No progress on finasteride + min. Help needed

[Baldinho7]

I have been taking finasteride 1.25 mg once per day for 14 months now, dermastamp 1.5 mm once per week for 1 year and topical minioxidil for almost 3 years and I haven’t seen any progress yet. I don’t see a lot of hair on my pillowcase like before when I wake up, but when I shower or wet my hair, I lose a lot. Also, a few hairs fall randomly during the day. I feel like my crown and mid scalp are more visible now than before and my temples are worse. It looks really bad when my hair is wet. I really don’t know what to do. Dermatologists where I live have no idea how to treat hair loss. I only found out about finasteride online. Oral min isn’t available where I live so it’s not an option. Should I wait for 3-6 more months to see if there’s any improvement or should I switch to 0.5 mg dutasteride? Ive uploaded a few photos. Pics 1-3 are 2 years ago when I was still using min only. Pics 4-9 were 14 months ago exactly before I started finasteride. Rest of the pics were taken in the past month. Any advice/opinions would be really appreciated.

 

[Dr Bicer’s Consultant]

Hello @Baldinho7 , to a certain extent it is not just about the hair shedding daily, but a balanced hair cycle. That said, there are conditions such as telogen effluvium that interrupt the natural growth cycle and cause an increase in shedding, this is mostly over brief time periods, due to stress, health issues and more.

We normally have around 90% of our hair in a growth phase, and when a hair follicle enters the dormant stage hair grows back, keeping a head of hair balanced. If male pattern baldness begins, slowly the hair cycle changes as the follicles atrophy and eventually stop growing hair. The amount shedding may not change a great deal.

Minox and Finasteride work in quite diverse ways as a result using both is ideal. No specific result can be promised with treatment, it can thicken a head of hair, improve the quality and growth. However, the cosmetic change can be far less, but it does stabilise or massively slow down the receding or thinning of the hair. It should also be noted that expectations play a role in what you would like from treatment and what treatment can do for you.

It is also important to consider stopping treatment, this will likely result in an increase in hair shedding over the coming months. This shedding is the result of the hair follicles not having the benefits of said treatment and going back into the natural hair cycle, often not regrowing any new hair. Basically you risk taking you to the stage you would have been if you had never started treatment in the first place. This makes it hard to change to a new treatment, stopping one to start another, especially as you have no way to know how you will respond to a new treatment.

 

[Baldinho7]

Hello @Baldinho7 , to a certain extent it is not just about the hair shedding daily, but a balanced hair cycle. That said, there are conditions such as telogen effluvium that interrupt the natural growth cycle and cause an increase in shedding, this is mostly over brief time periods, due to stress, health issues and more.

We normally have around 90% of our hair in a growth phase, and when a hair follicle enters the dormant stage hair grows back, keeping a head of hair balanced. If male pattern baldness begins, slowly the hair cycle changes as the follicles atrophy and eventually stop growing hair. The amount shedding may not change a great deal.

Minox and Finasteride work in quite diverse ways as a result using both is ideal. No specific result can be promised with treatment, it can thicken a head of hair, improve the quality and growth. However, the cosmetic change can be far less, but it does stabilise or massively slow down the receding or thinning of the hair. It should also be noted that expectations play a role in what you would like from treatment and what treatment can do for you.

It is also important to consider stopping treatment, this will likely result in an increase in hair shedding over the coming months. This shedding is the result of the hair follicles not having the benefits of said treatment and going back into the natural hair cycle, often not regrowing any new hair. Basically you risk taking you to the stage you would have been if you had never started treatment in the first place. This makes it hard to change to a new treatment, stopping one to start another, especially as you have no way to know how you will respond to a new treatment.

Thanks for your reply. SO what do you think I should do? Should I add dut once or twice a week and see if it will make a difference? So fin 5/6 days and dut 1/2 days. Or should I just keep using fin?

 

[Dr Bicer’s Consultant]

Thanks for your reply. SO what do you think I should do? Should I add dut once or twice a week and see if it will make a difference? So fin 5/6 days and dut 1/2 days. Or should I just keep using fin?

We can´t recommend combining finasteride and dutasteride, you already take finasteride 1.25 mg once per day, which is higher than the recommended dose for a hair loss treatment. You increase the risk of side effects, and there is little research into combining the two. You should really have an in-person assessment before consider changing what you are doing now, as that combination is well tested and researched.