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Dr. Pittella • Norwood 4A, Good donor: Easy case


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VIDEO - Watch this NW 4a - Full Video SOLVED Comb through 

Age: 52 yo

NW: 4a

Donor Area: GOOD

Total Number of Grafts: 4554 

Number of Sessions: 1 

Surgical Plan: Lower the hairline with good density, increase density in midscalp and crown areas.

Rx: Topical and Oral Minoxidil, clobetazol and ketoconazol Shampoo, biotin (NO FINASTERIDE or any other 5-ARI)

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Very nice @Dr. Felipe Pittella...

I think most of us are in admiration of your work ESPECIALLY those super tough cases you have exhibited.

I notice how it seems NONE of your patients are taking any 5-ARI. Do you think it is possible to stop the progression of baldness only with what you have been prescribing including Topical and Oral Minoxidil, clobetazol and ketoconazol Shampoo and biotin?

Also, what dose of oral minoxidil do you prescribe- 2.5mg or 5mg?

Thank you and look forward to continue to see some of your more challenging cases!

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24 minutes ago, SLA said:

I notice how it seems NONE of your patients are taking any 5-ARI. Do you think it is possible to stop the progression of baldness only with what you have been prescribing including Topical and Oral Minoxidil, clobetazol and ketoconazol Shampoo and biotin?

Indeed I don't like to prescribe Fina or Duta because of the possibility of one losing his libido. If so happens, the patient will give up using any rx at all.

For that reason I do not rely on 5-ARI to get a good result. 

I must admit that it is much more dificult to stop baldness progression without it (5-ARI). In some cases when the genetical target is not so "strong" for baldness, it may be possible to stop progression (with oral minoxidil). 

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11 hours ago, 5BetaReductase said:

@Dr. Felipe Pittella I see you prescribe clobetasol to many of your patients. How often do they use it? Since it is a super potent class corticosteroid, can it have the possibility of thinning the skin over time?

great question.

twice in week. Since there is no deposit of cobetasol under the skin, i.e., the foam is rapidly washed away after 5 minutes in the shower, there is no significant tissue alteration. 

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19 minutes ago, Dr. Felipe Pittella said:

great question.

twice in week. Since there is no deposit of cobetasol under the skin, i.e., the foam is rapidly washed away after 5 minutes in the shower, there is no significant tissue alteration. 

Thank you doctor. So are you prescribing the shampoo version? Is it a combination version of ketoconazole and clobetasol in one?

Edited by 5BetaReductase
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