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Mark Waldman, MD

Physician
310 E. Broadway, Ste. 200, Louisville, Kentucky
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21 Questions Answered
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QUESTIONS ANSWERED

Is it too late to start Finasteride?

Asked By:AnonymousANSWERS (1)

FInasteride is a long term medical option.  It will most likely not work overnight.  If you are thinking longer term then it is not too late.  If you want it to help yesterday then yes it is too late. But I would still consider starting it for the future.

Mark Waldman, MD

Physician

Has my hair transplant been over harvested?

Asked By:AnonymousANSWERS (1)

How long ago was your transplant? The donor looks weak at this point but your hair is still looks short- it could look fuller as the hair grows out.   The answer will show itself when you hair is it’s normal length- not the answer you probably want now.  If you plan to leave it short it appears that is may have a decreased fullness.

Did you ask them how many attempts they made to get the 2000 grafts?  That would give you your answer. For example if they made 4000 attempts to get 2000 grafts that could be an issue down the road for further transplants and your current fullness of the donor area

Mark Waldman, MD

Physician

This can be seen around this time.  Folliculitis just means inflammation of the hair follicle- it can be sterile(no infectious cause) which is most likely the case here as well as infectious.  Should be a temporary thing but see your doctor because no there are treatments that can help to minimize the inflammation.

Mark Waldman, MD

Physician

Is there a specific reason to switch meds?  If your hair is doing well then I will typically not rock the boat.  If you are losing hair or wanting to see if you can get more hair then it is reasonable to change meds.  The dose of dutasteride that was suggested is probably the most common regimen I have seen.  

Not sure about the combo you presented - would recommend you discuss with your doctor.  Would be great to get some follow up in 6 and 12 months

Mark Waldman, MD

Physician

I would be very cautious about doing a transplant.  Based on your pictures your donor density appears to be on the weaker side.  In person it may look stronger.  If you are going to do a transplant and keep your hair shorter you may want to consider FUE.  

Have you considered medical therapy?  You may get a good response.  

There many excellent HT surgeons in the UK that can give you an in person evaluation- it will be worth your time to see one.

Mark Waldman, MD

Physician

I did not see how many grafts you had the first time.  The need for more density could be from poor growth or just not enough grafts transplanted the first time.  Not knowing what expectations you and the surgeon discussed there is more info needed.  

FUT is a great method for someone with long hair.  

Just make sure your expectations match what the surgeon is saying.

Mark Waldman, MD

Physician

Since you are only 5 weeks into your TE it could take longer for everything to reset.  In order to get your hair follicles back in a normal cycle the anagen phase needs to be triggered.  Topical rogaine can be very effective as a first line therapy.  

If you are not convinced of the diagnosis then a biopsy may help.  I have seen a couple patients who I thought had early TE with a lot of shedding but ended up actually having severe alopecia areata.  

Mark Waldman, MD

Physician

You should find a surgeon who actually does the procedure. Listen to your own concerns and the other two doctors who are also telling you the same thing.  I would be glad to see you as well as  refer you to other surgeons in our area if you want other options

Mark Waldman, MD

Physician

I have a patient who occasionally complains of something similar to this-fairly rare that I have seen.  I would think that if it hasn’t cleared up within 1-2 weeks or isn’t significantly better within that time frame you should see your primary care.  You just want to confirm that’s there isn’t a coincidence of timing and something else isnt causing the issue

Mark Waldman, MD

Physician

Unless there has been some change I would expect a good result if you use it consistently. The good news is that you have not stopped it completely.

Mark Waldman, MD

Physician

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