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  1. #1
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    Default Dutasteride for regrowth and maintain on fin

    Hello, I am in the early onset of balding with some thinning at the crown and a slightly receded hairline. I am 7 months in on finasteride 1, 25 mg every day and I am using nizoral shampoo 3 days per week. So far, I have not seen that much of a difference and since my hair loss was slow to begin with it is hard to judge its effectiveness.
    I have decided that I will go all in to stop my balding and maintain as long as I can. I hope that some of the new solutions like Replicel will come to fruition in the near future and help us all. I can not use minox since I have mild scalp psoriasis and don’t wont to aggravate that. As everyone here I want to maximize my gains and particularly in the crown. For the hairline, I may go for a transplant in the future.
    Since I cannot use minox and have to resort to fin/niz I was wondering if I could use Dutasteride to boost regrowth, then stop DUT, and retain whatever gains I get on Fin alone?
    I don’t like the long term idea of using DUT for decades, but if Fin should not/stop working for me I am willing to make the switch permanently also. Since I am only 7 months into Fin would it be smarter to wait until I have used it for two years to assess the final results?

  2. #2
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    Hey bro. I'm in the same situation: fin for 9 months but unsatisfactory results. It's tempting to jump to dutasteride, but like you said I would wait out the two years first and reassess your situation. I'm going to give it fifteen more months (baaaah) and HOPEFULLY will get some progress by then!

    You started way earlier than me so you're in good shape with fin. It's good for maintenance at least. Got pics?

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  4. #4
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    Quote Originally Posted by George7 View Post
    Hello, I am in the early onset of balding with some thinning at the crown and a slightly receded hairline. I am 7 months in on finasteride 1, 25 mg every day and I am using nizoral shampoo 3 days per week. So far, I have not seen that much of a difference and since my hair loss was slow to begin with it is hard to judge its effectiveness.
    I have decided that I will go all in to stop my balding and maintain as long as I can. I hope that some of the new solutions like Replicel will come to fruition in the near future and help us all. I can not use minox since I have mild scalp psoriasis and don’t wont to aggravate that. As everyone here I want to maximize my gains and particularly in the crown. For the hairline, I may go for a transplant in the future.
    Since I cannot use minox and have to resort to fin/niz I was wondering if I could use Dutasteride to boost regrowth, then stop DUT, and retain whatever gains I get on Fin alone?
    I don’t like the long term idea of using DUT for decades, but if Fin should not/stop working for me I am willing to make the switch permanently also. Since I am only 7 months into Fin would it be smarter to wait until I have used it for two years to assess the final results?
    I don't think this is a good idea. Dutasteride is MUCH stronger than finasteride and in my opinion, if you see any gains from dutasteride there is zero reason to believe that you could switch back to finasteride and "maintain". It doesn't work like that. What I would consider is upping your dose. I've seen strong evidence to support the idea that results from finasteride are dose dependent. Just stay within reason, clear it with your doctor, and slowly move up. You have to increase your dosage once every six months to know if it is helping or not.
    Joe Tillman
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  5. #5
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    Quote Originally Posted by JoeTillman View Post
    I don't think this is a good idea. Dutasteride is MUCH stronger than finasteride and in my opinion, if you see any gains from dutasteride there is zero reason to believe that you could switch back to finasteride and "maintain". It doesn't work like that. What I would consider is upping your dose. I've seen strong evidence to support the idea that results from finasteride are dose dependent. Just stay within reason, clear it with your doctor, and slowly move up. You have to increase your dosage once every six months to know if it is helping or not.
    I can understand that one cannot maintain minox grown hair with anti-androgens since it works totaly different. However does it make sence that one can lower DHT levels with Dutasteride and get fully healthy terminal hairs and then not be able to maintain those hairs with finasteride when finasteride can help maintain other terminal hairs? Also regarding my photos. Would you say it would be ok to fix my crown at age 30-31? It bothers me and I would line to put some grafts there and make it less prounounced and also get a more straight symmetrical hairline. I have had the uneven hairline for 5 years and only been on fin for 10 months. My maternal grandfather had a hairline like that until he died and diffusly thinned on top only at late age just before he passes away. My father was a norwood 5-6 at mye age. Apart from that my fathers brother is a norwood 1 in HIS late 60s and mye two uncles on my mother side are norwood 2s in their 50s and 60s respectively. My mother has a bad/large/double crown just like me.

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    Moderator JoeTillman's Avatar
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    Dutasteride is much stronger than finasteride so I'm certain that gains made on dutasteride would disappear later on if you switched to finasteride. However, before you do anything I recommend you stick with finasteride since you've only been using it for 7 months. The efficacy can improve for up to 24 months so if you aren't seeing much now it doesn't mean you won't see anything in 7 to 10 more months. Give it time.

    Surgery is the last thing you should think about at this time. If your loss gets worse and meds don't work out then you'll be on a conveyor belt of surgeries as your loss continues. With the degree of loss you have now I think that Dermatch or another concealer would be ideal and would give you a result far better than any transplant could. You could also consider temporary SMP (tricopigmentation) if there is a reputable clinic near to you. Avoid permanent SMP like the plague.
    Joe Tillman
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  7. #7
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    Quote Originally Posted by JoeTillman View Post
    Dutasteride is much stronger than finasteride so I'm certain that gains made on dutasteride would disappear later on if you switched to finasteride. However, before you do anything I recommend you stick with finasteride since you've only been using it for 7 months. The efficacy can improve for up to 24 months so if you aren't seeing much now it doesn't mean you won't see anything in 7 to 10 more months. Give it time.

    Surgery is the last thing you should think about at this time. If your loss gets worse and meds don't work out then you'll be on a conveyor belt of surgeries as your loss continues. With the degree of loss you have now I think that Dermatch or another concealer would be ideal and would give you a result far better than any transplant could. You could also consider temporary SMP (tricopigmentation) if there is a reputable clinic near to you. Avoid permanent SMP like the plague.
    Thanks for the reply. I think I am reponding to the medication. My hair feels a bit thicker than before I started, but I have always had a large double crown even as a kid. The photo of me as a kid is taken from a distance with an over 20 year old camera. I want to fix the hairline when/if i know I have stabilzied. How long should I be on fin to be sure? I have planned two or three years before doing anything. I also read that you need to stop your hairloss before having a transplant, but what if the medication stop working after 5-6 years? I have read the studies and the vast majority of men that have positive results in the first two years will also have it after 10 years, but what about after 15-20 years? If one was to be 100% sure one should basically not have a transplant before being sure medication works and be above the age of 50-60. I would guess most patients do not fullfill these requirements. Sorry for all the questions, but you seem like an expert and I try to find out my long term options. I was rather unlucky since I have two brothers and both ended up being above 180 cm while I am bellow 170 cm. Living in Scandinavia being short is difficult enough, but I am doing quite well regardless. I just dont want to be put in the box short and bald since I am sure it would negatively influence my life both when it comes to women, but also career wise. I am willing to use Dutasteride since I know that losing my hair would be almost like a death sentence regarding women anyway so I dont have a lot to loose. If I do get sides I can always quit. However since my crown has always been strange and getting regrowth at the hairline is rare I will need a transplant one day regardless. How long should I wait? I will order some dermatech and try it out, but that will not solve the hairline issue that it is uneven and been like that for 5+ years.

  8. #8
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    Quote Originally Posted by JoeTillman View Post
    I don't think this is a good idea. Dutasteride is MUCH stronger than finasteride and in my opinion, if you see any gains from dutasteride there is zero reason to believe that you could switch back to finasteride and "maintain". It doesn't work like that. What I would consider is upping your dose. I've seen strong evidence to support the idea that results from finasteride are dose dependent. Just stay within reason, clear it with your doctor, and slowly move up. You have to increase your dosage once every six months to know if it is helping or not.
    Joe,

    When you refer to "upping the dosage", are you referring to the finasteride? With what amount of an increase have you seen evidence of potential improvements (i.e. an extra .25mg)?

    I had always been under the impression that there was no real benefit to increasing the dosage from 1mg.

    Thanks for your help!

  9. #9
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    Quote Originally Posted by George7 View Post
    Thanks for the reply. I think I am reponding to the medication. My hair feels a bit thicker than before I started, but I have always had a large double crown even as a kid. The photo of me as a kid is taken from a distance with an over 20 year old camera. I want to fix the hairline when/if i know I have stabilzied. How long should I be on fin to be sure? I have planned two or three years before doing anything. I also read that you need to stop your hairloss before having a transplant, but what if the medication stop working after 5-6 years? I have read the studies and the vast majority of men that have positive results in the first two years will also have it after 10 years, but what about after 15-20 years? If one was to be 100% sure one should basically not have a transplant before being sure medication works and be above the age of 50-60. I would guess most patients do not fullfill these requirements. Sorry for all the questions, but you seem like an expert and I try to find out my long term options. I was rather unlucky since I have two brothers and both ended up being above 180 cm while I am bellow 170 cm. Living in Scandinavia being short is difficult enough, but I am doing quite well regardless. I just dont want to be put in the box short and bald since I am sure it would negatively influence my life both when it comes to women, but also career wise. I am willing to use Dutasteride since I know that losing my hair would be almost like a death sentence regarding women anyway so I dont have a lot to loose. If I do get sides I can always quit. However since my crown has always been strange and getting regrowth at the hairline is rare I will need a transplant one day regardless. How long should I wait? I will order some dermatech and try it out, but that will not solve the hairline issue that it is uneven and been like that for 5+ years.
    George7,

    I think that if you are not having sides on the medication you should consider, with your doctor's blessing, taking it for as long as you can. The efficacy curve improved for up to 24 months so that is a good baseline to shoot for. At that time is when the efficacy supposedly levels off and then it is just a maintenance thing. I don't think the medication just "stops working" after five or six years. I think this is a myth and it is simply the cumulative effect seen on patients that have only had their loss slowed, not stopped. Your loss does continue in areas or all over then it is wise to consider this if you have surgery and don't get crazy with hairline lowering or with massive megasessions or obscene densities. In fact, if you can just not have surgery at all that is the best way to move forward.
    Joe Tillman
    The original Hair Transplant Mentor

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    See the full list at HairTransplantMentor.com/hair-transplant-doctors

  10. #10
    Moderator JoeTillman's Avatar
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    Quote Originally Posted by Momo View Post
    Joe,

    When you refer to "upping the dosage", are you referring to the finasteride? With what amount of an increase have you seen evidence of potential improvements (i.e. an extra .25mg)?

    I had always been under the impression that there was no real benefit to increasing the dosage from 1mg.

    Thanks for your help!
    Momo,

    Yes, I'm referring to finasteride. I remember a patient from several years ago that came in to the office and he had been on finasteride 5mg every day for years. The doctor thought the same as you and so he told the patient to cut the 5mg tablet into quarters as he had been wasting his money. He promptly lost all of his hair. I mean, within six months he hair just disintegrated. He went to maybe NW3A to a full blown NW5 and he was freaking out. He was put onto Dutasteride ASAP and his hair came back but it was direct evidence that 5mg does work better than 1.25mg. But, I've seen cases where 1.25mg wasn't doing enough and after the patient upped their dose to 2.5mg good things started to happen.
    Joe Tillman
    The original Hair Transplant Mentor

    Interested to know which doctors I recommend?
    See the full list at HairTransplantMentor.com/hair-transplant-doctors

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