Why Strong Genetic DHT-Sensitivity in Young Men is a Major Challenge of Hair Loss Treatment

Why Strong Genetic DHT-Sensitivity in Young Men is a Major Challenge of Hair Loss Treatment

Thank you for your question. You’re 25-years-old. You’ve submitted
several good photos of the top of your scalp. You state that you’ve been losing hair in
the past 2 years and you’re aware about PRP of maybe having a stimulatory effect to
strengthen existing hair but you want to know the best strategy to help your thinning hair
and prevent future balding. Well, I can certainly share with you my approach
to helping patients like yourself in our practice. 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 over the course of the
past 7 years using PRP and Acellular matrix as well as other modalities to help people
with male and female pattern hair loss. So I can certainly share with you certain conclusions
I have come to based on this extensive experience. Essentially, over the course of time, we have
learned of the invaluable benefit of Hair Regeneration and as you refer to as this stimulatory
effect on hair growth that can be significant with PRP and Acellular matrix. And in patients
your age, we certainly had dramatic improvement in outcomes. However, you’ve certainly focused in on
the one significant challenge which is the genetics. Your genetics clearly demonstrate
a fairly aggressive rate of progression. To give you some perspective, in the early years
of developing this, we looked at people at different stages of hair loss and saw that
the overwhelming majority of patients responded to the treatment of just the injection alone.
However, with time, we got to see different clinical profile trajectories. Yes, with PRP, with Hair Regeneration, we
can stimulate growth and we can make a big impact. However, when I think of patients
especially younger patients with aggressive progression, there are certain concepts that
I think are important to consider and to have some perspective on. Is it possible that genetically,
your hair growth cycles are going to be limited? In other words, how many times will your hair
grow before it stops growing altogether? Another perspective to this is what is the relative
sensitivity of hair to dihydrotestosterone or DHT. For many patients, especially during the early
years of the fears about sexual side-effects, a lot of our patients were able to use our
procedure as an alternative to finasteride successfully for the 3-4 years after we did
our injections. However, when I look at a younger person, I think well beyond what’s
going to happen in a 3-5 year timeframe. I feel particularly challenged if someone’s
genetics is so aggressive. So a lot of times, I do have a discussion with our patients who
are younger about a DHT blocker like finasteride and provide them with information that is
a context of current state of knowledge based on current published data about the drug finasteride
and whether or not there is some potential value. Unfortunately, there is no cure for hair loss.
And what you are facing is an aggressive pattern that without any intervention will naturally
lead to the permanent loss of your hair. When I am treating younger people, I have certainly
seen patients who even with a DHT blocker, even with Hair Regeneration, PRP, multiple
treatments, they will still lose hair and there are some people who have aggressive
pattern. Others, we are able to prolong the lifespan but the effects may ultimately be
limited by the genetic programming. Compliance with DHT blockers is also a challenge.
A lot of people, a lot of men who take DHT blockers will stop taking these drugs for
a variety of reasons. And so, you are essentially in that group of younger people with rapid
rate of progression. Essentially, seeking the guidance of a doctor who’s going to
provide you guidance in terms of management and understanding the limitations of any strategy
is still based on genetics and some unknown variables until you actually try the clinical
intervention. The art of medicine is ultimately treat and observe. And the way I look at it,
in a younger person, you do everything you can to slow down this rapid progression. And
ultimately, you want to get maximal coverage for the maximal time that is your potential
based on your genetics. That is the reality as it is currently. So I hope that was helpful, I wish you the
best of luck and thank you for your question.

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12 Replies to “Why Strong Genetic DHT-Sensitivity in Young Men is a Major Challenge of Hair Loss Treatment”

  1. dear sir i used finastaride last 2 months but no improvements …what is the time period of finastraide will work? ???

  2. Sir u grt the way u xplained vry calmly is amazing .. But i asked u a question before plzz help me out.. I told u before i had transplant in 16th oct. N 20th was my first head washout in clinic n after Dr. Told me dat regularly wash ur head in home to remove all scubs n crust but i was so Afraid dat if i touch my HT areas hair may b i loose Graft but on 23 evening Dr. Itself Washed my head in clinic but Dr. Washed my head little pressurely to remove all scubs n crust n all. i felt even pain that time i tried to stop. I dnt knw wat they trying to do? Even Dr. Clearly washed out my Hair which was full of scubs n crust But Is this the way to wash i asked to Dr. Did i loose Any Graft den Dr. Replied its about 7days nw the Graft r fully fixed thr place u must to remove scubs n crust between 7days. But nw its 26 i still feel little pain n irritation n somwhr Redness seems to be on left head where the Dr. Pressurized to wash but Im so much tentioned since den.. PLZZZ. AMIYA Prasad. Sir. Plzzz help me n Explain me well did i loose Any Graft or not.. Thnks

  3. Hello doctor
    This is the most confusing question I hope you put some light on the question
    Now suppose there are two x and y patients with similar aggressive progression at 18 . Now X has immediately started his hair loss treatment combing both pharmaceutical and non surgical and y has let nature take it course . Now at 25 X has able to keep all his hair and Y has lost half of his hair now both are on the treatment will dht will be effective with person who has more hair and person who has less hair

    Now can it be said that how aggressive the progression is at the very first time when you notice hair loss and take the best possible treatment you’ll be able to keep the hair you have forever ?

  4. Hello sir.
    My name is sandeep and I am 20 from India.
    I want to know what is the cost PRP+ECM.
    Please give me some idea…and one more thing …how long this therapy is beneficial?

  5. Happy day doctor
    My age is 18 I’m losing hair on the temples my hair line is slightly receding
    I’ve seen most of your hair loss videos and read most of comments below and one topic which is left untouched is what happens after 5 years I have aggressive hair loss early onset so my question is will repeating this treatment for every 5 years stop the progression until the natural ageing process starts i mean after 50 Is it possible to stop progression till 50s with a dht blocker like finastride and hair regeneration together I know it’s too early for yes or no since you’ve been doing this treatment only from 2011 but with your experience what do you think ?

  6. Hello
    What would be the prognosis for the young man who asked the question? Is the prognosis good? Based on your clinical experiences, will he see visible (density increased) sustainable results? Thank you Dr Prasad

  7. Good morning, Dr. Presad. What are your thoughts on minoxidil as a standalone treatment? And does it stop or reverse MPB indefinitely if used in perpetuity? Thank you.

    – Champ

  8. Doctor , i'm 18 and as you told me before that side effects of finasteride is low precentage cuz of my age so i think i'll use it , my doctor told me that prp is only for 35usd? Which is weird but makes sense cuz I'm living in egypt atm and their currency is weak that's why it's so cheap for me , should i do it or it's a scam?

  9. hi doctor my name is muhmand sabir from Pakistan my hair loss and my face is sebum and large pores whiteheads why this reason is my

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