Still thinning on meds - Depressed before procedure

[MissMyLongHair]

1 hour ago, NARMAK said:

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

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. 

 

I don't think the scalp DHT math checks out there based on what I have read. Finasteride is weak compared to Dut. If you are truly losing hair still, it is time to consider increasing the Dutasteride dose OP. 2.5mg a day would be ideal, or whatever the highest you can afford if not 2.5mg. Oral Min 2.5-5mg will help too.

https://www.bernsteinmedical.com/research/dutasteride-vs-finasteride/

"The 2.5-mg dutasteride dose was consistently superior to 0.5-mg dutasteride in promoting scalp hair growth. The 2.5-mg dose was also better than the 0.5-mg dose at suppressing scalp DHT (79% vs. 51%), whereas it was only marginally better at suppressing serum DHT (96% vs. 92%). This difference in the dose-response of serum and scalp DHT to inhibition with dutasteride is likely to be due to the greater contribution of type 1 5α-reductase to scalp DHT concentrations."

 

[Boomerang]

If you think your hairloss prevention regime isn’t working and you’re still losing hair then I think transplant is not a good option at this stage.

transplant is more successful when hairloss has stabilised as it will help you and your surgeon to come up with a better strategic plan. Else you will continue to chase the tail.

You should get blood test done to find out if there is another underlying cause. Hypothyroidism makes you lose hair as well.

I also think you’re overloading your body with too much medication. Maybe shave the head, take few weeks off the medication then start with basic big 3 (4 with micro needling).

 

good luck to you.

 

[LookMaxx]

From the photos you have clear terminal healthy hairs. Are you sure you’re losing hairs?

[NARMAK]

7 hours ago, MissMyLongHair said:

 

I don't think the scalp DHT math checks out there based on what I have read. Finasteride is weak compared to Dut. If you are truly losing hair still, it is time to consider increasing the Dutasteride dose OP. 2.5mg a day would be ideal, or whatever the highest you can afford if not 2.5mg. Oral Min 2.5-5mg will help too.

https://www.bernsteinmedical.com/research/dutasteride-vs-finasteride/

"The 2.5-mg dutasteride dose was consistently superior to 0.5-mg dutasteride in promoting scalp hair growth. The 2.5-mg dose was also better than the 0.5-mg dose at suppressing scalp DHT (79% vs. 51%), whereas it was only marginally better at suppressing serum DHT (96% vs. 92%). This difference in the dose-response of serum and scalp DHT to inhibition with dutasteride is likely to be due to the greater contribution of type 1 5α-reductase to scalp DHT concentrations."

 

Like i said, the maths won't be 1:1, but usually in isolation, Finasteride 1mg daily blocks circa 41% scalp DHT and Dutasteride 0.5mg Daily is about 51% but i don't think even with OP taking both together it would necessarily block that much because of probably some factors. 

OP may be able to get 2.5mg Dutasteride but i would seriously consult a medical professional before attempting this. 

[mister_25]

11 hours ago, Fabulous said:

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

If you are inconsistent with minoxidil use, your hair will shed. I am speaking from experience here

I had sloppy use of minoxidil but still applied it everyday and I went through very significant sheds. If you were inconsistent and not applying at all then you would probably undergo the same thing as me. I will provide photos once my phone is repaired cause I have some good examples if needed.

11 hours ago, Fabulous said:

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.

I don't think your hair is much different comparing the previous thread and this threads photos. To be honest the photos you posted on November 1st look worse than the photos you posted today. It looks like your forelock strengthened. I circled in Blue where I think your hair improved based on these photos. In my opinion just judging by these photos, I would say your hair is improving rather than regressing.

November 2021

Today

10 hours ago, Fabulous said:

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

I do not use topical DHT blockers myself. I just advised you that those options exist. 

Edited August 13, 2022 by mister_25

[mister_25]

On 8/12/2022 at 2:28 AM, Fabulous said:

Is there a way I may do more harm to my hair with microneedling ?

Dermarollers can "break" the hairs when you use them. Dermapens are better and you wont have that issue nearly as much. Pretty much dermarollers wont affect your hair follicles but can accidently cut the hairs.

[mafpe]

dermapen would still break the hair, both could and would pierce the hairs. still, dermapens does offer better stability on both depth and coverage, and one of the best advantage, that it deals less trauma since while both option pierces the skin, dermaroller could "tears" the puncture site due to drag factor. this is less of a concern on elastic skin though, but definitely moreso on less flexible skin.

[A Fue Good Men]

On 8/12/2022 at 3:23 PM, NARMAK said:

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

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. 

Dht inhibition doesn’t work that way with these 5ari’s…it’s not additive at all for an individual taking dut and fin.

 

If he is taking dut daily, it’s overpowering anything fin is doing. The fin is literally going to waste. The dut has a higher binding affinity to both types of 5ar

[deeznuts]

where's the diffuse loss?

[Fabulous]

17 hours ago, deeznuts said:

where's the diffuse loss?

I misused the term "diffuse". What I was trying to say is that my front hair is thinning

[BaldReaper]

Dont go for an ht

 

Try shaving your head or do SMP

[GoliGoliGoli]

43 minutes ago, BaldV said:

Dont go for an ht

 

Try shaving your head or do SMP

TBH I don't quite agree with the people telling this guy not to go for a HT. If you aren't responding to Meds that's fine, just understand you will need 2-4 HT's throughout the course of your lifetime. And a lot of that depends on your ability to have enough donor/beard hair to have that number of HT's,  and if you do have beard hair that it is a good match for your regular hair. 

[ciaus]

 

This is about expectation management, his ship continues to sink even with the assistance of medication. Can he be satisfied with a conservative sequence of hair transplants over his lifetime that will always leave some areas noticeably thin or even bare? That's alot to ask for a guy that's still in his 20s, and dealing with feelings of depression.

Edited August 15, 2022 by ciaus

[GoliGoliGoli]

That's certainly true, but I think vast majority of people will have tremendous improvement as long as they're willing to bite the bullet on accepting they will need multiple procedures.  Again though it really comes down to donor availability, beard availability, and money in the bank account. 

[Al - Moderator]

4 hours ago, ciaus said:

Can he be satisfied with a conservative sequence of hair transplants over his lifetime that will always leave some areas noticeably thin or even bare? That's alot to ask for a guy that's still in his 20s, and dealing with feelings of depression.

 

You are not wrong, but what's the alternative for someone who doesn't want to be bald? Do nothing and the hair will continue to get worse and you're more bald. Shaving your head makes sure you are completely bald right now and forever basically. SMP is just coloring your head and having a fake buzz cut look which still never lets you actually grow your hair. There aren't any other choices.

A lot of guys come on here saying they finally went for the hair transplant they've been thinking about because they got to the point where they couldn't stand it any longer and felt they had to do something. What if that person got to that same level of hair loss a year earlier? Wouldn't they have felt the same thing a year earlier? What if they got to that level of hair loss 5 years earlier?

 

Edited August 15, 2022 by BeHappy

[mafpe]

11 hours ago, BeHappy said:

 

You are not wrong, but what's the alternative for someone who doesn't want to be bald? Do nothing and the hair will continue to get worse and you're more bald. Shaving your head makes sure you are completely bald right now and forever basically. SMP is just coloring your head and having a fake buzz cut look which still never lets you actually grow your hair. There aren't any other choices.

A lot of guys come on here saying they finally went for the hair transplant they've been thinking about because they got to the point where they couldn't stand it any longer and felt they had to do something. What if that person got to that same level of hair loss a year earlier? Wouldn't they have felt the same thing a year earlier? What if they got to that level of hair loss 5 years earlier?

 

Hair system, fiber concealer, SMP. but like you said, SMP is "fake hair", but so are most options. so far only very dense packing of HT comes close, while most HT are only an illusion of density. Like how people view plastic faces (plastic surgery) as fakes, technically HT is also one.

Each option have it's drawback, what they meant is that normally under 25 it's a bad idea to do HT, just treat it like how people say "people under 18/21 shoulnd't drink/smoke/drive" etc. most of them are looking at it at the "long term viability", in which would one still be able to have hair until late age.

He can certainly have an HT, but depend on how you look at it, it can range from a bad decision, a decent one, or a good one. Several people said that i don't need one, but i got one anyway. Just be in the know and weight the consequences and risk, compared to the gain.

[ciaus]

 

Here is another strategy to consider from one of our member doctors @DrTBarghouthi

You can see the surgery and results below, basically you get a transplant to define your frontal hairline with real hair so it looks natural, and then use a hair system behind that.

 

[ciaus]

17 hours ago, BeHappy said:

You are not wrong, but what's the alternative for someone who doesn't want to be bald?

 

We all agree his situation can be improved by taking action. But he's only got so much donor hair to be transplanted, and the only thing worse than being bald is having patches of strong transplanted hair surrounded by thinning or bare areas because he runs out of donor hair down the road.