Edward Hsu, MD

The least invasive but less effective treatment would be minoxidil (rogaine). The most invasive but likely most effective treatment would be a hair transplant.

Thank you for the excellent question. Finasteride is very effective. According to the American Academy of Dermatology, Propecia or generic finasteride slows hair loss in 88% of men. It stimulates regrowth in about 66% of men as well.

Finasteride can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took finasteride in clinical trials: ejaculation problems, breast tenderness, rash, decreased libido* (sex drive), and erectile dysfunction. A 2017 study of 3177 men showed a 0.7% incidence of side effects while the hair growth continued to improve with negligible problems.

Thank you for your excellent question. Your donor area does not appear to be too thin in the pictures you have provided. You should be able to have a hair transplant with donor area of that density.

Hi, thank you for the excellent questions! You do not have to shave the recipient area if you have a 2nd hair transplant. Yes, you can do a second FUT. It is likely they will chose a 2nd donor site away from your first donor site (the scar from the 1st donor site would compromise the quality of donor tissue for the 2nd transplant otherwise). With FUT, it should not thin out the hair in the donor area since both scalp tissue and hair is removed (no change in density in the donor area, unlike with FUE). Yes, unfortunately shock loss would still be an issue with a 2nd hair transplant. However, fortunately, the loss is temporary and the hair will grow back.

Thank you for the excellent question. This is completely normal and the hair will grow back (not permanently lost).

Thank you for the excellent question. Hair transplant is both safe and permanent as long as the donor hair is permanent as well. If the donor hair was taken from an area at risk for future hair loss, then the permanence of the transplanted hair is in jeopardy. It is for this reason that the donor site is chosen carefully to ensure that it is within a "safe zone" to avoid future hair loss and the site is kept to as small an area as possible. In this respect, the FUT technique is advantageous when compared to the FUE technique.

Thank you for the excellent question. Finasteride is first broken down by the liver into what we call metabolites. The metabolites have less than 20% of the activity of finasteride and exit the body via the feces (57%) and the urine (39%). So to answer your question, yes, a portion of finasteride exits the body through urine. But it's not the process of urinating that stops the action of finasteride though. The majority of the function of finasteride is stopped when the liver breaks it down.

Thank you for your question. It is difficult to be 100% from the picture, but it does appear that your grafts were placed correctly and should give good density.

Both Rogaine (minoxidil) and Propecia (finasteride) have been shown to prevent hair loss and possibly increase hair growth, and are medications you can do at home by yourself. Rogaine is over the counter and usually sold as a topically applied medication. Propecia is a prescription medication that you would see your primary care doctor for and is usually taken as a 1 mg pill daily.

Thank you for the excellent question. If you are having difficulty cutting the 5mg pills evenly (especially into fifths for 1mg dosages), another option is to crush the pills completely and then use a scale to weigh 1/5th of the pill's weight to take daily (1 mg dosages).