Seeking advice on HT

[Jd98H]

Hi everyone,

Ive been following this forum for a while now and finally decided to make my own post. 
 

Im a 23yr old living in Melbourne and I’m considering getting my first hair transplant. I’ve always had a fairly bad hairline with a wide forehead, and for many years has been a source of insecurity for me. Over the past 4 years I haven’t noticed significant change to the hairline, although maybe some minor recession. Aside from my hairline the rest of my hair is very thick.
 

Over the past year I’ve been looking at options within Australia, but like many others on here, I’ve come to the conclusion that if I want it done right I’ll need to go overseas. 
 

Ive been taking finasteride 1mg every second day for around 2 months now. 
 

After looking at a lot of options and posts on this forum, I really like the look of Eugenix. Ideally I’d just like to get some opinions and advice for my situation.

Thanks

 

Edited November 22, 2021 by Jd98H

[hairlossPA]

I'd suggest you hold off on getting a hair transplant, and I think others will agree with me.

You have a good head of hair, and like you said its thick. Get on finasteride and hold onto as much as you can, while you can.

You are still very young and could potentially lose more hair, and you'll be chasing that lowered hairline the rest of your 20s

[hairlossPA]

Your hair transplant could end up less dense than your hair behind it, (it most certainly will be less dense) and it would look unnatural and add to the insecurity.

[JDEE0]

I agree with John, best to be cautious for a bit.

Your hair situation is similar enough to mine, but I'm five years older and waited purposely until I was approaching 30, had been on meds for a number of years and hadn't really noticed any discernible progression for a handful of years before just now biting the bullet. 

The main thing would just be to stay on fin for a good few years to make sure you're happy to commit to it in the long run and then if nothing changes, which I would be very confident it won't, start planning for a HT once you're on the other side of 25. You'll know at that point that as long as you stick to what you've been doing, you're very likely to be set for quite some time and overwhelmingly likely won't need to chase your hair loss with transplants (it's inevitable you will need more over the course of your life of course, but it's more likely to be a case of one 10, 15, 20 years down the line rather than every few years until you run out).

Keep on with the meds, hold on another 3 to 4 years, and then go ahead with confidence would be my advice in a nutshell.

Edited November 22, 2021 by JDEE0

[Britanium]

Erm I didn’t comment 😂 @JDEE0

Edited November 22, 2021 by JC71

[JDEE0]

2 minutes ago, JC71 said:

Erm I didn’t comment 😂 @JDEE0

Hahah, my bad, I think you used to have that same avatar not too long ago maybe, or I'm just losing it. Probably the latter haha

[Britanium]

Just now, JDEE0 said:

Hahah, my bad, I think you used to have that same avatar not too long ago maybe, or I'm just losing it. Probably the latter haha

Lol I did but changed it a while ago, as it’s used by many here 😂🤣 your not losing it 🤪

[Gatsby]

Unless your crown is bald you have a strong head of hair. It can take up to two years to see the full benefits from being on Finasteride. You’ve dodged a massive bullet avoiding any surgeons down here. All the best! 

[Mike10]

I also think you should not do HT at this stage

[Mike10]

20 minutes ago, JDEE0 said:

I agree with John, best to be cautious for a bit.

Your hair situation is similar enough to mine, but I'm five years older and waited purposely until I was approaching 30, had been on meds for a number of years and hadn't really noticed any discernible progression for a handful of years before just now biting the bullet. 

The main thing would just be to stay on fin for a good few years to make sure you're happy to commit to it in the long run and then if nothing changes, which I would be very confident it won't, start planning for a HT once you're on the other side of 25. You'll know at that point that as long as you stick to what you've been doing, you're very likely to be set for quite some time and overwhelmingly likely won't need to chase your hair loss with transplants (it's inevitable you will need more over the course of your life of course, but it's more likely to be a case of one 10, 15, 20 years down the line rather than every few years until you run out).

Keep on with the meds, hold on another 3 to 4 years, and then go ahead with confidence would be my advice in a nutshell.

To be honest, being at the end of your 20s is still young as well. Who told you that with the 10-20 years? Is that only your opinion or which Dr told you that? 

[JDEE0]

11 minutes ago, Mike10 said:

To be honest, being at the end of your 20s is still young as well. Who told you that with the 10-20 years? Is that only your opinion or which Dr told you that? 

Yeah, obviously it is young... I never said it wasn't. I said stay medicated, wait to see that your hair loss hasn't progressed for another 5 years or so on top of the time he said he hasn't lost anything in (which is four years and would bring him to a place where he has documented, factual knowledge that his hair loss hasn't progressed to any noticeable degree for a total of eight or nine years).

And told me what? I didn't make any factual claim about this '10-20 years'; I merely said that it's more likely to be a case of him not progressing to a point where another procedure will be needed for perhaps 10, 15 or 20 years at this point (if he does as I suggested). The many studies on finasteride, including those which show improvements in the majority of participants in direct comparison to their baseline at the ten year mark, told me this, considering my whole point was predicated on him sticking to fin in the long term...

Edited November 22, 2021 by JDEE0

[Mike10]

31 minutes ago, JDEE0 said:

Yeah, obviously it is young... I never said it wasn't. I said stay medicated, wait to see that your hair loss hasn't progressed for another 5 years or so on top of the time he said he hasn't lost anything in (which is four years and would bring him to a place where he has documented, factual knowledge that his hair loss hasn't progressed to any noticeable degree for a total of eight or nine years).

And told me what? I didn't make any factual claim about this '10-20 years'; I merely said that it's more likely to be a case of him not progressing to a point where another procedure will be needed for perhaps 10, 15 or 20 years at this point (if he does as I suggested). The many studies on finasteride, including those which show improvements in the majority of participants in direct comparison to their baseline at the ten year mark, told me this, considering my whole point was predicated on him sticking to fin in the long term...

From what you have written, I understand that this is rather your personal opinion. I certainly would not make a general rule out of the 10-20 years. 

My thoughts on Fin are as followed. The reality is most guys will progress slowly regardless of Fin. In a best case scenario, it can slow hair loss for decades. However that is not a given, sides can appear even after many years or the effects of Fin can fade. It is a medication that works best for mid scalp and crown, not the hairline. I think one needs to check expectations  in check.A truly conservative HT plan involves a planning without Fin in my opinion.   

[JDEE0]

55 minutes ago, Mike10 said:

From what you have written, I understand that this is rather your personal opinion. I certainly would not make a general rule out of the 10-20 years. 

My thoughts on Fin are as followed. The reality is most guys will progress slowly regardless of Fin. In a best case scenario, it can slow hair loss for decades. However that is not a given, sides can appear even after many years or the effects of Fin can fade. It is a medication that works best for mid scalp and crown, not the hairline. I think one needs to check expectations  in check.A truly conservative HT plan involves a planning without Fin in my opinion.   

Your argument really makes little sense when you say that my points stem from personal opinion, when they are actually based directly on studies that evidence them, and then goes on to make your own make your own points that are entirely based on opinion or that just aren't factual. 

Also, for arguments sake, I didn't make a general rule, I said in his personal case that if he gets to a point he has stabilised his hair loss for nearly a decade and continues on with fin after this point, I would be more surprised if he couldn't make it another 10+ before *needing* to get another one than the opposite. You think that at that point if this was the case for OP that his hair is more likely to dramatically regress in the following 5, 6 or 7 years that he has to go for another procedure than not? I think it would be far more likely that the latter would be the case...

With that said, I would certainly make it a general rule overall that most people can get by for 10+ years without their hair loss progressing if they stick to fin, yes. Let's reference the most recent long term study from a few years back that covered 523 Japanese men for over ten years. 

It used something called a MGPA score to track progress, which means the following: 1, significant disease progression; 2, moderate disease progression; 3, slight disease progression; 4, no change; 5, slight improvement; 6, moderate improvement; and 7, significant improvement

So, as we can see, 4 is equal to baseline, meaning no change from the start. Essentially, If you have a score of at least 4 after the 10 year period, your hair hasn't worsened in this time, and any score above this means it's actually improved compared to the start 10 years prior. 

We can see that Norwoods 1-3 all had a score of 6 or above after 10 years, so their hair was still classed as moderately improved from when they started a decade later. Norwood 4's and 5's had a score of between 5 and 6 after 10 years were up, so they still had a slight improvement from baseline. Norwoods 6 and 7 had a score of between 4 and 5 after 10 years, so no change to a slight improvement is their description. You can read it here to check my claims: https://www.oatext.com/Long-term-(10-year)-efficacy-of-finasteride-in-523-Japanese-men-with-androgenetic-alopecia.php

As you can see, NW2-3 such as OP would likely still be quite a bit above baseline after ten years, it clearly wasn't losing efficacy for these people at the 10 year mark and so it stands to reason that it would take quite some time from this point to regress further to baseline and then to regress below it enough to need a HT. Moreover, pretty much all the participants at least hadn't worsened in the 10 years, which is evidence of me saying I think its fair to make this general rule...

There are so many other studies, but I'm not going to start some meta-analysis here so have at it if you want to read them.

In regards to your second paragraph, no, the reality is that *everyone* will slowly progress regardless of fin in the long term. But either way, what does this have to do with anything I said?  I outright made it clear he will need more HT's, I said he could get away with things for maybe another 10+ years... you're backing up my argument here inadvertently. Yes, the best case is indeed that it will slow down loss for decades, that was my point, as I covered in the previous sentence. When did I say it was a given? I advised to use it for a while to make sure its working and is tolerated before getting a HT, nothing more.

Sides have been shown repeatedly to reduce over time, not increase. Is it possible that they could randomly show up 10 years down the line? Who knows, maybe, but I'm not really sure how that's relevant to you saying my comments to OP are incorrect and based on opinion. You're now just debating the use of fin in general. The effects don't really 'fade' either, androgens are just simply always doing their thing in the background and loss is slowly happening and accumulating over time.

Well, a truly conservative HT plan might involve planning without the use of fin, but again, what is your argument here? Originally it was that me saying OP could likely get away without needing multiple HT's within a ten year period if he does as I advised and waits is based on opinion, and now you seem to have diverged into a whole other kettle of fish. Not really sure what your logic is here with this.

Edited November 22, 2021 by JDEE0

[Mike10]

1 hour ago, JDEE0 said:

Your argument really makes little sense when you say that my points stem from personal opinion, when they are actually based directly on studies that evidence them, and then goes on to make your own make your own points that are entirely based on opinion or that just aren't factual. 

Also, for arguments sake, I didn't make a general rule, I said in his personal case that if he gets to a point he has stabilised his hair loss for nearly a decade and continues on with fin after this point, I would be more surprised if he couldn't make it another 10+ before *needing* to get another one than the opposite. You think that at that point if this was the case for OP that his hair is more likely to dramatically regress in the following 5, 6 or 7 years that he has to go for another procedure than not? I think it would be far more likely that the latter would be the case...

With that said, I would certainly make it a general rule overall that most people can get by for 10+ years without their hair loss progressing if they stick to fin, yes. Let's reference the most recent long term study from a few years back that covered 523 Japanese men for over ten years. 

It used something called a MGPA score to track progress, which means the following: 1, significant disease progression; 2, moderate disease progression; 3, slight disease progression; 4, no change; 5, slight improvement; 6, moderate improvement; and 7, significant improvement

So, as we can see, 4 is equal to baseline, meaning no change from the start. Essentially, If you have a score of at least 4 after the 10 year period, your hair hasn't worsened in this time, and any score above this means it's actually improved compared to the start 10 years prior. 

We can see that Norwoods 1-3 all had a score of 6 or above after 10 years, so their hair was still classed as moderately improved from when they started a decade later. Norwood 4's and 5's had a score of between 5 and 6 after 10 years were up, so they still had a slight improvement from baseline. Norwoods 6 and 7 had a score of between 4 and 5 after 10 years, so no change to a slight improvement is their description. You can read it here to check my claims: https://www.oatext.com/Long-term-(10-year)-efficacy-of-finasteride-in-523-Japanese-men-with-androgenetic-alopecia.php

As you can see, NW2-3 such as OP would likely still be quite a bit above baseline after ten years, it clearly wasn't losing efficacy for these people at the 10 year mark and so it stands to reason that it would take quite some time from this point to regress further to baseline and then to regress below it enough to need a HT. Moreover, pretty much all the participants at least hadn't worsened in the 10 years, which is evidence of me saying I think its fair to make this general rule...

There are so many other studies, but I'm not going to start some meta-analysis here so have at it if you want to read them.

In regards to your second paragraph, no, the reality is that *everyone* will slowly progress regardless of fin in the long term. But either way, what does this have to do with anything I said?  I outright made it clear he will need more HT's, I said he could get away with things for maybe another 10+ years... you're backing up my argument here inadvertently. Yes, the best case is indeed that it will slow down loss for decades, that was my point, as I covered in the previous sentence. When did I say it was a given? I advised to use it for a while to make sure its working and is tolerated before getting a HT, nothing more.

Sides have been shown repeatedly to reduce over time, not increase. Is it possible that they could randomly show up 10 years down the line? Who knows, maybe, but I'm not really sure how that's relevant to you saying my comments to OP are incorrect and based on opinion. You're now just debating the use of fin in general. The effects don't really 'fade' either, androgens are just simply always doing their thing in the background and loss is slowly happening and accumulating over time.

Well, a truly conservative HT plan might involve planning without the use of fin, but again, what is your argument here? Originally it was that me saying OP could likely get away without needing multiple HT's within a ten year period if he does as I advised and waits is based on opinion, and now you seem to have diverged into a whole other kettle of fish. Not really sure what your logic is here with this.

You take these studies at face value but you have to pay attention to sponsoring also. Bottom line is that I am not sure I can agree with  on the 10 plus year rule while on Fin. I have heard otherwise. 

But it is relevant to keep you expectations regarding Fin on check before embarking on HT. In the German Forum there have been a number of reportss complaining about severe sides after several years of Fin. It is naive to think that it is a given that you can take a particular drug for life. And yes, Fin may not be strong enough to hold off the loss, that is pretty established. 

My whole point was rather full disclosure to the thread opener . That is all.  I am not saying you gave bad advice

 

Edited November 22, 2021 by Mike10

[JDEE0]

6 hours ago, Mike10 said:

You take these studies at face value but you have to pay attention to sponsoring also. Bottom line is that I am not sure I can agree with  on the 10 plus year rule while on Fin. I have heard otherwise. 

But it is relevant to keep you expectations regarding Fin on check before embarking on HT. In the German Forum there have been a number of reportss complaining about severe sides after several years of Fin. It is naive to think that it is a given that you can take a particular drug for life. And yes, Fin may not be strong enough to hold off the loss, that is pretty established. 

My whole point was rather full disclosure to the thread opener . That is all.  I am not saying you gave bad advice

 

So, basically, it turns out that indeed you are the one using personal opinion to form your arguments, not me.

I'm not going to get into answering the rest of your response in any great detail as the thread has been de-railed enough, which is unfair to OP, and I've already covered responses to those such as yours on here a million times, but I'll just say that it is far more naive to base any amount of belief in completely anecdotal evidence from online forum posters which could have a thousand reasons you don't know about causing X, Y or Z than it is to look at clinical data and use that as your foundation for reason. It's worth absolutely nothing.

Anyway, I'm leaving it there.

[Mike10]

6 hours ago, JDEE0 said:

So, basically, it turns out that indeed you are the one using personal opinion to form your arguments, not me.

I'm not going to get into answering the rest of your response in any great detail as the thread has been de-railed enough, which is unfair to OP, and I've already covered responses to those such as yours on here a million times, but I'll just say that it is far more naive to base any amount of belief in completely anecdotal evidence from online forum posters which could have a thousand reasons you don't know about causing X, Y or Z than it is to look at clinical data and use that as your foundation for reason. It's worth absolutely nothing.

Anyway, I'm leaving it there.

I asked you which Doctor told you that? It became clear that no reputable Dr told you that. Your entire basis are some questionable studies. I am going to leave it at that. 

[JDEE0]

2 minutes ago, Mike10 said:

I asked you which Doctor told you that? It became clear that no reputable Dr told you that. Your entire basis are some questionable studies. I am going to leave it at that. 

Yes, lets leave it there, because your entire basis is just personal opinion based on nothing. And no, I have spoken to lots of top Belgian and Spanish doctors who have told me that it's more than reasonable for someone to maintain on fin for 10, 15+ years if they stick to it and began with fairly healthy hair overall anyway as they didn't have a huge amount of balding to begin with (which was the entire basis of my argument if you go back and re-read).

[Mike10]

21 minutes ago, JDEE0 said:

Yes, lets leave it there, because your entire basis is just personal opinion based on nothing. And no, I have spoken to lots of top Belgian and Spanish doctors who have told me that it's more than reasonable for someone to maintain on fin for 10, 15+ years if they stick to it and began with fairly healthy hair overall anyway as they didn't have a huge amount of balding to begin with (which was the entire basis of my argument if you go back and re-read).

Now you are backtracking 😉. In case you have only mild balding, yes then it makes more sense, I could agree.But certainly not in general sense as you phrased before. Let's leave it at that then

[JDEE0]

15 hours ago, JDEE0 said:

Also, for arguments sake, I didn't make a general rule, I said in his personal case that if he gets to a point he has stabilised his hair loss for nearly a decade and continues on with fin after this point, I would be more surprised if he couldn't make it another 10+ before *needing* to get another one than the opposite. You think that at that point if this was the case for OP that his hair is more likely to dramatically regress in the following 5, 6 or 7 years that he has to go for another procedure than not? I think it would be far more likely that the latter would be the case...

With that said, I would certainly make it a general rule overall that most people can get by for 10+ years without their hair loss progressing if they stick to fin, yes. Let's reference the most recent long term study from a few years back that covered 523 Japanese men for over ten years. 

Haha, no, I am not backtracking. My post here on this thread was in response to OP and his particular case - it was advice aimed directly at him after looking at his pics and seeing that he has thick hair everywhere else, hasn't lost hair in 4 years already and so if this trend continues on by the time he's closer to thirty after being medicated for a handful of years, I would say he has a good shot of being able to get a HT at that point and go the distance (for 10-20 years). Again, go back and read and you will see all of this...

I then said that I would however make a general rule for everyone, and not just in response to OP here in this thread's case, that they can likely maintain for at least 10 years from when they start finasteride based off of the study I referenced and quoted. You then said that this was questionable, provided absolutely no reason as to why, haven't even attempted to refute my evidence with any semblance of substance, but somehow still think your argument here has the most weight.

See the above quote from my post...

I won't be responding again, so all the best with whatever situation you're in with your hair anyways.

Edited November 22, 2021 by JDEE0

[Melvin- Admin]

Guys,

Please take this conversation on pm or create another thread, there’s no need to continue to derail this thread.