Been on fin for 5+ years, got a hair transplant 3 years ago (as I thought it was stabilized)

[HoldingOnForDearLife]

Hey. Recently found out about the community. 

My bad beforehand if I've made any post mistakes, it's my first one and it's a bit late.

As title indicates, I've done goofed. I'm 30, started noticing hairline receding at around 21, didn't want to go on fin then, hair kept falling. Went on fin + oral minoxidil close to my 25th birthday. After 2 years (as I thought hair loss had stabilized, and even reassured by my doctor that it did) I got a hair transplant.

Non transplanted hair kept falling after that. I can't really see any bald spots above my transplanted hairline, but I can tell there's a lack of density past the hairline, so I assume finasteride isn't doing it's thing.

Feeling kind of lost over this whole process, as I was hoping finasteride would halt the progress of hair loss or at least noticeably slow it down. Was wondering if anyone has gone through the same? Not sure if I should keep taking it or not.

I'll probably need to do another transplant sooner than later, as I'm not happy with what I've currently got.

 

 

 

[BackFromTheBrink]

Many people find dutasteride does a better job than fin. Have you considered introducing that to try to slow down your loss?

You're relatively young so may want to explore that before considering using more donor.

[Al - Moderator]

Hi. Welcome to the forums. The same kind of thing happened to me when I was taking finasteride. It worked for the first few years, but then eventually I started losing hair again even though I was still on finasteride. I think for some people who have aggressive hair loss the meds may only hold off the progression of loss for a few years. You could try adding minoxidil or dutasteride. Those may be able to get you a few more years of stabilization or even some improvement.

 

 

[HoldingOnForDearLife]

6 hours ago, BackFromTheBrink said:

Many people find dutasteride does a better job than fin. Have you considered introducing that to try to slow down your loss?

You're relatively young so may want to explore that before considering using more donor.

I have a scheduled appointment with my trichologist in a couple of months, I assume this is what he is going to recommend. I'm unsure if it's been approved in my country, I think a few years back it wasn't.

By the way, our forum usernames make us seem way too philosophical. 

2 hours ago, Al - Moderator said:

Hi. Welcome to the forums. The same kind of thing happened to me when I was taking finasteride. It worked for the first few years, but then eventually I started losing hair again even though I was still on finasteride. I think for some people who have aggressive hair loss the meds may only hold off the progression of loss for a few years. You could try adding minoxidil or dutasteride. Those may be able to get you a few more years of stabilization or even some improvement.

 

 

The worst part I think is not knowing if finasteride is actually doing its thing or not. It doesn't seem like it... But would hate to switch to a "stronger" drug to achieve the same effect. But would also hate to keep taking fin so my hair falls 10% slower. I don't know. Was just hoping for a bit for stability. Remember getting my HT, looking at it at thinking that I was happy with it and as long as I keep taking the meds I should be good. That was a short lived sentiment.

Thanks for the help mates.

Edited May 26 by HoldingOnForDearLife

[Dragonsphere]

14 minutes ago, HoldingOnForDearLife said:

The worst part I think is not knowing if finasteride is actually doing its thing or not. It doesn't seem like it... But would hate to switch to a "stronger" drug to achieve the same effect. But would also hate to keep taking fin so my hair falls 10% slower. I don't know. Was just hoping for a bit for stability. Remember getting my HT, looking at it at thinking that I was happy with it and as long as I keep taking the meds I should be good. That was a short lived sentiment.

I would first recommend that you upgrade to Dutasteride. Simply put, it is a superior drug and from a statistical standpoint, if you a loosing hair on finasteride you will likely stabilise on Dutasteride.  The side effect rate on both these drugs, contrary to popular belief, are the same. Some people are just more sensitive to DHT inhibition so if they have side effects on one, they will likely on the other. 

. 

 

As far as I can tell, you are not not on minoxidil, and  I can't emphasise enough how important this drug is to any hair loss regime. There has always been this myth populated on various hair loss forms that minoxidil is merely a growth stimulant and once that growth is achieved, people will continue to bald at their genetic rate. 

As well as its vasodilation capabilities, minoxidil works in other ways. 

To name a few, without going into great detail. 

1. Anti inflammatory

2. Prostaglandin Synthesis 

3. WNT pathway signalling 

 

The below graph is the minoxidil hair count over a period of 5 years. Yes there is a gradual decline but it is far slower than if they were on nothing at all. 

It is also worth noting that the 5 year finasteride study showed a gradual decrease in hair count but the 10 Year Rossi study showed 85%+ were above baseline after 10 years. 

My speculation, as well as others, is that after the initial spurt of growth from responders, the average is hair count is slowly decreasing due to non responders. 

No study has been done, but if I had to guess if you had 100 people who were loosing hair on finasteride and you changed their regime to DUT + 5mg oral minoxidil, 95% of them would stabilise.  

 

[HoldingOnForDearLife]

12 minutes ago, Dragonsphere said:

I would first recommend that you upgrade to Dutasteride. Simply put, it is a superior drug and from a statistical standpoint, if you a loosing hair on finasteride you will likely stabilise on Dutasteride.  The side effect rate on both these drugs, contrary to popular belief, are the same. Some people are just more sensitive to DHT inhibition so if they have side effects on one, they will likely on the other. 

. 

 

As far as I can tell, you are not not on minoxidil, and  I can't emphasise enough how important this drug is to any hair loss regime. There has always been this myth populated on various hair loss forms that minoxidil is merely a growth stimulant and once that growth is achieved, people will continue to bald at their genetic rate. 

As well as its vasodilation capabilities, minoxidil works in other ways. 

To name a few, without going into great detail. 

1. Anti inflammatory

2. Prostaglandin Synthesis 

3. WNT pathway signalling 

 

The below graph is the minoxidil hair count over a period of 5 years. Yes there is a gradual decline but it is far slower than if they were on nothing at all. 

It is also worth noting that the 5 year finasteride study showed a gradual decrease in hair count but the 10 Year Rossi study showed 85%+ were above baseline after 10 years. 

My speculation, as well as others, is that after the initial spurt of growth from responders, the average is hair count is slowly decreasing due to non responders. 

No study has been done, but if I had to guess if you had 100 people who were loosing hair on finasteride and you changed their regime to DUT + 5mg oral minoxidil, 95% of them would stabilise.  

 

Thank you for the explanation regarding the side effects of fin X dut.

Regarding minoxidil, I did mention I am on oral minoxidil. Didn't mention the amount, its 4mg daily. I don't know if you mean topical or not. The reason I'm not questioning the minoxidil in my regime it's because I actually trust it's doing something. With fin is a bit different.

[Dragonsphere]

11 minutes ago, HoldingOnForDearLife said:

Thank you for the explanation regarding the side effects of fin X dut.

Regarding minoxidil, I did mention I am on oral minoxidil. Didn't mention the amount, its 4mg daily. I don't know if you mean topical or not. The reason I'm not questioning the minoxidil in my regime it's because I actually trust it's doing something. With fin is a bit different.

Apologies, I missed that part out of your OP post. 

Is your scalp health OK? Do you not suffer from inflammation and/or Seb dem? 

Inflammation of the scalp can increase the amount of androgens, androgen receptors and their sensitivity. 

If not, then I would recommend DUT + Oral Min only. 

 

[HoldingOnForDearLife]

16 minutes ago, Dragonsphere said:

Apologies, I missed that part out of your OP post. 

Is your scalp health OK? Do you not suffer from inflammation and/or Seb dem? 

Inflammation of the scalp can increase the amount of androgens, androgen receptors and their sensitivity. 

If not, then I would recommend DUT + Oral Min only. 

 

No problems. 

It seems to be OK indeed. I don't cut my hair short often, so it's a bit harder to say so precisely, but I have a trich appointment every year for the 10th of July, pre-scheduled. The doctor analyzes my hair and scalp and mentioned nothing ever, so I assume I'm good. I have no itchiness (besides the normal amount, specially while still shedding) or inflammation.

EDIT: changed "shave" to "cut my hair short". English not main language.

 

Edited May 26 by HoldingOnForDearLife

[duchaine]

after many years on fina (20+ with some breaks) I switched to Duta.
It was a game changer.

[FinallyHT]

20 hours ago, duchaine said:

after many years on fina (20+ with some breaks) I switched to Duta.
It was a game changer.

Do you take Dut, every day? I've been on fin for 17 years and was thinking about doing dut once a week.