Finasteride / Minoxidil Combination

This is a Copy of HAIR TRANSPLANT forum page 16

I met Malcolm at the Toronto meeting. He has had excellent results using Finasteride and Minoxidil in combination, I could tell where he new hair had grown and it was quite impressive. – editor

Many patients come to us who will not have surgery for variety of reasons. We know that Minoxidil has been disappointing to patients with advanced degrees of hair loss. It also seems to lose its effect after 2-3 years of consistent use. Over the last 12 months I have prescribed a combination of Finasteride 7.5 mg. per week orally and minoxidil 4% lotion. This is based on the study paper I enclose with this letter*. The Finasteride is taken as half 5mg tablet on Mondays, Wednesdays and Fridays. The Minoxidil is applied twice a day in the usual manner. I have so far prescribed it to six patients. One of them is my associate and senior counsellor, Malcolm Mendelsohn, who you met in Toronto. He is at Norwood Type IV hair loss. The treatment was significantly effective over the left half of the front and the top of the scalp but not on the right side and crown. I have since transplanted the right side and crown with 400 minigrafts in two sessions. The Finasteride I Minoxidil seems to have generated enough "fuzz" around the hairline and Malcolm had been on Minoxidil in the past without satisfactory results.

I have also included before photographs of another patient, Mr. W.H. (see Fig. 3 & 4, page 21), who is 35 and at Norwood type VI hair loss. He went on the same treatment regime because he was very much against any kind of surgery. He commenced treatment in August 1993, and I saw him for the first time for review two weeks before the Toronto meeting. Remarkably, he too had a more significant result on the left side of the scalp and nothing on the crown. He is now seriously thinking about having surgery to complement his new growth.

Dr. David Whiting gave an excellent talk on Finasteride and commented that we should probably be worried. I think Finasteride can be very useful adjunct to surgery saving the need for very large numbers of grafts, especially micrografts.

I don’t think we have to worry too much.
*J Clin Endocrinol Metab 74:345.350, 1992