Thank you for your question.
You’re 25-years-old and you’re 2 years out of hair transplant and you submitted your
question without a photo. And you state in your question that you’re now taking finasteride
as well as biotin and folic acid and you’re asking are you taking the correct medication.
Well, in the absence of a photo or other details of your hair loss situation, I can certainly
share with you my perspective on what your situation is currently. A little bit of background,
I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and
reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years.
Hair transplant has been a significant part of my practice for many years. In fact, I
am the founder of TrichoStem™ Hair Regeneration Centers, a system that we developed that non-surgically
treats men and women with thinning hair in addition to the strategies that you’ve already
employed that might be of value to learn about.
So to begin with, by definition, you have a fairly aggressive hair loss genetic pattern.
And that’s essentially defined by the early age of onset. A degree of hair loss that’s
significant enough that you are able to actually undergo hair transplant which means that you
have probably lost a fair amount of hair.
So in understanding hair loss, essentially, the experience that we have in our practice
especially after doing a lot of hair transplants and developing this system of Hair Regeneration,
I’ve looked at essentially different variables and given people or assigned different categories
of what a person’s profile is. So that means besides gender, age of onset, degree of progression,
rate of progression and from that, I can also assign a relative value to DHT sensitivity.
So when you think about why a younger person loses hair early while their contemporaries
don’t so there is basically a Rule of Decades, that in your 20s, only 20% of men will have
hair loss and 80% of men will not. Well, there’s a genetic factor which controls the age of
onset. But the way I look at it and from clinical observation, it seems like everyone comes
to the table in life with a certain number of hair growth cycles. And essentially, when
you start losing hair, those hair growth cycles get shorter and resting phases get longer.
The one variable that you have some influence over is DHT or dihydrotestosterone. And through
suppression of DHT, you’re able to slow down progression. Now the slowing down of
progression is going to be variable. We have patients who have been on drugs like finasteride,
a DHT blocker is well established in hair loss who have been on finasteride for 15 years
and still progressed to a significant degree of hair loss and there’s the whole scale
of people who have had a more moderate rate of hair loss and a considerably slow rate
of hair loss. So I think you’re doing the right thing being on a DHT blocker.
Now when we see patients like yourself who come to us and who have already been on finasteride
and in your age range of early to mid 20s, we have also employed a treatment called Hair
Regeneration. This is a combination of Acellular matrix with a material called platelet-rich
plasma (PRP) which is derived from your own blood. This actually evolved from our doing
of hair transplant. And the intention was to improve the healing of the hair grafts
as well as to improve the healing of the donor area. Well, a great side-effect was that thinning
hair appeared to get thicker. Over the course of several years, I’ve developed systems
to actually treat different categories of people, men and women, different age groups,
different rates of progression and degree of hair loss. And we developed this system
of TrichoStem™ Hair Regeneration.
So what’s the differentiation here? Well, as much as finasteride may slow down progression,
it doesn't technically really stimulate hair growth. And so what we’ve been able to do
for patients who are on finasteride or not on finasteride is we’ve been able to reactivate
hair that isn't growing. We’ve been able to thicken hair that was thinning as well
as prolong the lifespan of hair that was basically progressively thinning.
Now, we look at our data very critically and we constantly review this. And essentially
what I look at, what we’re ultimately doing to our patients is we’re still managing
hair loss progression. Essentially, especially for a younger person, you have to have a very
realistic outlook. The early onset and very rapid rate of progression means that by definition,
your cycles are shorter. So the way I look at our role in managing our patients is that
we want to maximize the lifespan of every growth cycle for as long as possible. Sometimes
I refer to this as maximal medical therapy. So I think that the combination of a DHT blocker,
finasteride, in a younger person particularly with Hair Regeneration will optimize what
everybody wants which is coverage. These are not cures but these are ways to manage hair
loss.
So I think that you’re in the right path in terms of your medical therapy, in terms
of taking the medications that you’re taking. But also look into this concept of Hair Regeneration,
platelet-rich plasma, Acellular matrix and you may want to pursue this route further
to maximize the coverage.
So I hope that was helpful, I wish you the best of luck and thank you for your question.