Hair Transplants: Do They Last Forever? - The Truth
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- čas přidán 18. 05. 2024
- Hair transplants are often described as a "permanent solution" to hair loss. But is this really true? The answers are more nuanced (and fascinating) than you might expect.
In 1959, Dr. Norman Orentreich published the first robust study on human hair transplants for the treatment of androgenic alopecia (AGA). Over a 2.5-year period, Dr. Orentreich showed that healthy hairs transplanted from the backs of men's scalps into balding regions kept growing just fine; they remained resistant to hair follicle miniaturization. The implication? That scalp hairs are "donor dominant", that our scalp environments do not influence the onset of baldness, and that hair follicle miniaturization is likely genetically predetermined within each hair follicle itself.
Over the following years, other investigation groups confirmed Orentreich's initial findings... and the hair transplant industry was born. Today, hair transplants are considered one of the most reliable ways to restore a receding hairline, fill in a bald spot, and add density to thinning regions. Studies also show that transplant surgeries are overwhelmingly effective and that they improve the quality of life for patients. As such, they should remain a staple procedure in our fight against hair loss.
Having said that, more and more transplant surgeons are now admitting, contrary to popular belief, that transplanted hairs do thin... and for reasons probably linked to recipient site influence and not just donor dominance. This is especially true for patients 10-30 years post-procedure. But it may also be true over shorter time horizons. After all, a recent study found, over a four-year period, that 90% of patients showed a loss of transplanted hairs (despite their transplants originally growing in just fine).
So, how can we reconcile these new findings with the original studies from Orentreich - the ones suggesting that transplanted hairs will last a lifetime? The answers, as always, are complicated! This video provides my take on the data, and why I think recipient site influence might one day be leveraged to improve hair loss outcomes for everyone.
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Interview with Dr. Nilofer Farjo and Dr. Maksim Plikus:
• An Interview with the ...
About Rob English:
-Editorial board member of Dermatology and Therapy
-Medical editor specializing in hair loss disorders
-Peer-reviewed publications: perfecthairhealth.com/publica...
I had a transplant about 1200 follicles near my frontal hairline in 2008...now I have very visible scalp with thinning hair but it is in the area behind the original area that received a transplant...the original transplanted area still holds a reasonably thick hair ...so I think transplanted hair will last up to 90%😊
Are you on finasteride or minoxidil?
Are you taking any preventative medication like finasteride or minoxidil?
@@countyjay7651 Ive been on Finasteride or 15 years post transplant. I've had two. original still going strong. probably 90% still there.
you on finasteride or minoxidil?
@@countyjay7651 I've taken Fin for 15 years no issues. I had major issues with MInoxidil though. Chest pain through the roof.
You are the most genuine person giving information on hair loss. I am shocked to see how much information the doctors hide from their patients.
Thank you for doing this and helping out people.
Husband got his first HT in 1997, fast forward to second HT last week at 54, all of his original HT was still intact, without using fin or mon. He did thin farther back, requiring a second HT and he now uses topical fin/mon.
Wow thats a looong time testimonial. Thanks for sharing Mrs !!
Is the fin/mon necessary at this point for him?
Nice to know, but worth remembering that is only one anecdote. 10% of the subjects in the study rob references here did not show loss to their transplanted hair, so we know that it happens in a reasonable number of people.
This is why I like Rob. He is so genuine in his analysis
Thanks for watching! I know this was a long one...
@@PerfectHairHealthThe study subjects were also not taking dht blockers, were they?
@@PerfectHairHealthcan your hair still thin after the transplant
An excellent analysis of all data. I particularly enjoyed his unbiased analysis of the 1970,72 and 2022 papers. This man's only purpose it to accurately and dispassionately dispense accurate conclusions from multiple data sources. His is not shilling anything other than scientific truth. A breath of fresh air in this morass of ads and papers. An impressive post. Thank you.
Be prepared by being proactive as soon as you see hair loss, if, you want to keep your natural hair as long as possible. There's a lot of ways nowadays to keep your hair, including HT's. This channel is definitely worth following.
I watched this video coz I recently got a hair transplant. I get your point that there are no long term studies done which suggests that transplanted hairs last forever. But one of my uncle in his mid 40s, when his head was completely bald, had a hair transplant done using the FUT procedure 13 years ago. And 13 years later, his transplanted hair still lives. So that for me is an evidence that it lasts forever. However, the doctors told me after the ago of 40, the hair-fall naturally stops, so that might be a reason why his transplanted hairs survived for 13 years.
Just curious, did you and your uncle go on Finasteride or any other medication prior or after the hair transplant?
@@alexanderlouis4271 not sure about my uncle. But i have used minoxidil for 14 months and it did showed good results. But when I stopped using it, my hairs started falling again. Therefore, I decided to get a hair transplant. It’s been 5 days since i had my hair transplant. I’m planning to start using minoxidil again, use it for a year and will stop it. I’ll also start taking finasteride and if it goes well for me, I’ll keep using it for at least a couple of years. I’m hoping that one year use of minoxidil will help me get a good density of hairs after which finasteride will help me maintain that density.
@@ahmedfaraz5353 Good afternoon. Thanks. But the question is if your uncle go on Finasteride After. Many people concern is that after the transplant they have to take finasteride for years. But other people say they didnt. How was the experience of your uncle?
@@ahmedfaraz5353 I also opted to try minoxidil first due to worry about the potential side effects of finasteride. In hindsight, I really wish I'd never used minoxidil at all and just got on finasteride immediately. That cost me a year's worth of hair loss that I'll never be able to undo. So when I finally did start on finasteride, my scalp had already progressed to a point that I'm unhappy with and finasteride will never be able to fix on its own. It's crucial to start on finasteride at a point where you're still comfortable with your overall hairline, as finasteride mainly just sorta locks that in.
Minoxidil foam made me shed more than it regrew, so the net effect was overall worse than if I'd never used it. It turned a small area of exposed scalp into a wide area of visible thinning, with a few thick hairs scattered around. Those few seemingly stronger hairs that benefited were not worth the loss of the many small supporting hairs that filled in the overall area to cover the scalp.
@@rdean150 Perhaps minoxidil doesn't work for everyone.
This channel is going to be big one day. A truly scientific approach with a strong conclusion to support the facts. Continue the great work 👍
This channel deserves to be sooo much bigger. Hope it gets there soon.
I absolutely love your unbiased, critical information.
Thank you for making such high quality content. Always love to binge watch your videos.
I love the energy you’re bringing to the cause of male pattern hair loss.
I’d really love to see all of the big channels get together and form a foundation to fundraise for research. All men should probably just chip in $5 a month for research on male pattern balding. It’s coming for all of us but we could find a permanent solution a lot quicker through collective action.
I second this. Let’s start?
Just discovered your channel, great content and fascinating to learn !
Great video. I wish there was more critical research like this available.
Good information Rob, thanks 🙏🏻
Broo… u won my heart with your way of approach…
Here it is❤️…
Thoroughly researched and summarised. Brilliant.
Very well-documented video, the best I've seen.
Fascinating. Thank you so much for this well researched piece that has answered a bunch of questions no one else answered to this extent. Great job and much appreciated. Left a like, comment and shared the video!
Excellent discussion !
Absolutely amazing video! Congrats
Best AGA channel by far imo
What a satisfying video, you take us threw your whole thinking process, this is really instructive !
Well done, a very informative video covering various aspects of hair transplant and answering many commonly asked questions.
Amazing video! Keep up with your work! Could you do a video about different hair transplant techniques and which is the best? thank your
Very great job bro....
Useful info....
Excllent talk and analysis man
This is gold, keep it up.
Excellent content!
I was skeptical at first but this turned out very interesting and informative
Excellent video.
Impressive content. Good work
Great video and insight, and only 53k view? This video should have way more views. Thanks for your diligent work.
bro I never comment on yt videos like never.. but amazing video I really learned alot watching this keep up the great work!
Very informative video. Wow ! You nailed it.
Great video. Love your content
Great video Rob. I've always appreciated your work. When does your new microneedling study come out that you first mentioned a few weeks ago?
Thank you! The study is officially published: link.springer.com/article/10.1007%2Fs13555-021-00653-2
I’m hoping to put together a video on this in the next two weeks!
@@PerfectHairHealth Thanks Rob! Hopefully your next video covers microneedling after a transplant because now I'm very intrigued
About distant hair follicle communication signals : I think that’s why regrowing hairs always appear at the border area with existing hairs. And never where the surrounding area is slick bald.
It is interesting to think about. Regrowth almost always seems to be “last out, first in.” There are case reports of people who lose their hair to alopecia areata, undergo a therapy 20 years later, regrow it all back and discover they now have advanced male pattern baldness. This seems to suggest that the effects of AGA continue even when the hair follicles are struck in the kenogen stage and/or perhaps not even cycling. It’s an area of research that I think is underrepresented!
Legendary content!! Thank you
xlnt report. here's some personal exp: since the mid 90s (age 40) i've had 3 procedures for light to moderate loss in front and crown. all by top surgeons: 2 by bosley and one by another xlnt provider. since then and up to this date everything you state has been pretty right on. donor sight was deep FUT (safe donor zone) at border of skull and neck). hair loss in back crown was about 25%, and maybe 20% in front/middle front. i would say that today i have almost as much hair in the transplanted areas as i did after all 3 procedures, which were from about '96 to 2005 or so. so both my transplant sites had only 25-20% loss, so they weren't bald. further, i am not typical insofar as being a health nut, little drinking, organic, a runner, hanging a few times a week a la 'American Gigolo', and nuuuumerous supplements, esp for hair such as DHT inhibitors like saw palmetto, pumpkin seeds, and growth factors such as keratin, biotin, msm, silica, gingko, etc. NO pharmaceuticals, only over the counter 'health' supplements, meaning most of my supplements are not ONLY for hair, but other health outcomes such as stronger joints, etc. i've personally seen the effect the following have had on my hair: 1. lowering drinking to 2 hard drinks/week at most, 2. each of my hair oriented supplements, 3, exercise, aerobics/calisthenics/inversion (for blood flow). conclusion: without the lifestyle considerations of supplements/exercise/nutrition (organic/lowered drinking/no smoking/good nutrition) i no doubt would have seen the over time hair loss of the implants at about 20% of what they were after implant. each of my lifestyle changes brought results that i could literally see within a month or so to ongoing. it was a synergistic process where each lifestyle change added up to reversing any hair loss of the original procedures, as well as any which might have continued despite the procedures. the result was that my hair is virtually as thick and covers the same area as it did after all 3 procedures. i'm sure if i let my lifestyle changes slip, there would be increased hair loss...however since they affect my entire health, they are not changes i will forego. i have noticed at times in the past where stopping some of the supplements targeting hair growth, e.g. keratin, silica, etc, did have an effect. i absolutely do not want nor have i ever been on lifetime hair drugs such as finesteride/minoxidil etc...though i do saw palmetto and pumpkin seeds, again for overall health since they affect prostate, keeping DHT down. hope this helps. my background was as a reporter/editor, and clearly a health nut.
Great video!
This is really insightful, and I am glad that I watched all of it. I have been aware of the recipent site influence phenomenon for a while now but the original Dr Orentreich study is utterly fascinating. The devil is certainly in the details.
Another interesting event was me using hair dye. I tested the stuff on my arm to verify that I had no allergic reaction. There was no reaction at all. However, my scalp had a different opinion. A rash appeared in some areas, and it took close to a year for the skin to return back to normal skin color. The areas affected, were bald areas. Six months later, hair began to grow in those specific areas, and lasted about 3 years. So it appears that due to the damage done, the areas had shifted into repair mode, and the hair follicles located in those areas also got caught up in the process.
Wow! Interesting
very true, I dyed my hair 2 years ago and then a year later I started noticing it thinner at the front even my barber notice it. That's when I realized I had alopecia but it had not been for the dying chemical it would've taken more years to show.
Hey rob, nice video very informative and well construct
Do you plan to make a video about the long-term efficacy of massage ? and maybe do you think it could make the transplanted hairs stay longer or even permanently ?
Thanks! I wish we had more long-term data on massaging, but unfortunately, the only information we have are anecdotes. In that regard, there’s also a selection bias for those doing massages long-term: those seeing results early on tend to stick with the efforts longer than those who aren’t seeing results.
I think that any intervention that’s working will likely help improve the long-term survivability of hair transplants. So, if you’re responding well to the massages, I would put those efforts into that category.
@@PerfectHairHealth How are the information anecdotes when you've conducted a study about massaging without drugs and have shown pictures of people's scalps growing lost hair despite of age and having AGA, plus your website gives alot more representation about scalp massage as a main natural treatment and it has tons of pictures all of which show growth in people who've only done scalp massage regimen regularly
@@mastawitcha231 You're totally right - we have a lot of people reporting long-term success from massaging (with photos, and even over 2+ year periods without the use of other treatments). So we know that for a portion of people, these techniques appear to work (according to photographic assessments and self perceptions). The part we're missing is objective endpoint data: for example, hair count / diameter changes. Another thing we're missing is the percent of success for those massaging 1.5+ years - as the dataset from our study wasn't very robust after the 18-month mark. Perhaps my last message read as if it discounted these things too much, which wasn't my goal. I just want to avoid overstating anything :)
Hi Rob, I have just recently subscribed to your email course.
How long after a hair transplant will it be good to start doing head & scalp massages?
Fascinating ❤thanks dude
Fascinating! I didn't know that hair transplants could be temporary. Also, that injuries can spur hair growth. And thanks for the details, and all the work on the video.
its forever!
Hi I'm french and I enjoyed your video, but i had a question, you say that recipient sites do inluence the fate of the hair, the only factors that could lead to that are DHT level and some other things like low oxygen levels etc.. but mostly the DHT Level right ? So my question would about how DHT works exactly, when it is created, does it remain in our sclap or is it just something that will last some some but will likely disappear within a few days but since it's created every days so every days there is like a DHT supply from our system leading to baldness? cause my final question would be does medicines/drugs like oral finasteride or dutasteride only impact the produced dht or also the ones remaining in our scalp, cuz instead of talking about hair transplant, an healthy solution would just be to make the scalp just as low antigen levels as the mice's back so the actual front hair would just stop miniaturizing?
Masterful analysis of a frustrating problem! Your hypothesis of using injury to cause or preserve hairgrowth is already well known: Dr. George Cotsarelis at the U. of Pennsylvania has been studying this phenomenon for many years. He has used this idea as the basis for his start-up company, Follica, but I don't know how successful this venture has been. In any event, I much appreciate the depth of your analysis and, more importantly, the skepticism you show for all of the so-called "baldness cures", even those that are well-researched.
Were those patients in the 2020 study on Finasteride and minox treatments?
Hey Rob, but the Hairs generally thin out if we don't support them with nutritions and vitamins (+Finasteride). So in conclusion; transplanted hairs would not thin out if we support them with Vitamins etc. 🤔
Regarding the study at 16:40, where they using finasteride or dutasteride? If not I would like to see a comparison between the hair transplant while on fin/dut and one without it. I would assume that people on who get the transplant on fin/dut get better results
I have diffuse thinning on my crown area. I did the prp and extra cellular matrix in Manhattan. The first round seemed to work. I was given finasteride to take but didn’t take it bc I was concerned about side effects. Now my hair is worse about 3-4 years later.
After seeing 4 videos on this channel, I can see if I can’t get Botox and finasteride or saw palmetto.
My friend has told me about a scalp massaging which I have to find.
I also started micro needling but don’t know all the ins and outs of it. I have a derminator 2 from Europe I order. I have 9 and 12 needle cartridges.
quality vids as usual
Damn, what a great video!! In emotes watching every single bit of it. 👏
Okay, here is something that is not mentioned that often. If you are not that old at the time of the transplant, you may end up with more hairs than expected. Take my case. 3,000 hairs transplanted, led to about 5,000 new hairs. It looked great. However, those extra 2,000 hairs were old hairs that had come back to life due to an increase in blood supply in the general area, and other reasons related to the hair transplants shifting things into a repair mode. Sadly, they don't last forever. And so eventually those extra 2,000 or so hairs, went right back to being in dormant state.
How long after your ht were they gone?
You counted? Lol
@@caleb-kunfr like we’re is the source on this or analysis from someone who is credible and has a PHD?
I wondered about that, if the injury would actually cause more hair growth.
You might have been able to retain them with routine microneedling
What I've Learned always gets very close to truth and geniune analysis, or experts that do just that
These follicles are taken from the donor region. If they are left in the donor region, they continue to produce hair for life. So, why should it be any different if they’re transplanted into the galea? Unless the galea environment gradually causes an epigenetic mutation (upregulation in androgen / cytokine receptors), just like the indigenous galea follicles that do miniaturise.
in the 4 year study about transplanted hair follicule thinning/disapearing. Did the testing subjects where on any medical therapy throughout the entire study ? especialy Finasteride ?
But does the signal need to be from the scalp?
And does it really need to be a big signal, that we could check from just taking blood once?
Because as stated here, hair seems to undergo many cycles and they then get thinner, maybe there is a quick signal or something that blocks a signal for just a short amount of time.
Maybe hair has a designated amount of elements which it consists of and while those special elements are being transported to the hair follicle, that signals gets cut.
Which in result doesn't provide the hair follicle with a certain amount of things.
Also hair seems to fall out just after a long time has passed, is there maybe some kind of "shield" that gets weaker from time to time?
Also something else that I wondered about, dogs and some other animals do shed their hair at certain times, there needs to be signal or change that makes that area lose the hair or replace it.
Can't we check if there is some kind of signal in the human body?
Maybe we focused on the wrong thing for to long and the reason for the hair to fall is not dht, but the reason for dht is the falling hair?
Maybe we should check people with no hair loss even closer, to find out what they have that helps them to keep their hair.
I lost about 30% of my transplants in the front area over the past few years, I’m in my mid fifties, I had the work done in my twenties and it looked good for a few decades, now I’m considering a natural looking hair system
Hi @gbluesrocker. Curious to know if you stayed on any hair loss meds over that period? Thanks
So u got hair transplant about 25 to 30 years ago?
Hi Rob. I had FUE 9 years ago now and they look better than ever. Mind you I do regularly microneedle and apply topical caffeine when I do and do your scalp massage technique aswell.
That's awesome! Glad to hear your FUE procedure was a success and that the hairs are looking great!
@@awalon2572 been doing it once per week all over for two years now and all my hair is fine.
Hi Jonathan - have you ever taken finastride or minoxidil after transplant?
@@rohitkaul1741 no never
@@Jonathan-tl7ll thanks for reply... where did you perform the transplant?
One could hypothesize that 5-alpha reductase enzyme activity, the enzyme that causes the vast majority of hair loss/thinning , is still acting on the transplanted hair but starting with a thicker follicle begins its whittling down of the follicle thickness. . Of course, one could be taking Finasteride to minimize this affect so yea...Its complicated.
Hey Rob, good video. Are you aware of any study that deals with microneedling/dermarolling-induced fibrosis on the scalp and how it could make the whole process counter-productive to hair restoration?
Thanks. When done correctly, I've only ever seen studies demonstrating the opposite - that percutaneous wounding (i.e., microneedling) attenuates and/or reduces fibrosis. In vivo studies show - even at 3mm needle lengths - that repeated microneedling improves the appearance of acne scars - with those effects sustaining even after treatment. The needle lengths in those acne studies are far longer than the needle lengths used in AGA studies - which typically range from 0.6mm to 2.5mm but average around 1.5mm. So, the data (so far) seem to imply that if you're following the right methodologies, this shouldn't be an issue.
@@PerfectHairHealth Good to know, thanks for the answer 👍 You're producing high effort, quality content and it won't go unnoticed.
What about if Your on finastride or Minoxidile ?
And would your transplanted hair last if you didnt take these tablets?.
What about the inversion method? Can that promote hair growth
Curiously, if transplanted hairs acquire some of the characteristics of recipient site hair, might transplanting balding follicles from the top of the head to the back of the head cause those balding follicles to regrow? If so, this might be practical in the case of those large punch grafts before FUE was developed.
Because before the punch grafts are transplanted into the top of the head, holes have to made in the top of the head to receive the punch grafts.
Why not take the tissue from the excavated holes and stick them in the holes left by removing the donor punch grafts in the back of the head?
Doing so might rejuvenate those balding follicles, perhaps even creating a fresh supply of new donor grafts decades later when the earlier transplanted grafts have thinned.
And in any case, at least the donor area might grow thicker over time, allowing the hair on the back and sides to be cut shorter.
Best video so far .. also clinical studies are always highly inconsistent and inaccurate .. nothing surprising here
Does hair follicle die and disappear ? Or just get "desactivated" ?
Can the body create new hair follicle and only reactivate them ?
So whats ur advice.? Is it Worth it? To take the hair transplant M
I don't normally comment but this video got me excited for the future of hair loss treatment. I wonder, is it possible to do a more refined version of that first procedure? The one where the transplanted hairs survive better?
Those original plug grafts are a bit unsightly, but if what is presented in this video bores out to be true and is confirmed by more research groups, I think that you're right. I personally feel that most transplants are maintained long enough to warrant the procedure itself. But it would be nice to find techniques to better ensure survivability in the long-term.
Satya skin and this guy are the only ones not afraid to tell the truth not caring about their pockets(humanity)
I like your hair, Rob ! Do you use any products? It looks so healthy and thick
Thanks! No products - just hopped out of the shower and pushed it to the side for the video. I do have diffuse thinning though. I've been lucky enough to retain the hairline, and I've been a great responder to stimulation-based interventions like microneedling / massaging. I've mentioned this in almost dozen other comments in other videos, but I'll likely start using some sort of DHT reducer in 2022. Just waiting on timing to decide if we're going to have another kid.
@@PerfectHairHealth Always family first ! Bless to you and to your family and a happy new year full of whatever you want !
How long should someone go off dht lowering stuff if they want to have kids? Should you not do anything that lowers dht ever on your life before having kids?
@@PerfectHairHealthI haven’t seen anything about finasteride and pregnancy issues. Are you saying that There’s a connection between the two? What connection would that be?
wounding should not be discounted. I have been using microneedling with topical finasteride. While the microneedling is a hassle, the slick bald periphery grew normal strong hair. I think maybe there was communication from the normal hairs in the strong borders to the miniaturized hairs in the bald areas.
Congrats on your success so far! On the topic of wounding, many transplant surgeons have reported transplant survival rates greater than 100% over a one-year period. Some people argue that this is due to hidden telogen hairs transferred during the transplant, but others believe it's the actual wounding from transplantation itself alongside the restoration of adipose tissue that initiates new hair growth surrounding the transplants.
@@PerfectHairHealth The wounding theory makes a lot of sense.
This is confusing...the video mentions that after only 2 years there's thinning but then concludes that hair transplants will probably last a very, very long time. Which is true?? If someone doesn't take finasteride then will it not be worth it even for transplanted hairs?
@@jimandrews8768 it all depends on the genetics. While not taking Finasteride, some loose the transplanted hairs, some don't. Nevertheless, if there was a transplant in a thinning area, (which means there were strong hairs and you supplemented the thinning hairs with DHT resistant hairs) and if Fin was NOT taken to keep the original hairs in the recipient area; after a certain amount or time after DHT has ran its course, you will be left with a huge thinned out area. Meaning only the resistant Transplanted hairs will stay. I hope that helps. Cause some clinics don't specify that holding back DHT is important
I have done transplant a few days ago....and i always had the same concern till now that how can transplanted hairs can be ever lasting when we dont have any practical examples present around us that had transplant 15 to 30 years ago?
Surely we olnly look for the results that are maximum 3 4 or max 6 years old.... i havent seen any guy with the transplant 15 or 20 years ago....and this is my biggest concern till the day and always in my opinion i was clear about the fact that may be transplanted hair can,t be there forever...
May be after 7 to 8 years they will lose....
Well studied and researched topic...❤
How is your hair transplant now? YOu are at 4 months. that's when things really start to happen.
Thanks❤️
Rob I'm planning on going to Istanbul for treatment. I currently do microneedling and massages. I have a loose scalp which thanks to your technique is pliable. Would transplant hairs survive longer because of this without the need for finesteride?
I think any treatments with clinical efficacy will help improve the survivability (and longevity) of transplanted hairs - even if those treatments aren't finasteride. Having said that, is there anything holding you back from using finasteride? Have you tried it and experienced side effects?
@@PerfectHairHealth I haven't tried finasteride, but did take dut which was daily and seemed to have given me sides. I'm contemplating fin, but I know some people who have hair transplants and don't take finesteride, or were asked to take it by clinics.
@@prabshiro Depending on your price sensitivity, mesotherapy dutasteride might be an option. Mesotherapy changes the pharmacokinetics of dutasteride to slowly leak into the system over a series of weeks following an injection. We have a case report in peer review about this.
So long as the injection volume and dilution are setup to account for this, you can really localize tissue saturation in the scalp while minimizing systemic leakage and thus preserving blood levels of DHT (and likely DHT everywhere else).
@@PerfectHairHealth hey Rob, i’ve tried it experienced side effects. topical and oral. so i use a natural protocol or non-pharmaceutical protocol.
i’m doing meso therapy with stem cell growth factor czcams.com/video/T1pqcxhh2AY/video.html , ketoconazole shampoo and micro needling, planning to get a hair transplant in three months from now hopefully all these things will keep it stable and will continue to do to keep my translators in place. I am very intolerable to finasteride and minoxidil.
@@rileyswaav8881 thanks for sharing your experience, and I’m sorry to hear that. I hope your latest regimen is helping you maintain. Despite natural interventions being less clinically supported, they can work for a lot of people.
Hi Rob ,
When minoxidil is discontinued does one lose all the hair or the only ones that would have been lost if not started applying in the first place?
Thank you.
Scary, hopefully those meds help me keep alopecia at bay long enough.
good one
Well... I wish this was out before I had my hair transplant - it would have given me a greater understanding of transplanted hair survival.
Hair transplant Apr 2019 = about 2 months before, I started to take a cocktail of vitamins and minerals to help achieve greater survival of the hair transplant.
The hair surgeon suggested I take Finasteride and Minoxidil as well as the hair transplant, I said I was getting a hair transplant so I would not have to take medication, but I agreed to applying Min5% as directed after the hair transplant along with my cocktail of vitamins and minerals.
I was to go back in May 2020, for 2nd transplant, but did not because of Covid.
Dec 2021, I stopped taking my cocktail (also my thyroxine tablets) and Minoxidil... well, with in a month I noticed my hair quality and colour subsiding. A couple of months my hair was thinning again and coming out in my brush like it used to when I was first going bald with the use of Roaccutane and genetic disposition.
I feel, the hair surgeon new that a hair transplant is not the be all and end all - he did not discuss this directly but suggested I take other FDA approved medication as well as the hair transplant.
Since Mar 2022, I have started a course of direction to try and achieve better hair quality and regrow some of the transplanted hair and the original miniaturized hair back again.
For me, a hair transplant was part of the puzzle, I now attack the miniaturization of hair follicles in more than one way.
Thanks, great video.
Dude.. you cant get a HT and not take finasteride
@@ordinaryguy815 WOW!
One thing that makes a huge different in finding is who is on medication vs not on medication and what is the difference
Would getting a transplant and then taking medication to prevent further thinning (like finasteride) greatly increase the chances that the transplanted hair stays?
While that finding wasn’t reflected in the 2020 study, I personally think this is a great approach.
It's the only rational method, thus far. You will buy yourself as much time as possible before you will be bald permanently.
I have a ridge on my hairline after getting my transplant about 7 years ago. So I can't shave my head completely now because the ridge makes my hairline look bad when i have no hair. This is tough because my hair is now quite thin and not looking good any more. It's very annoying. I wish I hadn't got the transplant in a way. Although sometimes it looks ok in certain light it still looks like a transplant now. My advice would be to stay bald and shave it if it looks good.
do you think a beard transplant on someone with no hair loss issues would cause thinning as well?
I have see people 7 years after a transplantation with great result, Seems like he lost nothing.
But yes, you have to take care of it, eat good and get right vitamins/minerals and take care of the scalp. And maybe also make prp or take Finasterid?
You have to use finasteride, minoxidil, red light therapy, PRP, exosomes, etc to maintain results.
I'm thinking if my hair transplants last at least 3 to 5 years then hopefully it would just be a slow progression back to thinning hair. So maybe it would at least slow and delay going completely bald
Do you talk about SCUBE3 in any of your videos?
The reality is, one needs to take a dht blocker. This, even if the majority of the top of the head contains transplanted hair. I truly believe that it is not the hair that's dht resistant, but it is the areas on the scalp that is resistant.
The underlying condition of scalp tension must be the “root” cause of MPB.
@@bobbylee2853 ... scalp tension TFF
DHT in the scalp is the hair killer, not scalp tension.
Regarding the 2020 study, do you know if patients who were using finasteride saw better outcomes in terms of the amount of transplanted hair they retained?
According to the study, there was no statistically significant difference in loss of transplanted hairs for those using / not using medical treatments like finasteride. But on a personal note, I think that finasteride use would absolutely improve retention of transplanted hairs!
Thanks for the reply. I would have assumed that something like finasteride would have significantly improved retention rates. Could it be that individuals who lose transplanted hair are both highly sensitive to DHT but also testosterone, so a combination of Dutasteride (greater level of DHT suppression) and something like RU58841 (to deal with scalp testosterone levels) is required to retain these transplanted hairs by protecting them from the conditions which originally caused the balding to occur?
@@collinsx62 It's a good question, and I don't know! At the outset, there's no arguing that higher degrees of androgen deprivation in balding scalps tend to improve outcomes (up to a point). So, transplant or no transplant, layering in androgen receptor antagonists like RU58841 or switching from finasteride to dutasteride should improve AGA endpoints and, in my opinion, increase the long-term survivability of transplanted hairs. At the same time, Orentreich's 2002 study demonstrated that human miniaturized vellus hairs regenerate thicker than terminal scalp hairs when transplanted to the backs of immunodeficient mice - even in low- and high-androgen environments. We know from Rushton's research that hair regrowth from finasteride does not involve the conversion of vellus to terminal hairs. So, that suggests to me that something in the scalp environment itself - the mesodermal sheath - is also antagonizing hair growth in AGA. I think it's this signaling between the surrounding tissue and the transplanted tissue that is likely responsible for the miniaturization of transplanted hairs in the long-term.
My husband had a hair transplant at the hairmax medical center in Beverly hills 22 years ago and taking 1 mg of finasteride. He felt the side effects at the beginning, then they went away. He has kept his hair.
So the one thing I gathered from the end of the video is a FUT transplanted hair follicle possibly has better survivability than an FUE transplanted follicle.
4 years later my hair transplant is maybe 10-15% thinner. Meaning each hair follicle seems a fraction thinner.
No loss though. I'm really happy with mine.
I guess the "5 years later" picture may still be better then without the hair transplants because if you're already losing hair before the transplants then likely without transplants that guy would have been completely bald.
Yes is for everything!! Nothing last forever 😂😅🥹😕😫🫠🫠
19:59 the fact that you highlight that phrase while the next sentence (and other sentences alike) says "there is no arguing that transplanted hairs last forever" makes me think you could be a bit biased too...
Big help in deciding to NOT get a transplant. I'd wait for cloning, where you at least keep what you had. That also has variants pending; true cloning, plus injections of special cells near existing hair.
This is what I been waiting for
Aint nobody got time for that, by the time it happens and is affordable i’ll be old and ugly anyway 😂
I’m mind blown by this video. There’s a lot I haven’t heard of. You go into more detail instead of saying the cause of hair loss is genetic etc unlike other youtube videos.
Please consider making a video deep into finasteride. Some people manage to keep most hair even after the drug was supposed to lose it’s effectiveness.
I feel like you’re getting close to the reason hair falls out. A topic left untouched is just on the tip of your tongue.
when is finesteride supposed to stop working? I'm taking it at 21 and worried that it'll loose it's result in few years
@@Sanket.vjadhav You might be in a better rout than me. I’ve taken minoxidil for 2 months before deciding to stop. I’ve taken finasteride for a month and discontinued as well. But I believe finasteride keeps more hair if you discontinue use. Minoxidil stimulates scalp whereas finasteride blocks dht. After not having any more stimulant the follicles shrink. It’s strange, some people have finasteride working for longer periods than expected. I’ve seen an accurate chart with the typical time how long fin and minoxidil last for most men, but I can’t remember.
I don't understand why this is a surprise... they check your donor area to see if you have enough grafts to do the transplant in the first place and they check because the donor area might have thinned out....which tells you that the donor area thins out and surgeons know this. I know when looking at my donor area it looks too thin for a hair transplant and I know it wasn't always that thin, especially before I started balding.
Absolutely. The donor area can thin over time and this has been known since transplants were first trialed in humans. A good transplant surgeon should always check that area and make an assessment for someone’s risk. The part that is just recently being acknowledged is that these donor hairs may thin faster once placed in balding environments, which suggests a role for recipient site influence that was previously believed to not be a factor.
Another thing that would be interesting to see is the pattern of the thinning. What if, for example, the transplanted hairs followed a recession pattern similar (if not identical) to the one of androgenic alopecia?
This is of course purely speculative. But if one were to discover such a finding, I'd imagine that would have major implications for the scalp tension hypothesis.
Interesting thought! Dr. Plikus hypothesized that the miniaturization of transplanted hairs might be due to their cellular exchanges with surrounding adipose tissue. It’s possible that differences in skin tension might also play a role.
It really is odd how little long-term research we have documenting the survivability and immunological changes to transplanted human hairs. Personally, I think Orentreich’s 2002 study is the most impressive study - whereby those completely vellus human hairs regenerated on the backs of mice in a single hair cycle. Very cool stuff.