Do you need to continue with a DHT blocker after surgery?

[Andyman79]

Hi all,

 

I'm doing some research and wondering if a DHT blocker is still required after a transplantation for Adrogenic Alopecia?

 

If not then how is this possible if it is considered genetic, surely the excess production of DHT will attack the new hair follicles?

 

Any help would be greatly appreciated.

 

Many thanks

 

Andy

[Andyman79]

Hi all,

 

I'm doing some research and wondering if a DHT blocker is still required after a transplantation for Adrogenic Alopecia?

 

If not then how is this possible if it is considered genetic, surely the excess production of DHT will attack the new hair follicles?

 

Any help would be greatly appreciated.

 

Many thanks

 

Andy

[SpaceBetween]

Are you asking if DHT will attack the new follicles?

 

All of your non-transplanted hair will continue to fall out without a DHT blocker.

 

Transplanted hair does not fall out, but I cannot personally give a good explanation as to why DHT does not attack it. Hopefully someone else can weigh in?

[Andyman79]

Thanks for the initial information SpaceBetween,

 

Yes I am interested to know if DHT attacks the new follicles and if not then hopefully to gain an insight into why not.

 

I'll keep searching!

 

Thanks again.

[SpaceBetween]

Now that I think about it, I really don't know the answer to this question at all haha.

 

How does the transplanted hair stay there and avoid the dooms of male pattern baldness?

[Dr. Michael Beehner]

Andyman,

"Attacking" is probably not the best way to think about what is happening. A better way to picture it is that the presence of DHT (which virtually every man has) PERMITS the genetic expression of each individual follicle to occur. The follicles on the sides and back of our heads have no genetic programming for miniaturization and eventual loss, whereas the follicles on the top of the head of men with hair loss do have this genetic programming. An experiment was done around 50 years ago, I believe by a Dr. Hamilton, in which he followed the paths of around a dozen pairs of identical twins, one of which was institutionalized and castrated (yes, those things occurred back then!) and the other was mentally normal and out in the world. The twin who was not castrated went on to lose all his hair on top, but the twin brother in the institution kept all of his hair because he there was no DHT present, since the testicles which produce testosterone, which breaks down into DHT, weren't present. My recollection is they then gave testosterone to the institutionalized twin (cruelty on top of cruelty) and he then went on to lose his hair.

Regarding the question of whether a man who has had a transplant is better off taking finasteride after his transplant or not, I believe he is - providing he has native hair on top that can still be salvaged and reversed from its miniaturization. If he is middle ages and a Norwood Class VI (shiny bald on top), then I generally don't advise taking it. I don't believe good proof has ever been shown that transplants do better with finasteride. A good way to picture the benefit of adding finasteride to the treatment package along with transplants is this: imagine two men with a similar hair loss pattern have a transplant and then return to see their doctor 4-5 years later. One takes finasteride and the other does not. The majority of men using finasteride, in my experience, have a net gain of hair mass during those first 5 years of treatment. When the doctor and the patient who had transplants plus finasteride looks at his results, he is looking at an ADDITION of two things: the newly moved transplanted hair PLUS the increase in hair mass from the medication. The other fellow who didn't take finasteride is instead looking at a SUBTRACTION on his head: the addition of the transplanted hair on top MINUS the increase in male pattern baldness that occurred during those years. That difference is a huge one. The man who doesn't take finasteride often unfairly blames his hair surgeon for not bringing about the transformation he envisioned, whereas the patient who did both often gives undeserved credit to the transplant for creating such a great result when half of the credit is probably due to the finasteride.

Mike Beehner, M.D.

[crow1]

Dr. Beehner,

Would you say the excellent results posted lately on high NW's can be contributed to finasteride just as much as the actual HT? Thanks.

[Dr. Michael Beehner]

Crow1,

I have no idea what percentage of the patients shown with "befores and afters" owe some of their "fullness" to finasteride or dutasteride. My guess is that it probably plays a role in at least 10-20% of those shown. That is probably true for the ones I show, except for the "shiny bald" ones.

Mike Beehner, M.D.

[Andyman79]

Thank you for the information on this Dr Beehner, it has certainly given me a better insight.

 

Kind regards

[miked]

Excellent explanation Dr. Beehner.

 

I would also like to remind everyone that if hair is a top priority, that an orchiectomy is by far the most convenient, cost effective and thorough method of reducing the amount of DHT on your scalp. You may also find that it helps with your a-cappella renderings of some of those Michael Jackson tunes on Karaoke night.