How important is finesteride in the transplant process?

[Razzle1980]

I recently underwent a 4,000 graft transplant. My doctor never really pushed finesteride and recommended that I get PRP injections on the day of the transplant, 30, 60, 90 days later, and at 6 month intervals after that. He's a firm believer that PRP will maintain native hair and help grow both native and transplanted hair. He said he doesn't recommend finesteride due to it's possible side effects. I was curious as your thoughts on this

[mafpe]

PRP doesn't really do much for hair restoration, except makes healing and growth go faster.

PRP is also marketed in beauty clinic for regeneration etc, healing, which works, albeit marginally compared to the price, but that's beauty industry for you.
unfortunately for us, while it aids, it wont regrow lost hair, and whether it will maintain and prevent you from losing more hair is unproven. and while it help grows hair that is already there, those hair most likely will still grow without it, and for the new hairs, they would most likely stay as baby vellus hairs, no more than that.

[NARMAK]

Considering the cost of PRP and the lack of scientific evidence to support it being as effective as Finasteride, i would seriously be questioning the motives of this Dr. It seems like they're using a slight fear mongering tactic to up sell you. 

Finasteride in general imo is an extremely important component of halting or slowing hair loss. Moreso the latter for the majority of people. It's now cheaper than ever before and it's been on the market for 20+ years and if it was that bad, i'm fairly confident to say it would have been yanked but the media being the media, they deliberately sensationalise the drug as a boogey man and its what stopped me from trying the medication back when i was 21. I wish i could go back in time to start earlier and that's coming from somebody who was classed as a Norwood 2 at 32 before my hair transplant. 

So i would say there's still every reason to take Finasteride. A common misconception is that the donor area is "permanent" and DHT resistant but it's actually still affected, just to a much lesser degree and that's why imo people still see and feel the hair thickening up anecdotally when they're like 40 or 50 and had a hair transplant and started using Finasteride for the first time. 

You can also stop or reduce dosage if you experience side affects. Permanent side affects are extremely rare but like all medication any and all possible sides HAVE to be listed or the company is opening themselves up to lawsuits galore.

There is evidence to suggest Merck weren't honest 100% in their clinical trial data, but this isn't exclusive to just them and this one medication. It's an industry wide problem. However, as i said, drugs been on the market 20+ years. If there was many problems, it would have had been taken off or at least had a significant uptick in people reporting problems, which in todays social media age is a guarantee. 

[LookMaxx]

1 hour ago, NARMAK said:

Considering the cost of PRP and the lack of scientific evidence to support it being as effective as Finasteride, i would seriously be questioning the motives of this Dr. It seems like they're using a slight fear mongering tactic to up sell you. 

That’s unfair

Dr Pitella also doesn’t recommend finasteride, will you question his motives?

Doctors also have divided opinions on finasteride, there’s one camp which thinks PFS guys are cuckoo and absolutely will not do HT unless the person is on finasteride for a year before because it helps with HT results. Then there’s another camp which doesn’t prescribe fin for their patients.

 

PRP has its benefits, how much is debatable but it’s not useless. Hair grafts placed in PRP solution survive more and for longer periods of time compared to cold saline solution. I don’t think his doctor is upselling him because he doesn’t like fin and suggests PRP. There has to be other evidence of scammy tactics to form such an opinion.

[NARMAK]

1 hour ago, LookMaxx said:

That’s unfair

Dr Pitella also doesn’t recommend finasteride, will you question his motives?

Doctors also have divided opinions on finasteride, there’s one camp which thinks PFS guys are cuckoo and absolutely will not do HT unless the person is on finasteride for a year before because it helps with HT results. Then there’s another camp which doesn’t prescribe fin for their patients.

 

PRP has its benefits, how much is debatable but it’s not useless. Hair grafts placed in PRP solution survive more and for longer periods of time compared to cold saline solution. I don’t think his doctor is upselling him because he doesn’t like fin and suggests PRP. There has to be other evidence of scammy tactics to form such an opinion.

A doctor saying they believe PRP alone will maintain native hair and transplanted hair, whilst telling you to come in at practically every month at a cost of maybe a few hundred isn't giving an alarm bell? 

Doctors who don't push Finasteride as an absolute must merely have to inform you of what can happen and then the responsibility is yours. Doctors who are providing an aesthetic service who don't want to take on patients that they feel will have a sub optimal result without being on medication are also free to refuse you. 

I think you are incorrect on PRP as a holding solution. There are modern solutions that can help better preserve grafts whilst out of body, but it's not PRP. 

[Razzle1980]

If I were to start the finesteride/minoxidil spray (I was told 2 weeks after procedure), will it negative impact my transplanted hair in any way? I've heard there's a shedding period with the native hair once you get on it. Is that true?

[NARMAK]

17 minutes ago, Razzle1980 said:

If I were to start the finesteride/minoxidil spray (I was told 2 weeks after procedure), will it negative impact my transplanted hair in any way? I've heard there's a shedding period with the native hair once you get on it. Is that true?

There can be a shedding process but even the transplanted hair will shed by the first 2 to 3 months, so it shouldn't negatively impact you long term but get better results. Usually i only think you should try one treatment at a time to see how effective it was, but that also depends on how much hair loss you had and what your restoration goal is. 

You underwent 4000 grafts, that doesn't seem like a small amount, so it's difficult to say unless somebody had come here beforehand and just wanting help with their hair loss. Post-op it's harder to say, but i would say Finasteride at the very least should help you over a longer term keep good results. 

[Razzle1980]

I was on finesteride (propecia) for about 6 years in my 20s. I was hoping I could get away with not using it after my HT now that I'm in my 40s. Im considering using the topical spray since it also contains minoxidil and potentially less side effects than the pill.

 

Btw, my doctor is an extremely reputable doctor with high success rates and high profile clients. He told me less than 30% of his clients are on finesteride. He does the entire HT procedure by hand.

[Mike10]

I do not even consider Propecia with the sides and all that, long term damage who knows. Anyway, I am on PRP since many years and all is well.

[NARMAK]

59 minutes ago, Razzle1980 said:

I was on finesteride (propecia) for about 6 years in my 20s. I was hoping I could get away with not using it after my HT now that I'm in my 40s. Im considering using the topical spray since it also contains minoxidil and potentially less side effects than the pill.

 

Btw, my doctor is an extremely reputable doctor with high success rates and high profile clients. He told me less than 30% of his clients are on finesteride. He does the entire HT procedure by hand.

If you want to use it, you can, if you don't, then you don't have to. It's always a personal choice but i just wanted to dissect what you said above a little bit. 

Just because you get to a certain age and the hair loss seems stable, it's not a guarantee it won't start getting worse and quickly. There's many examples of people having this happen to them. That's why even somebody on medication could be fine for a while, but then the hair loss accelerates past that point where it stays effective and it becomes worse, even when using Dutasteride for example. Unfortunately those people are very unlucky, but they are out there. 

[Mike10]

Then again I think most are likely going to be fXXked doing a HT without the Propecia. Just too stupid and desperate to get that hair loss is progressive throughout whole life.

[NARMAK]

13 minutes ago, Mike10 said:

Then again I think most are likely going to be fXXked doing a HT without the Propecia. Just too stupid and desperate to get that hair loss is progressive throughout whole life.

Personally i think it's because the majority end up at a hair mill and get a hairline way too aggressive for them and their future hair loss potential. If you're not on finasteride or similar, a good clinic will weigh up your suitability on other factors and potential progression. Melvin for example is a great example of somebody who couldn't tolerate Finasteride but his result from where he started to where he is today is simply outstanding. 

[Hairy Henderson]

I’ve been on Fin for about 17 years, stabilized my loss completely.

 The past 2 weeks I’ve noticed shedding hairs in the shower and when I put gel in. This hasn’t occurred since I started fin. Concerned that now all of a sudden it’s losing it’s stopping power!

 At what point should I consider a change to Dut??

[general-etwan]

Finasteride has zero importance in the transplant process. Its importance is to preserve existing head hair behind any transplanted area and retain it for as long as possible. Finasteride is very essential to creating that maximized look for as long as possible, as long as it’s effective for the person. 

PRP is useful and beneficial during a HT to maximize health and growth of relocated grafts. But beyond the time of the HT and the few months after, PRP is very much a gimmick. Very minimal, very temporary benefits if any and the cost has always seemed absurd to me for something that will produce essentially no visible difference.