted grafts. Particularly for the hairline. I wouldn't be too surprised if even years (decades?) after some form of injectable HM is workable, we might still be getting hairlines created with old-fashioned HT surgery for the best appearance. Part of the reason I raised this question is because of the technology jump. Every new medical advance sounds do-able in a press release, but so often the "little stuff" takes decades to iron out. In the HM research, it sometimes seems like the cell cloners are in charge more than the hair people. I 'm glad they're working so hard on it, but I also hope they're not so preoccupied with developing the technology that they miss the forest for the trees. ANYTHING that reliably turns one hair follicle into two would be absolutely life-altering for lots of us balding guys. We don't need it to be developed all the way to a perfect "plug & play" no-scar needle proceedure before they start commercially offering it. Anything that's cosmetically acceptable will change thousands of lives. ------------------------------------------------

I'm not saying the skin will look terrible or anything, but I'm just trying to explain why nobody wants to get a low hairline in their 20s and then move it higher later on. From what I've seen about this issue, a good HT surgeon usually does a really good job at minimizing the damage to the skin when he puts in the hairline. But everyone seems to agree that it won't be good enough to actually erase the hairline later without showing a bit. About the possible "discoloration" I was referring to . . . uneven tanning & skin tones on non-white people are the most common thing mentioned. And of course, scarring is usually a bit lighter than the original skin on everyone no matter what race. But of course, every case is different so there's no absolutes. ------------------------------------------------

The surgeons CAN put your hairline anywhere on your head. But once they put a hairline on, it's permanently there. (Even if you decide to just shave the hair off later, there will be slight uneven spots & discolorations in the skin where the surgeons had put the hairline on.) So you cannot get a hairline put on your forehead down low when you're young, and then just "change your mind" and get a higher hairline done later on in life. Not EVER, or else the slight scarring will be showing on your forehead from that first transplanted hairline you changed your mind about. You can get rid of the hairs growing out of the hairline later, but the skin will never look perfect & shiny up close after it's had transplants on it. And if you insist that your surgeon puts the new hairline on too low, then you might not have enough donor hair to cover all the bald scalp behind it later on in life when the balding gets worse. So if you don't want little scars from hair transplants showing visibly on your forehead for the rest of your life, then you have to get the new (transplanted) hairline put high enough to be sure you won't run out of donor hair later on. ------------------------------------------------

My reason for suggesting the artificial skin environment is because of the hair growth direction problems we keep hearing about. Basically, when I read about HM research, I keep reading variations of this: "We can already inject hair-growing cells and get new hairs to grow from them. But right now we still can't control the direction/characteristics of the hairs that we get from those injections." So . . . If you just took a "shotgun" approach and grew several times more new follicles (in an aritifical skin sample) than you actually wanted, then wouldn't that cancel out the direction problems? Once the follicles were fully-developed and growing out of the surface of a chunk of artifical skin, it would be obvious what direction/characteristics each follicle had. So from there, a conventional HT surgeon could pick and choose only the most suitable follicles to use. They could be transplanted onto the patient's head like a normal HT procedure. Even if 70% of the new hairs are still unsuitable, there's no reason they couldn't just grow 10,000 follicles for every 3000 they actually want to transplant. ------------------------------------------------

Good to know. Good to know. I've never been convinced that 50% is truly fine for a "full coverage" appearance, but I can live with that density as long as it looks decent and not unnatural. Sunny, wet, dry, bright light, etc. It doesn't have to look ideal but it has to look natural all the time. I'm a lot more concerned about getting extensive HTs, and then discovering that I'm trapped into a very specific hairstyle and constantly using concealers just to keep it looking half as good as I thought it would look in the first place. Is this why there are so many spiked-up hairstyles among HT patients? Do even the "dense" transplanted regions still look unnaturally thin otherwise? ------------------------------------------------

Thanks for the quick response, Bill. The "high school hairline" idea has never even been on the table for discussion with me. I think a NW#2 with a mild widow's peak would be the best-looking hairline on my face, period. (Even if donor hair wasn't any limitation.) However, I do have some real demands about density in transplanted areas. I see photos of way too many HT patients that barely look better than if they had just stayed un-transplanted. Bad hair sometimes looks worse than baldness. Maybe I can't get near original density, but at the same time I'm not gonna live in concealers and fear every rainstorm or gust of wind for the rest of my life. Does 50% of original density provide a "normal looking" density in the average case, realistically? Or do most of these HT patients still live in concealers 24/7 and build their whole hairstyle around hiding the lack of density? ------------------------------------------------

Hey. I've been lurking for months and finally started posting the other day. I'd love any input on my case, particularly if anyone has any thoughts/predictions on future loss possibilities. My case doesn't quite fit the common patterns. -- 28-yo caucasian male. NW3, no HTs, just starting finasteride. -- Currently a sharp-pointed NW3 in front. Visibly thinned front & top, but it's mostly still terminal hairs at this point. -- NW4A-5A seems possible eventually. It's the only MPB pattern in any blood relatives. Center/ very top of my head is thinning and is gonna be gone eventually. But my crown still looks & feels very thick at this point. -- No adult hair loss in my father or either of my grandfathers (all have lived to their 60s-80s). My father's brother is still a NW1 in his 50s. The only blood relative with MPB that I can find is one of my mother's cousins, who is a NW4A-5A in his 50's. -- I didn't actually lose most of my temples to MPB. My natural (un-MPB) hairline has always been at least a NW2.5 ever since I was 15-16 years old. This temple-recessed hairline was stable and I had no thinning until my mid-20s. (My father also had the same severe temple recession as a teen, except that he is currently 61 years old with no further hair loss at all since his teens.) Any thoughts on my hair loss case? I'm eventually seeking transplants (but not this year. Probably wait until age 29-30). I'm trying to figure out what my long-term situation might be. With future HTs, I'd love to do as much temple closing as possible. (My deep temple recessions are particularly ill-suited to my facial features. And as I said above, they've been that way since late puberty. So I've never gotten to be a NW1 or even a NW2 in my entire adult life.) But I don't really have a good idea about what is in store for my hair loss. If I eventually end up having to live with visible crown loss (because of MPB progression vs the limits of my HT donor area), then I don't think a NW2 hairline in front would look normal at all. Do you guys think transplanting a hairline with NW2.5-ish temple points is a safe bet in my situation? ------------------------------------------------

Hey. I've been lurking for months and finally started posting the other day. I'd love any input on my case, particularly if anyone has any thoughts/predictions on future loss possibilities. My case doesn't quite fit the common patterns. -- 28-yo caucasian male. NW3, no HTs, just starting finasteride. -- Currently a sharp-pointed NW3 in front. Visibly thinned front & top, but it's mostly still terminal hairs at this point. -- NW4A-5A seems possible eventually. It's the only MPB pattern in any blood relatives. Center/ very top of my head is thinning and is gonna be gone eventually. But my crown still looks & feels very thick at this point. -- No adult hair loss in my father or either of my grandfathers (all have lived to their 60s-80s). My father's brother is still a NW1 in his 50s. The only blood relative with MPB that I can find is one of my mother's cousins, who is a NW4A-5A in his 50's. -- I didn't actually lose most of my temples to MPB. My natural (un-MPB) hairline has always been at least a NW2.5 ever since I was 15-16 years old. This temple-recessed hairline was stable and I had no thinning until my mid-20s. (My father also had the same severe temple recession as a teen, except that he is currently 61 years old with no further hair loss at all since his teens.) Any thoughts on my hair loss case? I'm eventually seeking transplants (but not this year. Probably wait until age 29-30). I'm trying to figure out what my long-term situation might be. With future HTs, I'd love to do as much temple closing as possible. (My deep temple recessions are particularly ill-suited to my facial features. And as I said above, they've been that way since late puberty. So I've never gotten to be a NW1 or even a NW2 in my entire adult life.) But I don't really have a good idea about what is in store for my hair loss. If I eventually end up having to live with visible crown loss (because of MPB progression vs the limits of my HT donor area), then I don't think a NW2 hairline in front would look normal at all. Do you guys think transplanting a hairline with NW2.5-ish temple points is a safe bet in my situation? ------------------------------------------------

That would suck badly. Offhand, I'm tempted to say, "Man, you'd have to be pretty damn insecure about your height to want to go through that just to add another inch or two!" . . . but then again, think about US HERE. This whole forum is full of guys willing to pay tens of thousands of dollars to have strips of their scalps cut off & stuck into the front, all just to regain a few centimeters of thin hair coverage. I guess it all depends on what you have to begin with and what your life situation is. ------------------------------------------------

I appreciate the response Hairbank. But I'm still struggling to understand the workings of this issue, at least in regards to the DHT inhibitors like fin/dut. Lemme give an example: Let's say I was hypothetically destined to lose 20 hairs to MPB. I was genetically prone to losing 10 hairs per year for 2 years, starting in 2007. But let's say I take finasteride for all of 2007 and it preserves the 10 hairs. I finish 2007 with all 10 hairs intact. Then for the next year of 2008, I stop the finasteride and do nothing. So by the end of 2008, after one year of finasteride and the second year without, I would expect to have lost 10 hairs in total. However I would NOT expect to have lost 20 hairs in total yet, which is what would have naturally happened if I had never taken the finasteride during 2007. I would expect a one-year-long regimen of finasteride to permanently put me one year behind my genetically-programmed hair loss rate, even though I might eventually lose those same hairs later on. Does my thinking sound correct, or am I still misunderstanding the situation? ------------------------------------------------

After several months of surfing HM issues, I have a question. From my (limited) knowledge and understanding of the issue, it seems to me like there's a potentially successful method that's not being investigated. Assuming these things: -- Human hair follicles can be successfully cloned/multiplied using raw cells. But the direction (and possibly other factors) cannot yet be adequately controlled. -- Existing skin-grafting technology seems to be able to grow/multiply raw human skin in usable amounts. (Or am I wrong on this?) Now, given that . . . Why can't you use raw skin tissue (New, generated in a lab like a skin graft) as a surface, and use it to grow batches of new hair follicles TO A COMPLETED ADULT STATE? Then these fully-grown hair follicles could be transplanted onto the person's head with nothing more than traditional HT procedures. So, in effect, I'm asking: Why can't the medical community grow me a whole big "donor strip" using existing skin grafting methods + existing HM accomplishments? Sure, half the newly-generated follicles in the skin graft might grow out at odd angles . . . but that's where the traditional HT methods come into play. The surgeon could pick & choose only the most suitable of the new grafts to transplant onto the patient's head. Even if 3/4 of all the new-grown hair follicles end up in the trash, you've still basically got unlimited donor hair if you're willing to throw enough money at it. So what am I missing? Why isn't this being looked into? -------------------------------

I've been thinking for a long time that maybe the .02 dose of fin is really the best idea in regards to side effects. According to the charted evidence, this is a point at which the DHT levels are disproportionately reduced in the scalp skin in relation to serum levels. Assuming that the serum DHT levels really have more to do with sexual/genital effcts, then the .02mg dose would seem to be more "bang for the buck," when it comes to hair growth vs side effects. Any thoughts on this?

I'm just at the point of starting propecia after reading about it in various places for months. I get the strong impression that finasteride will probably shine a spotlight onto any pre-existing penile/genital problems, as well as amplify any problems that had been building up over time. I guess the bigger question - for us all - is whether the problems are things that finasteride is illuminating, or whether these things are evidence of new finasteride-related DAMAGE that's occurring. I believe the finasteride dosage arguments are valid too. Some bad findings are not necessarily evidence of all DHT suppression being bad. (Heck, iron is necessary for the body too. But all I have to do is feed a truck axle to a lab rat, and I'll get mountains of evidence that iron is extrememly harmful.) I really wonder what Merck is thinking about Propecia. If they seriously suspect that long-term DHT suppression will wreck a normal healthy man's weiner, I have a hard time believing they'd put the stuff out there. (Could they be that cruel? Yes. But HOW ON EARTH could they expect the issue not to eventually be discovered?)

Question: I've never quite understood this issue of "losing everything as soon as you quit the drug." I understand it perfectly when we're talking about anti-inflammatory drugs like Minoxidil. Minox will only shield the hair follicles from being attacked by the immune system. But the minox can't actually prevent more ongoing DHT-binding from occcurring the whole time. So when you quit using minox the original hair loss pattern resumes, PLUS you have a lot of built-up DHT binding ready to show itself. The DHT had still been binding to the hair follicles during the whole period of minox use, even though the minox had been hiding the evidence of it. But this is not the case with finasteride & other DHT blockers, right? If you quit them, you'll just quickly resume your original hair loss rate/pattern, right? And even if you never use finasteride again, you will still have at least bought yourself the time that you spent on it, correct?

That's exactly the point, unfortunately. You DID start going bald on the steroids. Which means you've more than likely inherited some genetic susceptibility to MPB. Which means it's probably gonna be attacking your hair again, steroids or not, at some point in the future. Best to wait a few years for the HT. It's aggravating to hear this, but a lot of other guys in their 20s (including me) are doing the same thing. It beats messing up your head/hair for life by acting too early.