Why Am I Conservative

[Guest Brad Limmer, MD]

Over the years I have approached my hair loss patients in a conservative manner allowing for the various options with regards to treatment to be fully explored. This approach also allows them to hold off on unnecessary surgery or excessive graft numbers while they get a better understanding of what is and what is not possible in the field of hair restoration.

 

For many years I have read on the forums how some who post seem to think this is too conservative of an approach. Instead many people think the only solution is greater graft numbers …More Is Better. So below I present a recent case of a very young man that I am sure some would have told him the only answer to his problem was transplantation of some 3000-5000 grafts.

 

Well that was not my approach. After evaluating all data I felt he should not have an HT, but instead begin a full court press, using only medical management. Below are presented his before photos and current photos, 5 months into medical treatment.

 

So while some physicians and posters might feel transplantation is the panacea for all hair loss, I hope this example shows many who are wondering what to do that there are options available to them and all means of treatment need to be explored. While I firmly believe in the values of transplantation, I also know it is not the only choice patients need to consider.

 

Brad Limmer, MD/jac

[horses12]

i'm a new member justing having ht 8 weeks ago, i can only speak for myself but what i have always read on this site is that they 100 per cent agree with you, especially with a young patient, they always recommend meds to at least stabilize the hair loss. the threads i have read is that the docs on this site will turn away or try to dissuade a young patient from doing a ht because of the finite amount of hair they can use and maybe not seeing where the hair loss pattern is going. also that is why you are so highly recommended on this site along with the other docs because you think long term and trying the easiest path for the patient. i do have a question though i have heard med are very helpful with a young patient but what if you are a n5 or n6 and in your 50's but still have mini hairs would that hair come back if your on the meds

[Tsakalos]

what kind of treatment is this that works so well for the frontal scalp ?

Edited April 11, 2011 by Tsakalos

[lorenzo]

Most top doctor have a moral obligation towards patients and many follow the same protocal what is better for the patients. In my experiences most doctors would recommend proscar for a patient this young and tell him to come back in one year to see how he progress using meds.

Then when he returns there is a number of questions to ask depends on how he has progressed.

How has he responded to the drugs? This is a simple question but can be answered many different ways from different people. In some cases the doctor is happy with the progress while the patients isnt.

How old is the patient? Age is important as many doctors refuse surgery on young patients as there hairloss hasn't yet stablized. In many cases the type of hair transplant that the patient wants is no visible for the future. So its even better to wait till the patient matures or has much more realistic goals.

 

Thanks you for giving your example but I feel this is the norm rather than the exception. Top doctor think about the long term future that is why years later they are still considered top doctors.

[Guest Brad Limmer, MD]

Guys…one thing to make note of regarding these results is that this patient had been on Propecia for quite some time. It was not until the routine use of Rogaine, biotin, and a dandruff shampoo was added to the finasteride that his regrowth occurred. This case highlights the fact that combine medical management works considerably better than mono-therapy.

Brad Limmer, MD/jac

[Cant decide]

Thanks Dr. Limmer - So if someone is already on Rogain and Finasteride, what would you advise he add to his regimen?

[Guest Brad Limmer, MD]

They are both cheap and safe. Over the years of watching patients, I have been quite surprised what a difference it can make for patients.

Brad Limmer, MD/jac

[RCWest]

Dr. Limmer, how much do you think Biotin and Nizoral contribute to the overall success? I am on Tegretol for seizures and read in a medical journal that Tegretol somehow interferes with the production of Biotin in the body. That is why I ask.

[alix]

is Biotin safe to use on daily basis? what dosage is recommended hair-wise?

[RCWest]

is Biotin safe to use on daily basis? what dosage is recommended hair-wise?

 

Biotin is a water soluble vitamin, therefore it's nearly impossible to overdo it. Your body will just pee out what it doesn't use. Dr. Limmer recommends 2.5 mg. Walmart has a 5 mg. capsule, 120 for $7. That's 4 months worth. I've noticed a big change since starting them 4.5 months ago.

[alix]

RCWest,thanks for the info,I did some more research and I'm gonna add Biotin to my 1MG Finasteride treatment.I'm going to use Nizoral 2% too.

[bonkerstonker]

Decent result that limmer fair play to you for not shoving a ht down his throat but he still looks like a balding doosh so he's gonna need some work to change his life for the better. I'd be happy with his hair now if i was 42 or something.

[Guest Brad Limmer, MD]

2.5mg of Biotin is the dose I most often recommend and beyond 5mg I never have a patient comment that they have seen it work to any greater degree.

As for shampoos, I have more patients using the zinc based shampoos such as Head and Shoulders 2 in 1 over Nizoral. Reason being is because unless your hair is very oily most patients find it a little too drying to use on a daily basis.

Brad Limmer, MD/jac

[RCWest]

I am pleased you posted this result, as I'm glad to see that the addition of Biotin, Nizoral, and Minoxidil really kicked things in.

[cardel25]

Biotin is a water soluble vitamin, therefore it's nearly impossible to overdo it. Your body will just pee out what it doesn't use. Dr. Limmer recommends 2.5 mg. Walmart has a 5 mg. capsule, 120 for $7. That's 4 months worth. I've noticed a big change since starting them 4.5 months ago.

 

On ebay you can get 2.5 mg at the same price.

[cardel25]

2.5mg of Biotin is the dose I most often recommend and beyond 5mg I never have a patient comment that they have seen it work to any greater degree.

As for shampoos, I have more patients using the zinc based shampoos such as Head and Shoulders 2 in 1 over Nizoral. Reason being is because unless your hair is very oily most patients find it a little too drying to use on a daily basis.

Brad Limmer, MD/jac

 

Why not use Nizoral once or twice weekly and Head and Shoulders on a daily basis ? I can see that another recommended doc at this site suggest using both. I use Nizoral 2 % and i could be interested in using head and shoulders on daily basis.

[NEWHAIRPLEASE]

Why not use Nizoral once or twice weekly and Head and Shoulders on a daily basis ? I can see that another recommended doc at this site suggest using both. I use Nizoral 2 % and i could be interested in using head and shoulders on daily basis.

Dr Limmer does suggest that on his website.

[cardel25]

Dr Limmer does suggest that on his website.

 

Thats correct. One thing that i took notice of is the high amount of finasterid that Dr. Limmer is recommending. My doc told me that clinical studies showed significant more people having serious side effects like man boobs etc. When people took over 2 mg instead of 1. mg. But i havent found any support for it.

[NEWHAIRPLEASE]

Thats correct. One thing that i took notice of is the high amount of finasterid that Dr. Limmer is recommending. My doc told me that clinical studies showed significant more people having serious side effects like man boobs etc. When people took over 2 mg instead of 1. mg. But i havent found any support for it.

 

Again, Dr. Limmer does NOT recommend taking high amounts of finasteride on his site! He states for WOMEN 2.5 mg POST MENOPAUSE, FOR MEN he clearly states 1 MG of finasteride.

[cardel25]

2.5mg of Biotin is the dose I most often recommend and beyond 5mg I never have a patient comment that they have seen it work to any greater degree.

As for shampoos, I have more patients using the zinc based shampoos such as Head and Shoulders 2 in 1 over Nizoral. Reason being is because unless your hair is very oily most patients find it a little too drying to use on a daily basis.

Brad Limmer, MD/jac

 

Head and Shoulders have a sahmpoo with almod oil for dry hair. Is there any reason that the 2 in 1 should be better than this one ?

 

When you recommend 2 x nizoral 1 % usage per week. Would you then recommend to use the 2% once a week or twice ?