Is Propecia necessary after HT?

[gtz101]

After you have done HT, is it necessary to take Propecia continously?

 

I don't intend to use Propecia after HT but am wondering what effects this would have on HT. I have been using 1mg tab a day for about 1 year. Long term wise staying on pills is just not good for the body.

[hdude46]

yes it is necessary, you will continue to lose hair once u get off it. why in the heck even get a ht in the first place if u dont plant to continue on propecia? u will look like a freak eventually.

[phil mascallpen]

Like all questions that apply to thousands of different people it depends.

 

A general rule of thumb might be that older patients with smaller loss could probably avoid it and younger patients with more aggresseve loss probably will need to take it.

[EpilepticSceptic]

I've been on and off fin for over 10 years now. I can't even really say for sure if it has worked for me or not, but I'm not willing to risk stopping it. Almost all of my hairloss occured rapidly from age 20-25, and then it just mysteriously halted. I was a NW3 at age 25 and the loss has been extremely slow since then.

 

By age 30 I was a NW3v when I noticed that a small spot in the crown was thinning some. So I started taking fin at that time. I never noticed any significant improvements (especially to the front), but I have photos of my head at age 30 and I would say that almost nothing has changed since then. And that's taking 1mg of fin 3 days per week.

 

I even found a photo yesterday after a pretty bad shed when I first started using 12.5% minox along with propecia, and suprisingly the loss looks even worse than it does now! So I would assume that keeping on the fin (even at lower than recommended doses) has definitely held back the MPB to some extent. But the older I get the more confident I get that nature did not intend for me to be an advanced Norwood, even without fin. I'm 41 now, and it seems the HT route might really be a realistic possibility for me.

 

Besides, there is a history of prostate cancer in my family. So taking the fin is for more than just retaining hair at this point.

[Sac]

Thanks to the experienced guys for this answer. I have a similar question - Is it important to get on Propecia or any other medicine 3-4 months BEFORE surgey?

 

I havent taken any any hair loss medicine so far and considering HT in 5-6 months. Do you think one should get on to Propecia before surgery? I read this somewhere on this forum.

[gtz101]

Originally posted by hdude46:

yes it is necessary, you will continue to lose hair once u get off it. why in the heck even get a ht in the first place if u dont plant to continue on propecia? u will look like a freak eventually.

 

I thought the purpose of having HT is that the hair is genetically not prone to hair loss since the hair is taken from the back donor area???

 

Obviously in areas where HT has not taken place say for example the crown area, coming off propecia would probably result in gradual hair loss but I fail to understand if you have had HT done all around why would it be essential to have Propecia???? Isn't the hair genetically not prone to hair loss? I thought HT lasts a lifetime.

[gtz101]

Extract taken from Hassan and Wong's website..............

 

"Will hair transplants ever fall out?

 

No. The transplanted hair is harvested from the permanent donor zone. This hair is resistant to the effects of DHT. No matter where the hair is moved to it will maintain its resistance to DHT and survive indefinitely."

[EpilepticSceptic]

Dude, take a GOOD LOOK at that measly patch/fringe of hair that remains on the average Norwood 6 patient's head. This is someone who eventually goes COMPLETELY BALD !!!

 

Now consider that, under ideal circumstances, only 1/2 of that hair can be taken from that area.

 

So how in the world is that little amount of hair going to cover the balding area of a Norwood 6 ?

 

ANSWER: IT WON'T !!! The best that can be done (in most cases) is a thin, wispy, combover type look. There's just too much area to cover and too little hair for the average Norwood 6 patient.

 

Now ask yourself, would you be happy with a COMBOVER LOOK and no chance to shave down anymore because of a huge scar on the back of your head ?

 

So, by NOT taking the meds, if you have a HT now and you head to Norwood 6 territory later then you might find yourself in a situation where your HT starts looking REALLY WEIRD -- and you won't have enough donor hair to fix it because it was all used up making your hairline look full and dense, when it really should have been used conservatively to give you an old geezer's COMBOVER to begin with !!!

 

Now are you seeing the light on WHY meds are CRUCIAL ???

[gtz101]

but wouldn't the HT surgeon advise you on what NS you are on (or heading towards) and how many grafts you are likely to need to cover all the relevant areas??? Isn't that the whole purpose of a consultation with a HT surgeon???

 

Even with propecia, if you did HT say on frontal area it won't stop the crown from losing hair if you are heading towards NS 6 or 7 further down the line.

[gtz101]

So how in the world is that little amount of hair going to cover the balding area of a Norwood 6

 

I am sure I have seen several pics on this site with people on NS 6 and 7 with HT cover all the relevant areas. Although not as dense as someone on 3 or 4 NS but have managed to cover some areas more lightly as opposed to more densely packed.

[dakota3]

Propecia loses its effectiveness after 10-15 years so whether you take it or not if you have a NW6-7 balding pattern or are heading in that direction you will eventually lose all the non-transplanted hair anyways. All propecia does is slow down the process. If you are destined to be a NW6-7 you better well make sure you have atleast 10,000 grafts available in your donar before having a procedure done, or you better have a really good doctor who can use your donar to the best of its ability so it looks like a natural balding pattern and age appropriate when your older.

[Megatron]

Originally posted by dakota3:

Propecia loses its effectiveness after 10-15 years so whether you take it or not if you have a NW6-7 balding pattern or are heading in that direction you will eventually lose all the non-transplanted hair anyways. All propecia does is slow down the process. If you are destined to be a NW6-7 you better well make sure you have atleast 10,000 grafts available in your donar before having a procedure done, or you better have a really good doctor who can use your donar to the best of its ability so it looks like a natural balding pattern and age appropriate when your older.

 

wait up...where are you getting these facts from???

 

to answer the original Q - the sad fact that labrat is trying to express is that a HT usually does not look good on NW 6 and beyond. It's simply a supple - demand issue.

 

My advice would be stay on the meds or don't have the HT and accept going bald. One or the other.

[dakota3]

wait up...where are you getting these facts from???

 

Its common knowledge! Ask any of the docs here. Propecia only slows the process.

[aaron1234]

dakota3 could be right about finasteride losing its effectiveness after a decade or so. However, I do remember Dr. Rassman saying that he has never seen a man go completely bald while on propecia. Of course, he hasn't seen a patient go from his 20's to his 60's either.

[gtz101]

Originally posted by Megatron:

Originally posted by dakota3:

 

to answer the original Q - the sad fact that labrat is trying to express is that a HT usually does not look good on NW 6 and beyond. It's simply a supple - demand issue.

 

My advice would be stay on the meds or don't have the HT and accept going bald. One or the other.

 

This still makes no sense. Have you seen some pics of people on NW 6 or 7 with HT on this site?

[dakota3]

dakota3 could be right about finasteride losing its effectiveness after a decade or so. However, I do remember Dr. Rassman saying that he has never seen a man go completely bald while on propecia. Of course, he hasn't seen a patient go from his 20's to his 60's either.

 

Also propecia hasnt been around for all that long.

[aaron1234]

Also propecia hasnt been around for all that long.

 

Exactly.

[Time to do something]

I believe it has been around for close to 20 years first as a medication for the prostate.

[Megatron]

gtz - yes. take a look at NW6 and beyond patients that have had HTs. they've all needed multiple HTs to achieve decent density and still I don't think it's quite the result most people would seek. that's just my opinion though.

 

another way to look at it is, your natural hairs are precious and you should do everything you can to save them (short from harming your health of course)!

 

re: propecia not working after 10/15 years....I can understand people saying it may becomes less effective, but to say it doesn't work anymore I think is unfounded.

[Cam Simmons MD ABHRS]

There is a mixture of good and bad information in this thread.

 

Transplanted hair does not need medical treatment but existing hair can benefit from it.

 

You can preserve existing hair for a long time with medical treatment. Few men get side effects and, contrary to what some people have posted in other threads and websites, in the studies and in my experience those side effects have always been reversible. We only have study data for 5 years of Finasteride use. I have patients in my practice who have been taking Finasteride for 15 years (since before they met me) and they feel they have not lost hair. I have other patients who have lost hair slowly while taking Propecia.

 

A Norwood 6 patient can usually cover their whole head reasonably well with 7000 to 7500 grafts, with denser hair in front and lighter coverage in the crown. I can only post photos of my hair transplant patients from this office (since 2006) so for now, I can link to a Norwood 5 patient who was on his way toward a Norwood 6 pattern. http://hair-restoration-info.c...?r=78710849#78710849. He could have returned to cover his crown in one more visit and had lots of donor hair to spare but he felt he looked fine after 2 visits and 5220 grafts and he didn't mind having thinner coverage of his crown, in his 50s.

 

Currently, someone who will go on to develop a Norwood 7 pattern will not be able to cover the whole balding area well with scalp hair. Someone with potentially aggressive hair loss should be encouraged to take medications but they should not count on taking them forever or for those medications to work forever. If they choose to have hair transplantation, it is safer for them to start higher, use lower densities, always leave some donor hair "in the bank" and to accept that they will be left with a bald or balding crown.

 

If we plan ahead, patients may need to have more hair transplantation later but nobody should ever look like a "freak."

[Megatron]

dr. simmons - while I think you did a great job on that patient and I agree that it's a huge improvement, I'd still rather choose to go bald than have that hair. again, just my opinion.

[Cam Simmons MD ABHRS]

Originally posted by Megatron:

dr. simmons - while I think you did a great job on that patient and I agree that it's a huge improvement, I'd still rather choose to go bald than have that hair. again, just my opinion.

 

Megatron

 

It is great to have a choice and I respect yours. Some of my own family members don't mind going bald but my patient is thrilled to have hair again. Despite having lots more donor hair available, he is satisfied as he is.

 

For other people to post that Norwood 6 patients require multiple sessions to only get a whispy comb-over look is obviously patently false.