48M on Finasteride for 17 Years: Now Thinning at Crown, Considering Transplant Options

Hair Transplants
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I just got my hair colored today and just applied Monox, so it’s all greasy and weird. But you can see the loss well. I just took all 5 of these pics starting at the front and slowly going back.

I started 5mg Proscar (1/4’d) daily in 2008 when I was 29 and thinning at the temples. Took it every day without fail and as a dude in a Metal band, I have long hair past my shoulders. Thought of it as a wonder drug (it was for me), because I gained back anything that I lost and got compliments on my hair constantly for years. Never had a side effect or any issues.

Over a year ago, I was walking into a grocery store with one of the camera feeds that you can see above the door that shows the back of your head, and I saw a line of scalp, basically extending my part about an extra inch or two down the back of my head.

When I got home, I grabbed a mirror out and sure enough, I had started loss at the crown. I immediately started taking half of the 5mg Proscar pills daily thinking I should up the dose. And since I had never even tried Monox, I ordered the foam from Amazon and started applying it daily as soon as I got out of the shower. Sometimes at night if I could remember, but definitely EVERY morning without fail.

It has been a year and there has been more loss. Basically the whole top of my head is thinning. Luckily my long hair hides a lot of it, but it won’t for much longer.

So my routine for the past year is: 2.5mg Oral Fin daily, Topical Rogaine foam at least once a day. I also added Lustriva in March, but I’m pretty sure that is doing nothing.

From what I have read so far, it sounds like a transplant is my next option. And I’m expecting around $10k (according to a Joel McCale interview I saw a while back about his?)

I live in Vegas, so there are tons of hair transplant doctors in this town. But my questions to anyone that has made it this far is:

  1. Before I pull the trigger on a transplant, is there anything else that I should try? Anyone else take Fin for years, had it stop and then switch to something like Dua and have re-growth?

  2. If I do go for a transplant… what do I need to know to find a good doctor? Because there are so many here, I’m nervous about getting a shitty one. I see Neograft and FUE, and I’m just overwhelmed with info.

Thanks for any advice!

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Adding oral min is a solid move since it can potentiate hair growth where fin is lacking. Keep up with the ketoconazole, and consider using CBD with MCT oil to address any scalp issues. How about microneedling?

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Thanks for the reply!

Can I add oral Min + Dut? Does Dut usually replace Fin, or does that stay in the mix too?

I’ve never even heard of Ketoconazole. That’s a topical, right?

Microneedling seems like a massive pain with my long hair, but I was considering Alma TED since there are multiple clinics in Vegas that advertise that. Although it is hard to find a lot of reviews of it.