Two consultations, two opposing opinions?

[JFR8]

Also manual.Co popped up on Google (damn those cookies), but there’s is 10% Monox and 0.1% Fin.

 

[JFR8]

Maybe try propecia 3 times a week

I’m not sure I want to go down the tablet route again. Even with topical I have concerns about dosage and systemic build up.

 

[Bigmac]

Thanks for enabling links.

Unfortunately there’s a history of cardio vascular disease in the family. My resting pulse (~60 bpm) and BP (~110/63) are pretty good, so hopefully that issue will skip me. But I do have familial hypercholesterolemia, which is probably one of the main contributing factors that’s led to that family history. So I’m reluctant to take oral minoxidil.

I haven’t checked out Forhims, I’ll take a look now.

I have a heart murmur and my blood has had some issues which is why I`m choosing not to use it.
Forhims seems to have a good reputation and look legitimate.

 

[JFR8]

I’ve sent them a mail to ask what happens if I suffer side effects.

When I tried Propecia it was through Belgravia. The one good thing about them was they didn’t mess me around. They gave me a free follow up appointment quickly and then refunded me for the unused portion of the prescription.

6 months supply is only £136 with their new customer offer. So not the end of the world if they won’t do the same, but would be an indication of their general attitude and trustworthyness.

 

[JFR8]

Also would you go for the lotion or spray?

I was reading about Hassan and Wongs formulation:

Topical Finasteride | Topical Finasteride With A Proprietary Silicone Base

Topical finasteride is quickly becoming an alternative to oral finasteride. Learn more about Topical Finasteride with a silicone base!

hassonandwong.com

But it’s not available in the UK. Not sure if the delivery system is actually as good as they suggest, but if so it’s probably exactly what I need.

 

[JFR8]

One concern I have with topical Fin, I have two young kids.

I know the doses are low and hopefully it absorbs before too long. But how do others who use topical Fin and have kids get on?

 

[Bigmac]

I’d probably go for the spray for ease of use but you’d have to factor in does it penetrate through the hair enough or would rubbing the cream in be the better option.
I`m not sure about using it and kids being exposed to it. A doctor or the supplier would be the people I’d ask for confirmation.

 

[JFR8]

I’d probably go for the spray for ease of use but you’d have to factor in does it penetrate through the hair enough or would rubbing the cream in be the better option.
I`m not sure about using it and kids being exposed to it. A doctor or the supplier would be the people I’d ask for confirmation.

I was thinking the same WRT spray.

I will ping them to see what they say about safety. I asked them about their policy if I buy 6 months and then suffer sides, essentially they said tough :/ And I haven't been impressed with the daily spam trying to get me to buy. But they are the only "mainstream" option for topical Fin in the UK.

 

[Bigmac]

Have you reached out to Dr Tam and Dr Farjo to see if they are supplying it?

 

[JFR8]

Have you reached out to Dr Tam and Dr Farjo to see if they are supplying it?

No I’ll give them a try aswell. Thanks for the pointer.

 

[JFR8]

I received a response from HIMs to my query about safety around kids (see below). In short they suggest its absorbed within 15 mins, but remain on the fence wether its safe to use with kids in the house. I guess thats to be expected given no ones gone to the trouble of going through official approval process, when such things are considered and evaluated. They are just riding of the studies to date and haven't really done any work themselves wrt safety/etc.

I guess if I were to use it, I'd apply it first thing, then give my hair a quick wash at the end of my morning routine. Using it in the evening may mean it gets onto my pillow/etc and my kids like to get up nice and early at the weekends (not school days), jumping around on our bed to wake us up

Our Topical Finasteride treatments are usually absorbed into the scalp within approximately 15 minutes of applying.
This is quicker when using the spray, as this is compounded with a fast-drying alcohol base.

Our clinicians have advised that no clinical studies have been carried out on the effect of Finasteride on children under 18 years of age.
There may be a small risk of transfer of Finasteride from you to another individual via touch.

Although in theory the amount of the medication transferred would be minute, unfortunately there is currently a lack of studies and scientific documentation on the exact risks attached to this.
Without strictly controlled clinical testing environments, any recommendations or advice on the part of our clinicians would not hold scientific merit.

As a best practice though, they would encourage hands to be washed shortly after coming into contact with the solution, and for any other individual to avoid touching your hair until the solution has dried. I hope this helps, but please do let us know if you have any further questions.

 

[Bigmac]

Putting it on first thing and washing it out sounds like your best option when there is the uncertainty around your children and exposure.

 

[JFR8]

I've decided I'm going to give the topical a shot. Been doing lots of reading and so far the studies have shown even at low concentrations it has proven effective. In fact some have shown topical concentrations of 0.025% have been almost as effective as 0.1% and much lower impact on systemic levels of DHT. Caveat being, they are still small scale studies and not significantly peer reviewed.

Given my history with Oral Finasteride I figure it would be best to start with a lower concentration. Taking a look at ForHims the spray is 0.3% Fin, 6% Min. The solution is 0.05% Fin, 5% Min. I'm going to email them to ask why, perhaps the spray is not as efficient and less Fin is absorbed into the scalp.

Anyone have any thoughts in the meantime?

 

[JFR8]

For other UK users, I mentioned it to my GP during a consult for something else. Given I had issues previously with oral Finasteride she kindly agreed to do a baseline hormone test and another several months later. I'd expected to have to pay for private bloods, so was pleasantly surprised

 

[Bigmac]

It is difficult to accurately assess how much will be absorbed. If there is hair in the way, then it will block the spray from landing directly on the scalp. Having your blood work done via your GP is great. Please let us know what the tests show.

 

[JFR8]

It is difficult to accurately assess how much will be absorbed. If there is hair in the way, then it will block the spray from landing directly on the scalp. Having your blood work done via your GP is great. Please let us know what the tests show.

I think i'm going to buy the spray initially as its a better deal because they offer almost 50% off for 6m purchase. Also given the current state of my hair, there isn't that much to get in the way If it works then i'll probably have to switch to the lotion.

My biggest concern is side effects, so I was really grateful my GP agreed to do the blood work and follow up bloods. So I can see the effect on my systemic DHT levels.

I've also be looking through forums to see how people that had sides with oral Fin get on with topical. There wasn't as many examples shared as i'd hoped, perhaps wrongly I'd presumed most people that went for Oral Fin did so because they suffered sides like me. But (anecdotally) it appears in fact many either didnt get results from Oral Fin, or never tried it out of fear and went straight to the topical.

During that reading, I was surprised at the results some people got. Perhaps my analysis is self serving, but there were quite a few with loss greater then mine that ended up in positions I'd gratefully take. Moreover (anecdotally) it appears the fact my bald areas are not slick and I still have militarised hairs (black, couple of mm's in diameter and length) is a promising sign.

I'm just waiting to get an appointment for the bloods, then its fingers crossed and time to dive in.

 

[JFR8]

Also, lots of people seem to be combining Fin/Minoxidil with Derma rolling. Is there any sound evidence behind Derma rolling? One of my concerns would be it may provide a pathway for more of the Fin to go systemic.

 

[Bigmac]

I took a look at your picture from your other thread. You’re right, you do have hair still there and I don’t see any issues using the spray. Oral Finasteride sides is a small percentage considering the number of users. Propeciahelp probably has the most documented cases.
Personally, I don’t think derma rolling makes much of a difference but there are others including doctors who say it works better. The rollers are fairly cheap to buy.

 

[Frankie1983]

Thanks, @loui, Dr. Nikos starts with the donor hair characteristics. Hair qualities, follicular unit density, average hair count, etc. Under magnification. Without the quality of hair in the donor area, it really stops further discussion of hair restoration. This can be for a number of reasons. A higher than average % of hair miniaturisation. A generally low hair count. Low follicular unit density. Very fine hair calibre. If the donor is poor it really negates any hair restoration. Even if minimal restoration as it´s unlikely further hair restoration can be sustained. Or the hair quality will not blend well with the existing hair in the recipient.

Assuming the donor area is strong enough. The next step is to discuss the goals and expectations of the candidate. In line with the level of hair loss today. Against their age, whether using any hair loss treatments and the potential for future hair loss. The hairline design is often the next aspect. Occasionally the Dr may ask the person to design, to get an idea of what they are looking to achieve. On other occasions, Dr. Nikos may simply draw the hairline he would recommend. Then discuss the basis for his design. For instance, to ensure balanced hair coverage. While still looking to frame his face. Complement the facial bone structure etc. Often a hairline position is a compromise between doctor and patient. It´s important both are happy, especially the patient as it´s their hairline. That said, happiness within what is natural when grown out. Not simply agreeing to create a hairline the doctor knows will not look natural.

The hair density and coverage are normally the next aspects needing to be addressed. With higher NW patterns, there is a balance between spreading the hair at the expense of hair density. Or loading the density up at the expense of hair coverage. Even with a balance hairline position. You don´t want to front-load the hair restoration. It often has the opposite effect and highlights the untreated area. The density placed is going to be influenced by the natural quality of the hair characteristics. To create a natural-looking hair coverage, even with only partial hair coverage.

No different from the hairline discussion. It is important everyone is on the same page. The patient understands that if the doctor disagrees with a plan/idea. Then explains why they disagree. That the doctor has their best interests in mind and tries to push the individual in a better direction. For instance, spreading the hair to increase the area covered at the expense of hair density. Hardly ever works out well for anyone. Listening goes both ways. As the doctor listens to the patient. To ensure their goals are perfectly achievable and can be met. As a result, each hair transplant is different. As it´s not just about creating a natural hair restoration. But ensuring goals, expectations, and understanding of what is achievable are all met. Hopefully, then, everyone is happy with the result achieved.

That seems the right way to go about it. Out of curiosity, do you know what your % limit/threshold would be when it comes to miniaturisation of the donor area?

 

[Frankie1983]

I think i'm going to buy the spray initially as its a better deal because they offer almost 50% off for 6m purchase. Also given the current state of my hair, there isn't that much to get in the way If it works then i'll probably have to switch to the lotion.

My biggest concern is side effects, so I was really grateful my GP agreed to do the blood work and follow up bloods. So I can see the effect on my systemic DHT levels.

I've also be looking through forums to see how people that had sides with oral Fin get on with topical. There wasn't as many examples shared as i'd hoped, perhaps wrongly I'd presumed most people that went for Oral Fin did so because they suffered sides like me. But (anecdotally) it appears in fact many either didnt get results from Oral Fin, or never tried it out of fear and went straight to the topical.

During that reading, I was surprised at the results some people got. Perhaps my analysis is self serving, but there were quite a few with loss greater then mine that ended up in positions I'd gratefully take. Moreover (anecdotally) it appears the fact my bald areas are not slick and I still have militarised hairs (black, couple of mm's in diameter and length) is a promising sign.

I'm just waiting to get an appointment for the bloods, then its fingers crossed and time to dive in.

From what I've read topical Fin can ve absorbed and go systemic after a while and sides can become present although less likely than orals. I believe topical dutasteride which is harder to get hold is likely to present sides due to the weight of the molecules.

Im also in a similar position to you. Visited 4 reputable docs. 2 didnt have an issue going ahead although noting i have a limit of approx 2k grafts. The other 2 didnt think Id be a good candidate to the quality of my donor.