What should I do? (Doctors were no help) 28M Aus

[AxelShip]

Hi everyone,

 

I’ve been reading quite a bit on this forum over the past month but I’d like to get your opinion on what I should do. I’ve been to 3 different doctors in the past 12 months and they’ve all told me not to take finestaride and have pretty much dismissed my hair loss concerns (one told me that I’m married so why do I even care about my hair anymore!). Recently I have noticed that my hair is receding worse than it was previously and am at that point where it looks bad so I’m either going to have to shave it completely bald (which I really don’t want to) or fix it somehow.

 

I haven’t ever taken any medication or anything for my hair, mainly because the doctors have not even entertained the idea of prescribing it. I have read that the only true fix is a transplant, which I am open to, and money isn't really an issue. I was reading through posts for recommendations on different surgeons but I guess I'd love some overall advice because I’ve also read on these forums that you should be on medication for a while before even considering a transplant.

 

So with that in mind, and my photos below can you please let me know what you think my next course of action should be?

[Eugenix Hair Sciences]

1 hour ago, AxelShip said:

Hi everyone,

 

I’ve been reading quite a bit on this forum over the past month but I’d like to get your opinion on what I should do. I’ve been to 3 different doctors in the past 12 months and they’ve all told me not to take finestaride and have pretty much dismissed my hair loss concerns (one told me that I’m married so why do I even care about my hair anymore!). Recently I have noticed that my hair is receding worse than it was previously and am at that point where it looks bad so I’m either going to have to shave it completely bald (which I really don’t want to) or fix it somehow.

 

I haven’t ever taken any medication or anything for my hair, mainly because the doctors have not even entertained the idea of prescribing it. I have read that the only true fix is a transplant, which I am open to, and money isn't really an issue. I was reading through posts for recommendations on different surgeons but I guess I'd love some overall advice because I’ve also read on these forums that you should be on medication for a while before even considering a transplant.

 

So with that in mind, and my photos below can you please let me know what you think my next course of action should be?

You are a candidate for hair transplantation. You should also take finasteride to prevent any further progression of baldness on your scalp. You would require around 3000 to 3500 grafts for the tarsnplantation procedure in your frontal zone and mid scalp. The crown shall regain density with the use of finasteride.

[Gatsby]

@AxelShip going by your thread title are you an Aussie?

[mafpe]

1 hour ago, AxelShip said:

I haven’t ever taken any medication or anything for my hair, mainly because the doctors have not even entertained the idea of prescribing it. I have read that the only true fix is a transplant, which I am open to, and money isn't really an issue. I was reading through posts for recommendations on different surgeons but I guess I'd love some overall advice because I’ve also read on these forums that you should be on medication for a while before even considering a transplant.

there is some side effect regarding the meds, most commonly, sexual one.
in the forum you can see several cases of people with sides and why they don't want to take it at all, while some other keep taking it despite the side.

all of us here doesn't want to go bald, but there aren't that many option, and most effective are meds, hair transplant, or hair system.

Think about the sides, and if it's worth the risk, this applies to meds, HT, hair systems, and any other measure.
If you already know about them, and the problem is the prescription, perhaps someone here around you can refer to one.

[Euphoria]

I hate doctors who dismiss the patient’s concerns as bullcrap and instead give their nonsense opinions on how a patient should live or behave. They’re pretty common in poor countries, surprised to see this phenomenon in a country like Aus too. We pay for their medical opinions not their opinions as human beings on life - there’s a difference. 

Anyway seems like you would be able to get good regrowth and halt further hairloss with the big 3 - min, fin and ketaconazole where a transplant might not even be needed.

I think you can order both Nizoral and Minoxidil online, not sure about Finasteride except in topical solutions 

 

Edited April 28, 2022 by Euphoria

[NARMAK]

2 hours ago, mafpe said:

there is some side effect regarding the meds, most commonly, sexual one.
in the forum you can see several cases of people with sides and why they don't want to take it at all, while some other keep taking it despite the side.

all of us here doesn't want to go bald, but there aren't that many option, and most effective are meds, hair transplant, or hair system.

Think about the sides, and if it's worth the risk, this applies to meds, HT, hair systems, and any other measure.
If you already know about them, and the problem is the prescription, perhaps someone here around you can refer to one.

Please try to frame your post a little bit more objectively. 

Finasteride can and does have some side affects including sexual and is a reason why some cease use of Finasteride, however the vast majority of people that experience side affects do so in a milder more tolerable form. Lower libido is commonly the sexual side affect cited but not to where it is detrimental to the quality of an individuals life to perform when the moment calls for it. 

Medication should always be encouraged as a first step towards hair restoration and if a person experienced side affects that are beyond a tolerable limit, they can cease use. Also, they are recommended to do blood tests etc. before starting to identify any other issues with their body that can influence side affects. 

Most people also after ceasing Finasteride who experienced issues return to a normal baseline. 

For those whose side affects persist on a much more permanent basis, this would be a very extreme case and outlier against the millions that use the medication successfully. 

I believe OP would benefit from still trying it and being able to save their crown are and strengthen the donor if they are able to use without any issues of sides. 

[mafpe]

44 minutes ago, NARMAK said:

Please try to frame your post a little bit more objectively. 

Finasteride can and does have some side affects including sexual and is a reason why some cease use of Finasteride, however the vast majority of people that experience side affects do so in a milder more tolerable form. Lower libido is commonly the sexual side affect cited but not to where it is detrimental to the quality of an individuals life to perform when the moment calls for it. 

Medication should always be encouraged as a first step towards hair restoration and if a person experienced side affects that are beyond a tolerable limit, they can cease use. Also, they are recommended to do blood tests etc. before starting to identify any other issues with their body that can influence side affects. 

Most people also after ceasing Finasteride who experienced issues return to a normal baseline. 

For those whose side affects persist on a much more permanent basis, this would be a very extreme case and outlier against the millions that use the medication successfully. 

I believe OP would benefit from still trying it and being able to save their crown are and strengthen the donor if they are able to use without any issues of sides. 

my bad, i just reread my post and notice that it seem to be too strong on their side effect part as if it will definitely happen.

i cannot say that the side effect is rare, but it is mild like you said for most people.

i'd still say to think about the risk however, and believe that people should know of it before trying it.
i do advise people with hair loss problem to use the meds myself, i am a user, and i normally tell people to weight it with their self confidence and comfort.
i always tell them before hand that there is possibility of what could happen, and tell them to decide if they want to take it.

[Mike10]

4 hours ago, mafpe said:

my bad, i just reread my post and notice that it seem to be too strong on their side effect part as if it will definitely happen.

i cannot say that the side effect is rare, but it is mild like you said for most people.

i'd still say to think about the risk however, and believe that people should know of it before trying it.
i do advise people with hair loss problem to use the meds myself, i am a user, and i normally tell people to weight it with their self confidence and comfort.
i always tell them before hand that there is possibility of what could happen, and tell them to decide if they want to take it.

I do not think your post was too strong, I would agree that sides on Fin are not rare in the long term. Any serious Dr will tell that it is not a given to take a medication lifelong. The sides are not always mild, they can persist or semi-persist.It is all difficult to quantify,these ,may be rather unusal I woudl agree  

[NARMAK]

49 minutes ago, Mike10 said:

I do not think your post was too strong, I would agree that sides on Fin are not rare in the long term. Any serious Dr will tell that it is not a given to take a medication lifelong. The sides are not always mild, they can persist or semi-persist.It is all difficult to quantify,these ,may be rather unusal I woudl agree  

The implication of that posts original wording is that side affects are a guarantee almost and some choose to continue the medication despite the sides. 

The truth of Finasteride etc. is that if the side affect profile was as prominent as described, it would very likely not have been given approval however its now been like 20+ years since it released and long term safety studies can be seen and it is prescribed to millions of men yearly. 

The old chestnut of people who usually see positive results and don't day anything, just getting on with their lives and the minority of users who have side affects screaming as loud as possible happens. 

In fact, this applies to many things and unfortunately that fear mongering imo without scientific backed basis as an all but guarantee for most people is spread a lot online and has probably stopped a lot of men trying the medication and probably saving their hair. I say that as a person who also didn't take anything because of those unfounded points until i was 31. Fortunately still in a position to benefit from medication to hold onto whatever i could and now planning to do a hair transplant also after trying to do as much research as possible. 

I really have my brother to thank tbh, he was the one that actually started Dutasteride firstly almost a year before me and seeing he was fine on the medication i also decided to give it a go. 

[Mike10]

23 minutes ago, NARMAK said:

The implication of that posts original wording is that side affects are a guarantee almost and some choose to continue the medication despite the sides. 

The truth of Finasteride etc. is that if the side affect profile was as prominent as described, it would very likely not have been given approval however its now been like 20+ years since it released and long term safety studies can be seen and it is prescribed to millions of men yearly. 

The old chestnut of people who usually see positive results and don't day anything, just getting on with their lives and the minority of users who have side affects screaming as loud as possible happens. 

In fact, this applies to many things and unfortunately that fear mongering imo without scientific backed basis as an all but guarantee for most people is spread a lot online and has probably stopped a lot of men trying the medication and probably saving their hair. I say that as a person who also didn't take anything because of those unfounded points until i was 31. Fortunately still in a position to benefit from medication to hold onto whatever i could and now planning to do a hair transplant also after trying to do as much research as possible. 

I really have my brother to thank tbh, he was the one that actually started Dutasteride firstly almost a year before me and seeing he was fine on the medication i also decided to give it a go. 

That may be true also and I guess at the end it is a personal decision. You seemed to have a good experience with Fin. Personally  I never really needed Fin. Now at 40 with the PRP my hair is stable and still in good shape.  

[NARMAK]

24 minutes ago, Mike10 said:

That may be true also and I guess at the end it is a personal decision. You seemed to have a good experience with Fin. Personally  I never really needed Fin. Now at 40 with the PRP my hair is stable and still in good shape.  

Personally speaking, if i could go back to when i was 21 or so  i would 100% have started Finasteride. It likely would have helped me preserve even more hair and in many ways i'm still lucky it was as slow as it has seemed to be to keep me where i am now abd tying to hold it before my hair transplant. 

I would urge everybody to give it a go first whilst having done a blood test etc. to rule out any other potential issues from hormone imbalance, vitamin deficiencies etc. 

[Mike10]

49 minutes ago, NARMAK said:

Personally speaking, if i could go back to when i was 21 or so  i would 100% have started Finasteride. It likely would have helped me preserve even more hair and in many ways i'm still lucky it was as slow as it has seemed to be to keep me where i am now abd tying to hold it before my hair transplant. 

I would urge everybody to give it a go first whilst having done a blood test etc. to rule out any other potential issues from hormone imbalance, vitamin deficiencies etc. 

I see your point.but then again you may have developped an intolerance by now . so you never know

[NARMAK]

1 hour ago, Mike10 said:

I see your point.but then again you may have developped an intolerance by now . so you never know

I don't believe you build an intolerance. I have heard of people say they think Finasteride has stopped working for them as effectively but imo this isn't an indication the Finasteride is less effective than it started off as. It's to do with the DHT having got to near the end of where it was able to slow down the hair loss and that's why you might need to switch to Dutasteride to block further DHT and reinforce the blocking. 

Personally i have started off on Dutasteride as i felt i would already be playing catch up, so i'm happy to now stay on it for life or late into my 70s and beyond if i live that long. 

[Mike10]

2 hours ago, NARMAK said:

I don't believe you build an intolerance. I have heard of people say they think Finasteride has stopped working for them as effectively but imo this isn't an indication the Finasteride is less effective than it started off as. It's to do with the DHT having got to near the end of where it was able to slow down the hair loss and that's why you might need to switch to Dutasteride to block further DHT and reinforce the blocking. 

Personally i have started off on Dutasteride as i felt i would already be playing catch up, so i'm happy to now stay on it for life or late into my 70s and beyond if i live that long. 

If your body can't tolerate anymore a drug is not up to you. In the German Forum there are several guys who had to drop Fin due to sides after 10 years plus. The hard reality is that you can't exclude these things. Same goes for effictiveness, as most will slowly comtinue to lose ground on Fin. It is what it is, there no assurances and it is not a miracle drug.

[mafpe]

2 hours ago, NARMAK said:

I don't believe you build an intolerance. I have heard of people say they think Finasteride has stopped working for them as effectively but imo this isn't an indication the Finasteride is less effective than it started off as. It's to do with the DHT having got to near the end of where it was able to slow down the hair loss and that's why you might need to switch to Dutasteride to block further DHT and reinforce the blocking. 

Personally i have started off on Dutasteride as i felt i would already be playing catch up, so i'm happy to now stay on it for life or late into my 70s and beyond if i live that long. 

the term might not be intolerance, but there are cases where the meds just.... stopped working for the said guy. this is why sometime guys switch from finas to duta, altho some simply switches since duta is more convinient andmore effective. i've been using fin for 6 years now, and i can say that it is somewhat less effective than the first year. the caveat however is that there are several factor that affect it, like stress. doctors and researcher also don't know why it just stop working sometime, or why some people doens't have any side effect or why some just develop one after some years.

still, fact is that without it, my hair loss would be much, much worse.

[NARMAK]

21 minutes ago, Mike10 said:

If your body can't tolerate anymore a drug is not up to you. In the German Forum there are several guys who had to drop Fin due to sides after 10 years plus. The hard reality is that you can't exclude these things. Same goes for effictiveness, as most will slowly comtinue to lose ground on Fin. It is what it is, there no assurances and it is not a miracle drug.

 

14 minutes ago, mafpe said:

the term might not be intolerance, but there are cases where the meds just.... stopped working for the said guy. this is why sometime guys switch from finas to duta, altho some simply switches since duta is more convinient andmore effective. i've been using fin for 6 years now, and i can say that it is somewhat less effective than the first year. the caveat however is that there are several factor that affect it, like stress. doctors and researcher also don't know why it just stop working sometime, or why some people doens't have any side effect or why some just develop one after some years.

still, fact is that without it, my hair loss would be much, much worse.

This isn't a perfect explanation by any means but it is a likely situation. 

Hypothetically if we assume that a persons natural DHT resistance in the hair follicle is 50% and using Finasteride you are now blocking a further 41% scalp DHT (1mg/every day) then your total is now sitting at 91% scalp DHT blocked. Now if your hair are still susceptible to that 9% DHT, it could very well take years and years before you see hair loss noticeably progress. That's what usually explains the "Finasteride isn't working for me any more" anecdotes imo because Finasteride took them as far as they could do for that length of time. In quite a lot of cases, Finasteride never is designed to or ever claims to stop hair loss. Merely slow it down as much as possible for an individual with DHT inhibition. 

Now, taking the same example but using Dutasteride which blocks 51% scalp DHT at 0.5mg everyday, you get a circa 101% DHT block. However, if the starting point of an individual is 25-45%, even Dutasteride won't stave off hair loss eternally. 

This is the current issue with existing medication and the massive variation for men out there in how susceptible we are to DHT and how much effectiveness we can get from Finasteride or Dutasteride. That's why i do hope a future treatment comes sooner rather than later where maybe we can start using Finasteride in combination with new topical treatments to further bolster DHT inhibition and keep guys from going bald where possible. 

[AxelShip]

On 4/28/2022 at 5:17 PM, Gatsby said:

@AxelShip going by your thread title are you an Aussie?

Hey Gatsby, Yeah I am  

I've seen some of your posts around too, you seem really knowledgeable! Would love to get your thoughts 

[Gatsby]

4 minutes ago, AxelShip said:

Hey Gatsby, Yeah I am  

I've seen some of your posts around too, you seem really knowledgeable! Would love to get your thoughts 

Hey @AxelShip welcome to the forum. I'm an Aussie in Melbourne and I can promise you that after 27 years of research here alone we have the worst doctors and even worse surgeons when it comes to MPB. I would speak with a good doctor and have a script made for Finasteride 1mg a day. Even in studies the placebo group developed side effects. Having said that I have recently dropped finasteride (after surgery three months ago) as my libido really dipped. Too hard to tell if it was a nocebo from work stress or from the drug. I will wait until the 12 month mark from my surgery and then revisit finasteride (and add minoxidil) once my transplanted hair has fully grown out. When it comes to surgery forget it here. The so called best surgeons here are charging what the best overseas has to offer but without the skill set. Wishing you all the best mate!

[AxelShip]

4 minutes ago, Gatsby said:

Hey @AxelShip welcome to the forum. I'm an Aussie in Melbourne and I can promise you that after 27 years of research here alone we have the worst doctors and even worse surgeons when it comes to MPB. I would speak with a good doctor and have a script made for Finasteride 1mg a day. Even in studies the placebo group developed side effects. Having said that I have recently dropped finasteride (after surgery three months ago) as my libido really dipped. Too hard to tell if it was a nocebo from work stress or from the drug. I will wait until the 12 month mark from my surgery and then revisit finasteride (and add minoxidil) once my transplanted hair has fully grown out. When it comes to surgery forget it here. The so called best surgeons here are charging what the best overseas has to offer but without the skill set. Wishing you all the best mate!

@GatsbyThanks mate! I will go to another doctor and be a bit more forceful to get the script. I did originally look into the Aussie surgeons and I'm so happy I found this forum because everything I've read is exactly what you've said. I can't believe they can be so bad.. but I guess the whole industry seems pretty shady which is what makes it so hard to find decent advice anywhere.  

 

Also, thanks heaps to @NARMAK, @mafpe, and @Mike10 for the discussion on Fin and the side effects. My wife is more concerned than I am on that front but it's definitely something I'll be keeping an eye on. The doctors I spoke to were dismissive instantly due to the side effects but it does seem like so many people are using this drug.

 

Do you guys think that I should give the meds a go first and then see how that goes before looking into a HT? Any idea how long should I wait before making that call? Also, is there anything to look for that might be an important to note in making a decision for or against a HT?

 

Another thing, @Euphoriamentioned that the other two meds, min and ketaconazole with fin might work to regrow the hair, is this something I should be jumping on straight away with the finasteride?

 

Thanks so much to everyone for your replies, I'm so happy I found this forum!

[Gatsby]

12 minutes ago, AxelShip said:

Do you guys think that I should give the meds a go first and then see how that goes before looking into a HT? Any idea how long should I wait before making that call? Also, is there anything to look for that might be an important to note in making a decision for or against a HT?

I would definitely start with finasteride first and trial this for a good six to twelve months. It may grow back hair in the crown and vertex but what you want is to stabalise your hair loss before surgery begins so the surgeon will know what he is working with. You could add minoxidil but then you won't know which drug is doing what and if finasteride doesn't work you will then have minoxidil to fall back on to. Nizoral 2% can't hurt (I take it) but you need it to stay in the scalp for at least 5 minutes or more. Otherwise you're just washing it down the drain and not into your scalp. Remember surgery is a last resort and you look to have a very good donor. All the best mate!

[NARMAK]

9 minutes ago, AxelShip said:

@GatsbyThanks mate! I will go to another doctor and be a bit more forceful to get the script. I did originally look into the Aussie surgeons and I'm so happy I found this forum because everything I've read is exactly what you've said. I can't believe they can be so bad.. but I guess the whole industry seems pretty shady which is what makes it so hard to find decent advice anywhere.  

 

Also, thanks heaps to @NARMAK, @mafpe, and @Mike10 for the discussion on Fin and the side effects. My wife is more concerned than I am on that front but it's definitely something I'll be keeping an eye on. The doctors I spoke to were dismissive instantly due to the side effects but it does seem like so many people are using this drug.

 

Do you guys think that I should give the meds a go first and then see how that goes before looking into a HT? Any idea how long should I wait before making that call? Also, is there anything to look for that might be an important to note in making a decision for or against a HT?

 

Another thing, @Euphoriamentioned that the other two meds, min and ketaconazole with fin might work to regrow the hair, is this something I should be jumping on straight away with the finasteride?

 

Thanks so much to everyone for your replies, I'm so happy I found this forum!

Personally i would recommend you start Finasteride and if you are going to combine it with Minoxodil which imo you would probably be best to do so to try and regrow hair, you NEED to combine it with Microneedling once a week at 1mm to 1.5mm once a week. 

Right now, if you give it around 12 months and consistently use the products and take progress pictures, that time gives you the ability to save and also see how things shake out and pick the right place for your hair transplant. 

I personally would ignore so called medical professionals who dismissed Finasteride and cited side affects without even having you try it out and see how you responded. Your wife is probably concerned as a laymen because of all the BS around Finasteride out there and the so called professionals who also said no. 

I personally did my own research and started almost a decade after i bought into the BS around Finasteride etc. and i wish i could have gone back in time to start at 21. I'm still pretty fortunate with where i am, but i think i could have probably saved a few hundred grafts from being necessary if i had started much sooner at least. That's without taking into account any diffuse thinning and miniturisation that happened which is harder for me to assess. 

One thing i would say though is that if you are going to go down this road of keeping your hair. It's a commitment and you need to stick with it indefinitely. Particularly Minoxidil. Popping a pill once a day is easy enough imo but taking time to properly apply Minoxidil and Microneedling even is more demanding. 

The other alternatives and there are, is to either shave/buzz your hair down and live with that look if you personally are happy to do so. The next alternative is a hair system. You have solid temple points and could probably be happy with that option too. 

All the options have Pros and Cons. The question is what works best for you. 

[Mike10]

@Narmak: It seems a bit odd that you are pushing Finansteride in many threads. It is the user's decision based on all the information gathered including medical professional. There is a risks/benefits analysis that goes into this and is particular to each case, irrelevant of your personal experience.