Restarting fin. Are my follicles dead?

The finasteride needs 1 year to work. Often, you can recoup this hair if you give the finasteride time. Your baseline might not return to normal but I would expect some rebound. I normally do not have patients stop finasteride when trying to conceive unless conception has proven difficult for 6 months and a workup for both partners has not revealed a cause. It is also important to know that pregnant women should not touch/handle finasteride pills while pregnant.

Hello, your hair loss secondary to stopping finasteride is likely due to removing the medication and the resumption of the culprits that lead to hair loss in the first place (in androgenetic alopecia). Unfortunately, getting back on the medication will not quickly reverse the processes that lead to the hair loss in the first place. I believe you should give it more time with the current therapies you are on. We usually recommend 3-6 months of treatment to be able to assess for improvement or worsening. After that point, you can consider alternative and/or additional therapies.

It sounds like you're doing all the right things to manage your hair loss, and restarting finasteride after a temporary break can definitely help slow down the shedding and potentially promote regrowth. The fact that you've only been off finasteride for 3 months means your follicles likely haven't died off—they've just been more exposed to DHT during that time, which is why you’re experiencing the shedding.
Since you’ve already restarted finasteride and are continuing with minoxidil, PRP treatments, microneedling, and LLLT, you’re giving your hair a strong chance of recovery. These treatments can complement each other and promote better hair growth and density. While it’s tough to predict how much regrowth you’ll achieve, there’s definitely hope of regaining some of the hair you lost during the shedding phase. It may take several months—often 6 to 12—to see significant improvements, so patience is key.
Other options you could consider to boost recovery:
Dutasteride: If you feel finasteride isn’t enough after some time, switching to dutasteride may provide a stronger DHT-blocking effect. Dutasteride inhibits both types of the 5-alpha reductase enzyme, offering more protection against DHT.
Topical Finasteride: Some patients use topical finasteride as an adjunct to oral treatment or as an alternative to minimize systemic side effects. It can be worth discussing with your dermatologist.
Scalp Health: Ensure that your scalp is in optimal condition for hair regrowth. Address any irritation, flaking, or inflammation, as these issues can affect hair recovery.

Hair thinning is a complex condition. There are a few things that may be considered:
1) Sometimes, it is essential to perform an extensive workup, including blood work. Recent studies have confirmed that pattern alopecia is associated with metabolic changes (we have learned this from the fact that patients with COVID and pattern alopecia have similar metabolic profiles). Therefore, if there are any underlying issues that can be addressed, it is important to identify them.
2) There are other medications that may be used in addition to (for example, oral minoxidil or spironolactone), but it is essential to make sure that there are no contraindications or interactions.
3) When choosing a provider for PRP, it is important to remember that not all systems are the same and give the same results. The results can vary depending on the system used.
4) In addition to PRP, there are some other non-surgical restoration techniques available, such as:
Keralase treatment, which is a laser treatment with the application of growth factors or Alma TED among others.
If you need a consultation or would want to learn more, feel free to contact us for the consultation.