HT without Meds?

[grufti]

Hi all,

 

I'm considering a HT but don't wish to take meds due to side effects (been there, done that). Does this mean that a HT is not a viable option as I'm getting the general consensus that meds are still required to maintain existing hair and help the newly transplanted hair?

 

All advice would be appreciated, especially from anyone with experience of a HT without meds if there are any, as it's a lot of money to invest if the rewards wouldn't be worth it.

 

Thanks!

[Thehairupthere]

It depends on your situation. You can probably have the procedure done, but if you don't take the medication you will most likely lose more hair as you age, and you will most likely need more treatment in the future. You will also get a more conservative approach in your procedure because the surgeon will have to take into account the loss of more hair. The medication can be pricey, but having the procedure done several times is certainly more expensive. Also the side effects are not very common, it's worth a shot to see if you react well to the meds and if you get the side effects you can stop and it will get out of your system within a few weeks.

[sc64]

What he said above,without meds you will probably wind up in the chair more often then not

[HARIRI]

Forget about Propeicia or Finastride buddy its a sexual poison, just use Saw Palmetto 500mg instead, atleast it will do some of the job, and get a higher minoxidil like 10% or 15% with azelaic acid (DHT blocker). Check out MOPC LABS or PERFECT IMAGE SOLUTIONS. Both are great but i prefer the first cause its not sticky.

[RCWest]

Propecia is the best thing to come out since the hair transplant itself. You would be surprised at how much better your outcome would be on meds. Look at it this way-Propecia saves you money by helping you keep more original hair and needing less grafts!

Edited April 27, 2011 by RCWest

[Dr. Glenn Charles]

The truth is that certain regimens work for some people and not others. There will always be some degree of trial and error to find what works best for each patient. If you have strong genetics for male pattern baldness you might want to consider at least trying some of the natural DHT blockers.

[Mike73]

I wonder why there's so much resistance towards 'meds'. The side effects affect very tiny percentage of users. Try it - if you don't like it, drop it. I'm very happy with Fin - I belong to the lucky group that actually experienced hair regrowth when I started taking it 2+ years ago. I'll never stop using it. No side effects whatsoever and I pay approx. $10 / month.

[biscuit]

Here's a thread with more info on HT's with no meds:

 

http://www.hairrestorationnetwork.com/eve/136170-hair-transplant-meds-necessary-well.html

[CaptainO]

I took Propecia for 5 years. It stopped all hair loss. During my 5th year of taking it, it virtually rendered my sex drive kaput. Literally, stopped in its tracks.

 

I stopped taking propecia in 2007. I had my HT #1 in jan 2010. Never took propecia after the HT. I did continue to lose more hair, but with permanent damage done to my sex drive, I will NEVER take it again. I have HT # 2 scheduled for Sept 2011

 

It simply comes down to which you want more?

[ej]

even if the meds work , they wear off over a period of time ! so plan for the worse case situ both financially and with your donor hair reserves

 

regards

ej

[Dr. Glenn Charles]

Obviously those who have negative side effects are not going to have nice things to say about the medication. There are also those who have been taking it for 10-15 years and have remained stable. I agree it is always a good idea to consider the worst case scenario and adjust a long term plan with that in mind.

[Tao]

I never took Propecia and never plan to (and don't use Rogaine anymore either). I had two HTS. You can check out my link below to see my situation. I think my hairloss pattern was well established and I wasn't going to lose much more anywhere else. I was also 41 when I had my first procedure. I know Propecia works really well for a lot of people, but I really just don't like messing with the body's hormones. I've seen what can happen when you do. That said, everyone is in a different situation and has to make the choice that makes the best sense in their individual case. I approached my HTs as a chance to not have to mess with medications or foam and it worked out really well in my case.

[Dr. Glenn Charles]

That is a nice story. Thanks for sharing it. This is another example of how everybody's situation is different and all you can hope for is that as many patients as possible find that right combination. Allowing them to think about other things besides their hair.

[mahhong]

Finasteride gave me moderate and persistent side effects the both times I tried it, so I'm in that unfortunate but fairly rare percentage of men who had side effects strong enough to render the medication unusable.

 

I think the drugs can be fantastic for stabilising hair loss and some men are keeping their crowns and vertex intact with drugs alone for 5, 10, 15+ years. But I've always had some lingering issues about the drugs and their overall place in hair restoration.

 

There's no doubt they work and play a major role in having a good head of hair for millions of men. They're relatively cheap and seem in most men to be able to keep hair over a long period of time. But we have to remember neither finasteride nor minoxidil have been studied rigorously for long term efficacy. Looking at finasteride, broadly speaking it lowers your DHT levels, slowing down or stopping the "choking" effect this hormone has on genetically susceptible follicles. It does not remove DHT though (which would not be advisable), so there is still somewhere between 30-40% DHT in your body (if my memory serves me correctly).

 

To me, that indicates that, over time (whether that be a decade, three decades, whatever) finasteride will lose ground on your genes and you will continue to lose hair. In short, whilst I have no specific knowledge or resources to back my theory up, I believe that many men taking finasteride in their twenties will probably still end up losing the hair they're genetically programmed to lose by the time they're in their fifties or sixties. They might have kept onto it for a lot longer (itself, a mini-miracle), but I don't think many men will end up winning the war.

 

Therefore (and I'm just speculating here), any good and ethical hair restoration doctor will not be willing to use up your donor supply under the assumption finasteride will continue to work forever. If you have, say, 7000 grafts, no good doctor would allow you to put all of them in the frontal third and hope for the best with the drugs. A good Master Plan should probably always be based around the idea that your genes will win, you'll eventually lose all their hair you're determined to lose, and your donor supply should be considered in light of these facts.

 

So it would seem to me that if you don't use drugs you just have to be prepared for multiple procedures, and most likely a lot earlier than if you did use drugs. However, I don't think this should have any bearing on your overall success or the density or coverage of your hair in the long term. If propecia works for 20 years but then you lose the hair in your crown and want it back, you'll need to have a further procedure. You might have stalled it by a few decades but I don't think you can totally avoid (unless you come to terms with your hairloss and accept it later down the line).

 

This is all just my speculation of course, but I think you should always plan and proceed as if you're going to be a Norwood V or VI. You should assume the worst and base your goals for each procedure as if the worst has already happened. That way if you can't or won't take drugs, you shouldn't find yourself caught short long term. I'd rather have 35g/cm2 in my frontal 3rd and 15g/cm2 in my crown than 65g/cm2 in the frontal third and 6g/cm2 in the crown!

 

So I think it's clear the drugs have a use but I don't honestly think they allow you greater density in the hairline/frontal third in the long term, because you'll always need to plan as if hair you're maintaining with finasteride will one day be gone. It's just too much of a risk to believe finasteride will keep you looking the way you do now forever and I don't think you can be sensible and plan like that.

 

I think, without drugs, you need to accept a much more erratic and patchier battle in the fight against hairloss. You'll likely find you have one procedure and, by the time it's filled in, more hair has gone making that procedure look less successful. Someone who has a procedure and takes fin is likely to see definite results from one procedure alone; someone who doesn't take fin might have to be thinking about the results after their second or third procedure and understanding the longer term result is what's at stake (2-4 years, say) and not the result after the first 12 months. If you're happy to think like this though, and are willing to have the procedures done when they're needed and think about goals and results in the mid and long term, my belief is that, over the long term, the people on drugs and the people off them will always end up near enough in the same place, and a HT is still the only permanent way to deal with that problem.

[Tao]

If that is the case, and it very well may be, then I apparently saved myself a lot of expense,fuss, and possible

side effects by just going with my HTs and skipping the meds and foam.

[Sigildark]

I wonder why there's so much resistance towards 'meds'. The side effects affect very tiny percentage of users. Try it - if you don't like it, drop it. I'm very happy with Fin - I belong to the lucky group that actually experienced hair regrowth when I started taking it 2+ years ago. I'll never stop using it. No side effects whatsoever and I pay approx. $10 / month.

 

2% isn't that tiny and the fact that persistent side effects have been documented in some unlucky individuals really increases the importance of the decision. Problem is, it's really hard to know what the odds are to get persistent sides. You have to be really unlucky i suppose.

 

The Medicines and Healthcare Products Regulatory Agency of the United Kingdom and the Swedish Medical Products Agency have both updated their patient information leaflets to include a statement that “persistence of erectile dysfunction after discontinuation of treatment with Propecia has been reported in post-marketing use.”

 

So then the question is, is the risk worth the potential reward? Not a decision to be taken lightly, i can understand people that choose either road. But it's not just an ah what the hell lets see what happens deal imo. The implications can be greater and warrant a really well thought out and validated decision.

 

A study was released in the Journal of Sexual medicine relating to this topic. Nice to see some research being carried out on the subject.

 

edit: Apparent Merk has updated their side effects to include the following statement:

 

"In general use, the following have been reported: breast tenderness and enlargement; depression;

allergic reactions including rash, itching, hives and swelling of the lips and face; problems with

ejaculation; testicular pain; difficulty in achieving an erection that continued after stopping the medication;

and, in rare cases, male breast cancer."

 

 

http://www.merck.com/product/usa/pi_circulars/p/propecia/propecia_ppi.pdf

Edited May 9, 2011 by Sigildark

[grufti]

Okay so if I were to plan for the worst-case scenario; Norwood 6, I personally don’t think I’ll reach this, but I would then want the option to be able to shave my head down to a grade 2, possibly 1. This has made me think that I would prefer a FUE surgery with Shapiro, as I most likely wouldn’t be able to hide a strip scar at this length. I’ve been quoted 1400-1800 grafts, which would strengthen and improve my hairline so I should be able have my desired hairstyle, grade 4 all over and feel comfortable with it. I know FUE is not a scar less procedure and the yield is about 75% compared to FUT, but thinking long term it would seem the best option for myself right now as if I did continue to have a significant amount of hair loss, I don’t feel I’d want to, or could afford to chase it with more procedures.

[biscuit]

If your goal is to shave to a 1 or 2 then strip is not a good choice. If you prefer to wear your hair that short I'd say don't get HT. A HT is going to be expensive, leave potential scarring, take 6 months to heal, and you will only end up with a little stubble where you didn't have it before. Just cut it short and be happy.

[Levrais]

Grufti,

I don't think it's correct that fue only gives 75% of the yield that you get with strip. If you go with a doc that is really into fue, you should do much better than that.

[grufti]

Grufti,

I don't think it's correct that fue only gives 75% of the yield that you get with strip. If you go with a doc that is really into fue, you should do much better than that.

 

You could be right, I've been looking into Dr. Bisanga and hearing great things about his FUE work, so potentially he's my future HT Dr, as more convenient for my location.

Edited May 31, 2011 by grufti