Still thinning on meds - Depressed before procedure

[Fabulous]

Hi guys,

My background:

Age: 26 in November

Hair loss started since I was 15-16, I've started with minoxidil at 19 which helped me to stabilize the condition for around 3 years.

Current situation: NW3 diffuse

 

Even though I'm on medication (finasteride for 1Year and 3Months) and dutasteride (9Months) my hair is still thinning and growing shorter. My current regimen is pretty crazy as well. I made my way up to 0.5mg Dut daily + 1.25mg Fin 5x week. Alongside this DHT blockers I'm using keto 2% shampoo (2-3x week), 5% minoxidil 2x day and dermarolling with 1.5mm 1x week.

As my procedure with mr. De Freitas is approaching (January 2023) I'm unsure if it's the right decision to keep going and I started to take into consideration getting a hair system but I have 0 knowledge in this domain (never met someone who has one, no real idea about the maintenance and costs), but it looks appealing to me because of hairline and density you can get. Does anyone have any experience in this area ?

What I would like to know is: Given the time I'm on Fin and Dut,  am I probably non-respondent to the medication or is this the way fin and dut work ? Some hairs have to shed and stronger hair will grow ? Is there a way I may do more harm to my hair with microneedling ?

Are there any other meds I can add to my routine which could help ?

There are few days in which I feel my hair looks better then before meds, but in the majority of time I feel depressed looking in the mirror and started to wear a cap almost everywhere I go. I never thought my hair loss will go this far so quick and that my first depressive episode in my life will be caused by it...

 

[civic]

I would not proceed with transplant in this situation, considering your age & none response to meds, it might not end up well. Talk to De Freitas about this, they might refund your deposit, he has a long wait list & surely in no loss of prospective clients. Hair systems came a long way, and can look very realistic,  search on youtube, some great tutorials on how to get started .

Edited August 11, 2022 by civic

[sukh123]

Depends on your hair loss tbh if you still have a lot of native hair then maybe it’s not best to procede , as you don’t know the progression of your hair loss. Pictures would help if you could post them

[LookMaxx]

You absolutely must go with the transplant because the surgeon you chose is great and you will not get appt so soon again. You will have to get a transplant in future anyway. 

 

Edited August 11, 2022 by LookMaxx

[ciaus]

15 months on dut/fin is enough time to know for sure if its going to stop or slow down your loss enough to make hair transplants worthwhile. If you're still losing and only 26, its time to think non-surgical. You don't want to add unnecessary scarring on your head as well. The remaining options

-Shaving it is the easiest and cheapest option. If you have some decent facial hair, letting it grow out can help frame your face, highlight your good features, help hide the bad ones. Working out in the gym, thickening up your neck can also make your head/face look better.

-SMP/scalp micropigmentation

-Hair system, aka hair piece

 

[thetdog666]

Im slowly losing hair while on avodart 0.5mg daily. Iv just started oral minoxidil. Minoxidil Foam doesn't seem to be doing much for me You could maybe look into that?

[sukh123]

12 minutes ago, LookMaxx said:

Minoxidil doesn’t stabilise hairloss, it only keeps them up above the skin while DHT does the damage below to the follicles. If you want to see where your hairs actually are at, stop minoxidil. The hairs that are left are what you have actually, the rest are minoxdil regrowth.

Your crazy regime is nothing more than just a waste of money and exposing yourself to unnecessary sides. Finasteride 1mg daily is more than enough. Dutasteride alone nukes your DHT and T and has a realllyyyy long half life. Why would you combine them both? 

Your hairs appear to be thinning because they are probably minoxidil hairs finally going away. Finasteride doesn’t keep minoxidil hairs. This is what exactly what happens on Minoxidil, the hairs don’t stay up forever and slowly goes away I imagine when the damage becomes too severe that even Minox can’t bring them up. 

You should either use dutasteride alone or finasteride alone with Minoxidil. If the thinning hairs bother you, stop minoxidil to see what Norwood you actually are at then you will notice your hairs not thinning anymore due to finasteride keeping your alive follicles alive.

This is why I don’t like Minoxidil and didn’t use it. It masks your baldness and do nothing to stop the damage, finasteride actually stops the damage. 

 

You absolutely must go with the transplant because the surgeon you chose is great and you will not get appt so soon again, finasteride isn’t going to give you regrowth and minoxidil hairs will disappear as you’re finding out. You will have to get a transplant in future anyway. 

 

Your wrong on minoxidil is works a different way to finasteride. Finasteride works to stop or stabile hair loss and deal with the root cause , while minxodil acts a growth antagonist. Which is Why the combination is better to use than just one. Once I noticed my hair loss stabilised I then added minxodil which helped with some regrowth 

[mr_peanutbutter]

in what norwood endgame are youre older male relatives atm?

[GoliGoliGoli]

I mean, there are guys at NW6 who get transplants and have great results. Guy in link below was NW5/NW6 on no meds and got a great result with a transplant. Maybe that isn't always the case, but it does happen. Frankly I would never do a hair system, sounds like a pain in the arse. 

 

A lot comes down to your donor, and how much money you have in the bank for multiple surgeries. Amazing how many people describe continued loss while being on Fin/Dut though so thanks for sharing your experience

Edited August 11, 2022 by GoliGoliGoli

[LookMaxx]

Turns out I had wrong info about Minox

Edited August 11, 2022 by LookMaxx

[sukh123]

4 minutes ago, LookMaxx said:

This guy has been on minoxidil since 19, now 25. Used finasteride for 1.5 years. You do the math. 

His hair follicles are damaged and minoxidil has kept them alive but his real Norwood could be 5 or 6 since he just started using finasteride a year ago. This is why he’s noticing his hairs thinning because those hairs are minoxidil hairs and going away. 
 

Minox should never be used alone to maintain, it’s does nothing for maintaining except give an illusion and a few good years but the moment you stop minox, those hairs disappear along with the rest that are damaged

I don’t what your talking about, it doesn’t make sense. Your blaming his hair thinning on minxodil lol. He just not a responder to dht blockers it’s seems .Being on a dht blocker for two years in particular dut should of stabilised it  .Tbh I cant really make a judgment nor can anyone as we don’t have comparison pictures. 

Edited August 11, 2022 by sukh123

[Mike10]

Sounds like a lot of stress. Have you tried shaving? In terms of quality of life should be the best option for you in the long term

[LookMaxx]

27 minutes ago, sukh123 said:

I don’t what your talking about, it doesn’t make sense. Your blaming his hair thinning on minxodil lol. He just not a responder to dht blockers it’s seems .Being on a dht blocker for two years in particular dut should of stabilised it  .Tbh I cant really make a judgment nor can anyone as we don’t have comparison pictures. 

You are right, I had the wrong information and confused. My apologies, I will edit out the post

 

 

 

[mister_25]

4 hours ago, Fabulous said:

Are there any other meds I can add to my routine which could help ?

There is Saw Palmetto which I take everyday with Finasteride. I haven't gotten any side effects with it. Its weaker than Finasteride/Dutasteride but its something additional you can take.

There are a lot of topical anti-androgens and people get on these massive pharmaceuticals stacks for hair. Something that one of the people on this forum used to be knowledgeable about and praise a solution until they were banned.

 

[HappyMan2021]

8 hours ago, LookMaxx said:

You absolutely must go with the transplant because the surgeon you chose is great and you will not get appt so soon again. You will have to get a transplant in future anyway. 

 

I agree with this. 

OP, for all i know you are not a good candidate for a HT. 

You are very young at 26 and youre hair loss does not seem stable. 

That being said....in 4ish months you are getting operated in by an elite surgeon, and as @LookMaxx said, if you are not getting a HT now you will still be getting one down the road. 

An elite surgeon will still be able to improve your appearance with a HT. But perhaps Dr Freitas will just be more conservative in his approach than he otherwise would be. 

Life is short and 4 months will be here before you know it. Stay the course

[Mike10]

So what is Dr Freitas's approach here? Is he saying well the guy is on Finansteride that is enough for me? He do not care if it works properly or not? Come on

[Tiger2050]

When did you start the minoxidil? Did you have any periods where you stopped and restarted minoxdil? Starting and stopping min causes long shedding periods. I shed for over 3-4 months when I started minoxdil and when I quit the shed was horrible and lasted over 9 months. I am certain it was the minox causing my shedding because I was very stable on fin for 4 years before I started experimenting with min.

 

You’ve gotta give one medication time to work and see if you’re responding before adding another medication. Constantly changing or adding new medications will induce shedding. I also had a bunch of shedding when I switched from fin to dut as well but it stabilized after some time. Don’t add any more medications or switch from topical min to oral min, you’re gonna introduce another big shed and think fin/dut isn’t working.

Edited August 12, 2022 by Tiger2050

[Rahal Hair Transplant]

Fabulous,

I apologize if you’ve answered any of these questions already but my first question is, when is the date of your upcoming procedure? How much time do you have before undergoing surgery?

Also, it seems that you are on both Nostrand and dutasteride which means you are essentially using the most potent and powerful DHT blockers to combat hair loss. You say that your hair loss is still progressing after one year and three months of finasteride use and nine months of dutasteride use simultaneously.  My question is, how’s your hair loss slow down at all or is it still progressing as rapidly as it was prior to using this medication?

Note that I work for Dr. Rahal but I am not personally a doctor so please don’t take this as medical advice. But in my opinion, I suggest progressing with your treatment as long as the doctor has approved it until you reach at least two years.  That said, there is a very real possibility that you’re just not a responder to the medication.  But I think giving it more time would be a good idea.

also, the surgeon you selected, what has he said about the fact that medication doesn’t seem to be working for you at this time? I don’t know how much hair you have left on top of your scalp but I think it’s important that the surgeon you selected knows what you’re going through and you discuss and agree on the actual surgical plan in the event that you are not responding to the medication.

for example, I don’t know what your donor hair looks like and how much you have available throughout the course of a lifetime rather than just a single procedure, but if you have a lower donor hair supply and you have aggressive hair loss on top of the scalp and you’re not responding to the location, you may end up with a fairly thin looking result. And then you have to decide whether or not this is even worth it. 

Note but I’m not trying to talk you out of anything.  But I am a firm believer in informed consent and it’s important that you know exactly what you’re getting into and that your expectations are realistic. It’s also equally important that you are satisfied with what can be realistically achieved. Because if you’re not, and there’s no sense in going through with the procedure as it will just be a waste of money and you will be unhappy.

A hair system is always a possibility and there are some advantages and disadvantages of going that route.  The primary band just that I can look very natural and give you the appearance of much more density than a hair transplant ever could.  On the flipside, a hair system will require ongoing maintenance and it can and will be expensive.  Moreover, it doesn’t take a lot for it to look on natural so regular maintenance will be important. You will also have to worry about weather conditions and other things that could potentially affect the natural appearance of your system.  There’s also a much greater chance of show me noticing that what’s on top of your head isn’t natural.  but, as long as you rarely attend to the system and have the money and use it for regular upkeep, it may be a rather decent solution.  In fact, some people will combine a hair system with hair transit surgery in that they will undergo a hair transplant surgery to re-create a natural looking hairline and then use the hair system behind it as it’s not always easy to use a hair system to create a natural looking hairline.

if you are willing, I do encourage you to post some photos of your current hair loss and the side the back of your scalp so we can see what your donor area looks like. I also suggest that if you are having second thoughts that you talk to your doctor about postponing the procedure until you are fully confident with the decision you have made.

I hope this helps.

Rahal Hair Transplant 

[Legend007]

20 minutes ago, Tiger2050 said:

When did you start the minoxidil? Did you have any periods where you stopped and restarted minoxdil? Starting and stopping min causes long shedding periods. I shed for over 3-4 months when I started minoxdil and when I quit the shed was horrible and lasted over 9 months. I am certain it was the minox causing my shedding because I was very stable on fin for 4 years before I started experimenting with min.

 

You’ve gotta give one medication time to work and see if you’re responding before adding another medication. Constantly changing or adding new medications will induce shedding. I also had a bunch of shedding when I switched from fin to dut as well but it stabilized after some time. Don’t add any more medications or switch from topical min to oral min, you’re gonna introduce another big shed and think fin/dut isn’t working.

Words of wisdom .. i kinda went thru the same thing too .. 

[Fabulous]

Thank you everyone for your advice and support.

Here you can see my first post in which I included photos from July 2021 (I was on fin for 2 months): 

Below you can see some photos I took today. Indeed, as @Tiger2050 mentioned, I started few months ago (4 I guess) to use the dermaroller and apply minoxidil to my thinned area, and I wasn't very consistent with that because of commodity (would use only on the bald spots from time to time). Until then I used the minoxidil only on my bald spots, as instructed by my dermatologist. 

The hair in the front is mostly miniaturized: thinner than usual and it grows only to certain lengths.

I think that the real issue for me isn't that I can't improve my current situation with a transplant, but maybe not getting what I was dreaming of. I saw a lot of good results(low dense hairlines) but those guys had more hair before the procedure than I do. This + the potential progression of the alopecia made me to take into account the potential benefit of a hair system.
@civic @sukh123 @LookMaxx @GoliGoliGoli @HappyMan2021 @Tiger2050 @Rahal Hair Transplant and others interested,
What do you guys think after seeing the photos ?

 

 

Edited August 12, 2022 by Fabulous

[Fabulous]

On 8/11/2022 at 8:21 PM, thetdog666 said:

Im slowly losing hair while on avodart 0.5mg daily. Iv just started oral minoxidil. Minoxidil Foam doesn't seem to be doing much for me You could maybe look into that?

Unfortunately I can't find oral minoxidil where I live...I'll try to ask friends who live abroad to ship it to me. Thank you for the idea.

[Fabulous]

On 8/11/2022 at 8:30 PM, mr_peanutbutter said:

in what norwood endgame are youre older male relatives atm?

My dad and his father are both NW7. I think my dad got to NW6-7 even before getting in his 30s..somewhere in his mid-late 20s.
On my mother's side everyone is a NW1.

[Fabulous]

23 hours ago, mister_25 said:

There is Saw Palmetto which I take everyday with Finasteride. I haven't gotten any side effects with it. Its weaker than Finasteride/Dutasteride but its something additional you can take.

There are a lot of topical anti-androgens and people get on these massive pharmaceuticals stacks for hair. Something that one of the people on this forum used to be knowledgeable about and praise a solution until they were banned.

 

Could you please share with me from where I could buy a topical DHT blocker ?

On 8/11/2022 at 9:29 PM, Mike10 said:

Sounds like a lot of stress. Have you tried shaving? In terms of quality of life should be the best option for you in the long term

Tbh I don't even want to think about shaving right now, even though it might not be as bad as I think. I prefer to let it be the last available solution.

[Fabulous]

7 hours ago, Rahal Hair Transplant said:

Fabulous,

I apologize if you’ve answered any of these questions already but my first question is, when is the date of your upcoming procedure? How much time do you have before undergoing surgery?

Also, it seems that you are on both Nostrand and dutasteride which means you are essentially using the most potent and powerful DHT blockers to combat hair loss. You say that your hair loss is still progressing after one year and three months of finasteride use and nine months of dutasteride use simultaneously.  My question is, how’s your hair loss slow down at all or is it still progressing as rapidly as it was prior to using this medication?

Note that I work for Dr. Rahal but I am not personally a doctor so please don’t take this as medical advice. But in my opinion, I suggest progressing with your treatment as long as the doctor has approved it until you reach at least two years.  That said, there is a very real possibility that you’re just not a responder to the medication.  But I think giving it more time would be a good idea.

also, the surgeon you selected, what has he said about the fact that medication doesn’t seem to be working for you at this time? I don’t know how much hair you have left on top of your scalp but I think it’s important that the surgeon you selected knows what you’re going through and you discuss and agree on the actual surgical plan in the event that you are not responding to the medication.

for example, I don’t know what your donor hair looks like and how much you have available throughout the course of a lifetime rather than just a single procedure, but if you have a lower donor hair supply and you have aggressive hair loss on top of the scalp and you’re not responding to the location, you may end up with a fairly thin looking result. And then you have to decide whether or not this is even worth it. 

Note but I’m not trying to talk you out of anything.  But I am a firm believer in informed consent and it’s important that you know exactly what you’re getting into and that your expectations are realistic. It’s also equally important that you are satisfied with what can be realistically achieved. Because if you’re not, and there’s no sense in going through with the procedure as it will just be a waste of money and you will be unhappy.

A hair system is always a possibility and there are some advantages and disadvantages of going that route.  The primary band just that I can look very natural and give you the appearance of much more density than a hair transplant ever could.  On the flipside, a hair system will require ongoing maintenance and it can and will be expensive.  Moreover, it doesn’t take a lot for it to look on natural so regular maintenance will be important. You will also have to worry about weather conditions and other things that could potentially affect the natural appearance of your system.  There’s also a much greater chance of show me noticing that what’s on top of your head isn’t natural.  but, as long as you rarely attend to the system and have the money and use it for regular upkeep, it may be a rather decent solution.  In fact, some people will combine a hair system with hair transit surgery in that they will undergo a hair transplant surgery to re-create a natural looking hairline and then use the hair system behind it as it’s not always easy to use a hair system to create a natural looking hairline.

if you are willing, I do encourage you to post some photos of your current hair loss and the side the back of your scalp so we can see what your donor area looks like. I also suggest that if you are having second thoughts that you talk to your doctor about postponing the procedure until you are fully confident with the decision you have made.

I hope this helps.

Rahal Hair Transplant 

Hi and thank you for your input,

- The date of the procedure is 9&10 Jan 2023

- The only issue I see since I start with fin and dut is that parts of my hair (which are at the border) are growing thinner and shorter(last 3 photos). I never had problems with the hair in the crown area or from back, but even those area improved in strength. Im not aware if dht blockers could grow new hairs, and in fact those small hair I see are in fact new hairs, but I highly doubt it.

- I did not inform my surgeon yet about the meds not fully stopping my thinning yet. I just recently saw a pic of mine and noticed that my hair looks thinner. I did not pay much attention to my hair after starting with Fin, thinking that I was safe.

[NARMAK]

I'm going to be perfectly honest. I cannot wrap my head around HOW you are losing hair still. 

On 8/11/2022 at 5:28 PM, Fabulous said:

My current regimen is pretty crazy as well. I made my way up to 0.5mg Dut daily + 1.25mg Fin 5x week. Alongside this DHT blockers I'm using keto 2% shampoo (2-3x week), 5% minoxidil 2x day and dermarolling with 1.5mm 1x week.

This stack, IF i am reading it correctly says you are on 0.5mg Dutasteride daily. Just that alone reduces your scalp DHT by like 51%. Adding Finasteride into the mix, which at 1.25mg for 5x a week is almost the same as 1mg everyday, that reduces scalp DHT by 41%. Now, i'm not say the maths is always 1:1 here, but you're blocking at a guess around 80% or more scalp DHT as well as Ketoconazole in the mix which inhibits marginal amounts of DHT but still helps. 

Dude, you need to go get some blood tests done ASAP to figure out if there's some underlying causes elsewhere and i think you may want to consider switching to Oral Minoxodil for a more effective treatment if possible. 

I'm sending my best to you to get through this and find a way but damn, i wouldn't have been able to convince myself to take that much medication together.