So are the Big 3 still the big three 20 years on?

[ssimpson7511]

When I started the big 3 were considered to be - Topical Minoxidil, Finasteride, & Nizoral.  I don't often visit hair loss forums like I used to but as far as I can tell it's the same as it was all those years ago.

 

Yes there are still experimental stuff, and people taking variations of the same med's (i.e oral minox instead of topical etc...).  And adding things like micro needling.

 

Am I right in this assumption as far as detailed, scientific documented evidence the big 3 from back then are still the big 3?

[Berba11]

I'd say drop Nizoral and replace with Dutasteride, which itself is essentially just an alternative to Finasteride. So it's more of a Big Two now; Min + Fin/Dut.

[Eli_Avdikian]

As per Dr. Sergio Vano, the big three today are Oral Dutasteride, Oral Minoxidil, and Dutasteride injections

[Eli_Avdikian]

Maybe it's true that these are variations of the same hair loss drugs we had 20 years ago, but they are important variations, as Dutasteride is more effective than Finasteride, and Oral Minoxidil is more effective than topical Minoxidil

[Sunset Dune]

Nizoral/Keto doesn’t do anything 

[wembley]

how many times per week you wash your hair with nizoral and how much time do you keep it in your scalp every time before washing?

[Melvin- Admin]

4 hours ago, Eli_Avdikian said:

As per Dr. Sergio Vano, the big three today are Oral Dutasteride, Oral Minoxidil, and Dutasteride injections

^This

 

[SoSoz]

@Melvin- Admin are you still on oral minoxidil? If yes what dose?

[Reecee]

On 1/12/2024 at 7:59 PM, wembley said:

how many times per week you wash your hair with nizoral and how much time do you keep it in your scalp every time before washing?

I use it only about once every 10 days and leave it in for about 4 or 5 minutes

[wembley]

On 1/16/2024 at 3:51 AM, Reecee said:

I use it only about once every 10 days and leave it in for about 4 or 5 minutes

i think u should use it more often if you want ketoconazole 2% to work and leave it about 7 minutes in your scalp before wash.

[alopie]

On 1/17/2024 at 10:01 PM, wembley said:

i think u should use it more often if you want ketoconazole 2% to work and leave it about 7 minutes in your scalp before wash.

3x week, leave it for at least 8 minutes, make sure it reaches the roots. Don't expect miracles, though

[alopie]

The big three should now be oral dutasteride, oral minoxidil and microneedling or some kind of mesotherapy. We found out that LLLT, biotin, caffeine, PRP, can be somewhat effective but the result is minor.

[Sunset Dune]

59 minutes ago, alopie said:

3x week, leave it for at least 8 minutes, make sure it reaches the roots. Don't expect miracles, though

Even that is pretty useless 

[alopie]

9 hours ago, Sunset Dune said:

Even that is pretty useless 

According to the general consensus in literature, any DHT inhibition that is lower than 50% is unlikely to have an impact. However, combining treatments like finasteride with ketoconazole and caffeine, may take you from 60% to a 65% percent, depending on the type of DHT isotypes that each individual produces. If you want that 5%, then use ketoconazole and caffeine, but it won't change your overall condition. In that regard, I agree that it could be considered "pretty useless". 
Like making $50 per month from a side hustle is pretty useless compared to your salary. But compounding other side hustles on top of it could be less useless.
Top HT doctors incentivise the usage of ketoconazole and caffeine a couple of months post-op, 3x week. It's because they want to maximize their results, so they want that minor boost that comes with it, even if it's a 3% increase.