25 & continued hair loss on 5ar Inhibitors, what else can I do to protect my hair? (Photos)

Question

I began taking 5ar inhibitors and using min 3 years ago, when I just turned 22. My primary concern at the time was my hairline. I experienced some regrowth, but it has continued to recede slowly. This is also evident from the pictures of my crown, from 2020 and now. Since I had a nearly full head of hair when I started, I'm not sure why I've continued to lose hair, since the data shows best improvement in men with mild hair loss. I'm not sure what else to do to protect my hair.

Ross Kopelman, DO · Answer

It's frustrating when you’ve been diligent with 5AR inhibitors (like finasteride or dutasteride) and minoxidil, but continue to experience slow hair loss. While these treatments are highly effective for many, a few factors may contribute to continued loss, even if the regimen has slowed down the overall progression. Here are some additional strategies you can consider to help protect your hair:
Consider Switching to Dutasteride: If you’re currently on finasteride, switching to dutasteride could be a more potent option. Dutasteride inhibits both types of the 5-alpha reductase enzyme, while finasteride only inhibits one. This stronger DHT-blocking effect could provide better results.
Low-Level Laser Therapy (LLLT): Devices like laser caps or combs can stimulate hair follicles, increasing blood flow and promoting hair growth. LLLT is often recommended as an adjunct therapy and has been shown to improve hair density over time.
Platelet-Rich Plasma (PRP) Therapy: PRP involves injecting your own platelets into the scalp to stimulate hair follicles and promote regrowth. It can be especially helpful for those who don’t see sufficient improvement with medications alone.
Microneedling: Microneedling the scalp, combined with minoxidil, has been shown to enhance the absorption of the medication and stimulate hair growth. This method can help improve the efficacy of your current treatments.
Optimize Scalp Health: Ensure that your scalp is in the best condition to support hair growth by avoiding irritants and maintaining a healthy environment. Using gentle shampoos and addressing any scalp conditions like dandruff or seborrheic dermatitis can make a difference.
Hair Transplant: If the hairline continues to recede and other non-surgical treatments are not enough, you could consider a hair transplant to restore density in specific areas, such as the hairline or crown. Modern transplant techniques can provide natural-looking results, especially if you still have good donor hair.

Jeff Donovan, MD, PhD · Answer

These meds don’t help everyone, no. But they do help slow it down. I don’t know if some of the hair changes in the frontal hairline was just hairline maturation (or another diagnosis altogether besides androgenetic alopecia). But 5aR and min do not help maturation. You are on a good plan if male balding is the sole diagnosis. Be sure to see an expert to exclude other causes of loss and also other causes that impair full responses to 5AR and min. Thereafter, you can consider if options like oral minoxidil, laser or PRP have a role in your plan.

25 & continued hair loss on 5ar Inhibitors, what else can I do to protect my hair? (Photos)

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25 & continued hair loss on 5ar Inhibitors, what else can I do to protect my hair? (Photos)

Answers (2)

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Everything you need to know about Hair Loss Treatment

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