Should I take finasteride or other supplements after hair transplant?

[orko]

I'm 47 years old. I had my first hair transplant more than 15 months ago. I didn't use finasteride or any vitamin supplements. I had about 5000 grafts put in, and I think 3500-3800 of those survived.
I just had a second transplant 2 days ago, and I'm wondering if I should use finasteride this time. I really don't want to use any long term medication personally, but the guy at the clinic said that I should use finasteride for 5 or 6 months while the transplanted grafts mature and strengthen, and then gradually stop using it. This strikes me as odd, because from what I know once you start using finasteride you have to use it for the rest of your life or at least for a very long time. And when you quit using it, you lose all the benefits you've got up until then.
Getting supplements to support the grafts in their 'incubation period' kind of makes sense, but the idea of getting to depend on them in the long term puts me off. I was about Norwood 4.5 to 5 before my first hair transplant, and being 47 now, I'd like to think that my hair loss has more or less stabilized. But still, before my second hair transplant, I would lose about 30 or 40 hair strands every day when washing my hair.
I'd like to hear your opinion. Thank you very much!

 

[David Anderson]

Yes you should use finasteride to maintain not just your existing hair but to help preserve the longevity of the transplanted hairs. There is no point in using it for a few months and then stopping as you will lose any benefit that you have gained. Medications are a lifelong commitment or at least as long as you care what your hair looks like.

 

[orko]

Medications are a lifelong commitment or at least as long as you care what your hair looks like.

That sounds scary. I believe I've already shed most of my native/existing hair. They transplanted hair from my beard and neck, the areas that are supposedly immune to hair loss, so would I still need to use finasteride? Bearing in mind I'm 47.

 

[cooty]

David is right - you really should use meds following a hair transplant as its important to retain as much native hair as you can as well as the transplanted hair, bear in mind that with Regaine and Finasteride some people (not all) can actually recover thinning native hair too. I couldn't take Finasteride as I had side effects from it, so i apply Regaine (Minoxidil) twice daily and also take vitamins which help with hair growth and quality etc. - as well as my own research on what to take I also took advice from my hair surgeon (Dr Muresanu of Hattingen Hair Clinic) and so i take these;- Biotin, Zinc, Vitamin B Complex, Vitamin C, Iron, and Vitamin D3.

 

[David Anderson]

That sounds scary. I believe I've already shed most of my native/existing hair. They transplanted hair from my beard and neck, the areas that are supposedly immune to hair loss, so would I still need to use finasteride? Bearing in mind I'm 47.

I don't see it as scary, if you are not seeing any side effects then it is just a tablet. I assume that this beard hair is mixed with scalp hair so it is important that you use medication to keep this hair. I am not sure there is long term studies on beard hair into scalp and the longevity of it once moved to scalp. For that reason I would not assume that it will not have some degree of thinning over time.

 

[cooty]

I don't see it as scary, if you are not seeing any side effects then it is just a tablet. I assume that this beard hair is mixed with scalp hair so it is important that you use medication to keep this hair. I am not sure there is long term studies on beard hair into scalp and the longevity of it once moved to scalp. For that reason I would not assume that it will not have some degree of thinning over time.

I can only endorse what David says Orko - David is a long standing and respected professional in the hair transplant community and really knows what he's talking about..... if you don't get sides with Finasteride then take it however if you do then use Regaine (Minoxidil) - had you have done upon your first transplant you may not have needed the second, so its just not worth risking it as David rightly says for the sake of small meds; and this coming from someone who actively avoids taking medication of any sort - however if its a difference of losing hair or keeping it then its a no-brainer.

 

[Tom80]

It is interesting because in my case, reputable HT Drs said I do not need Finansteride. However, you have a higher degree of loss, so I also think also Finansteride is recommendable in your case.

 

[David Anderson]

I'm 47 years old. I had my first hair transplant more than 15 months ago. I didn't use finasteride or any vitamin supplements. I had about 5000 grafts put in, and I think 3500-3800 of those survived.
I just had a second transplant 2 days ago, and I'm wondering if I should use finasteride this time. I really don't want to use any long term medication personally, but the guy at the clinic said that I should use finasteride for 5 or 6 months while the transplanted grafts mature and strengthen, and then gradually stop using it. This strikes me as odd, because from what I know once you start using finasteride you have to use it for the rest of your life or at least for a very long time. And when you quit using it, you lose all the benefits you've got up until then.
Getting supplements to support the grafts in their 'incubation period' kind of makes sense, but the idea of getting to depend on them in the long term puts me off. I was about Norwood 4.5 to 5 before my first hair transplant, and being 47 now, I'd like to think that my hair loss has more or less stabilized. But still, before my second hair transplant, I would lose about 30 or 40 hair strands every day when washing my hair.
I'd like to hear your opinion. Thank you very much!

Did the clinic you went to provide an explanation of the low graft survival and did you go back to them for the second transplant?

 

[David Anderson]

I can only endorse what David says Orko - David is a long standing and respected professional in the hair transplant community and really knows what he's talking about..... if you don't get sides with Finasteride then take it however if you do then use Regaine (Minoxidil) - had you have done upon your first transplant you may not have needed the second, so its just not worth risking it as David rightly says for the sake of small meds; and this coming from someone who actively avoids taking medication of any sort - however if its a difference of losing hair or keeping it then its a no-brainer.

Thank you Cooty. I was so put off taking finasteride for years but the reality is that I have been using it now for nearly 20 years without issues. Not everyone's donor hair is resistant to thinning over the long term so it makes sense to use it providing you tolerate it ok.

 

[David Anderson]

It is interesting because in my case, reputable HT Drs said I do not need Finansteride. However, you have a higher degree of loss, so I also think also Finansteride is recommendable in your case.

It depends on your age and hair loss pattern, family history etc as to whether you can avoid taking finasteride. I have met patients in the past where I have questioned their need to be on medication if all they have is a mature hairline for instance.

 

[orko]

I have provided pre-op, post-op and 4-5 monthly pictures from my first HT in another forum, but unfortunately I'm unable to share links here for some reason.
The clinic I chose wasn't/isn't the best in business, but they're fairly cheaper with satisfactory results (based on what I saw/learned in a legitimate Turkish HT forum). I was personally satisfied with my first HT (as compared to my former Norwood 5 self) , but it was by no means a 100% success. I suspect that 1000 to 1500 grafts (out of 5200) didn't survive, but I have no way of proving that. You'd probably be the judge of that if you could see the pictures (if only I could post that link here). As I said, I didn't take any medication after my first HT, since I was 46 at the time I thought that I was immune to DHT related hair loss (I'd definitely have taken finasteride if I were 32, if that makes sense). I think I was a bit careless during the first 3 months post-op. I'd apply the hair serum they gave me on my head and take long walks in the park. I'd noticed a few times insects getting attracted to that sticky balmy thing on my head and having to clean them off. I started getting PRPs 5 months later. I also tend to consume alcohol more than the advised limits. I don't know if any of those things contributed to those grafts not surviving (again this is just my theory, it's entirely possible that nearly all of them have survived).
I went back to the same clinic for the second HT as they offered me a good deal and I'd already known the people there. I'd like to be more careful this time, but the idea of depending on drugs long term puts me off. I can live with vitamin pills (though I hated them the first time round), I'll definitely get a PRP very month. Other than that I don't know what else I should do. A good HT with grafts taken from areas that are immune to shedding like beard, neck etc. should be sufficient to do the job in my opinion (otherwise this whole thing would be a joke, right?)
The guy at the clinic suggested that I use finasteride for the first 5 of 6 months until the transplanted grafts have matured and grown, and then I stop taking it, but from what I read on the internet this doesn't make sense. Like David says it's supposed to be a "long term commitment", something which I personally dread.

 

[Tom80]

It depends on your age and hair loss pattern, family history etc as to whether you can avoid taking finasteride. I have met patients in the past where I have questioned their need to be on medication if all they have is a mature hairline for instance.

Indeed David. Here are my characteristics: Age: 44, NW2, Donor Density 90cm2, Miniaturisation limited to temporal corners. Family is big so it is difficult to draw inferences. Perhaps more importantly, I am on (high quality) PRP therapy since 8 years and hair has been pretty stable.

 

[Kevboy]

I have provided pre-op, post-op and 4-5 monthly pictures from my first HT in another forum, but unfortunately I'm unable to share links here for some reason.

Post your pictures on here Please.