Thank you for your question!
You’re 21-years-old and the photos and history that you submitted, you’re describing a
scenario where you had some hair thinning and initially you also had to deal with fungal
infections in your scalp and that you lost some hair. And after undergoing three platelet-rich
plasma (PRP), you appear to have some improvement. However, in more recent history, you’ve
been placed on a 100mg Fluconazole to take weekly and finasteride and you state that
the hairs fallen out because of those drugs so you are asking what to do next.
Well I can give you some guidance and my thoughts about your situation. I’m a board certified
cosmetic surgeon and a fellowship trained oculofacial plastic surgeon, practicing in
Manhattan in Long Island for over 20 years and I am also the founder of Trichostem™
Hair Regeneration centers, a system we’ve developed to treat hair loss which does involve
with the use platelet-rich plasma (PRP) as well Acellular matrix and has been a very
successful treatment as a non-surgical treatment for hair loss so I think that what we have
to define is the causes of your hair loss and then decide on the solutions.
First of all, having a fungal infection can have a negative impact in your hair. Fungal
infections are often difficult to manage, do require both topical and systemic treatment
which appears you to be getting. I would agree that there is some degree of hair loss associated
with fungal infection but at the same time what appears to be is that you also have a
genetic male pattern hair loss also called androgenetic alopecia. Now the challenge for
you was that of course you went to the PRP injections which appear to help you and then
the hair fell off or fell out and so you may be making the error of correlating the initiation
of finasteride and fluconazole with causation of the hair loss.
To just get some concept to the challenge of with hair loss, with finasteride what you’re
doing is you are inhibiting an enzyme called 5-alpha reductase. This is the enzyme responsible
for converting testosterone to dihydrotestosterone. Dihydrotestosterone follicles or sensitive
follicles will thin therefore, when you diminish it actually will slow down the thinning process
and that’s an important distinction. Finasteride does not necessary stop hair loss, it actually
slows it down very effectively in many people. Unfortunately, a lot of our younger patients
and a lot of patients in general come to us don’t want to take Finasteride because of
concerns of long term sexual side effects. Now it is important that you do manage your
fungal issues but at the same time there is a little bit of a window where you may have
some benefit from a treatment that is a little bit different from the PRP. As far as my experience
is concerned, platelet-rich plasma which we use a lot in our practice we use it for fine
line and wrinkles, we use it for acne scars, we use it for scar revision, we use it for
complexion improvement. We love using platelet-rich plasma, we use it for dark circles under the
eyes but in my experience Platelet-rich plasma for hair loss has a short term benefit. This
is reflected by my observations on patients who come to us. People have come to us after
they had platelet-rich plasma injection will say that I went for injection every month
for about 4 months and although I have seen some improvements, I just didn’t know If
I can keep doing that. In our practice, Hair Regeneration has been
our solution for long term treatment of male pattern or female pattern hair loss. We do
use platelet-rich plasma as part of our treatment but we also use extracellular matrix. Now
this combination appears in our experience with over 5 years of data and hundreds and
hundreds of patients come to us from around the world, with one single session treatment
we’ve been able to for the majority of our patients 99% for both men and women stop the
progression, initiate or reactivate growth of hairs that is not growing and have thinning
hairs become thicker. Now we do customize the treatments so there
are people will do maybe a second treatment in the second year but over all that system
has been able to be successful for people who aren’t on any other medications and
are particular on men who are on finasteride or don’t want to take finasteride. Finasteride
by the way also is beneficial for approximately 60% of men. That means 40% will not respond.
If you are 21 and you are undergoing hair thinning then you have very aggressive pattern.
You’ve started at a younger age and you’re losing hair relatively quickly which means
that you have limited window to do something that will at least will treat the hair loss.
I think taking the finasteride is a reasonable step but at the same time you may want to
learn more about a treatment like Hair Regeneration to get you to a place where you can maximize
your results. There are patients of ours who will take finasteride and will combine that
with Hair Regeneration treatment. The fascinating thing about hair regeneration is that we basically
uncovered and reveal that there is more to hair loss than just DHT and that it works
also for women as well where it is not considered a factor that causes female pattern hair loss
opens up even new avenues for treatment that for us has been very gratifying .
So again understand that you may be making an error in coloration and causation that
the finasteride and fluconazole are not causing the hair loss, it might be more of the wearing
off of the platelet-rich plasma and the concurrent presence of a fungal infection. You have to
see whether or not finasteride will be added quick to stable your hair loss but you may
also want to consider treatment like Hair Regeneration.
So I hope that was helpful, I wish you the best of luck and thank you for your question!