Finasteride Side Effects - Am I eligible for a hair transplant in the future?

[James K.]

Hi All, 

I was diagnosed with MPB in March of 2023, and was on 1mg daily for 8 months before experiencing sexual side effects in October 2023 (Low Libido, ED). 

Since then, I have tried lowering my Finasteride dosage and trialing with Topical Finasteride, but sides did not improve. 

I am currently on a Finasteride break and considering re-starting with a low dosage once side effects are gone. Its currently been 1 month since my last Finasteride usage and ED has slightly improved but libido is still low. I would say I am maybe 30-40% recovered, still a long way to go. 

I have included photos of my currently hair loss for reference. I will be 27 years old in December. As for family history, my maternal grandfather did not have much hairloss, maybe a NW 1.5 at the time of his passing. My hair loss genetics are stronger on my Dad's side, as my Paternal Grandfather had much more hair loss. I included photos of my material and paternal grandfather for reference. 

Given my current situation, I was wondering if I would still be able to get a hair transplant in the future if needed? Thank you and any advice would be greatly appreciated. 

[Berba11]

Your ability to get HT’s in the future depends entirely on your donor resources (which are currently excellent). 
 

From these photos there’s no evidence of hair loss at all - certainly nothing that warrants medications that you can’t tolerate.  
 

Your family history seems mostly favourable also. 

[Shadman]

3 hours ago, James K. said:

was diagnosed with MPB in March of 2023

Who did that diagnosis ? 

[TorontoMan]

I would not rely on hair transplants. You have great hair now, I would do what I can to maintain it. I'm not sure how long you were on fin, but in my personal experience some side effects tend to improve further down the line. As well, I've personally noticed over the years on these forumns, that most guys are afraid of medication, state that they won't take it, and then return in desperation when they reach a point of more hair loss and then get back on and do other things in desperation too. So if hair matters to you while you're young, medication is a part of the equation whether anyone likes it or not. It will control for the outcome of a hair transplant as well, but you want to avoid getting to that point anyway, because hair transplants are not great all the time, they are half of natural density and are complicated get done given the expertise involved, time, money, stress etc. I don't wish to deny that you're experiencing sides, but in my own experienace as well, a lot of my sides were due to anxiety in the anticipation of sides, the idea of sides was always on my mind and for that reason id percieve everything and anything as a side effect. 

Anyway, if you care for your hair, and its great now, I think you need to put the hair transplant stuff in the back of your mind and reconsider medical strategies. 

[James K.]

3 hours ago, TorontoMan said:

I would not rely on hair transplants. You have great hair now, I would do what I can to maintain it. I'm not sure how long you were on fin, but in my personal experience some side effects tend to improve further down the line. As well, I've personally noticed over the years on these forumns, that most guys are afraid of medication, state that they won't take it, and then return in desperation when they reach a point of more hair loss and then get back on and do other things in desperation too. So if hair matters to you while you're young, medication is a part of the equation whether anyone likes it or not. It will control for the outcome of a hair transplant as well, but you want to avoid getting to that point anyway, because hair transplants are not great all the time, they are half of natural density and are complicated get done given the expertise involved, time, money, stress etc. I don't wish to deny that you're experiencing sides, but in my own experienace as well, a lot of my sides were due to anxiety in the anticipation of sides, the idea of sides was always on my mind and for that reason id percieve everything and anything as a side effect. 

Anyway, if you care for your hair, and its great now, I think you need to put the hair transplant stuff in the back of your mind and reconsider medical strategies. 

@TorontoMan Thank you for the feedback. Fully agreed that medical therapy is first priority, I am trying to exhaust all options to be able to tolerate Finasteride. Since I started experiencing sexual side effects, I have tried dose titration (going down to 0.25mg 3x per week) and Topical Finasteride, but side effects remained the same. Do you have any advice on any other way I could try Finasteride to see if I can tolerate it? 

[James K.]

14 hours ago, Shadman said:

Who did that diagnosis ? 

My dermatologist made the diagnosis. 

[Gatsby]

@James K. I’m not a doctor but from the photos, for 27 especially, you have a great full head of hair in my opinion. You could always consider oral minoxidil but I honestly don’t think your great head of hair warrants it. All the best! 

[YodaHead]

Where is MPB? Change your doc. You are fine. That is super full head of hair. Even if there is any sign of MPB…you are not at a stage where you need to mess with any meds. 

[Berba11]

12 hours ago, James K. said:

My dermatologist made the diagnosis. 

Can you elaborate on what they said? All we can see is an excellent head of hair with no signs of hair loss at all. 

[James K.]

3 hours ago, Berba11 said:

Can you elaborate on what they said? All we can see is an excellent head of hair with no signs of hair loss at all. 

The dermatologist said I had temple recession. I had also been noticing a lack of density overall (harder to style hair the same way) and was diagnosed with diffuse thinning also. 

This photo is a comparison before finasteride vs. 8 months on 1mg daily (before I got hit with the sexual side effects). 

This photo can perhaps show the temple recession more clearly. 

Once my side effects are fully recovered, will give it one more shot with 0.025% Topical Finasteride. Really hoping I will be able to tolerate it. Thanks. 

 

 

[Berba11]

30 minutes ago, James K. said:

The dermatologist said I had temple recession. I had also been noticing a lack of density overall (harder to style hair the same way) and was diagnosed with diffuse thinning also. 

This photo is a comparison before finasteride vs. 8 months on 1mg daily (before I got hit with the sexual side effects). 

This photo can perhaps show the temple recession more clearly. 

Once my side effects are fully recovered, will give it one more shot with 0.025% Topical Finasteride. Really hoping I will be able to tolerate it. Thanks. 

 

 

This amount of temple recession is so miniscule as to be virtually nothing. It looks more like the hairline maturing ever so slightly and shedding the baby/juvenile hairs, which is normal for everyone regardless of whether their hair loss progresses further. I don't really see that you have anything to worry about and personally wouldn't bother with medication if I were in the same boat as you, but it was causing me issues and side effects then it would be a total no-go.

Bear in mind that jumping on and off medications is likely to induce some temporary shedding as well.

[Al - Moderator]

As some others have said, you have minimal, if any, hair loss. You are not going to keep the same hairline you had at 15 no matter how much you try. You have great hair for 27. 

[FUEtile]

HTs without fin aren’t advisable