HT w/o propecia

[inkQbus]

I am 26 and have been researching HT for about 2 years now before I have finally decided to take the dive. I tried propecia, but have not been able to live with the side effects. They have been too severe for me to justify the continued use.

 

My question is, has anyone else had a hair transplant without the use of propecia? My fear at such a young age is that I get the HT, then I continue to bald and then end up with a very unnatural look.

[CHB8]

Not sure if this will help but I wasn't on fin when I got 1000 FUE 5 months ago. After seeing the diffuse grow-in on top of shock loss in the weak areas I went on it 6 weeks later.

 

I don't feel any side effects so far so that is a major factor for me. Good luck.

[mav]

I have gone in for a Propecia free HT but its just been over a month so the results are still months down.

 

I am aware that I might lose hair in the non transplanted region and am prepared to go in for further surgeries to beat the loss.

[Ja-Man]

InQbus - It really depends on where you'll end up on the NW scale and if you have relatives that are NW6-7. At 26, if you have significant loss, most likely you'll end on the higher side of the NW scale (although I hear only a small percentage end up a 7).

If you get an HT, you'd have to plan conservatively and commit to more HT's down the road (even if you were on fin, you'd have to commit to more down the road). Personally, I'd recommend waiting until your 30, you may feel differently about the hair loss at that time, and you'll have a better idea where the hair loss is headed on the NW scale...

[Bill - Seemiller]

InkQbus,

 

I just posted the below on another related topic, but I thought I'd post it below since it applies to you also.

 

Propecia (finasteride) isn't necessarily required to have a hair transplant, but understand that if you are at high risk for future hair loss, you and your hair restoration physician should plan ultra conservatively. Hair loss is progressive, but hair transplantation can be even riskier in young patients, if hair loss is noticeably agressive, in men or women who just started losing their hair, or if there are no signs of stabilization. Thus, it's vital for hair transplant surgeons to use donor hair wisely as if you were going to advance to the highest stages of hair loss.

 

Best wishes,

 

Bill

[CHB8]

Originally posted by Ja-Man:

If you get an HT, you'd have to plan conservatively and commit to more HT's down the road (even if you were on fin, you'd have to commit to more down the road).

 

Just curious how true this really is? I've definitely heard of cases where the meds seemed to stop working and that is a bit concerning.

 

As a late 20s diffuser I'm not sure what my odds are. My loss became pretty noticeable in the past year and the fin seems to be working well so far.

 

I had originally planned to get the HT, use fin if necessary and go in again after 5 years in a worst case scenario. Now I'm not too sure as I haven't heard of too many young guys with just one HT and fin doing the rest of the work.

[MikeTheDane]

If you're in need of a HT in your mid twenties, but cannot live with the sides of propecia, I would advice against a HT.

 

Propecia blocks around 2/3 to 3/4 of the DHT, which in theory means that you bald 3-4 times as slow when you're on the pill.

[mahhong]

This is something I'm a little confused about as well. It seems to me that Propecia, whilst very effective, is not a drug that is useful across somebody's lifetime. If you start taking it when you're 25-30 and you take it for 20-25 years it seems that, for most people, the drug has stopped working or simply that their hair has slowly fallen victim to the effects of the DHT propecia was unable to block and, although the hair has fallen out much slower, it will always eventually go. I know that's not a medical fact but it does seem that's the case.

 

In addition the long term effects of propecia are unknown. I'm not suggesting it's dangerous or problematic with long-term use, but just saying that, these two factors combined, it seems that within say 15-20 years of use most men will have stopped taking propecia, either because it has stopped working for them and they have virtually no native hairs left to save or because they are concerned about the overall long-term effects the drug might be having.

 

To that extent would it be fair to say most HT surgeons would cautiously plan their procedures with the belief or at least the knowledge that propecia will at some point in a patient's lifetime no longer be effective for them (especially if they are young, between say 25-40)? They're not going to pack every donor hair in to the bald gaps at the first instance because they know they may need to plan for longer term hairloss and the eventual reduction in efficacy of any drugs.

 

So, with that being said, surely everybody who is on propecia will eventually have to either have further HT's as their propecia-maintained hair loses it's admittedly sturdy battle with MPB or resign themselves to losing the hair in those areas.

 

I guess what I'm trying to say is would it be fair to say a HT is the only pretty much guaranteed method of permanent reversal of hairloss? And, if that's the case, whilst propecia has its uses surely those who cannot take the drug for whatever reason are still good candidates for successful (if multiple) HT's?

 

I just can't imagine that in 30 years time anybody who started propecia now will really be seeing any major benefits from it (apart from losing their hair very slowly). To that extent is simply starting with HT's not a viable option?

[Severn]

I started using finisteride(Propecia) around 1997. It worked great and restored most of my crown hair. However the positive effects only lasted about 3 years. By the 4th year I was back to where I started. I stopped taking it and was worried that I would go through the reported shed and accelerated loss but no visible changes happened after that.

 

I had my HT October 12th last year and have no plans to restart finisteride or avodart.

[Megatron]

I think every HT should be planned as if you're going to go to a NW 5 which is probably very likley if you're experiencing any kind of MPB.

[nsuede]

I agree with Megatron. I look like I am thinning and going bald, but that is different from being bald...which I will be later without an HT. I tried Propecia for a month, my nuggets (testis) ached and where sore. I said to hell with that. For me the plan is to get work done with the knowledge that I will probably be a 5A when all is said an done.

[mahhong]

That's always been my thinking. I'm having to make a big decision about whether or not to use propecia in the next few months and I'm leaning towards possibly saying no (need to consult with a few professionals first though).

 

My logic has always been that you can't really factor propecia into your life as a permanent way to halt hairloss. It might work for 5 or 10 years; perhaps even 15+, but if it inhibits "most" of the DHT it stands to reason that, over time, those small amounts of DHT still being produced will eventually remove near enough every susceptible hair on your head.

 

To that extent you're gonna go bald eventually. You might be able to get 10 or more years out of your existing hair and that's good news but you'd still have to plan to one day have one or more transplants to replace lost hair.

 

I think I'd rather just start down the HT route now and have multiple surgeries over the next 15-20 years. I'm starting to believe I'll end up a Norwood 5a based on my Dad's hair, his Dad's hair and my own hairloss at the moment (diffuse thinning across the top but a fairly high line on the back and sides). In many ways I'd rather just plan for getting there now than saving some hair for a decade, losing it eventually and having to go for a 2nd/3rd transplant anyway. It saves time, removes being on a drug for the long-term and with the increasing refinement of HT and the excellent results I think it's the best way overall.

 

For me propecia just has too many variables; lack of knowledge over long term efficacy, cost, potential side effects, relatively scant data on long term usage etc. I can't help but feel it's a very good but ultimately limited stop-gap and as long as my donor amount and scalp laxity are solid I'd rather go down the HT route and know the hair on top of my head is stable than try and cocktail my way to success. Not that I'm trying to diminish propecia's use, it's clearly a godsend, I just feel HT is even more of a godsend and one we know we'll have to turn to eventually (lest we don't mind going bald in our 40's/50's).

[Megatron]

I actually would accept a small risk of side effects for the benefit of having better hair for 10 years. That's why I choose to be on propecia.