Topical Finasteride/Minoxidil Combo

[Friedman]

I did a consult with a doctor who recommended 8 months of a topical finasteride/minoxidil mix before doing a second surgery. I'm a bit skeptical this will work, but I'm also not really looking forward to doing another surgery at the moment. Part of the reason I'm skeptical is because I did 14 months of micro-needling plus minoxidil pre-op, and the benefits were tangible but modest compared to the huge positive impact of a transplant. Adding in finasteride seems unlikely to be a game changer. On the other hand, there is a chance I might need fewer grafts...

I looked online, and it does look like there are RCTs backing topical finasteride. Seems less chance of side effects?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609098/

https://clinicaltrials.gov/ct2/show/results/NCT03004469

 

Thus it seems like this topical finasteride/minoxidil combo plus micro-needling will be the way to go? Plus PRP if you can hack it?

 

 

 

[LaserCap]

The reason why doctors may recommend any type of retention management is just that.  To help avoid shock loss after a procedure.  Women, particularly, tend to be examples of this.  

Tangible and modest, (I like the way you said that).  There is importance tin this.  The medication is meant for you to keep what you have. And, if you do see a visual change for the better, is not because you regrew hair.  Nothing does this.  But there can be enhancement of the miniaturizing hair.  So, if you did see this, you should consider any of all modalities. (Propecia, Rogaine, Laser and PRP).  These work in different ways as the mechanism of action is completely different.  Consider only a small percentage of the population does experience this enhancement.

Given your decision to wait, I would go on medical therapy and give it a year.  Take photos and keep a record otherwise you'll forget.

[Friedman]

How many people on this board have had a "shock loss" after a procedure? Do you know anyone personally?

I've seen people whose results weren't as good as they were hoping, but even they had clear gains. Can you link to a shock loss example?

After my last procedure, I had a "shock gain". In any case, doctors have incentive to tell you to do a surgery now, so when one says to wait, we at least know they aren't just trying to drum up business. 

LaserCap, i'm guessing, by your name, you've had success with the lasers? There are RCTs supporting the laser treatment as well? Which exact combo do you use yourself?

 

 

 

 

[Friedman]

Update: I just did an online consult with a doctor. He was raving about the benefits of the topical finasteride/minoxidil combo. Suggested also doing 3 months of PRP to start off. He told me some doctors have been prescribing the topical finasteride/minoxidil combo for years with results. What is unclear to me is why this isn't widely known. In any case, I'm going to give this a go. He said this only lowers overall DHT levels by 1/18th as much as the pill. He did warn it might darken my hair a bit, but I am fine with that outcome. 

[LaserCap]

I take Propecia/Finasteride and have a LaserCap cap which I use 30 min every other day.

With regards to your last post, if the doctor is so enthused about topical finasteride, why not use it alone? Why 3 months of PRP? I find that suspect only because most people that do PRP don't know what they're doing.  Most will only use a syringe size and do treatments every few weeks, (meaning - they are not drawing enough blood).  And combine with Rogaine?  So, at the end of the day, how do you know what is doing what?

To give him credit, however, doing multiple modalities is a good thing.  Propecia, Rogaine, Laser and PRP.

With regards to the laser I use, made by LaserCap.  Model 224.  They have studies on this particular unit and carries a lifetime guarantee.  It's made by a doctor and the company is supported by physicians.  

 

[Friedman]

The reason not to use topical finasteride alone is because these different treatments work in different ways, they are complimentary, and different people will respond differently to different treatments, and no single treatment is going to work on everyone. The best chance of a good result is to use all of them. Randomized trials do show benefits of topical finasteride alone. I'm not going to be using it as part of an RCT. However, I'm going to add that, but probably not do the PRP. Reason not to is that the cheapest PRP place is about a 30 minute taxi ride away for me. That's 90 minutes I lose, plus about $50 a session. Overall, that makes a cost of about $200. Doing 3 times is fine, but then what happens when you quit? I'm going to do this every month for the next few years? It's too much hassle. 

I am a bit suspicious though -- I don't think this will end up doing much for me. I expect some tangible but modest benefits. 

The doctor I talked to was not a fan of laser therapy, btw. He did not believe it works. 

[Friedman]

On 7/24/2019 at 3:57 PM, LaserCap said:

I take Propecia/Finasteride and have a LaserCap cap which I use 30 min every other day.

With regards to your last post, if the doctor is so enthused about topical finasteride, why not use it alone? Why 3 months of PRP? I find that suspect only because most people that do PRP don't know what they're doing.  Most will only use a syringe size and do treatments every few weeks, (meaning - they are not drawing enough blood).  And combine with Rogaine?  So, at the end of the day, how do you know what is doing what?

To give him credit, however, doing multiple modalities is a good thing.  Propecia, Rogaine, Laser and PRP.

With regards to the laser I use, made by LaserCap.  Model 224.  They have studies on this particular unit and carries a lifetime guarantee.  It's made by a doctor and the company is supported by physicians.  

 

 

Do you take oral propecia, or the topical propecia?

[LaserCap]

Oral.  Sometimes the 1 mg and sometimes I 1/4.

[Friedman]

^Why don't you try topical propecia?