How important is it to go on finasteride for one year before a hair transplant?

[MyKindaMoves]

Are there any benefits to starting fin a year before your surgery compared to starting it on the day? If fin does help then would taking it at the same time as my surgery mean that the donor hairs that are transplanted grow thicker anyway over the next year? So in that case what's the point of waiting a year. On the other side of the coin if I don't react well to fin then I'm in the same position I am now anyway. Thoughts?

 

For some context I have a hair transplant surgery booked with Dr Path in about 16 hours. I went to BHT in Belgium last year to get a consultation with Dr Bisanga and he put me oral minoxidil for a year. I thought I noticed thicker hair on my donor areas on the sides and the back but one year later yesterday at Dr Paths clinic, after using the microscopic tool to check could see for myself as they told me some areas were okay for donor hairs but most weren't ideal. I know Dr Bisanga told me if I still didn't have good donor hair then he would put me on oral finasteride for another year and then reassess and I feel that's what I should do now. Rather than get my first hair transplant as 4000 graft surgery which includes 500 beard hairs, I should wait another to see how I react to oral fin first. It could increase the density in my donor hair. 

Sorry if I'm flooding this forum right now, as you can quite easily guess I'm feeling incredibly stressed about this and I know the real well informed opinions come from this forum. Time is of the essence to make a decision though. 

 

Edited June 25, 2023 by MyKindaMoves

[Bhumik Shah MD]

5 hours ago, MyKindaMoves said:

Are there any benefits to starting fin a year before your surgery compared to starting it on the day? If fin does help then would taking it at the same time as my surgery mean that the donor hairs that are transplanted grow thicker anyway over the next year? So in that case what's the point of waiting a year. On the other side of the coin if I don't react well to fin then I'm in the same position I am now anyway. Thoughts?

 

For some context I have a hair transplant surgery booked with Dr Path in about 16 hours. I went to BHT in Belgium last year to get a consultation with Dr Bisanga and he put me oral minoxidil for a year. I thought I noticed thicker hair on my donor areas on the sides and the back but one year later yesterday at Dr Paths clinic, after using the microscopic tool to check could see for myself as they told me some areas were okay for donor hairs but most weren't ideal. I know Dr Bisanga told me if I still didn't have good donor hair then he would put me on oral finasteride for another year and then reassess and I feel that's what I should do now. Rather than get my first hair transplant as 4000 graft surgery which includes 500 beard hairs, I should wait another to see how I react to oral fin first. It could increase the density in my donor hair. 

Sorry if I'm flooding this forum right now, as you can quite easily guess I'm feeling incredibly stressed about this and I know the real well informed opinions come from this forum. Time is of the essence to make a decision though. 

 

 

All these are things you should have considered months before your transplant not 16 hours before. If you are hesitant about the surgery, the best thing would be to pull out, step back and reevaluate. You may lose money doing this, so be prepared for that. 

 

 

[Turkhair]

The reason is finasteride will help thicken up your donor hair and make them more able to survive the traumatic experience of hair transplant. Healthy less damaged hair follicles can survive trauma better than miniaturised already under attack by DHT hair follicles already on the way out.

All hairs go through trauma, they’re being displaced from their cozy home to another part of body and have to get blood supply, connect to new blood vessels etc.

So being on finasteride will help you get a better result. 

[MyKindaMoves]

1 hour ago, Bhumik Shah MD said:

 

All these are things you should have considered months before your transplant not 16 hours before. If you are hesitant about the surgery, the best thing would be to pull out, step back and reevaluate. You may lose money doing this, so be prepared for that. 

 

 

I agree that I should've considered this more however after a year on oral minoxidil I thought my donor area had improved significantly and I would be ready for a HT. Looking through the microscope at Dr Path's clinic showed that I actually didn't have too many great areas.

 

24 minutes ago, Turkhair said:

The reason is finasteride will help thicken up your donor hair and make them more able to survive the traumatic experience of hair transplant. Healthy less damaged hair follicles can survive trauma better than miniaturised already under attack by DHT hair follicles already on the way out.

All hairs go through trauma, they’re being displaced from their cozy home to another part of body and have to get blood supply, connect to new blood vessels etc.

So being on finasteride will help you get a better result. 

Never considered that actually, interesting. 

[candvlc]

 

Starting finasteride before a hair transplant surgery can help stabilize or improve existing hair loss and prevent further hair loss. It may provide a better foundation for the transplant. However, finasteride doesn't directly affect the thickness of transplanted hair. Waiting for a year to assess your response to finasteride is a cautious approach, allowing you to evaluate side effects and potential improvements in hair density.

[TheGreatPretender]

I always feel like one year is the optimal waiting time before proceeding for any hair transplant surgery because it gives your body time to stabilise and regrow a little bit of lost ground. As the previous user said, it lays the foundations for a successful hair transplant. 

When I scheduled my surgery for the current year I was already 2 years on Finasteride and nearing 1 on topical Minoxidil. Now I am 3 on Finasteride and 2 on minoxidil which I have stopped it temporarily as requested by the clinic. 

I always had a very pragmatic approach to my situation because I wanted to be as sure as I could about my surgery. Of course there are always moments of doubt but I did my due diligence and chose the best path money and time could buy to make this right. 

Edited June 25, 2023 by TheGreatPretender

[YodaHead]

I understand that starting finesteride earlier is always beneficial; however, does it really matter (in terms of long term HT results) whether you start now and delay the HT vs. have the HT now and immediately start the fin? 

For e.g

- Person A starts fin in Jan-2023, have HT in Jan-2024, and remain on fin.

VS.

- Person B does the HT in Jan-2023, and then start fin immediately.

Now, if we are to evaluate both persons in Jan-2025, everything else being equal, do we expect that Person A will have better results? How about in Jan-2026? Long term?

[MyKindaMoves]

5 hours ago, YodaHead said:

I understand that starting finesteride earlier is always beneficial; however, does it really matter (in terms of long term HT results) whether you start now and delay the HT vs. have the HT now and immediately start the fin? 

For e.g

- Person A starts fin in Jan-2023, have HT in Jan-2024, and remain on fin.

VS.

- Person B does the HT in Jan-2023, and then start fin immediately.

Now, if we are to evaluate both persons in Jan-2025, everything else being equal, do we expect that Person A will have better results? How about in Jan-2026? Long term?

This is what I wondered too.

[Gatsby]

Medication should always be the first port of call when treating MPB. Finasteride can take up to two years to see peak benefits. That would put you in a better position to plan your surgery for the lifespan as MPB is progressive. If you are a good responder you potentially would need less grafts for surgery and could stabilize your hair loss.

[TheGreatPretender]

11 hours ago, YodaHead said:

I understand that starting finesteride earlier is always beneficial; however, does it really matter (in terms of long term HT results) whether you start now and delay the HT vs. have the HT now and immediately start the fin? 

For e.g

- Person A starts fin in Jan-2023, have HT in Jan-2024, and remain on fin.

VS.

- Person B does the HT in Jan-2023, and then start fin immediately.

Now, if we are to evaluate both persons in Jan-2025, everything else being equal, do we expect that Person A will have better results? How about in Jan-2026? Long term?

It may not matter in terms of regrowth (though I do believe that a variable percentage of hairs are likely to regrow) but it may stabilize enough to prevent shock loss post surgery. You got to understand that native hair within the scalp is more fragile then transplanted hair so detaching the DHT from those folicles and have them the relief they need for a good while becomes essencial for better results in my opinion. Both Finasterida and Minoxidil peak at the two years mark, after that you can go and schedule the surgery. 

So to answer your question person B may have a higher likelihood of suffering from shock loss then person A because person A has already been enough time in the drug to evaluate its benefits. 

It doesn't mean it will because as we know there are several factors that come into play for the success of the surgery and medication is just one of them. 

[ScottishGuy21]

It’s a life medication first of all, if you do choose to use it you need to 100% commit. Stopping a few years down the line means any stabilisation achieved will dwindle and you’ll be back to the point nature intended.

If you do intend to use it then jumping on a year prior to your hair transplant is good idea because 

a) You’ll be able to see if it does stop further recession

b) In a small % of cases people respond with new growth (although that’s mainly minoxidil)

c) You can be sure your body tolerates the meds

d) Dr’s can plan a hairline or procedure in the knowledge your situation is now stable. So they can make a better judgement of what’s appropriate long term for you.

Not every Dr will insist on its use. The ethical ones will factor in your age, family history, current hair loss and potential future hair loss before recommending. If for eg it’s quite aggressive and you are only touching 30 then it’s a much better idea to jump on it than say if you are 50+.

 

 

 

Edited June 26, 2023 by ScottishGuy21

[Rahal Hair Transplant]

@MyKindaMoves

To answer your initial question, there are benefits of using finasteride for a year prior to undergoing her transplant surgery for some patients.  Examples of patients that could benefit from this will include diffuse thinners and or anyone that has a good amount of natural hair left in an area that’s being transplanted into.

The reason this is beneficial is because it takes up to a year for finasteride to reach its capacity for efficacy. In other words, if finasteride is going to work for you, and you have an area of thinning hair that’s about to be transplanted into, giving finasteride a year before your transplant could be beneficial because some of those thinning or miniaturizing hairs may thicken up.  As a result, transplanting into this area, may minimize or even illuminate the potential for permanent shock loss which typically occurs to natural hairs that are miniaturizing when hair is transplanted in between or around it 

To sum up the above, taking finasteride a year prior to surgery, may minimize or illuminate, permanent shock loss, resulting in a gain of hair over those who started finasteride on the day of surgery or didn’t start at all.

I hope this makes sense and helps.

Rahal Hair Transplant
 

[Turkhair]

On 6/26/2023 at 12:31 AM, YodaHead said:

I understand that starting finesteride earlier is always beneficial; however, does it really matter (in terms of long term HT results) whether you start now and delay the HT vs. have the HT now and immediately start the fin? 

For e.g

- Person A starts fin in Jan-2023, have HT in Jan-2024, and remain on fin.

VS.

- Person B does the HT in Jan-2023, and then start fin immediately.

Now, if we are to evaluate both persons in Jan-2025, everything else being equal, do we expect that Person A will have better results? How about in Jan-2026? Long term?

The difference is

When doctor tries to extract person B hair grafts, he will see a lot of miniaturised weak dying grafts limiting his ability to extract and he might even avoid grafts that would’ve been good choice if stabilised with medication. The hair grafts he extracts will have less chance of survival.

 

When doctor tries to extract person A hair grafts, he will see nice juicy hair grafts that will have a better chance of survival and allow the doctor to pick and choose freely. 
 

When person A gets a hair transplant he will experience shed of transplanted hair that will want to resync hair cycle. 
 

When person B gets a hair transplant, his existing hairs will commit supaku due to starting finasteride to start a new hair cycle. His newly transplanted hairs will also shed to undergo resync hair cycle.

 

Person B is disadvantaged. Person A will have better results versus person B. Don’t be person B