Sublingual Minoxidil and Oral Dutasteride | 10+ Months Results

[Viney]

Hey all,

I thought it was a good time to start a thread in the Hair Loss drugs section given I've been on medication for a while now and have a decent bank of photos and data to share. I'll probably provide more details and pictures in other posts below but here's the key stuff:

Medication and Timeline:

• 15 January 2022 - 16 March 2022 - 1mg Oral Finasteride daily.
• 17 March 2022 - 24 July 2022 - 0.5mg Oral Dutasteride daily, 0.9mg Sublingual Minoxidil daily
• 25 July 2022 - 7 February 2023 - 0.5mg Oral Dutasteride daily, 1.8mg Sublingual Minoxidil daily
• 8 February 2023 onwards - 0.5mg Oral Dutasteride daily, 2.7mg Sublingual Minoxidil daily

I was 29 when commencing the medication.

Comparative Pictures:

Here's some pictures taken from my clinic, these are taken with a professional camera with flash on and they try their best to make them as comparable as possible. The cheeky buggers made me pay extra for these photos (they post them to you in the mail via USB lol?) so I hope you enjoy....

The left is March 2022, while the right is January 2023.

 

 

I can post more of my own photos if you want from more angles, but they won't be in as controlled lighting or with a camera of this quality. You can also find more in my other topic which I'll link in the post below.

Side Effects:

In terms of side effects, I haven't noticed anything significant, any bad trends or lingering issues. I don't really think about side effects and try not to read much online, I just focus on ensuring I take my meds every single day and so far that's worked fine for me. Everything still works as it should.

I also don't recall ever experiencing or noticing a shed and I've taken my own pictures of my hair approx every 2-3 months.

Donor Density:

I've got comparative data from when I first saw my dermatologist in March 2022 (prior to any minoxidil or dutasteride) to now. This involves my dermatologist trimming my hair short in 3 donor areas and counting under a microscope the number of hairs per square cm. My dermatologist works at Sinclair Dermatology in Melbourne (under Rodney Sinclair) and has previous experience working at BHR Clinic with Dr Bisanga so I think he should be pretty good at doing this examination.

I wanted to check if I had stopped further hairloss in my donor, given back when I had mine examined in March 2022 mine was below the average of 70-75. Please keep in mind it's basically impossible for my dermatologist to find the exact same location he counted from previously, so given this, there is obviously variability in this hair density data depending on where he counts from, nonetheless he has tried his best to count the same location.

I honestly had no idea increasing donor hair count was even possible, but according to my dermatologist this is a common thing he sees in his patients and he believes it's due to Minoxidil. He says his clinic 'should probably' publish more of their data on this - I think they should - because I've tried to do some research myself but can't find much information. Back in March 2022 I was freaking out about having a poor donor for a hair transplant and now I'm apparently back around the average. Does anyone else out there have their own donor density data and experienced something similar?

The only other factor I've considered is potentially I could have been experiencing a Finasteride shed as I was approx 2 months into restarting it at the time I had my donor examined in March 2022, but is fin known to shed the donor area? I also don't recall experiencing a shed on restarting fin.

Next Steps:

After my last dermatologist apppointment we've increased my sublingual monixidil again, now to 2.7mg daily which I will start on Wednesday. He is hopeful that we can get even more hair gains to increase my mid scalp density. I asked him if there's anything possible he thinks I could add to my routine to improve the hairline but he said he's doesn't believe there's anything else out there proven to produce good results. Regardless I'm very happy with the improvement I've gotten already.

This time last year I was certain I wanted a hair transplant, now I'm still strongly considering it, but I'm no longer certain. I'm curious to see if I can get more gains (particularly around my mid scalp and hairline) out of this medication. Despite experiencing no noticeable side effects I'm still undecided if I want to commit to hairloss medication for the rest of my life and if I pull the trigger on a hair transplant I have to take medication forever.

The concerns I had around my crown balding or being visible are gone and while I still have a lot of thoughts about my poor hairline, I can live with that.. for now.

My dermatologist thinks that if I take the hair transplant route do not consider going beyond 2,000 grafts. He thinks 1500-1750 is adequate. This is a huge shift from the 2500-3200 grafts I was previously quoted prior to commencing medication from some of the recommended surgeons on this forum. I would obtain some updated quotes from these clinics to cross check if he's overly conservative but I don't want to waste their time.

In the next post I might add some extra detail and potentially more pictures, we'll see, but if you have any questions about my experience please feel welcome to ask.

 

 

Edited February 6, 2023 by Viney

[Viney]

Sublingual Minoxidil:

For those curious of what Sublingual Minoxidil is, it's simply a sugar tablet which dissolves below the tongue over a space of a few minutes. I'm not supposed to eat or drink anything for approx 30 minutes after taking it. I won't lie it tastes pretty good. I get the sublingual minoxidil made at a compound pharmacy. Here's a picture of it on the left next to Dutasteride (Avodart) on the right. Not sure if this is or will be available outside of Australia.

Here's a 10min presentation on it, if you can sit through it. I believe it's quite similar to oral minoxidil but it bypasses the liver which could result in even more efficacy (I also hope this might also be healthier for the liver): 

 

More info:

More of my experience, pictures and other stuff can be found in my other thread here for those curious.  I started this thread clueless back in December 2021:

 

Edited February 6, 2023 by Viney

[sunsurfhair]

Curious why sublingual vs just classic oral Minox? Does the doc explain why?

[Viney]

37 minutes ago, sunsurfhair said:

Curious why sublingual vs just classic oral Minox? Does the doc explain why?

During my first appointment with him I asked about it. I didn't indicate a preference for it, I was just genuinely curious about it. I didn't realise he would prescribe sublingual minoxidil until I looked at the script following my appointment. Anyway since it had been working for me I just stuck to it.

I believe sublingual allows you to administer lower doses and still see a good response given it's converted directly in the blood stream. I also think side effects are even less common than oral so I don't see why I shouldn't take it? Many doctors will say sublingual is actually a better method of delivery for medication, you can see this if you use the search function on this forum.

[sunsurfhair]

2 minutes ago, Viney said:

During my first appointment with him I asked about it. I didn't indicate a preference for it, I was just genuinely curious about it. I didn't realise he would prescribe sublingual minoxidil until I looked at the script following my appointment. Anyway since it had been working for me I just stuck to it.

I believe sublingual allows you to administer lower doses and still see a good response given it's converted directly in the blood stream. I also think side effects are even less common than oral so I don't see why I shouldn't take it? Many doctors will say sublingual is actually a better method of delivery for medication, you can see this if you use the search function on this forum.

Thanks. Sublingual is quite effective in terms of drug delivery - gets into your system faster, but curious if they use it for any other additional benefits vs. just classic oral. Glad it works for you. I’m a big fan of oral minox. 

[ThePerseverantWarrior]

Hey! 

Just curious for your 1 year results. How's it going?

[Viney]

6 hours ago, ThePerseverantWarrior said:

Hey! 

Just curious for your 1 year results. How's it going?

Hey, it's all going well. Still on 0.5mg Dut and 2.7mg Min.

I'll try post a proper update over the weekend with pictures.

I know you asked in another thread but I was age 29 when commencing dut&min and NW3-4.

Edited May 9, 2023 by Viney

[Gatsby]

Excellent example @Viney why medication should be the first resort for MPB. Looking forward to your update! 👌

[Melvin- Admin]

Excellent review, can I share this on YouTube? 

[Viney]

Here's some updated pictures @ThePerseverantWarrior. It's impossible to recreate the exact same photo, I have a new phone, the lighting although in the same place at a similar time of day is still different and I can't easily recreate the same angles but nonetheless here you go.

These are comparing December 2021 with May 2023.

Medical regime over this period:

• 15 January 2022 - 16 March 2022 - 1mg Oral Finasteride daily.
• 17 March 2022 - 24 July 2022 - 0.5mg Oral Dutasteride daily, 0.9mg Sublingual Minoxidil daily
• 25 July 2022 - 7 February 2023 - 0.5mg Oral Dutasteride daily, 1.8mg Sublingual Minoxidil daily
• 8 February 2023 onwards - 0.5mg Oral Dutasteride daily, 2.7mg Sublingual Minoxidil daily

 

 

 

Edited May 13, 2023 by Viney

[Viney]

On 5/13/2023 at 2:56 AM, Melvin- Moderator said:

Excellent review, can I share this on YouTube? 

Hey Melvin, I'm okay with some of this being shared as I really appreciate what you do and the information you provide. I might also be able to give you more info on certain things if you'd like.

If you're sharing the donor density data please make this part really clear in one way or another, as my Dermatologist made this very clear to me and I don't want to give false expectations or information to the community which might reflect bad on my dermatologist or his clinic.

Quote

Please keep in mind it's basically impossible for my dermatologist to find the exact same location he counted from previously, so given this, there is obviously variability in this hair density data depending on where he counts from, nonetheless he has tried his best to count the same location.

Some other reputable dermatologists and hair transplant surgeons will tell you it's literally impossible to increase donor density hair count through medication (as donor hair is not prone to MBP) so you could experience some kick back on this. Personally I think there needs to be more published research and data.

Edited May 13, 2023 by Viney

[Gatsby]

@Viney that is a night and day difference based solely on medication. Congratulations and well done on your persistence for staying the course. As someone who experiences side effects from Finasteride myself, I still think people are throwing the baby out with the bath water, if they at least don’t try Finasteride to prevent or halt MPB. 👍

[aNewHairHope]

Excellent gains - congrats! Oral min (2.5mg/day) has helped me alot - way more recovered hair than Fin. You have some more gains to come as well...

[ThePerseverantWarrior]

11 hours ago, Viney said:

Here's some updated pictures @ThePerseverantWarrior. It's impossible to recreate the exact same photo, I have a new phone, the lighting although in the same place at a similar time of day is still different and I can't easily recreate the same angles but nonetheless here you go.

These are comparing December 2021 with May 2023.

Medical regime over this period:

• 15 January 2022 - 16 March 2022 - 1mg Oral Finasteride daily.
• 17 March 2022 - 24 July 2022 - 0.5mg Oral Dutasteride daily, 0.9mg Sublingual Minoxidil daily
• 25 July 2022 - 7 February 2023 - 0.5mg Oral Dutasteride daily, 1.8mg Sublingual Minoxidil daily
• 8 February 2023 onwards - 0.5mg Oral Dutasteride daily, 2.7mg Sublingual Minoxidil daily

 

 

 

Excellent. Medication has brought your grade down from a NW 3-4 to a NW 2. Such cases deserve to be highlighted and appreciated more often. 

Do you plan on getting a hairline surgery in the future?

[ajsr8]

Really happy for you and the results you have gotten.

I was also prescribed 0.5mg dutasteride everyday but 0.45mg sublingual minoxidil at sinclair dermatology. 

I was just wondering, did things get significantly worse before they got better, or did you just improve as time went on? Also, would you have any idea which of the two meds was getting you the regrowth (between the dutasteride and the minoxidil)?

Thanks 

 

[Viney]

3 hours ago, ajsr8 said:

Really happy for you and the results you have gotten.

I was also prescribed 0.5mg dutasteride everyday but 0.45mg sublingual minoxidil at sinclair dermatology. 

I was just wondering, did things get significantly worse before they got better, or did you just improve as time went on? Also, would you have any idea which of the two meds was getting you the regrowth (between the dutasteride and the minoxidil)?

Thanks 

 

Hey thanks for the words.

How long have you been on minoxidil for? I imagine they are starting you on a low dose to monitor side effects and will slowly aim to build you up to something higher if you can tolerate it like they did with me.

In terms of things getting worse I think I was extremely lucky and didn't notice a shed. I have some progress pics in another thread here where you'll see it was fairly linear improvement over time: 

 

Personally I think the minox is what caused the visual improvement given I had used fin previously and didn't notice any changes. My dermatologist at Sinclair's clinic also said in his experience it's adding minoxidil which seems to cause the big visual improvements. I think it thickened a lot of my previously thinning hairs which has made me scalp look much thicker than before.

Edited June 1, 2023 by Viney

[Gatsby]

Your hair now looks crazy good @Viney. So glad you are sharing your results from what can happen when medication is used correctly under the guidance of an excellent dermatologist as the first port of call for MPB. You're awesome bloke!💪

[ajsr8]

16 hours ago, Viney said:

Hey thanks for the words.

How long have you been on minoxidil for? I imagine they are starting you on a low dose to monitor side effects and will slowly aim to build you up to something higher if you can tolerate it like they did with me.

In terms of things getting worse I think I was extremely lucky and didn't notice a shed. I have some progress pics in another thread here where you'll see it was fairly linear improvement over time: 

 

Personally I think the minox is what caused the visual improvement given I had used fin previously and didn't notice any changes. My dermatologist at Sinclair's clinic also said in his experience it's adding minoxidil which seems to cause the big visual improvements. I think it thickened a lot of my previously thinning hairs which has made me scalp look much thicker than before.

Only just started but unfortunately even in the past, the foam minoxidil gave me a bunch of side effects including fatigue, puffy face and dark circles. 

Currently experiencing a shortness of breath with this very low dose sublingual minoxidil. Wondering if you experienced the same when you first started using it? I'm probably going to have to drop the minoxidil which is extremely disappointing and just go on dutasteride. 

Edited June 2, 2023 by ajsr8

[Viney]

11 minutes ago, ajsr8 said:

Only just started but unfortunately even in the past, the foam minoxidil gave me a bunch of side effects including fatigue, puffy face and dark circles. 

Currently experiencing a shortness of breath with this very low dose sublingual minoxidil. Wondering if you experienced the same when you first started using it? I'm probably going to have to drop the minoxidil which is extremely disappointing and just go on dutasteride. 

Honestly from the start I wouldn't even know that I'm taking it. I got no sides.

It's a shame sublingual delivery doesn't seem to be able to prevent side effects in your case. Consider reaching out to your derm and most importantly look after your health.

 

Edited June 2, 2023 by Viney

[noobineub]

Hi Viney, impressive improvement just from medications. Can I clarify that you have stopped taking FInasteride? You are only on Minoxidil and Dutasteride? Am unfamiliar with Dutasteride, will have to look into it. I also have a question on how to get Sublingual Minoxidil. I was actually in Australia recently for a holiday and was trying to look for oral Minoxidil but couldn't find it at any of the pharmacies. Do you have to get a prescription to get it? If so does your clinic provide to people overseas?

[duckling]

fantastic results @Viney. 

On 5/13/2023 at 7:30 AM, Viney said:

• 15 January 2022 - 16 March 2022 - 1mg Oral Finasteride daily.
• 17 March 2022 - 24 July 2022 - 0.5mg Oral Dutasteride daily, 0.9mg Sublingual Minoxidil daily

any reason why you made this switch so fast ? you would have finished 1st cycle of finasteride shedding when you went on dutasteride. that would have started another shedding cycle for small amount of hair because of more potent DHT blocker. and it wasnt enough time to see finasteride gains 

[Viney]

43 minutes ago, noobineub said:

Hi Viney, impressive improvement just from medications. Can I clarify that you have stopped taking FInasteride? You are only on Minoxidil and Dutasteride? Am unfamiliar with Dutasteride, will have to look into it. I also have a question on how to get Sublingual Minoxidil. I was actually in Australia recently for a holiday and was trying to look for oral Minoxidil but couldn't find it at any of the pharmacies. Do you have to get a prescription to get it? If so does your clinic provide to people overseas?

Hey, yes I stopped fin and have only been on dut and min since March 2022.

Sublingual min is likely only available here in Australia and oral and or sublingual min is only available with a prescription. Sorry but I'm not sure if they would provide it overseas. I think it would be unlikely to get a perscription without first having an in person appointment. I'm considering moving overseas so I will ask about this in my next appointment in September.

Edited June 8, 2023 by Viney

[Gatsby]

Prof Rodney Sinclair has a patent on sublingual minoxidil. I don’t know how this affects overseas buyers. 

[Viney]

26 minutes ago, duckling said:

fantastic results @Viney. 

any reason why you made this switch so fast ? you would have finished 1st cycle of finasteride shedding when you went on dutasteride. that would have started another shedding cycle for small amount of hair because of more potent DHT blocker. and it wasnt enough time to see finasteride gains 

I mentioned earlier in this thread but it was actually a result of a miscommunication between my dermatologist and I.

He thought I had been on Fin for about 5 years and hadn't seen results but in fact I had been taking fin on and off for 5 years. He knew I was eager to try to save my hair so immediately put me on something stronger. We only realised this miscommunication as I was leaving my appointment after he had written my script.

In terms of cycles, I can't recall having a shed on fin or dut at any point, so I might have gotten out of it pretty lucky. Since my previous experience with fin didn't really yield any results I was happy to stick with dut given my side effects are minimal.

[duckling]

1 hour ago, Viney said:

I mentioned earlier in this thread but it was actually a result of a miscommunication between my dermatologist and I.

He thought I had been on Fin for about 5 years and hadn't seen results but in fact I had been taking fin on and off for 5 years. He knew I was eager to try to save my hair so immediately put me on something stronger. We only realised this miscommunication as I was leaving my appointment after he had written my script.

In terms of cycles, I can't recall having a shed on fin or dut at any point, so I might have gotten out of it pretty lucky. Since my previous experience with fin didn't really yield any results I was happy to stick with dut given my side effects are minimal.

well it all worked at the end for you quite well. normally i have seen dut given at 3 times a week when making the switch to fin but he gave a daily dose which is given little later. good that you didnt get any big sides and responded so well to the meds.