Thank you for your question.
You submitted a question without a photo. And you describe in this question that you
are 58-years-old and that you’ve noticed over the past 2 years that although you’ve
had a good head of hair that you have receding temples that you’re not bothered by and
thinning in the crown area which you are able to cover with hair. And you’re asking if
minoxidil could be of any value for someone your age. Well, I can certainly help you understand
the role of minoxidil in the management of hair loss.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island
for over 20 years. I am also the founder of TrichoStem™ Hair Regeneration Centers, a
system we developed based on a wound healing material that we used to help hair transplant
patients as part of the management of hair loss strategy. We’ve essentially developed
and almost essentially defined a new category of regenerative medicine for the treatment
of hair loss. So I can offer a certain perspective as to how I discuss hair loss with my patients
at different stages of their lifetime of progression.
As I said, I developed this hair loss treatment called Hair Regeneration and it was something
that required a different perspective in understanding various categories of people in terms of the
relative aggressiveness of hair loss. So when you describe yourself as 58-years-old and
still having a decent amount of hair and noticing some crown thinning, well you are already
in the more fortunate group in that you did not experience significant hair loss at a
much younger age. We are treating males as early as 17 or 18-years-old as well as men
in their 70s. So we eventually figured out a categorization system to help our patients
be managed optimally where our system can be used appropriately.
So when it comes to the question about minoxidil, generally speaking, minoxidil which was originally
a blood pressure medication was found to have a great side-effect which was hair growth.
And over time, we’ve learned that minoxidil, although the minoxidil is not fully understood
appears to have some stimulatory effect on hair growth and has some effect on prolonging
the growth cycle. However, one thing to be aware of, well there are a couple of things
to be aware of, one is there is a limitation of how effective it can be and you can certainly
use it as a treatment and is fairly safe. It’s over-the-counter and you apply it once
a day. I think it couldn't be less problematic in terms of anything else you do. But I would
also suggest that you get a view of the top of your head.
A lot of times when people come to us and they have a similar question and concern and
then when we take our photos and we take a view of the top of the head, because when
you look in the mirror, you basically see the front. And maybe from a side view mirror
or the last time you were at the hairstylist, you noticed that thinning area is getting
larger. And it’s important to understand that when you think of a temporal recession
and the crown area, basically you only have this area of the mid scalp. And generally
speaking, people tend to underestimate the degree of hair loss. And hair loss affects
both men and women throughout the scalp and is certainly expressed in variable ways amongst
men.
So it might also be a time for you to also consider a DHT blocker such as the use of
finasteride. Finasteride is currently a controversial drug but it’s not, in the experience of
myself and most of my colleagues, a DHT blocker does have a role in management of hair loss
and it is something that we do prescribe. It is important for you to get a realistic
understanding of the degree of hair loss and the amount of how aggressive you want to be
about the management.
To contrast, the value of the DHT blocker to minoxidil, the DHT blocker can more significantly
impact the longevity of the hair follicles. And this is seen with our Hair Regeneration
treatment. When we've taken patients who were on finasteride for a long period of time,
anywhere from a few years to 10-15 years, and then we did our hair treatment with Hair
Regeneration which is briefly it’s a combination of platelet-rich plasma (PRP) derived from
your own blood combined with Acellular matrix. And over the past 7-8 years, I developed an
algorithm and a system to help stimulate hair growth. The distinction here is that finasteride
will allow the hair follicles to live a little bit longer. And it is my observation that
it is more effective than minoxidil.
That being said, we use Hair Regeneration which reactivates hair that isn't growing,
thickens thinning hair and prolongs the lifespan of the hair growth cycle. The synergy has
worked out very favorably. Patients who were still on finasteride, they weren't growing
as much hair until after we treated them with Hair Regeneration. So I think that in a way,
your goal is to maximize coverage.
I always explain to my patients that hair loss is progressive and medical interventions
whether it’s pharmaceutical, regenerative or stem cell based technologies or surgical
is all about maximizing coverage. And so when you are at a point of threshold, you are seeing
enough hair loss and you want to do something about it, it is my perspective that you want
to do everything you can to extend the longevity of coverage and maximize that coverage. Scalp
coverage is a function of hair density and thickness of the individual hairs. If you’re
on minoxidil and you don't use finasteride, the progression may go on faster than it otherwise
would with finasteride. If you choose to do everything you can then a treatment like Hair
Regeneration can have a value in synergizing everything so you can get maximal coverage
for a longer duration.
Again, to answer the question about minoxidil, certainly it is safe and it is worth trying.
Certainly, a lot of the minoxidil studies have shown that to be the case especially
with slow progression in the crown area, it tends to be fairly effective but it’s only
one tool. I think that if you look at yourself not only at the top of your scalp but also
look at your scalp with your hair wet, you might realize that you have more extensive
loss than you may be aware of at this point. At which point, I think it’s best to be
proactive than reactive.
So I hope that was helpful, I wish you the best of luck and thank you for your question.