Would it be best to stop Finasteride and Minoxidil and let hair fall out, then do a hair transplant and SMP combo?

Hello. I noticed you wrote in a few months back and am wondering how you’re doing. Have you decided what to do? If you haven’t already I would see a reputable hair loss specialist and see what are your best options. Best wishes.Dr. T

Great question. I read your comments, questions and I reviewed the photo you included. It sounds that the medical treatment is working for you because you are 30 years old and losing your hair for the past 13 years. Unfortunately the genetic hair loss is progressive even with the best medical treatment (finasteride or dutasteride and Minoxidil) and/or hair transplantation. If you stop the medications, the hair will fall out in the following months. The hair transplant will only replace the hair you have already lost but without medications you will continue your regular pattern of hair loss and you will need 2, 3 or more surgeries in the future and your donor area will be decreased each time. Micro pigmentation of the scalp is not an option at the moment  and it is an illusion of hair. I will suggest you to do nothing at the moment except to book a consultation with a local and experienced hair loss specialist for further evaluation and discussion of the best options of your case. Good luck.  

If you are planning to stop using the medication that is treating your hair loss then you might lose a significant amount of hair over your lifetime if you are genetically predisposed to do so.If you see a reputable hair transplant surgeon, they will give you ethical advice on whether to proceed with a hair transplant surgery procedure and if so, where to place the hairline taking into account that you may lose your existing hair in the future.If you are going to have scalp micropigmentation (SMP) it might be wise to either do it before hair transplant surgery or wait until the full result of the transplant is visible which might take up to 18 months.A face to face consultation with an experienced hair transplant surgeon is the most important first step and if you are thinking about throwing SMP into the mix then you should choose a surgeon who is very familiar with the technique and what can be achieved with combination procedures.

You'd probably be better served trying to maintain your hair as best you can and preventing further loss whether or not you plan to have transplants done, so I wouldn't suggest stopping minoxidil or finasteride, especially if you are doing well with them.  SMP can be done before or after a transplant.  My prejudice is to graft first, wait until you have your final results from the transplant (8-12 months), then decide if you want more grafts or pigmentation.  

First, how do you know that you will bald? I would first start off with a HAIRCHECK test to determine what your pattern of balding presently is. At age 30, if you have the genes and they are active, this will tell me something about what may happen to you. Without balding, I wouldn't do anything, just stop the medication and then see what happens. These medications are never really adequate to completely stop genetic balding and from the pictures, you look hairy. Decision can be made once the test is in hand