Is taking fin right after a hair transplant a bad idea, due to shock loss?

[ridge9]

I heard that there is 'shock loss' when people start taking fin, but that it eventually makes up for it.

 

Is it a bad idea to take fin along right after you've had a hair transplant, or could it have a negative effect on the newly implanted hairs?

[hsrp10]

It's more of "shed" when beginning finasteride that typically occurs 2-3 months after starting

Though it can affect some people differently.

 

The "shockloss" is from the surgery itself. I think after a hair transplant can be a good time to start but there are no guarantees and you just never know until you take it for several months.

[KO]

Shed is actually not a common event, but it happens to some people. You should take fin as early as possible, IMHO.

[voipman]

Shedding is sometimes a reaction for a minor of people whom use the drug but shout about it on the net. Ive done Fin n Dut and i got a little sides but they went after 2-3 weeks, to which i would expect as my body becomes accustomed to the changes. If your in for HT you need to think about using it long term to combat DHT.

[gillenator]

The opinions on this topic vary widely. A fair number of docs will start their mature male HT patients on Propecia right after the procedure once they discover that their patient is not taking it and will potentially benefit from taking it.

 

Yet every now and then we read about someone what is having poor regrowth and yet went to a reputable surgeon. Every time that I hear from a guy who is having poor regrowth or delayed growth, the first thing that I ask them is if they recently started Propecia for the first time or another form of low dose finasteride. It's amazing how many say yes. And further, many of them have started all sorts of other topical applications along with starting Propecia right after their procedures. Many of them are beginning to experience a shed cycle from the drug right when their regrowth is about to start.

 

But they are the exception and not the rule so I imagine if a higher percent of these men were having issues with regrowth, their respective docs may tell them to wait until the procedure fully grows in.

 

We rarely hear from guys who were already on low dose finasteride having regrowth issues. In fact, some docs want their patients to be on Propecia for at least 3-6 months before the procedure. They also want their patients to stop applying minoxidil at least two weeks before their procedure.

 

So I have not heard of any studies of men who started finasteride right after a HT procedure as compared to men already on it but I think it would be interesting to do one.

[gillenator]

One other thing. I know some docs believe that being on finasteride prior to a HT procedure will reduce the level of shock loss, but I don't buy that theory.

 

Why? Because shock loss is more attributable to the level of trauma in the scalp from the effects of the procedure. And we all respond differently to the trauma, some worse than others. And this is also why shock loss is really unpredictable. And the larger the procedure, the more recipient incisions that are made resulting in more trauma.

 

Obviously the more volume of diffused existing native hair there is, the more susceptible that hair is to shock loss.

 

Many docs are leery of doing large sessions on females that have large masses of weak native hair that is diffused. Shock loss is a real risk with those candidates.

[hsrp10]

Yet every now and then we read about someone what is having poor regrowth and yet went to a reputable surgeon. Every time that I hear from a guy who is having poor regrowth or delayed growth, the first thing that I ask them is if they recently started Propecia for the first time or another form of low dose finasteride.

 

As always Gillenator a good post.

So you are saying that you've seen cases where Propecia can indeed affect DHT resistant hair (obviously for reasons other than DHT) and cause shedding of newly transplanted hair?

I have experienced this myself.

 

Or are you just talking about non-transplanted hair?

[gillenator]

hsrp10,

 

It was more like these guys had very delayed periods of regrowth and shedding.

 

I usually heard from them once they reached 6 months post-op or longer.

 

And it always involved guys who started Propecia for "the very first time" immediately after their HT procedures. Again, not a lot of men, but enough to start noticing the similarities between them and the resulting phenomenon.

 

Then, one day as I was reading the pharmacology data on Propecia, I noticed that the inhibition period was between 90 and 120 days. It's not unusual for hair follicles to enter the dormancy phase once the drug kicks in...:confused:

 

So my conclusion was that these guys were experiencing a shed cycle when they should have been experiencing new growth from their grafts. Some even think that their procedure failed and get angry at their docs but I tell them to be patient and wait it out for at least 12 months. Surely you also must remember some of these guys who come on to the forums with their stories of delayed regrowth. And we all tell them to be patient and wait.

 

This phenomenon also happens to guys who start finasteride for the first time and never even have HT surgery. They begin seeing their hair fall out approximately 60-90 days after starting the drug and freak out and quit taking it. I usually tell them that this is a good sign because the active inhibition of the DHT is inducing a shed cycle and if they are patient, the hair will cycle back into the growth stage and may even grow back thicker.

 

But the younger they are, the less likely they will continue with Propecia or they reason that taking it less frequency will reduce the level of shedding. It won't. Once the hair follicles retreat into the resting phase, they will rest for 3-4 months before they re-enter their new growth phase.

 

And for reasons unkown to me, some guys who had surgery had very delayed regrowth periods as long as 9 months post-op. Then out of nowhere, BAM, new growth emerges like wild fire!

 

We also will read of a few guys who have a HT procedure, then initially start Propecia, minoxidil, Nioxin, Nizoral, large doses of MSM, biotin, etc, etc, all at the same time thinking they will all produce a super sized result. Some of them experience a massive shed cycle as a result an then cannot figure out why.

 

IMHO, when there are numerous combined products and meds introduced to our hair follicles for the first time, they often retreat into the dormant phase which is defensive behavior. This has been my observation.

 

So I often tell guys, just let your own body heal itself post-op. Allow time alone to do its thing. That's what our auto-immune systems are for. Time alone will work miracles and often produce the best optimal results.

 

Then once the regrowth takes place and you want to add these hair loss meds and supplements, have at it. They obviously have their potential benefits but timing can be a huge factor especially right after surgery IMHO...

[hsrp10]

I've been through most if it myself, including Nizoral and Proscar sheds

 

Seems like the thing some people don't want to admit is that the sheds can also affect transplanted hair, I agree with you starting on a massive amount of new meds is a poor idea. You never know which one is working and which ones are causing nasty sheds (Nizoral for example).

 

The really only way we can inform ourselves is to listen to past experiences here and pass on the word, most docs won't admit to Propecia/Nizoral etc. causing shedding

[ridge9]

hsrp10,

 

It was more like these guys had very delayed periods of regrowth and shedding.

 

I usually heard from them once they reached 6 months post-op or longer.

 

And it always involved guys who started Propecia for "the very first time" immediately after their HT procedures. Again, not a lot of men, but enough to start noticing the similarities between them and the resulting phenomenon.

 

Then, one day as I was reading the pharmacology data on Propecia, I noticed that the inhibition period was between 90 and 120 days. It's not unusual for hair follicles to enter the dormancy phase once the drug kicks in...:confused:

 

So my conclusion was that these guys were experiencing a shed cycle when they should have been experiencing new growth from their grafts. Some even think that their procedure failed and get angry at their docs but I tell them to be patient and wait it out for at least 12 months. Surely you also must remember some of these guys who come on to the forums with their stories of delayed regrowth. And we all tell them to be patient and wait.

 

This phenomenon also happens to guys who start finasteride for the first time and never even have HT surgery. They begin seeing their hair fall out approximately 60-90 days after starting the drug and freak out and quit taking it. I usually tell them that this is a good sign because the active inhibition of the DHT is inducing a shed cycle and if they are patient, the hair will cycle back into the growth stage and may even grow back thicker.

 

But the younger they are, the less likely they will continue with Propecia or they reason that taking it less frequency will reduce the level of shedding. It won't. Once the hair follicles retreat into the resting phase, they will rest for 3-4 months before they re-enter their new growth phase.

 

And for reasons unkown to me, some guys who had surgery had very delayed regrowth periods as long as 9 months post-op. Then out of nowhere, BAM, new growth emerges like wild fire!

 

We also will read of a few guys who have a HT procedure, then initially start Propecia, minoxidil, Nioxin, Nizoral, large doses of MSM, biotin, etc, etc, all at the same time thinking they will all produce a super sized result. Some of them experience a massive shed cycle as a result an then cannot figure out why.

 

IMHO, when there are numerous combined products and meds introduced to our hair follicles for the first time, they often retreat into the dormant phase which is defensive behavior. This has been my observation.

 

So I often tell guys, just let your own body heal itself post-op. Allow time alone to do its thing. That's what our auto-immune systems are for. Time alone will work miracles and often produce the best optimal results.

 

Then once the regrowth takes place and you want to add these hair loss meds and supplements, have at it. They obviously have their potential benefits but timing can be a huge factor especially right after surgery IMHO...

 

So gillenator, in your opinion, I should NOT start finasteride right after the procedure and should wait like 9-12 months? What would you do if you were me?

 

I'm 25 for the record.

[KO]

^That is a poor idea. If you wait 9-12 months, you will lose more hair, and taking fin after that point will not help you retain that. Shedding is very uncommon on fin, and has not been noticed often in the clinical trials.

 

If your goal is to take fin on an ongoing basis, then ideally you should start it about 6 months before transplant, if not earlier. But in no case should you wait a year before starting the drug, especially if you are facing any kind of aggressive loss. If you have slow, or stable loss, you can do as you like.

[hsrp10]

Shedding is very uncommon on fin,

 

I don't think that's true, if you're not shedding at least miniaturized hairs than the drug is not working, and it does seem to work for a lot of people.

Also not all the hundreds of people who report shedding are crazy.

 

Though I do think the OP should give it a try for at least one year initially to see how his individual reaction is to the drug. Unfortunately sheds or not still remains one of the few proven meds out there.

[KO]

Shedding is uncommon according to almost all of the studies. I'm not saying it doesn't happen, but it is not the typical experience. In many cases, people are checking their hair far more when they start the drug, and can imagine things.

[hsrp10]

Weren't the clinical studies done by the drug maker anyway?

Once you've actually gone through a nasty shed especially after paying a lot of money and expending a lot of emotional effort for a HT, you won't be calling it your imagination if it happens.

 

Gillenator is a patient advisor for quite a few clinics, and I don't think the reports and stories he presented here are all made up either.

Again not trying to scare anyone from at least trying the drug, but sheds are part of the process with this drug.

[ridge9]

The only reason I ask is because I have my hair transplant soon (few weeks - date set and paid for), so I'm trying to determine the best thing to do. I do think I'm losing my hair aggressively and not slowly, so it's really something I'm considering.

[voipman]

Ive never shed on using Fin and Dut. Dut was more effective for me but my hair line was getting dire so i did a ht and had hair line n scalp done and will drop to Fin as im unsure of Dut long term.

 

Many people shout about sides but i think many are just an assumption as i lost my father as i started Dut and thought i had brain fog, however on reflection think it was stress related and it was so easy to assume the wrong conclusion.

 

Some people will hate drugs and expect issues and some like me dont, but that said all drugs are actually a side effect and that must be considered

[KO]

Weren't the clinical studies done by the drug maker anyway?

Once you've actually gone through a nasty shed especially after paying a lot of money and expending a lot of emotional effort for a HT, you won't be calling it your imagination if it happens.

 

Gillenator is a patient advisor for quite a few clinics, and I don't think the reports and stories he presented here are all made up either.

Again not trying to scare anyone from at least trying the drug, but sheds are part of the process with this drug.

 

I could argue with you more, but you could simply post clinical evidence of sheds being common. I do not expect that you will do so, because no such evidence exists.

 

As for the OP, taking fin as early as possible is the best idea, your surgeon will likely recommend the same.

[KO]

The only reason I ask is because I have my hair transplant soon (few weeks - date set and paid for), so I'm trying to determine the best thing to do. I do think I'm losing my hair aggressively and not slowly, so it's really something I'm considering.

 

Hey do you have photos of your situation? Are you in a case where you have a lot of miniaturization throughout a large area or is it relatively localized to a receding pattern?

[hsrp10]

I could argue with you more, but you could simply post clinical evidence of sheds being common. I do not expect that you will do so, because no such evidence exists.

 

As for the OP, taking fin as early as possible is the best idea, your surgeon will likely recommend the same.

 

Experiencing sheds first hand on the drug is enough evidence for me as well as Gillenator's reports of patient experiences. Again the hundreds or more of experiences on the web as well, I don't think they are all crazy either.

 

What we do here is report our experiences, whether or not they fit neatly within scientific clinical trial results is irrelevant as they are actual experiences.

[KO]

Your experiences are of relevance only to yourself. The fact is that few people experience sheds, and the empirical evidence supports that. Try to understand the fact that people posting their experiences on the internet is not a representative sample of all those who take the drug.

 

Oh btw, do you have photos that demonstrate you had a shed, for example before and after photos?

[hsrp10]

Absolutely ridiculous, passing on individual hairloss experiences is what this forum is all about.

I mentioned not only mine but those posted on Page 1 of this thread by Gillenator.

 

You've never experienced a shed yourself so you are taking that to mean it is "very rare."

This forum used to be about fellow hairloss sufferers helping out each other, seems your're not interested in listening to any opinions or experiences other than your own. And at the same time trying to argue about someone's own experiences. Really sad the way it's become here recently.

[KO]

This may be difficult for you to understand, and I get that, but personal experiences are just that, they are not the typical experience for somebody on the drug and they are only applicable to you, and yet you keep going on about how you experienced etc etc. This person has not taken the drug, has not experienced a shed, and yet people are foolishly warning him about shedding when in fact all evidence shows that sheds are uncommon.

 

The best thing to do is to start taking the drug as early as possible, ideally 6 mos, to test for side effects. Even if you have a "shed", it may well be over by the time you get to surgery day.

[hsrp10]

Neither I nor the Gillenator were trying to warn the OP of not taking the med, I actually mentioned he should try it and see what his individual experience is.

Shedding is something that is a real possibility, and we tried to relay that information to him. That's what hairloss sufferers on this forum do.

 

No need for anyone to argue strongly about that possibility as it does exists, or to make multiple repetetive posts trying to refute others' personal experiences because of so-called lack of scientific evidence.

 

Anyway, I hope the OP if he has aggressive hairloss does have the chance to try Propecia as it's one of only two proven drugs out there (as I mentioned previously in this thread), and sheds are part of the process where miniaturized hairs shed and thicker darker hair grows.

[Garageland]

Gill makes some excellent points as usual and talks sense. There is a risk of shedding when getting on medication and if it does happen it is can be a good sign that it is working and some improvement can be seen when the hair grows back. Nizoral can have the same effect. I have heard from a number of patients that have experienced a shed from both Propecia and Nizoral, is it common? well you can argue that forever as there is just not the accurate information out there to say for sure. In general I do not get many patients contact me to say there are shedding since going on Propecia in relation to the number that go on it but it does happen and should be pointed out to the OP.

 

In a idea world all patients would have been on the medication at least 6 months before going ahead with surgery that said getting on the medication as soon as you can has got to be better than waiting 9 months after surgery to do it. If we are talking about personal experiences I went on the medication 3 months after surgery but I had very little native hair to shed in the first place it also didn't effect my growth and my 6 month results were very promising.

 

I would maintain that the sooner the better when getting on the medication and I see no reason not to take it immediately after surgery.

[gillenator]

I think everyone who posted their opinions on this thread made some good points.

 

And it is true that those individuals who experienced a shed from the "initial use" of finasteride are the exception and not the rule. It's just so hard to put it in percentages because I usually hear from the guys who are experiencing the shed from starting Propecia immediately after surgery "for the very first time". The guys who do not have this problem are happy and go on with life.

 

All that I am saying is that it does happen and probably more apt to those who have a more diffused thinning pattern, not as much to those with recessionary loss. And as I stated, those who have a larger mass of weakened diffused hair, have a higher potential risk of both shock loss and sheds. So I think it's important to get started on finasteride well ahead of the surgery date than to wait until the day after. Even the diffused patterned guys who choose to never get on finasteride still have a greater risk of shock loss than others, generally speaking.

 

And although IMHO it does not make that much difference in waiting for the regrowth from their procedure to take place over the next 6-9 months, introducing all of the meds for the "first initial time" can be more risky that beneficial regarding "timely" regrowth. I am just of the opinion that waiting for our own bodies to regrow the grafts is best when the individual is considered a higher risk for sheds and shock loss. Yet getting on finasteride is the best clinically proven hair loss medication to date than anything else out there. So we are not advocating not using finasteride, it's simply more of a question as to when to start "if" you are in the higher risk category for shock and sheds.

 

MPB is progressive in nature, and those of us who have it will have to deal with it for most of our lifetimes which is decades of time. And when the guys who do experience massive shedding after surgery and have stifled regrowth, many docs will inform them that it's undoubtedly related to starting Propecia and that it would have been better to have started it six or more months before the procedure. So there you have it.

 

So really, it's in the consultation appointment that the doctor should IMHO prescribe Propecia and get the individual on finasteride as soon as possible. And ideally, their procedure date put off for at least six months "if" the individual has a very obvious diffused thinning pattern with a fair amount/mass of weak native hair. The problem is that we are impatient. We want to do the procedure once we find the right doctor and who wants to wait 6-9 months? Yet it makes the most sense to stabilize the hair loss as much as possible and get their bodies introduced to the hair loss meds before surgery.

 

So in conclusion, yes, it's critical to get on low dose finasteride. But the timing of when to start it can be more complex that what it appears to those who have a higher risk of shock loss and sheds.

 

None of us hold a crystal ball as to how we will respond to the meds and surgery so that's the tough part of the decision making process. This is where we sometimes must simply fall back on just common sense. I know if I had a large amount of weak diffused hair, that I am more susceptible to the things that can cause it to fall out. So I have to be careful that I am not introducing my native hair follicles to numerous things that can cause them to retreat into the resting phase especially during and immediately after the procedure.

 

That's an opinion base on what I have observed over many years and many HT cases. They are not just premonitions and guesses otherwise there would be no point in talking about them. I have better things to do with my time...