Regular Member Rafael Manelli Posted January 30, 2023 Regular Member Share Posted January 30, 2023 You seem to be thinning over a large area. Without stabilising with meds, you’re playing a game of catch-up by transplanting areas as they fall. Best thing you can do is finasteride, and dutasteride if fin is not enough. if you can stabilise, you almost definitely have enough grafts to restore a full appearance of density. Maybe 1000 at the front and 1000 in the mid to back would be enough. it’s understandable to want to be conservative because you’re young, so I get why you’re reluctant to spend 2000 grafts. But the grafts should last a lifetime (more or less), and you’d end up using them anyway in the long run, so I don’t see much downside to using them now. They’ll remain even if the native hairs fall, so it’s not as if they’d be wasted. The main concern with wasting grafts is if you dense pack a particular area and then run out of grafts to cover another area that thins. Link to comment Share on other sites More sharing options...
Regular Member DavidFrancis Posted January 30, 2023 Author Regular Member Share Posted January 30, 2023 (edited) 19 minutes ago, Rafael Manelli said: You seem to be thinning over a large area. Without stabilising with meds, you’re playing a game of catch-up by transplanting areas as they fall. Best thing you can do is finasteride, and dutasteride if fin is not enough. if you can stabilise, you almost definitely have enough grafts to restore a full appearance of density. Maybe 1000 at the front and 1000 in the mid to back would be enough. it’s understandable to want to be conservative because you’re young, so I get why you’re reluctant to spend 2000 grafts. But the grafts should last a lifetime (more or less), and you’d end up using them anyway in the long run, so I don’t see much downside to using them now. They’ll remain even if the native hairs fall, so it’s not as if they’d be wasted. The main concern with wasting grafts is if you dense pack a particular area and then run out of grafts to cover another area that thins. Thank you for your answer, Yes I completely agree with you, once it's down I might as well put it on now I'm on finasteride 0.5mg a day, but I'm hesitant to switch to topical, or 0.25mg a day, or even stop, because I really don't want any erectile or fertility side effects. And, can i hope regrowth with oral minoxidil ? Edited January 30, 2023 by DavidFrancis Link to comment Share on other sites More sharing options...
Regular Member Rafael Manelli Posted January 30, 2023 Regular Member Share Posted January 30, 2023 Minoxidil works by extending the anagen (growth) phase of the hair. At any time, up to 20% of your hair may be in the telogen (resting) phase, wherein the follicle lies dormant under the skin rather than producing hair. Minoxidil should basically prolong the time your hairs are active . so it can effectively increase density, but it doesn’t actually do much to stop the effects of DHT related miniaturisation and alopecia. So it might appear to give you more hair, but they’ll likely end up shrinking too. I trust DHT inhibitors more as a long term treatment. Minoxidil is more ancillary. Give minox a bash. It’ll probably do some good. But I’d stick to the fin as well. I believe side effects are overrated, people worry too much. I’ve never noticed any sides from it. A relaxed attitude is a healthy one. Link to comment Share on other sites More sharing options...
Regular Member DavidFrancis Posted August 29, 2023 Author Regular Member Share Posted August 29, 2023 On 1/30/2023 at 3:12 PM, Rafael Manelli said: Minoxidil works by extending the anagen (growth) phase of the hair. At any time, up to 20% of your hair may be in the telogen (resting) phase, wherein the follicle lies dormant under the skin rather than producing hair. Minoxidil should basically prolong the time your hairs are active . so it can effectively increase density, but it doesn’t actually do much to stop the effects of DHT related miniaturisation and alopecia. So it might appear to give you more hair, but they’ll likely end up shrinking too. I trust DHT inhibitors more as a long term treatment. Minoxidil is more ancillary. Give minox a bash. It’ll probably do some good. But I’d stick to the fin as well. I believe side effects are overrated, people worry too much. I’ve never noticed any sides from it. A relaxed attitude is a healthy one. Thanks for your reply Just a quick update: I've been on oral minoxidil 2.5mg a day for 7 months, and finasteride 0.5mg a day for 7 and a half months, and I'm still losing a lot of hair. Visually, I look the same as in the photos from January, but I'm losing a lot of hair. It scares me, I've tried everything, and I've never had the slightest positive result from either medication or a hair transplant. I'm planning to repair my transplant by removing 750 grafts to make the middle part denser, then re-densify the front, but for the vertex I don't have a floor. Link to comment Share on other sites More sharing options...
Valued Contributor Gatsby Posted August 29, 2023 Valued Contributor Share Posted August 29, 2023 Oral minoxidil can take a year to see peak benefits and finasteride can take up to two years. If you do go ahead for a repair give your scalp a year from when this surgery was first performed. All the best! GATSBY 'UNPLUGGED!' 15,671 (3 surgeries) Grafts FUE+BHT Dr. Sethi Eugenix Link to comment Share on other sites More sharing options...
Regular Member DavidFrancis Posted August 29, 2023 Author Regular Member Share Posted August 29, 2023 3 minutes ago, Gatsby said: Oral minoxidil can take a year to see peak benefits and finasteride can take up to two years. If you do go ahead for a repair give your scalp a year from when this surgery was first performed. All the best! Thank you, my friend, Yes, I had my operation 2 years ago, I'm already 8 months, I hope to see some improvement. If not, can ketocozanole shampoo help? Link to comment Share on other sites More sharing options...
Valued Contributor Gatsby Posted August 29, 2023 Valued Contributor Share Posted August 29, 2023 Just now, DavidFrancis said: Thank you, my friend, Yes, I had my operation 2 years ago, I'm already 8 months, I hope to see some improvement. If not, can ketocozanole shampoo help? Many people claim that Nizoral 2% can help. I've swallowed humble pie and I now use it three times a week. It certainly isn't hurting! All the best! GATSBY 'UNPLUGGED!' 15,671 (3 surgeries) Grafts FUE+BHT Dr. Sethi Eugenix Link to comment Share on other sites More sharing options...
Regular Member DavidFrancis Posted August 29, 2023 Author Regular Member Share Posted August 29, 2023 5 hours ago, Gatsby said: Many people claim that Nizoral 2% can help. I've swallowed humble pie and I now use it three times a week. It certainly isn't hurting! All the best! But i can use Nizoral without scalp irritation ? Im afraid that it's accentue hair loss. I have very agressive hair loss, when i pass my finger in the hair, i got 50 hairs. Link to comment Share on other sites More sharing options...
Regular Member Nikoni Posted August 29, 2023 Regular Member Share Posted August 29, 2023 Follow verteporfin thread . This maybe a key to scarless wound healing. In couple of months it will be possible to say if the drug works. 1 Link to comment Share on other sites More sharing options...
Regular Member DavidFrancis Posted January 4 Author Regular Member Share Posted January 4 hello friends, Since last year, my diffuses is progressing.. Oral minoxidil and finasterid do nothing .. I will remove 800 grafts from my hairline and put them in the middle, and then redensify. it’s good idea ? Link to comment Share on other sites More sharing options...
Regular Member ScottishGuy21 Posted January 4 Regular Member Share Posted January 4 You’re only mid 20s and unfortunately your hairloss is still progressing despite medicinal intervention. Try dutasterdie. Your main priority right now needs to stabilise your losses. This is the nuclear option but in your case I think may be necessary. I wouldn’t be looking for a second op right now. You would be creating additional scar tissue to areas which will shortly become exposed (if your hairloss remains aggressive). Without stabilisation you’ll be in exactly the same position again in 12-18 months, and eventually you’ll run out of grafts. You need to think long term on this. Good Luck, hopefully further medicinal interaction can help. Link to comment Share on other sites More sharing options...
Regular Member DavidFrancis Posted January 4 Author Regular Member Share Posted January 4 Thanks for your help, But in all cases i need remove hairline, so i can use grafts for the middle now ? I cant dutasteride im very affraid of side effects, even finasteride i got little side effects. Doctor told me increase oral minoxidil to 5mg ( im on 2.5 mg), but i saw that there isn’t hudge difference. Link to comment Share on other sites More sharing options...
Regular Member BackFromTheBrink Posted January 4 Regular Member Share Posted January 4 24 minutes ago, DavidFrancis said: Thanks for your help, But in all cases i need remove hairline, so i can use grafts for the middle now ? I cant dutasteride im very affraid of side effects, even finasteride i got little side effects. Doctor told me increase oral minoxidil to 5mg ( im on 2.5 mg), but i saw that there isn’t hudge difference. I cannot explain why, but it appears that dutasteride can (and anecdotally appears to in most cases) have less side effects than finasteride. Perhaps consider switching a day or two per week to it initially? Link to comment Share on other sites More sharing options...
Senior Member HappyMan2021 Posted January 4 Senior Member Share Posted January 4 17 minutes ago, DavidFrancis said: finasteride i got little side effects What side effects did you get? Most people seem to love or hate fin. So i am curious if the side effects are.manageable At least for me minoxidil was useless Link to comment Share on other sites More sharing options...
Regular Member DavidFrancis Posted January 4 Author Regular Member Share Posted January 4 4 minutes ago, BackFromTheBrink said: I cannot explain why, but it appears that dutasteride can (and anecdotally appears to in most cases) have less side effects than finasteride. Perhaps consider switching a day or two per week to it initially? I’m so affraid of this medication.. im on 0,5mg per day of finasteride, i will up to 1mg, but 1/2 days. I will see in 6 months Link to comment Share on other sites More sharing options...
Regular Member DavidFrancis Posted January 4 Author Regular Member Share Posted January 4 5 minutes ago, HappyMan2021 said: What side effects did you get? Most people seem to love or hate fin. So i am curious if the side effects are.manageable At least for me minoxidil was useless Less of libido.. that’s it. The problem is that i have very dry hair, and oily scalp after 2 days without shampoo. It speed my hair loss. I use ketoconazole but it’s not working. Link to comment Share on other sites More sharing options...
Senior Member HappyMan2021 Posted January 4 Senior Member Share Posted January 4 9 minutes ago, DavidFrancis said: Less of libido.. that’s it. My own personal take but I dont think loss of libido (importantly - as long as you do not have ED), i dont necessarily see a negative in having a minor loss in libido If anything, lower libido will allow.you to focus more on work and other productive areas of your life Also, are you 100% certain loss of libido is due to Fin and not due to normal aging? Link to comment Share on other sites More sharing options...
Regular Member DavidFrancis Posted January 4 Author Regular Member Share Posted January 4 Yes im almost sure that it’s from fina I will see for the libido.. doctor said me that with 1mg 1/2 days it will be better Have you an idea about oily hair after 2 days of shower ? Im sure that it’s speed my hair loss Link to comment Share on other sites More sharing options...
Valued Contributor Gatsby Posted January 5 Valued Contributor Share Posted January 5 2 hours ago, DavidFrancis said: Have you an idea about oily hair after 2 days of shower ? Im sure that it’s speed my hair loss I would use Nizoral 2% shampoo. GATSBY 'UNPLUGGED!' 15,671 (3 surgeries) Grafts FUE+BHT Dr. Sethi Eugenix Link to comment Share on other sites More sharing options...
Regular Member DavidFrancis Posted January 5 Author Regular Member Share Posted January 5 7 hours ago, Gatsby said: I would use Nizoral 2% shampoo. Ketoconazole it’s the same ? Link to comment Share on other sites More sharing options...
Valued Contributor Gatsby Posted January 5 Valued Contributor Share Posted January 5 1 hour ago, DavidFrancis said: Ketoconazole it’s the same ? Yes 1 GATSBY 'UNPLUGGED!' 15,671 (3 surgeries) Grafts FUE+BHT Dr. Sethi Eugenix Link to comment Share on other sites More sharing options...
Regular Member Eli_Avdikian Posted January 6 Regular Member Share Posted January 6 On 1/4/2024 at 11:13 PM, DavidFrancis said: Thanks for your help, But in all cases i need remove hairline, so i can use grafts for the middle now ? I cant dutasteride im very affraid of side effects, even finasteride i got little side effects. Doctor told me increase oral minoxidil to 5mg ( im on 2.5 mg), but i saw that there isn’t hudge difference. Maybe increasing the Oral Minoxidil dose to 5 mg/day can actually do the trick for you. Dutasteride doesn't necessarily have worse side effects than Finasteride, especially when administred in small doses. I advise you to watch the video that Melvin uploaded on the hair transplant network on the safety of low-dose Oral Dutasteride (it's from an interview with Dr.Sergio Vano). By the way, are there doctors in Paris willing do prescribe Oral Minoxidil for hair loss ? What's his:her name if I may ask Link to comment Share on other sites More sharing options...
Regular Member DavidFrancis Posted January 6 Author Regular Member Share Posted January 6 16 hours ago, Eli_Avdikian said: Maybe increasing the Oral Minoxidil dose to 5 mg/day can actually do the trick for you. Dutasteride doesn't necessarily have worse side effects than Finasteride, especially when administred in small doses. I advise you to watch the video that Melvin uploaded on the hair transplant network on the safety of low-dose Oral Dutasteride (it's from an interview with Dr.Sergio Vano). By the way, are there doctors in Paris willing do prescribe Oral Minoxidil for hair loss ? What's his:her name if I may ask Thanks for your help, Im very affraid of dutasteride it’s my limit, but i will se the video. About Oral minoxidil, Bisanga told me to increase to 5mg, but i have seen that it’s increase side effects for similarly results. 1 Link to comment Share on other sites More sharing options...
Valued Contributor Berba11 Posted January 6 Valued Contributor Share Posted January 6 Bonjour David! Sorry to see you're having issues post-op and hair loss is progressing. Oral finasteride + oral minoxidil may very well help you, but it's a long game. Sometimes you'll shed hair in the early stages but you have to stick with it. In terms of your repair... Who else have you consulted with? Dr Lupanzula is a fine choice (seeing as you mentioned him). Dr Feriduni has the most hairline extraction cases on this forum and they're all outstanding (long wait time for a consultation though - 2025). Link to comment Share on other sites More sharing options...
Regular Member DavidFrancis Posted January 6 Author Regular Member Share Posted January 6 Hello! Yes Lupanzula, but he doesnt' want remove grafts, just densify. About minoxidil and fin, it has no effects .. i shedding very very miniaturized hair. I suspect the dry of my scalp to be at origin. Link to comment Share on other sites More sharing options...
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