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HT without Finasteride


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Hi all, 

Hoping to get some stories and see some results of those who have undergone HT but do not use Fin. 

I was on fin for a while and unfortunately I am one of the people who got horrible sides. Took me months after stopping to recover, so fin is off my list of options for good. Am open to trying min but dread the initial shed.

I know the traditional view is an HT without meds is not the best idea, but I've seen a few people on various threads say otherwise. Have been searching around trying to find threads with such results and stories, but it's hard to search this forum with such generic keywords.

Wondering if anyone has stories/threads the could link to on this forum (or others). Trying to get a sense of what is possible with just an HT long term plan that does not include any fin products, but may integrate min. 

Thanks!

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I don’t use fin, though I’ll admit my crown is thin, and as a result I use concealer in the crown.


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

Check out my final hair transplant and topical dutasteride journey

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check my journey...I am at 7 months post my 3rd HT without fin and Minoxidil.

But deep down I know that I am gonna lose my transplanted hair as well if I don't get on meds. 

I also got side effects from fin so decided against it for rest of my life.

Somedays I think that if I was on meds then I didn't have to go for 3 HTs in a span of 7 years.

It's a never ending fight for us :(

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3 hours ago, BaronVonHairline said:

Hi all, 

Hoping to get some stories and see some results of those who have undergone HT but do not use Fin. 

I was on fin for a while and unfortunately I am one of the people who got horrible sides. Took me months after stopping to recover, so fin is off my list of options for good. Am open to trying min but dread the initial shed.

I know the traditional view is an HT without meds is not the best idea, but I've seen a few people on various threads say otherwise. Have been searching around trying to find threads with such results and stories, but it's hard to search this forum with such generic keywords.

Wondering if anyone has stories/threads the could link to on this forum (or others). Trying to get a sense of what is possible with just an HT long term plan that does not include any fin products, but may integrate min. 

Thanks!

Did you try topical finasteride? The chances of side effects are basically nil since it's local and not systemically absorbed. 

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My advice does not constitute a patient-physician relationship nor as medical advice and all medical questions/concerns should be addressed to your medical provider. 

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It is very difficult to be able to give a generalised answer to this question, and using another patient as an example of success in terms of long term preservation and not using finasteride is really not very relevant. 

How old are you, when did your hair loss begin, how aggressive is your hair loss, family history of loss, overall general health, what are your objectives in terms of a restoration procedure, do you have further signs of miniaturisation, do you have miniaturisation in your donor area... these are all important elements.

Taking any kind of medication, including hair loss preventative medication is a personal decision. 
For any individual that has experienced hair loss due to male pattern baldness, we are genetically pre disposed to lose further hair. We want to mitigate this as much as possible to preserve the best scenario long term.

Your age and extent of hair loss may dictate if your doctor will recommend or agree to proceed with surgery without medication. For some patients with minimal loss and who are that little bit older, whilst medications would in most cases still be recommended, they may not be a pre requisite as such. 
However the patient should be educated on the potential risks in terms of future loss and also the longevity of transplanted hair if miniaturisation takes place in his donor area.

Even if a patient were to agree to medication at the time of surgery, but then discontinued at a later date, the taking of daily medication is the really the responsibility of the patient.

I myself used finasteride many years pre surgery and continued post surgery.  I discontinued for around one year and lost native hair amongst my transplanted hair. My intention was always to return to medication because for me it is necessary, but I was not able to recover what was lost in this interim time. 

Chasing progressive loss with subsequent procedures and without medication is risky and not a recommended approach.
The first thing to look to achieve should ideally be to stabilise, preserve and possibly strengthen what you already have.

As previously mentioned, topical finasteride is also now available. Whilst there are many formulations, studies suggest that due to local absorption, DHT is less inhibited in the blood whilst restricting more DHT to the scalp.

Humans have a delicate physiology and some individuals are sensitive to the smallest changes in the blood. We all respond uniquely and some individuals can be extremely sensitive to small amounts of alcohol or caffeine for example.
Whilst undoubtedly some patients have suffered aggressive side effects from oral finasteride, there are also studies that show that patients who had concerns regarding finasteride and were unknowingly given placebo pills still experienced side effects. 

There is a lot to consider and we all experience the emotional effects of hair loss uniquely. We all consider potential restoration surgery for our own reasons and place our own importance on this. Despite being a difficult decision, it normally comes down to priority.
I think that it is fair to say that nobody wants to take finasteride or minoxidil, but the idea of what may be without these medications is more daunting than the idea of taking them.
For others, it may be the opposite and therefore they decide against medication despite this having its own risks in terms of further loss.

I wish you the best in your decision.

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I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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No back and white answer as no 2 cases are the same.  The younger you are the more relevant it maybe to take meds to sustain your native hair.  

If you are 35-40 with a fairly well established hair loss patten and no 'miniturasition '  (take a test) and you have strong robust hair in your remaining hair, finasteride is less of a requirement in my opinion .  Especially if your goals are also more on the conservative side.  Bottom line Depends how much loss you have and the state of your native hair remaining.

I took Fin for a year, over 10 years ago.  Had no sides then they creeped in after a year.  Although not major sides like some reported it was enough for me to ditch.

I also didn't want to commit to a life long drug which alters your hormonal endocrine system.   The percentage of people with sides is way higher than the official figures reported and i truely believe some have been permanetly affected.  Equally many also seem to tolerate the drug for 10+ years without feeling the need to ditch it although i don't believe they are all fully free of sides.  

You pays your money you take your chances. 

IMO Proceed with caution and get all your baseline blood work if you start on it so you have core data if you have issues. Once your on Fin i found it can grasp a strong hold on you psychologically as you feel reluctant to come off it due to a fear of shedding and losing more hair.  I do remember that vividly. 

Edited by BaldingBogger
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20 hours ago, Melvin-Moderator said:

I don’t use fin, though I’ll admit my crown is thin, and as a result I use concealer in the crown.

Watched your HT video. Looks incredible! Very nice to see and hear that you managed that without fin.  I will definitely check your other posts and read about your journey. Thank you!

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20 hours ago, nishchd said:

check my journey...I am at 7 months post my 3rd HT without fin and Minoxidil.

But deep down I know that I am gonna lose my transplanted hair as well if I don't get on meds. 

I also got side effects from fin so decided against it for rest of my life.

Somedays I think that if I was on meds then I didn't have to go for 3 HTs in a span of 7 years.

It's a never ending fight for us :(

I hear you. Believe me, even if I had mild to medium sides on fin I'd probably still be on it. My sides were severe though, and without wishing to derail this into an anti-fin thread, I will just sum it up by saying it was hell. And I'm one of the lucky ones who eventually got better. I've read stories of men who never recovered or it took them years, and I 100% believe them. 

Have you tried or considered min to maintain your HT results?

Will def check your journey. 

 

 

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18 hours ago, Dr. Suhail Khokhar said:

Did you try topical finasteride? The chances of side effects are basically nil since it's local and not systemically absorbed. 

I appreciate the reply. But after what I went through on Fin, it is 100% off my list of options, no matter the form of application. And I have also read from people on this forum that their sides were the same, or some even worse, with topical.

In either case, it is off my radar for life.

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11 minutes ago, BaronVonHairline said:

I hear you. Believe me, even if I had mild to medium sides on fin I'd probably still be on it. My sides were severe though, and without wishing to derail this into an anti-fin thread, I will just sum it up by saying it was hell. And I'm one of the lucky ones who eventually got better. I've read stories of men who never recovered or it took them years, and I 100% believe them. 

Have you tried or considered min to maintain your HT results?

Will def check your journey. 

 

 

Minoxidil was working fine for me till the time I was using it, but my recent surgeon asked me not to use Minoxidil as well because hair become somewhat "dependant" on it ,even the transplanted ones. Which I guess is a logical reason. Instead I am using procapil serum which said to be natural DHT blocker ( not sure to what extent) ,but I don't think I had any benefit from it neither did I lost anything. So its all even at this stage.

I want to use Minoxidil to regain some of my native hair but then I am afraid all my hair will be dependent on it and when I will stop it I will lose them.

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1 hour ago, BaronVonHairline said:

I hear you. Believe me, even if I had mild to medium sides on fin I'd probably still be on it. My sides were severe though, and without wishing to derail this into an anti-fin thread, I will just sum it up by saying it was hell. And I'm one of the lucky ones who eventually got better. I've read stories of men who never recovered or it took them years, and I 100% believe them. 

Have you tried or considered min to maintain your HT results?

Will def check your journey. 

 

 

There’s plenty of people who HT without finasteride, some can unquestionably get away with it, without it even having to be a consideration - depending on their hair loss rate, donor quality, aspirations, hair loss pattern, and surgical plans .... 

and of course there are others who maybe can’t avoid continued loss at a faster rate, yet still remain realistic with their options and accept what they are likely to achieve - because the sacrifice for mental and physical well being and peace of mind outweighs that for them. I don’t know where I personally fall . . I think probably somewhere in between the two, however I’m confident I’l never look bald. 
 

I was actually willing to start on a Microdose recently after years and hours of research, however ran bloods to get my baseline and booked a consultation with a specialist - in which, without wanting to be labelled as a ‘scare mongerer’ by the propecia fan boys, I decided not to go ahead, after meeting with him for over an hour. 
 

There are options - if you hover over the boards, you’l come across tons of successful cases, who also have realistic plans for the future in place. 
 

Don’t forget , users will still eventually end up bald, it can’t hold off loss forever.  

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I am in the same exact boat. I am trying to conceive a child right now and Fin is a no bueno with that. I am getting a HT in January, but should I even bother doing it if my hair loss is going to progress? I have MPB and it's not going away... Any alternatives besides Fin? I refuse to take Fin as I am not taking any risks associated with it.

I am 27 and my surgeon is recommending it, but I am too scared of the side effects. Even users who have never had sides, stop taking it and then develop side effects. Scary shit. I thought HT was the solution to not taking oral meds, but it only seems to be a more permanent bandaid? Considering ditching the HT route altogether if I have to take meds...

Edited by hybonix

1st Procedure: 3332 FUE Grafts | Shapiro Medical Group | 10.29.20
2nd Procedure: 1908 FUE Grafts | Shapiro Medical Group | 11.13.23

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2 hours ago, hybonix said:

I am in the same exact boat. I am trying to conceive a child right now and Fin is a no bueno with that. I am getting a HT in January, but should I even bother doing it if my hair loss is going to progress? I have MPB and it's not going away... Any alternatives besides Fin? I refuse to take Fin as I am not taking any risks associated with it.

I am 27 and my surgeon is recommending it, but I am too scared of the side effects. Even users who have never had sides, stop taking it and then develop side effects. Scary shit. I thought HT was the solution to not taking oral meds, but it only seems to be a more permanent bandaid? Considering ditching the HT route altogether if I have to take meds...

HT route is fine If you are ready to  have more HTs in the future. It depends on your level of baldness also and is your hairloss stable?

I was Norwood 3 back in 2013 and I had 3 HTs since then otherwise I would have been a slice NW 6 by now. So if you are already NW6 by now get 1 HT done and its all sorted but if you are just receding right now, be prepared for future HTs if medicines are not in the list.

 

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53 minutes ago, nishchd said:

HT route is fine If you are ready to  have more HTs in the future. It depends on your level of baldness also and is your hairloss stable?

I was Norwood 3 back in 2013 and I had 3 HTs since then otherwise I would have been a slice NW 6 by now. So if you are already NW6 by now get 1 HT done and its all sorted but if you are just receding right now, be prepared for future HTs if medicines are not in the list.

 

I am a Norwood 3 getting close to Norwood 4... Idk. I don't want to get multiple transplants either.

1st Procedure: 3332 FUE Grafts | Shapiro Medical Group | 10.29.20
2nd Procedure: 1908 FUE Grafts | Shapiro Medical Group | 11.13.23

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I stopped Finasteride 1 month after my HT, Fin didn’t have much of a side effect in regards to ED but it definitely felt like it was messing with my mood, memory, mental clarity. I am considering giving a diy topical fun solution a go  as it should be less be less systemic.

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Guys, the first ever side effect free topical anti androgen - Clascoterone - has been FDA approved for human use as of today, 8/27/2020

This is huge news 

The initial product is an acne cream vehicle but the same molecule can be used at higher percentages in a liquid - ethanol etc.. for scalp delivery

 FIN ins't the only option anymore 

Edited by elduterino
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18 minutes ago, elduterino said:

first ever side effect free

It would indeed be the first without side effects, which is why I’m confident that it def will have side effects. 
 

Thanks for the heads up, though. I’m curious to see how that does for people.

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Living up to my name, I'm curious as to how any form of anti androgen would come side effect free? Even if it stays localised to the scalp, for it to have any effect on the follicle receptors, it has to be induced systemically some how, no? Also, what is it? 

 

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18 hours ago, hybonix said:

I am a Norwood 3 getting close to Norwood 4... Idk. I don't want to get multiple transplants either.

Unfortunately 99.9% of patients will always require more than 1 HT - given that they want to maintain their hair looking full. 

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17 minutes ago, Curious25 said:

Living up to my name, I'm curious as to how any form of anti androgen would come side effect free? Even if it stays localised to the scalp, for it to have any effect on the follicle receptors, it has to be induced systemically some how, no? Also, what is it? 

That would be interesting to understand as topical fin also bares the same side effects at a reduced rate per my understanding.

Edited by hybonix

1st Procedure: 3332 FUE Grafts | Shapiro Medical Group | 10.29.20
2nd Procedure: 1908 FUE Grafts | Shapiro Medical Group | 11.13.23

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13 hours ago, elduterino said:

Guys, the first ever side effect free topical anti androgen - Clascoterone - has been FDA approved for human use as of today, 8/27/2020

This is huge news 

The initial product is an acne cream vehicle but the same molecule can be used at higher percentages in a liquid - ethanol etc.. for scalp delivery

 FIN ins't the only option anymore 

This is great news but 

a) like you said we need a higher concentration which isn’t approved yet

b) most people don’t want to order from some black market Chinese lab like you’re so fond of. We haven’t seen the best things come out of China as of late

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From my experience I would recommend anyone doing a HT to start fin, even if it's 1mg a week. Studies show 0.2mg, 0.05mg and 1.0mg reduce DHT by a similar amount so start with very low dose. Even as little as 0.25mg twice a week. I think even if you take this small dosage over time you will see benefits compared to not doing anything.

I was scared using fin originally because of all the horror stories. But I am convinced even if I took 1mg a week over the last 4 years my hair would have been better now than it is and I don't think I would have suffered any side effects on such a low dose. I am now doing 0.5mg twice a week, my plan is to stick with this for a few months and if ok I will use 0.5mg three times a week. I will not be taking more than that as I don't believe it's needed. 

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The problem with micro dosing is that if it's still reducing the DHT levels in your body similar to what the recommended doses do,

*and you are prone to having negative side effects*

you will eventually have the same side effects, albeit potentially slightly delayed and further down the line, once the build up of continuous 5AR inhibition has reached a level great enough to affect you adversely. 

Think about it logically - the reason side effects occur in the first place, is because of 5AR inhibition, and the subsequent lowering of DHT. Therefore, no matter what the dosage you take, if you are achieving reduction in DHT by a similar amount to what the recommended doses achieve (as you stated) - there is no reason why this would make you immune from adverse side effects because exactly the same thing is essentially going on inside your body. 

Now if you stated micro dosing was proven to not reduce DHT by a similar amount (which I think is what some studies suggest) the argument for side effect mitigation holds more credibility - however Its similar to fat loss, in the sense that you can't spot reduce fat in the gym, as you equally can't spot reduce DHT, and specifically target just the hair follicles (unfortunately). Dependent on the individual - even the slightest reduction in DHT levels and fiddling with the endocrine system may incur adverse and unwanted effects, however IMO, in the majority of users, it probably wouldn't cause an issue.

The same goes for larger doses - theres seemingly people who take 1.25mg proscar daily without any issues, as there is for dutasteride users. 

Edited by Curious25
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4 hours ago, LonelyGraft said:

This is great news but 

a) like you said we need a higher concentration which isn’t approved yet

b) most people don’t want to order from some black market Chinese lab like you’re so fond of. We haven’t seen the best things come out of China as of late

a) no but compounding pharmacies will be able to order the raw powder and prepare higher concentrations in liquid forms depending on the country, and pharmacy

If you use Minox, and Stemoxydine, you actually don't need that much Clascoterone for maintenance , as the 3 drugs have a synergy effect.

I use 50mg a day with medium length hair. Assuming a small 20g acne cream tube at 1% you have about 200mg of the active ingredient in it. You would go through a tube every 4 days, and dilute about half in ethanol to get it liquid enough to apply over hair, so that probably means two applications of 25mg a day due the large amount of vehicle.

IF the tube costs 10 usd thats's 2.5USD a day, not bad for an incredibly better alternative to fin, the topical which also blocks testosterone and is thus more effective than fin at the hairline over time....until breezula is approved in 2-3 years

b) I have been using Chinese providers for 12 years for RU and CB and never had any issues, I still have hair and my dick is working great much better than when I was on fin or DUT.

I had two FUE HT but that's because of the loss I had prior proscar release into the market, and I also wanted a better hairline that I had originally from birth

Edited by elduterino
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19 hours ago, elduterino said:

Guys, the first ever side effect free topical anti androgen - Clascoterone - has been FDA approved for human use as of today, 8/27/2020

This is huge news 

The initial product is an acne cream vehicle but the same molecule can be used at higher percentages in a liquid - ethanol etc.. for scalp delivery

 FIN ins't the only option anymore 

I’ve never heard of this, link any articles?


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

Check out my final hair transplant and topical dutasteride journey

View my thread

Topical dutasteride journey 

Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube.

 

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