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How do I proceed with my hair loss?


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Hi all,

I am new to this forum and in general I have never looked into hair loss solutions before but it has really started to bother me recently so I need your opinion on the matter.

I don’t have any medical diseases or any health conditions. I do not use any medicines and I don't use any particular products for my hair.

I was looking into a possible hair transplant as I noticed that I have started losing hair 9-10 years ago. I am 34 years old and recently I've visited a trichologist and diagnosed me with androgenic
alopecia.The trichologist suggested to me a 4 month treatment and then he needs to examine me to suggest how to proceed. He informed me that I will most probably go with a PRP treatment after the 4 months but he wanted first to see the results of the products I will be taking which would be the following:

- Krim up Andro supplements (one pill every morning after breakfast)
- Golden Crim B+C from Solgar (one pill every morning after breakfast)
- Liquid Vita D3 (1ml after breakfast)
- Minoxidil 5% Biorga (apply one time every 2 days and not twice a day
as the recommended dosage)
- Tricovel PRP plus gel (apply once a week)

He also subscribed to me 3 different shampoos to use every other day:

- Micro Peel Dercos from Vichy
- Kerium DS from la roche ponay
- Dercos DS greasy hair

I was thinking of proceeding with a hair transplant sooner rather than following other treatments but I am not sure whether it's better to wait for my hair loss to advance before I do a hair transplant.

I am also hesitant to use Finasteride as even the trichologist told me it has side effects and reduces sexual libido. What is your opinion on this? Is there any alternative after a hair transplant?

Right now my budget would be around 4000 euros and I was looking into Turkish clinics but reading through this forum I really got sceptical so I am not sure anymore if to wait to gather more money and do it somewhere like Portugal at Mr Ferreira.

Could you suggest to me some good Drs or Clinics in Italy and Greece as well or I should go with a safe bet in Portugal or HLC in Turkey?

In case I need to wait for a hair transplant would you say it would be good to start using minoxidil or other products? How about shampoos?

Looking forward to your comments and thanks for your attention.
 

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Just want to say it is really unfortunate that your trichologist is emphasizing the sexual side effects of finasteride so much. They are rare (under 5%) and reversible. Finasteride is the single best medication for you to hold onto your remaining hair. I would highly recommend you give it a try. Don't make the same mistake I and many others did by delaying it.

Also worth noting that most hair transplant surgeons will much prefer you to be taking finasteride. In fact, some may even deny you as a patient if you are not taking it.

And sorry to say, but most of the products your trichologist has you on are snake oil. The only things that really work are finasteride, minoxidil, and maybe microneedling. PRP, shampoos, vitamins/supplements (bar deficiencies in something that is actually essential, like D3) are all BS unproven treatments. You may want to check out "Kevin Mann" on YT, he provides no BS info based on studies and isn't trying to sell anything.

Edited by giegnosiganoe
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@giegnosiganoe

I think 5% is low, and the claim to reversibility is also questionable, but I agree it’s worth trying. It’s just good to understand the risk any time you toy with your hormones. I don’t want start a huge debate about it, just saying I wouldn’t take it quite so lightly.

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“You may say I’m a dreamer, but I’m not...”

- John Lennon

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Thanks for your input. However 5% isn't a small percentage. I have a friend who used to take finasteride and had the reduced sexual libido so I am a bit hesitant. Of course if I go with a transplant I will take it if prescribed but I wanted to know if there is alternative in the market that is equally as good.

Is it recommended to use minoxidil and finasteride a certain period before hair transplant or I can also do the surgery without using these before?

In any case, I have already contacted hair transplant clinics with these questions but I wanted also a general opinion to compare answers.

Thanks again all for your comments.

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On 6/14/2020 at 11:50 PM, solidsn2004 said:

Hi all,

I am new to this forum and in general I have never looked into hair loss solutions before but it has really started to bother me recently so I need your opinion on the matter.

I don’t have any medical diseases or any health conditions. I do not use any medicines and I don't use any particular products for my hair.

I was looking into a possible hair transplant as I noticed that I have started losing hair 9-10 years ago. I am 34 years old and recently I've visited a trichologist and diagnosed me with androgenic
alopecia.The trichologist suggested to me a 4 month treatment and then he needs to examine me to suggest how to proceed. He informed me that I will most probably go with a PRP treatment after the 4 months but he wanted first to see the results of the products I will be taking which would be the following:

- Krim up Andro supplements (one pill every morning after breakfast)
- Golden Crim B+C from Solgar (one pill every morning after breakfast)
- Liquid Vita D3 (1ml after breakfast)
- Minoxidil 5% Biorga (apply one time every 2 days and not twice a day
as the recommended dosage)
- Tricovel PRP plus gel (apply once a week)

He also subscribed to me 3 different shampoos to use every other day:

- Micro Peel Dercos from Vichy
- Kerium DS from la roche ponay
- Dercos DS greasy hair

I was thinking of proceeding with a hair transplant sooner rather than following other treatments but I am not sure whether it's better to wait for my hair loss to advance before I do a hair transplant.

I am also hesitant to use Finasteride as even the trichologist told me it has side effects and reduces sexual libido. What is your opinion on this? Is there any alternative after a hair transplant?

Right now my budget would be around 4000 euros and I was looking into Turkish clinics but reading through this forum I really got sceptical so I am not sure anymore if to wait to gather more money and do it somewhere like Portugal at Mr Ferreira.

Could you suggest to me some good Drs or Clinics in Italy and Greece as well or I should go with a safe bet in Portugal or HLC in Turkey?

In case I need to wait for a hair transplant would you say it would be good to start using minoxidil or other products? How about shampoos?

Looking forward to your comments and thanks for your attention.
 

IMG_4768.jpg

IMG_1524.jpg

back_dry.jpg

back_top_wet.jpg

Going by your pics you are a great candidate for minoxidil and finasteride. Both have been clinically studied for years! It is true that you might have some side effects and from finasteride sexual side effects can happen but in a very small percentage. You can always lower the dose/stop the medication 'IF' you do experience side effects. You have so much hair that you could potentially keep what you have with the possibility of even improving it with medication. Again it comes down to personal choice. But the number of people who state that they were never aware of these medications until they had lost most of their hair is quite high.

As to hair transplant surgery (and it is surgery) you really want to do lots of research . I highly recommend looking up Joe Tillman the Hair Transplant Mentor on YouTube and follow his story and watch his videos on how to vet out bad clinics and what red flags to look out for.As for Turkey, many clinics in Turkey have people performing hair transplants who are Syrian refugees, ex hair dressers and taxi drivers! Do not be guided by cheap prices and surgeons who take very little part in a hair transplant and opt to perform on more than one person per day (as in up to 10 or more!). There is no such thing as a stupid question to ask your surgeon or too many questions. Follow up care by your surgeon is equally important as the surgery itself. All the best!

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@Gatsby thanks for the valuable info!

I just watched a few videos and Joe Tillman seems to know his stuff pretty well!
As I said I will be waiting for replies from some clinics I have already contacted and decide how to proceed with the prescription my trichologist suggested.

Once again thanks for everything.

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59 minutes ago, solidsn2004 said:

@Gatsby thanks for the valuable info!

I just watched a few videos and Joe Tillman seems to know his stuff pretty well!
As I said I will be waiting for replies from some clinics I have already contacted and decide how to proceed with the prescription my trichologist suggested.

Once again thanks for everything.

solidsn2004 you are very welcome. Joe Tillman has been in the industry for 30 years and his experience, knowledge and advise is fiercely independent of any kick backs and he will call out everything that is wrong in this industry. Furthermore he is very picky on which surgeons he will recommend according to his very high standards. If you hold these high standards for your own hair transplant surgeon that you may choose, you are doing the most to protect yourself from a bad result, etc. Also this forum is just a plethora of knowledge from equally knowledgeable people who can give you first hand advice on helping you on your journey. Remember there is no such thing as asking too many questions! I wish you all the best.

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Given your budget I would suggest carrying on saving and trying fin.  You still have a lot of hair to save and it may not be the best idea to tinker with it at this stage.

Try a reduced fin protocol such as 3 x week, 0.5mg or 1.25mg (splitting either 1mg or 5mg Proscar tabs - I do the latter as it's really cheap).

If you absolutely had to do a surgery it would only be on the front hairline, 1500 grafts maximum, maybe even less.  But on your budget I'm not sure you would get an ethical enough doctor.

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4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020

Proscar 1.25mg every 3rd day

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@1978matt thanks for your reply. After a lot of research I am convinced not to perform a hair transplant in Turkey and I will be saving up to go to a more reliable clinic.

I am in conversation with Dr Bruno Ferreira from Portugal and he suggested to me that I might have DUPA which might affect my donor area but he needs to perform a closer examination.

I was also considering finasteride 3mg per week to begin with so I am weighing my options at the moment and decide, after consulting with more trichologists, how to proceed.

Thanks again for your feedback!

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I would try the finasteride and you could add the d3 as well.  D3 is thought to help immune system.  There is a lot of research suggesting that it may help fight covid and other respiratory  diseases.  You can  also get vitamin d level checked with 70.00 blood test.  Many people in the world have low vitamin d. 

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@O Hare 57 thanks for your suggestion. I have decided to proceed with finasteride. I had my doctor prescribe it to me and already bought it. Yesterday I did blood and urine exams to check my vitamin D, testosterone etc and I will start with a small dosage of 2mg per week for a month and then increase it to 3mg. I am in contact with Dr Ferreira and most probably going to be checked by him and decide about the proper dosage. Thanks again all for your suggestions.

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A couple things,

If you've shown the propensity to lose, this will continue.

Propecia, Rogaine, Laser and PRP are the modalities we typically discuss when dealing with this debilitating condition.  Within a 4-6 weeks it is likely you'll experience retention.  Enhancement, if you are going to have any, typically takes 1 year.  The premise behind the meds, there is synergism when used simultaneously.  

Be mindful, people tend to be very visual creatures.  If there is a visual difference, the meds work.  If you see no change, the meds did nothing.  This is incorrect.  The medications are intended for you to keep what you have.  So, if I year later you look the same or better, the meds did what they were supposed to do.  Better? What does that mean.  There can be enhancement of the hair as nothing out there regrows hair. There are two types of loss, the one you see and the one you don't.

The follicle gets tired of producing hair and takes a vacation.  The hair sheds and the follicle goes dormant for 3-4 months.  That hair will then start going through the cycle again.  This will happen at different intervals to all the hair in your head, throughout your life. We refer to this as shedding. Hair loss is different.

Under a bright light look at the hair in your temporal areas.  You'll notice the shafts of each strand. Some thick and some not so much so.  Some are even so thin you can hardly see them.  We refer to this as miniaturization.  Eventually the follicle withers and disappears.  The key is to get on meds before the follicle is lost.

There is plenty of printed material with regards to Propecia.  The recommended dose is 1 mg per day. Take it as suggested.  This has to do with the time the med is in your system.  

Try to use more than one modality and stay on it.  Getting on and off meds is just a waste of time and money.

Take photos every 3-4 months to keep record of your achievements.

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You could do with 2000 grafts approximately, depending on your choice of hairline for the reconstruction of the frontal zone. 

Finasteride would definitely help preserve the rest of the existing hair and also revive the miniaturising ones. 

Minoxidil, multivitamins etc can provide supplementary support for the hair.

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Edited by Gabreille Nelson Mukhia

Official representative of Eugenix Hair Sciences

Dr. Arika Bansal & Dr. Pradeep Sethi

https://www.youtube.com/channel/UC5crlGyTac2hlU1gHneADzQ

 

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On 6/16/2020 at 3:49 AM, Gatsby said:

solidsn2004 you are very welcome. Joe Tillman has been in the industry for 30 years and his experience, knowledge and advise is fiercely independent of any kick backs and he will call out everything that is wrong in this industry. Furthermore he is very picky on which surgeons he will recommend according to his very high standards. If you hold these high standards for your own hair transplant surgeon that you may choose, you are doing the most to protect yourself from a bad result, etc. Also this forum is just a plethora of knowledge from equally knowledgeable people who can give you first hand advice on helping you on your journey. Remember there is no such thing as asking too many questions! I wish you all the best.

I thought his name was banned from this forum, when anyone tried to post it in a message.  My recollection was him being argumentative for it's own sake and not advancing anything, creating turmoil.  I am glad he is long gone.

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13 minutes ago, AB2000 said:

I thought his name was banned from this forum, when anyone tried to post it in a message.  My recollection was him being argumentative for it's own sake and not advancing anything, creating turmoil.  I am glad he is long gone.

Sorry AB2000. I wasn't aware of a ban of his name? If that's the case then thanks for the heads up (though I personally have a lot of respect for him).

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@LaserCap that's great advise! Thanks for taking the time to reply. I am not planning to stop and I understand we are talking about a treatment and not a cure. I am not usually a person who gives up by not seeing results. I have already consulted with great doctors and they explained to me how this works, thanks for confirming it.

 

@Gabreille Nelson Mukhia thanks for your comment. To be perfectly honest I was also thinking that I would need around 2000 grafts but after consulting with 4 different doctors they all suggested to me that I will need between 3200 and 3800 grafts. However, I am planning to check my hair again after at least 6 months of finasteride and re-evaluate with them. I was also suggested to avoid combining finasteride with minoxidil at the beginning but introduce it after my hair gets stronger.

 

@AB2000 I tend to not follow blatantly whatever I see online and I take everything with a grain of salt. As @Gatsby said he has some interesting videos but to be honest I will only follow the indications of experienced doctors and the trichologists I am currently in contact with.

 

Thanks again everyone for your valuable comments. This is a great community and I am happy I can get insight from you guys!

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5 hours ago, solidsn2004 said:

@Gabreille Nelson Mukhia thanks for your comment. To be perfectly honest I was also thinking that I would need around 2000 grafts but after consulting with 4 different doctors they all suggested to me that I will need between 3200 and 3800 grafts. However, I am planning to check my hair again after at least 6 months of finasteride and re-evaluate with them. I was also suggested to avoid combining finasteride with minoxidil at the beginning but introduce it after my hair gets stronger.

Yes. You can try finasteride for 6 months and then have an evaluation done again.

Minoxidil is supplementary so even if you avoid it it's okay for now. Finasteride will completely stop the progression of baldness until you take it.

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Official representative of Eugenix Hair Sciences

Dr. Arika Bansal & Dr. Pradeep Sethi

https://www.youtube.com/channel/UC5crlGyTac2hlU1gHneADzQ

 

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Would you guys recommend using derma roller while on finasteride? I’ve read in other threads that it works wonders so I am willing to try it out 1-2 times a week. I’ve seen a few on amazon and from my understanding Dr Pen is the way to go. Is there any difference between Dr Pen A6 vs A7? Also I’ve noticed the most common pin needles online are the 36 ones but I’ve read somewhere that it’s best to use 12 pin needles if you don’t have advanced hair loss at 1,5mm in order avoid damaging existing hair follicles. What’s your opinion on that? Would you recommend the Dr Pen one with 12 pin needle?

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