Evidence of donor area being "DHT Resistant "?

[zhairz]

Hey guys, so I am a long time researcher of MPB and have read as many case studies as I could find over the years.

 

It seems most if not all HT Practices claim the donor area of hair transplants to be somehow magically "resistant" to genetic baldness. This claim goes against all studies which have proved the reason for balding to be DHT and lack of oxygen and blood flow within certain areas of the scalp making the follicles within these areas alone susceptible to DHT.

 

 

Additionally the only long term transplant results I've seen which are positive are from patients that continued the use of finasteride indefinitely after their procedure, protecting their newly placed follicles from being destroyed.

 

 

Meanwhile others who choose to not take finasteride seem to have 2-4 more surgeries before inevitably giving in to their baldness.

 

 

So, if as many doctors claim, this "donor area" is in fact resistant to MPB and the effects of DHT can anyone prove this with a non-finasteride patient photo 5-10 years after surgery?

 

 

If no such photo or case exists (which I'm already confident it doesn't)then doctors need to become more honest with their patients about the critical use of DHT blockers post operation in the interest of retaining their hairs long term.

[Al - Moderator]

Totally agree with you. That's one of the lies they tell you to get you to do the procedure.

[Melvin- Admin]

Totally agree with you. That's one of the lies they tell you to get you to do the procedure.

 

Didn't you mention that you took Finasteride and still continued to bald? I think a myth is that Finasteride indefinitely stops balding, it blocks 70% of DHT for those highly sensitive to DHT this means that the other 30% will continue to cause balding.

 

The truth is that DHT sensitivity changes from person to person, some men never bald beyond Norwood III while others bald significantly through out the entire scalp leaving a thin inch long band of hair around the head. The men with low sensitivity are better candidates for medical therapy and hair restoration because they can ultimately achieve a life long improvement, men with high sensitivity are generally poor candidates because medical therapy is limited as well as hair restoration.

 

In looking at your pictures Behappy it became apparent in your early 30's that you were going to be Norwood 7, if you would have waited until your 30's to have procedures there may have been a better utilization of the grafts and yield, have you considered a full hair system?

[zhairz]

Regardless of a person's sensitivity or individual balding pattern, I am suggesting that if hair follicles are moved from an oxygen and blood dense location to an opposite environment they will die without the use of DHT blockers.

 

I also believe this to be the reason many scalp therapies, exercises, and blood circulation supplements have been proven effective.

 

 

Until it's proven otherwise there is no such thing as DHT-resistant hair - it is merely a matter of location and how well oxygenated that area is which keeps the follicles alive throughout a person's life.

[n00b]

Wow... This is concerning!

 

Can any senior members chime in?

Are donor hair not dht resistant?

[Transhair]

I kind out doubt this.

There's an old guy who comes into work every now and then with a very obvious hairline transplant and the rest of him is bald.

I'd imagine that a decent amount of grafts are transplanted among existing hair, and when that falls out, the result of the hair transplant looks worse.

When a low density like 30FU/cm is transplanted to thicken up the rest of the head, of course it will look thin and undesirable after all the native hairs die. The hair transplant doesn't just magically make all the other hairs DHT resistant and stop them from falling.

[zhairz]

The hair transplant doesn't just magically make all the other hairs DHT resistant and stop them from falling.

 

That's not my argument - I am suggesting that the relocated hairs themselves are not DHT-Resistant, they are only alive due to their native location on the scalp, and therefor have an average 5-10 year life span after being removed from a healthier part of the scalp.

 

I think it is misleading for doctors to use the term "dht-resistant" or "terminal hairs" when there is no scientific evidence to prove such a thing is possible.

[Melvin- Admin]

Hair loss is genetic it has nothing to do with the location of the follicles, oxygen and blood supply certainly helps in growing hair especially newly transplanted hair, but it is not what makes hair more "susceptible" to DHT; what makes hair susceptible to DHT is your genetic predisposition not hair location.

[Mikey1970]

zhairz. how do you explain men that don't go bald then?

 

there is still a reasonable % of older men with good native hair intact.

 

i think it is a lot more logical that some men have androgen sensitive follicles and some don't.

 

also the overwhelming majority of bald men retain the donor fringe & those hairs, when transplanted remain permanent.

[zhairz]

what makes hair susceptible to DHT is your genetic predisposition not hair location.

 

That is a common theory which is not supported by science. Hundreds of clinical trials in and outside of the United States have proven otherwise.

 

also the overwhelming majority of bald men retain the donor fringe & those hairs, when transplanted remain permanent.

 

I think that's wonderful - have you seen any photographic evidence of transplanted hairs remaining permanently intact without the use of DHT inhibitors?

[Spanker]

Tons of people have donor that is resistant. This doesn't mean that they are immune to donor miniaturization. But, just walk out on the street and you'll see tons of old men with hair in their donor area. That said, I think a high percentage of men who get old enough are prone to senile alopecia. That said, look at all the men that you know that don't have perfect hair at an older age, but still have plenty on top. Not all men are destined to be Norwood 7s. There are a lot of men that can have long lasting results without fin that are low on the Norwood scale.

Edited August 14, 2016 by Spanker

[zhairz]

I agree completely @Spanker but I'm not sure how your post relates to the survival of "donor hair" after it has been relocated

[Melvin- Admin]

That is a common theory which is not supported by science. Hundreds of clinical trials in and outside of the United States have proven otherwise.

 

Please provide links to these clinical trials and studies.

 

Dr. Norman Orentreich was the originator of hair transplantation, he concluded "donor dominance" this basically means that the hair taken from a certain location on the body will retain its genetic characteristic, for example if you transplant a hair from the beard on your head it will grow like beard hair on your head.

 

There have been challenges most notably by Dr. Hwang who says that donor dominance does not exist, he conducted a study in which he transplanted scalp hair to his leg to find the transplanted hair began to mimic leg hair characteristics. Here is the problem with this theory, it's not true, I can provide numerous examples of individuals who have had body hair transplanted to the scalp with no change in characteristics.

 

Here is an example of a man who underwent 100% BHT transplantation notice the hair on his head is obviously body hair, meaning its retained its genetic traits

 

 

This gentlemen had armpit hair transplanted to his head, notice that the hair on his head notably looks like armpit hair, I don't say this to be mean or disrespectful i'm just stating the facts.

 

 

It would be amazing if what you believed was true, because then every single hairy NW7 guy wouldn't bother using scalp grafts they would just use body hair and eliminate balding all together, they wouldn't need Finasteride because body hair lives off of DHT.

[zhairz]

I do not know anything about body hair transplants, but I've lost interest in this thread thanks to your photo.

[Melvin- Admin]

I do not know anything about body hair transplants, but I've lost interest in this thread thanks to your photo.

 

I only used BHT as an example to prove the point about genetics and hair loss, the follicle is lost due to genetic predisposition, the hair that is transplanted from the safe donor region will retain its genetic immunity to DHT. Those guys who lose hair in their donor region were already genetically predisposed to lose hair in that region like many men with DUPA,you've lost interest as soon as your asked to provide proof of these "hundreds of clinical stuides" lol.

[Spanker]

There are tons of results, but probably most easily seen in repair cases, where someone lost all of their hair but plugs that were transplanted years ago. These are probably the most obvious cases you can see where the person was very likely not on fin and had retained transplanted hair. I'm not going to search one but you can just google images of hair plug repair and see that hair taken from the back holds out as well as the donor.

[Tj287]

Fantastic argument you present HTsoon - I agree. I think the follicle itself, irrelevant of location, is what is resistant to DHT. Obviously there is a huge variance in individual sensitivity but, for the right candidate operated on at the right age, you can predict with a fair degree of certainty how things should look going forward for a fairly long time. Staying on fin is, for most people, simply an insurance policy for their HT.

 

You don't see many cases of people who have discontinued fin after HT because why would you? It's been shown to be fine to take for years and if you have no sides, why not? It's a very small price to pay for virtually guaranteeing that you are locking things in as they were after surgery by taking a pill every day. I personally have never taken fin but I believe progesterone has done exactly what fin would have done for me. I wasn't balding horribly badly so I'm not as sensitive as some to DHT, so I could potentially be fine to stop progesterone now but I have no intention of doing so. It's doing nothing to me and the dose is so small I am happy to continue ad infinitum. It is also a naturally occurring hormone in my body so it is not a synthetic drug either.

 

Zhairs, please argue your point properly if you wish to make one. HTsoon made a point then backed it up, after which you seemed to withdraw entirely. I've seen nothing you've said backed up with any evidence at all.

[zhairz]

I just feel bad for armpit hair-head. Doesn't there come a point of acceptance in hair loss before you transplant armpit hairs onto your head?

 

There is still no scientific evidence of "DHT-resistant" hair follicles on our heads, until there is I've lost interest.

[gbhscot]

I think the DHT debate is a bit draconian. Yes DHT plays a role in MPB but it is further down the line than has been stated here. Recent research shows wnt-signalling and inflammation have huge roles to play. If anyone recalls the plucking paper two years ago, it suggested plucked hairs send signals to nearby hairs to grow. I'd argue that the hair at the back doesn't shed because the area isn't subjected to inflammation (caused maybe by DHT though I've often wondered if prolactin might be the real issue, which could explain progesterone having a fin like effect for the above poster) and that there is no interuption of signalling. Obviously very simplified but I think research supports this - I'm fascinated by the ivory dome theory of baldness, which found support by the doc who researched MPB by dissecting scalps & found consistent fibrosis...can't remember his name but can post tmrw.

 

Long story short, not all hair will fall out, for whatever reason, some follicles wont miniaturize.

[Rashid36]

It would still be a bigger risk to get a hair transplant then and depending on the percentage amount of donor hair that has been affected would need to be considered.

 

If a person went ahead and had a ht with donor thinning and then lost the transplanted hairs later they will also be left with the fue scars which can be seen amongst the thinning hairs in the donor worse if it was fut scar.

 

I have alot of hair on my sides the hair grows alot and quickly many doctors told me i could have a certain number of grafts yet when i saw

Dr Christian Bisanga at BHR Clinic, Brussels Europe he showed me I have thinning in the donor areas.

 

Not only is my donor limited for the demand now its the quality of that donor hair as well.

 

Looks like some of my donor is not resistant to the effects of dht so currently i'm taking fin and min with other supplements to see if that would improve things and see how the miniaturization progresses.

[Tj287]

I just feel bad for armpit hair-head. Doesn't there come a point of acceptance in hair loss before you transplant armpit hairs onto your head?

 

There is still no scientific evidence of "DHT-resistant" hair follicles on our heads, until there is I've lost interest.

 

Zhairz - there is obvious evidence that there are DHT-resistant hair follicles on people's heads - men that never go bald! As is the case with Rashid - he is obviously very sensitive to DHT and I am less so, and guys who never lose their hair, like Brad Pitt, for example are even less so (if at all) again.

 

I do feel bad for the armpit hair guy, it looks awful.

 

@gbhscot - progesterone works in the exact same way as fin , ie. a 5-AR blocker which inhibits the conversion of test to DHT. As such, it is a natural substitute for finasteride provided you use a bio-identical hormone and there are therefore no sides. I don't know anything about prolactin, so i can't comment on that. I feel like progesterone is a well kept secret that could help a lot of guys who are concerned about fin sides. Just google 'Progesterone DHT' and have a little read.

[gbhscot]

@gbhscot - progesterone works in the exact same way as fin , ie. a 5-AR blocker which inhibits the conversion of test to DHT. As such, it is a natural substitute for finasteride provided you use a bio-identical hormone and there are therefore no sides. I don't know anything about prolactin, so i can't comment on that. I feel like progesterone is a well kept secret that could help a lot of guys who are concerned about fin sides. Just google 'Progesterone DHT' and have a little read.

 

I'm 27, no doc in the world is going to prescribe me progesterone

[Tj287]

I'm 27, no doc in the world is going to prescribe me progesterone

 

 

FYI I am also 27. I was lucky because my dad is a physician so he could prescribe me the meds. I am not sure why more HT docs don't use it. Surely some have tried?! The sides from fin can be AWFUL and can last for life! Dr Hasson was very interested to hear about the efficacy of progesterone when I had my HT. I have nothing but good things to say about it.

[mahhong]

Tj287 - That sounds interesting about using progesterone. Do you really think it causes less sides?

 

The only reason I ask is because I don't really understand how it could. So far as I can tell, inhibiting 5ar and therefore DHT is the cause of sides, however that inhibition occurs. I know a lot of men want to use Saw Palmetto for example, because they perceive it to be a "natural" way to lower DHT, but this has never rung true for me. I don't think synthetically inhibiting 5ar is the reason for sides, it's simply the fact that lower DHT has the potential to cause sides, however you go about it. That's my understanding anyway, but I'd be interested to know if you have a different opinion or understanding of the situation.

 

The same for the potential for long-term effects from finasteride. Although it's still being researched, it would seem the potential for long-term effects from finasteride stems from the altering of hormone balances creating a sort of long-term hormone/chemical imbalance in a very small number of susceptible men. However, wouldn't the same outcome be possible using progesterone?

 

I'm interested in knowing more about this side of things - I'm also a bit on the fence about oral finasteride though there's still no doubt it's the best option for men who want to halt their hairloss. Alternatives, be they a different drug or a local or different way of lowering DHT, would be interesting (though I'm not convinced there is a way for a man to lower DHT without increasing the risk of sides, or that there's a truly local/topical only way of lowering DHT).

[Tj287]

Tj287 - That sounds interesting about using progesterone. Do you really think it causes less sides?

 

The only reason I ask is because I don't really understand how it could. So far as I can tell, inhibiting 5ar and therefore DHT is the cause of sides, however that inhibition occurs. I know a lot of men want to use Saw Palmetto for example, because they perceive it to be a "natural" way to lower DHT, but this has never rung true for me. I don't think synthetically inhibiting 5ar is the reason for sides, it's simply the fact that lower DHT has the potential to cause sides, however you go about it. That's my understanding anyway, but I'd be interested to know if you have a different opinion or understanding of the situation.

 

The same for the potential for long-term effects from finasteride. Although it's still being researched, it would seem the potential for long-term effects from finasteride stems from the altering of hormone balances creating a sort of long-term hormone/chemical imbalance in a very small number of susceptible men. However, wouldn't the same outcome be possible using progesterone?

 

I'm interested in knowing more about this side of things - I'm also a bit on the fence about oral finasteride though there's still no doubt it's the best option for men who want to halt their hairloss. Alternatives, be they a different drug or a local or different way of lowering DHT, would be interesting (though I'm not convinced there is a way for a man to lower DHT without increasing the risk of sides, or that there's a truly local/topical only way of lowering DHT).

 

 

Mahhong - you raise an interesting point, and one I've not actually considered. When I made the decision to take progesterone it was on the basis that it was not a synthetic drug. I hadn't actually considered that the potential sides that may occur are actually byproducts of the 5-AR inhibition process, rather than something in the drug itself. I see online that you can get progesterone cream which I suppose could be applied topically, much like minox. I am unsure though as I am taking mine orally.

 

Now that I think about it what you are saying it definitely makes sense, although I do not know for certain if you are correct. It may very well be the process that causes the sides and not something in the drug itself. I would be very interested to hear from someone who has a medical background or knows more than I do. It's also very hard to determine as I would imagine there are a large number of variables. From the top of my head I can think of a couple:

 

- Is there something in the fin/proscar chemical structure itself that can cause sides?

- How does the body absorb/metabolise/expel (if at all) the active chemical which is a 5-AR inhibitor in fin?

- How does the above occur with progesterone?

- What is the half life (which inevitably affects how often someone doses) for fin and for progesterone? If one has a longer HL than the other, one would inevitably need to take less of the drug in order to maintian the same effect

- Progesterone is a master hormone, and the root of a number of other hormones (incl estrogen and testosterone). How would the body convert this (if at all) to various other hormones in the chain and, if so, in what percentages? If a conversion is taking place, how much progesterone remains in order to block the DHT conversion?

 

Unfortunately, these are questions I cannot answer and I can only go on my personal experience.

 

In my experience, I have had no sides whatsoever. I am fairly certain that there is a percentage of men who, after hearing about potential sides, have a negative thought planted in their head. This ends up growing as a recurring negative thought that ends up manifesting itself physically. I personally believe that penile function and sexual performance are very much determined by mental state and frame of mind and, for some, planting the seed is enough for them to start questioning themselves and ultimately believing they are being negatively affected. As such, it becomes a self-fulfilling prophecy. Perhaps I was just lucky and my lack of sides is just the same as many men who take fin and have none. Perhaps there is something else in the fin/the absorption/secretion process that causes the sides, or perhaps they are inevitable whenever you are trying to inhibit 5-AR - I don't know.

 

EDIT: I've been doing some google searching and, interestingly, many of the neg sides of fin (erectile dysfunction, low libido etc) are actually symptoms of a lack of progesterone. It seems completely backwards that a deficiency of a natural 5-AR inhibitor (progesterone) would cause these things if they are inherent to the process of inhibiting 5-AR in the first place.