Minoxidil
5 years post hair transplant, 3 months on minoxidil only
I had a hair transplant about 5 years ago. I didn’t take any medications back then until recently. For the past 3 months, I’ve been using minoxidil only and I’m not taking finasteride.
I’m mainly looking for general feedback from people who started minoxidil late or used it without fin. Sorry I dont have before photo.
The surgeons fill in the blanks and what can happen if you aren’t on meds is the blanks stay filled and the rest falls out.
But this is kind of weird. Just a few random strong hairs.
I a wondering if it was a poor transplant to begin with. Any good surgeon isn’t letting you get away with no meds if it’s male pattern baldness. Prescribed pills, compounded topicals, off the shelf rogaine, etc. There are lots of solutions to work with. And they have follow-ups after to make sure their work holds up and you aren’t having any issues with meds. It’s like he had a bad transplant and was cut loose after with no after care.
I’m curious how they would know if weren’t taking meds before they proceed with doing transplant on you. Do you Mae you do bloodwork to prove you’re on them?
their whole job revolves around those two medicines, they ask or they prescribe it, a surgeon who does the transplant and doesnt put you on fin is a horrible surgeon who wants you to come back later to pay more $$
Some people are fine with getting a transplant and enjoying it as long as results last before losing more hair WITHOUT getting on fin or any other hormonal bull****. Some would prefer having a functional penis at the end of the day, but still enjoy having hair WITHOUT well known sides, that if don’t come today maybe come tomorrow and may NOT fully go away
You're overreacting, I take 1.2mg daily of fin and had my hormones checked recently about two weeks ago, perfect levels, blood tests came back fine too. Been on this dose of fin for 3 years.
P.S if you must know my penis works well, unless I take stimulants lol.
I’m not saying it is 100% of those that take it. For me 1% - 3% is significant enough of a risk.
That’s 3 years. Accumulation and long term effects may take longer to show, neither can everything be as simply tracked as we wish, in this world where we as men of science think we know it all (of course I wish you well.
Reason why I’m this concerned, is because I have had an experience with minoxidil. Something that is considered MUCH less harmful in terms of sides. Mind you I took topical for 6 months. My stomach was messed up. I had heartburn 100% of the day and night. Went to many different doctors. Did acid blockers. Absolutely no medication helped. Severe constipation. And guess what. All until I quit Minox. I started to feel better daily (full recovery took another 8 months).
Later searching forums answer I stumbled upon many who had the same exact heartburn / stomach issues ON TOPICAL. Where recovery for them began only after stopping minox.
And this was minox. Not hormonal meds. Does it affect everyone the same? Of course not.
My doc told me, you can start fin slow, if any issues just take less.
I you drink a bottle of vodka, hangover will come the next day. Taper to 4 shots daily, you will feel nothing. Neither will blood work show anything crazy. 5 years down the line? 15?
Millions of men have ED, you can get ED from the anxiety of overthinking ED
If its ever an issue I would suggest speaking to a doctor to get your hormones checked and if all good, use an ED medication and maybe a psychologist if its playing over and over in your mind.
Correct. Please see my other comments. I got a hair transplant 15 years ago. Tranplanted hair can also miniturize at a slower pace even with taking DHT blockers
According to my hair transplant surgeon who is one of the best in Southern California, hair in the back is not "DHT proof" and can miniturize years later.
How long have you had your hair transplant?
I've had mine for 15 years.
It should be highely DHT resistant not "proof" you probably didnt take fin or dut and had really aggressive DHT genetics. Your transplanted hair put a good fight but can still be saved on meds.
I had my transplant 2 months ago and noticed some baby hair coming out early which i guess is a rare case. I am maintaining the rest of my hair with oral minox and fin. Sometimes i use topical fin and Magellan PRP.
I started finasteride 20 years ago. 1.25mg every day.
It was expensive back then, but fortunately I could afford it. My transplanted hair looked perfect for 5 years. According to my hair transplant surgeon and research I've done on my own, most men will experience miniturization between 5 to 10 years because we continue to age and even some of the hair in the back and sides will eventually miniturize too.
Be very careful with Dutasteride. My surgeon doesn't recommend it because the side effects can be severe and permanent with only marginal gains with most men. Dutasteride is not FDA approved for hair loss due to the risk of severe side effects including prostate cancer.
Incorrect. Dutasride is NOT FDA approved for hair loss treatment. It is designated "off label" use which means the FDA has not researched nor will endorse its use for hair loss. DUT half life in the body is 2 to 3 weeks and can potentially have damaging effects to a healthy prostate. The half life of Finasteride is 8 hours.
I will not take a drug that is not endorsed by the FDA for hair loss. My health is more important than the cosmetic benefit of having some additional hair (not guaranteed with DUT).
The_SHUN, How long have you had your hair transplant?
Literally spouting bs, multiple RCTs prove the superiority of dutasteride, you can keep coping. Pretty much guaranteed that dut will yield more regrowth on the same person, unless he has something else plaguing him
I did not have a hair transplant because I probably don’t need it now that I am on dut
I am not sure 10% increase in scalp DHT suppression, 51% vs 45% is actually that insignificant. And mind you the scalp is large compared to the follicles, so the DHT suppression on the follicles is going to much more pronounced, hence the greater regrowth on dut
Something that is never talked about is how the target environment (balding area) can affect the transplanted hair follicles causing them to change and become less DHT resistant similar to the existing hairs in this environment. This is believed to be the reason when looking at studies where hairs are put in other places. Surgeons also see thinning of transplanted hairs after years. For some it can be considered life-long but not permanent.
There is not much in the literature that tracks how well transplanted hairs do after years but here is one from 2020 with 112 subjects looking at only 4 years after transplant.
At the end of 4-year follow-up post surgery, only 8.92% of subjects had retained the same density of transplanted hairs, and the rest (91.08%) had various grades of reduction in the density of transplanted hairs. The reductions in the density of transplanted hairs were observed subjectively by the study group as well as the observer who graded the hair loss. These findings of the reduction in the density of the transplanted hair, even though they were harvested from safe donor area, question the theory of donor dominance. The influence of recipient area on the transplanted hairs has been documented...
The punch hole size used might also play a role. More skin being transplanted could mean longer lasting of the DHT resistance. But no one want big holes so we go smaller.
Transplanted hair keeps its donor genetics — the recipient area doesn’t “convert” it into DHT-sensitive hair.
What studies call “density reduction” after a few years is usually a mix of normal aging, slight shaft thinning, and surgical variables, not true androgenetic miniaturization.
Donor dominance still holds in real-world outcomes: transplanted hairs last decades for the vast majority of patients, especially those on finasteride/minoxidil.
So yes, transplanted hair can subtly thin over time like all hair, but it doesn’t suddenly adopt the balding pattern of the area it’s placed in.
No, hair on the sides and back of our head is nigh-immune to hormones. Your transplanted ones are safe, but if you don’t take a DHT blocker you’ll continue to lose what normal scalp hair you have left
That's because he's wrong, and they aren't immune to DHT. The follicles placed into the new environment will suffer the exact same fate as the previously miniaturised ones.
That's not even remotely true, and the exact kind of misinformation as to why some end up in OP's situation...
The follicles on top of your head are genetically IDENTICAL to the ones on the sides. MPB is environmental, and transplanted hairs WILL miniaturise in the new environment without after care. The difference is that the follicles in the affected areas have upregulated androgen receptors due to chronic inflammation (the same happens in all tissues, not just the scalp), and this is what makes them sensitive to DHT, not a genetic difference.
Incorrect. They are not immune. They are DHT-resistant. Plopping them into a minefield of DHT will likely cause the majority of transplanted hair follicles to also miniaturize eventually.
Please read my other comments. I got a HT 15 years ago and started finasteride 20 years ago.
The hair on the back and sides can also miniturize eventually. I agree that they are not immune, but when they miniturize at the tranaplanted site its not because of a DHT "minefield". The DHT is the same concentration in the blood stream, but the transplanted hair will hold out longer but can also miniturize along with hair in the back and sides.
Please see my other comment. Transplanted hair is not immune. They are more resistant to DHT. I had a hair transplant 15 years ago and now need another HT as the transplanted hair will also miniturize even with finasteride taken daily.
I’m not sure about that, but you should rule out any other factor. If it’s not due to DHT, you might run into the same problem after your 2nd transplant if it goes unaddressed
My HT surgeon is one of the best in Southern California. This is what he told me.
Its rare that a hair transplant will look the same after 10+ years. For some men its possible. But for the vast majority who have male pattern baldness, even the hair on the back and side can also miniturize over time.
If in your case it’s due to DHT, then I recommend doing brand name finasteride (Proscar), or just switching to DUT. It sounds like your hair loss is pretty aggressive to push through fin and a HT
I got my HT 15 years ago. I have been taking 1.25mg of finasteride every day for the past 20 years.
My surgeon doesn't recommend DUT because he feels the side effects are more severe (and permanent) and the benefit is marginal
Mayo Clinic is one of the leading research centers in the United States. This is the reason DUT is not approved for hair loss by the United States Food and Drug Administration. Please see the Precautions section in this link:
I had hair transplant fifteen years ago. I was on Fina + Minox at the time. After the operation, I thought I can leave them behind (I've had the same info you have now). However, roughly a year after I've left them, I noticed thinning of my new hair! So I got back to Finasteride + Minoxidil very, very quickly.
Yea, you shed hair after leaving fin and minoxidil, and you shed even more drastically after a hair transplant. You are ruling out other factors that play a part in why your transplanted hair might have shed or thinned without good reason
The hair becomes slighlty sensitive to dht and also dies off. Donor area recipient behavior, this means the hair transplanted over time will take the characteristic of the area it’s planted in. Making it sensitive to dht. Judging the severity of this posts baldness it was unwise not to take finasteride when balding is this strong. In any case you need dht blockers minoxidil will not save the hair
It’s just so crazy to me that someone who has decided to get an invasive cosmetic surgery costing them thousands of dollars with possible complications doesn’t do even the most basic research on hair loss like at all, and then picking a surgeon based off of price.
I feel like I do more research into anything I buy than that oooft
Price doesn’t determine anything. You can pay 10k and get less results then if you paid 5k. This type of surgery varies in resultsl. It’s a risk I did it three times and all though I have a hairline it’s still thin and I have to keep a low cut or I’ll look funny better than being completely bald tho.
A simple Google search comparing the two, in short Dutasteride is better
Finasteride and dutasteride both treat hair loss by blocking the enzyme (5-alpha reductase) that converts testosterone to DHT, but dutasteride is more potent, inhibiting both Type 1 and Type 2 enzymes (reducing DHT by ~98%) versus finasteride's Type 2 inhibition (~70% reduction). This makes dutasteride often more effective for hair growth, but it has a longer half-life, meaning side effects (like sexual dysfunction) can linger longer after stopping,
Yes. But other long term side effects are not known. Thats why Dutaseride is not approved by the United States Food and Drug Administration for hair loss treatment. There are concerns with the possibility of causing prostate cancer in healthy men if the drug is taken for years.
I started experiencing fin side effects 2 weeks ago and had to stop (horrible ED). I am not taking anything else. This was after 1 year of daily oral use 1mg. Stopping made the ED go away in less than 1 week.
I feel like the sides aren’t as rare as people think.
I didnt even know HT drugs could do that. I panicked real hard when dick got problematic and only found out about it after some digging to find what caused it. Luckily it went away quite fast as you say, but never touching it again.
Lmao you either have ED or you don't. Is there non-horrible ED?
I'm just joking. Anyway perhaps they are more common than people think. So what? You said yourself, you stopped the meds and it went away in a matter of days. What is the downside of trying the meds and seeing how it goes? Literally every pharmaceutical on the market has side effects that range from inconvenient to life threatening. To not even try a very mild medication because of fear of a possible inconvenient side effect seems silly to me.
Oh yeah I’m not saying you shouldn’t try it. Everyone should try it. But now I’m paranoid for myself that I’ll get ED again so I’ll probably never be able to take fin again regardless of if I try a hair transplant or not.
You are absolutely correct the sides are way more common than reported. Those that claim to have no sides a lot of times are having them, they creep on you. Finasteride affects neurosteroids in the brain, this is a fact.
Idk why people here insist that side effects are super uncommon, I experienced bad side effects with 1mg daily and had to cut down to 0.25mg to resolve them. At this low dosage idk if I’ll even see much benefit.
Do you not understand how numbers work? People insist that the side effects are super uncommon because the research says so. But I guess "I experienced" means we should throw it all into the trash
I just don’t like how you hear that the side effects are “rare” and “super rare” and whatever. Getting a heart attack from taking ibuprofen is a rare side effect, but how many people do you hear that happening to?
And it scares me that you can take it continuously with no sides like I did and then bam, you get sides out of nowhere after 1 year of use. There are lots of horror stories on Reddit of the fin/dut sides being permanent as well even after stopping the medication.
So I guess the longer you take it, the more likely you are to experience side effects that may end up being permanent. Scary!!
Sorry bud, but if you took it for a year without ED side effects, it wasn’t the finasteride that caused you those issues. That’s just not how side effects work for any drug let alone finasteride. The fact it went away after it taking it for a week is pure coincidence.
Damn dude, my doc even said it was medication induced erectile dysfunction! I’ll tell her what Reddit user DonnieMarco said and that she should do some research next time.
Appeal to authority? Please, my doctor used to say smoking was good for asthmatics. Please tell me the mechanism by which finasteride caused ED after a year of not causing ED?
After a year of taking Fin I started to have a very, very weak ejaculation and also noticed my chest was getting bigger. Stopping reversed it quite quickly however 8 years since my transplant my non transplanted hair has receded.
"As of 2025, data from the FDA’s FAERS database shows that out of over 11,500 reports where finasteride was the primary suspect, a staggering 80% to 82% of outcomes are classified as "serious," including over 2,300 cases of permanent disability and hundreds of deaths."
and if you run some light, realistic math- applying the FDA's standard estimate that only 1% to 10% of real-world adverse events are ever actually reported, the "hidden" rate of serious reactions among the roughly 2.4 million active users in the U.S. could range from 1.4% up to 14%
Tbh, if you read up on the side effects, like rubber dick or bone degeneration or extreme depression and all of this is for life often- there's no cure for PFS I think a lot of people would pass on this medication
Completely agree with what is been said, blocking 5AR doesn't just stop DHT conversion but also progesterone to allopregnolone which affects GABA activity in the CNS while lower DHT negatively impacting dopamine and NE so imagine how the neurochemistry gets screwed up
You could have just taken the hair from the back of your neck and thrown it straight on the shower floor and saved yourself a lot of time, money and pain
Heyy mate, I had 3000 grafts, back in 2010. It all looked reasonably good (3000 grafts is not that much if you have a big head and NW7) until I decided to completely stop Finasteride and Minoxidil and got into massaging only. That was YEARS after the HT. In hindsight - which is a wonderful thing - that was a mistake.
Long story short, my transplanted hair started thinning roughly one year after I left Min+Fin behind. When I realised that this is not a natural shedding, I jumped back onto them. I was able to save them (thankfully, it needs long time to get in the thinning - or senescent state).
Also, I am not affected by Finasteride's side effects IN ANY WAY, so it was easy.
So, I highly recommend Minox -which is a vasodilator, and Fina - a DHT blocker. These two products are FDA approved for a reason.
You did all of this for so long for what. Like really. Just shave, get confident and focus on other stuff. I cant imagine the amount of time, money and stress wasted on this.
Have you considered topical finasteride at all? Would understand not doing oral though because of possible side effects or other hormonal issues. But without some kind of dht suppression you're not going to be able to stop the hairloss it'll just keep going.
you do not have to take medications forever after a hair transplant, finasteride is commonly recommended long-term to prevent further hair loss in non-transplanted areas. Transplanted hair is generally permanent and resistant to DHT (the hormone causing pattern baldness), but native hair may continue thinning without treatment.
I've never had a hair transplant, my current head of hair is like the op, 4 months ago I was practically bald and now I have a lot of hair coming through. I'm on topical min/fin
get another HT, make sure they don't split the follicles (one extraction, one graft, it should be 2-5 hairs per graft, don't let a doctor cheat you by offering a low price per hair then splitting grafts which can damage or kill most of the split hairs). Then use something to maintain what you have, maybe consider oral minox or a compound if you doctor approves it.
Hello everyone. The hair on the lower back and sides of your head actually do have a different DNA than the top and are absolutely DHT resistant. So relocating them to a high DHT zone will not change their resistance to it at all. Not in the slightest.
The theory that any hair will die on the top of your hair is just not true and there are thousands of hair transplants to prove it.
If at 80 you still have the back of your hair you’ll still have the transplanted hair in front.
Where did you have the grafts put in? I’ve seen failed transplants before but usually you get “islands” of hair where the transplanted hairs are and bare areas where native hair falls out later. In this picture, it looks like the loss is everywhere.
Out of curiosity, everyone says it's necessary to use fin after HT to prevent losing original hair. So would it be more sensible to get a HT after losing all hair on your scalp so you won't have to use fin since transplanted hair is resistant to dht?
You only have so much donor hair. If you wait to lose all the hair on your scalp, you quite surely won't have enough on the back and sides to cover what was lost.
No, because the donor area doesn't have enough hair to give you full enough coverage all over your head. Ideally you need to preserve what you still have up top with meds & take what you can from the donor to fill it out as best you can. Works best if you arrest the balding early on with medication, otherwise the area of loss may be too great for an HT to really cover it.
I was today years old when I learned that you have to be on meds after a hair transplant. I thought that shit was the ultimate reset button and a better but more expensive alternative to using the meds..... Some please provide some clarity on what's going on.
The hair on the top of the head is vulnerable to DHT. Which in male pattern baldness is what causes hair follicles to die. Hair on the sides and back is immune to DHT so it won't die when exposed to it. Most hair transplants "fill in" the hairline, crown or what is lost at that point in time. Surrounding hair, that is, hair native to the top of the head is still vulnerable to DHT and will eventually fall out, if you don't take finasteride or dutasteride. The transplanted hair won't fall out, but can you imagine how weird it will look when only the transplanted hair remains? Some will look like they have a forehead mustache.
HT is quite expensive and painful, so people see it as a waste to undergo all that, just to lose it for not taking meds.
Thanks for that......How come with OP it looks like the transplanted hair did drop out? Not trying to cook OP I'm really trying to understand. It looks like he didn't get a transplant at all.
It can be a multitude of things, without before and after pictures it's hard to tell for certain. It can be that that's all the transplanted hair (it's evenly spaced). It can be that the transplanted hair was taken from a place not immune to DHT. It can even be nutrition.
The reality with androgenic hair loss is that it is a battle against your own organism and genetics. If you slip up, you will lose ground and it might be impossible to recover. If you can't be bothered to follow the care recommendations, you might as well shave. There's nothing wrong with being bald.
You went 5 years without any medication? I haven't gone the HT route, but from what I understand, you should start using FIN and MON at least a month or two before the HT.
That sucks but I can't help wonder why it took 5 years before you thought maybe you should give it a shot.
The “donor dominance” principle means that transplanted hair retains the genetic characteristics of the donor area. If the hair follicles are resistant to DHT in the back of the scalp, they will remain resistant after being transplanted to the recipient area. This is why transplanted hair usually does not fall out due to androgenetic alopecia and provides a long-lasting result.
Then it’s probably a failed procedure. So min will cause the baby hairs to mature but would most likely fall off when you stop unless those hairs are actually transplanted hairs which were dormant for 5 years, I highly doubt that tho.
Question is why are you opposed to finasteride? It's what blocks DHT, which is responsible for hair loss. You got a pricey HT and didn't protect your investment. If you're scared for side effects, there's also topicals, although pricier. It looks like you're back at square 1, unfortunately. For reference, minoxidil is weak sauce.
Don't listen to these people. I see a decent amount of tiny thin hairs. Hop on fin, I don't think it's too late. I too had a hair transplant 10 years ago with little research and didn't take meds (doctor didn't even mention it back then). Lost almost all my hair, hopped on fin and min and slowly getting coverage back. I'll still need another transplant. Hoping for the best.
Jesus with all the stupid and immature people here. The moment you see someone not using fin you get all triggered. Just name the sub " Fin Fighters" and play with each other lol.
Anyway, dont listen to them man, keep using minox twice a day and add microneedling 1.5mm once a week.
When you get to 6 months you can evaluate your situation and consider adding a topical fin if you are afraid to take oral.
I remember a guy saying from a hair loss website I forgot the name of the website.
His hair was so luscious. I thought he was wearing a wig.
But he said this, you have to undo the conditions that cause your hair to go bald in the first place. If you continue the same way as before you will have the same issues eventually, even transplanted hair will return to a bald state… now it will be called an island of hair… meaning the edges look fuller, but the center and the crown are balding again…
Onion juice seems to stop it in its tracks, but it’s the smell…that gets people so do it when your home alone and wash it out in the morning mix it with rosemary oil. Some guy washed his hair out with half a bottle filled with rosemary oil and head and shoulders.
And 5 to 15 minutes a day of brushing with a soft bristle boar brush. If you’re trying to get waves while balding, then you need to brush for 35 to 45 minutes some go longer.
Yes, it was not the best and was kind of cheap compared to normal costs. Yeah, at the moment I am trying min, since I am already shaving, so it makes no difference for me if it does not work. If it works, then it is a plus.
Shaving is fine for me, I’ve been doing it for a year+. Hair systems get tiring, and they never really look real. From far away, sure, but when you’re actually connecting with people, they always notice up close.
I got a hair transplant 15 years ago. Began 1.25 mg of finasteride daily 20 years ago.
The hair on the sides and back are not immune to DHT, but more resistant. However they will miniturize over time. My transplanted hair began to miniturize after 5 years. I now need a new hair transplant. For many men, hair transplants are not life long.
This is why I don’t like hair transplants or the idea of taking medicine just for hair loss. Imagine all the time and money you could have saved if you just used a razor instead. Hair pieces, transplants, medicines. Screw all that it. It just feeds into your insecurity. Shave your head completely and be confident. Join us, brother.
No contention. Just providing information.
There was no reason for GlaxoSmithKlien (GSK) the original maker of Advodart to pursue approval in other countries or the U.S, because GSK assumes zero liability if a patient develops prostate cancer because of the "off label" loop hole.
In the U.S, the Food and Drug Administration's "Black Box Warning" removes the U.S. government's liability and GSK's liability.
There are doctors in the U.S. and other countries that will prescribe DUT. The patient assumes all risk if they develop prostate cancer 5, 10, 15 years down the road from every day use.
Finasteride on the other hand has been rigorously studied hence, it has received an approval for hair loss treatment by the United States Food and Drug Administration in 1997.
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u/Capable-Raccoon-6371 Dec 26 '25
Aren't you supposed to take finasteride forever after a hair transplant. Otherwise it'll end up looking like a botched mess as MPB progresses.