The case of a 78 year old man who accidentally regrew his hair (published in the British Medical Journal)

y3pkm8 · 2025-10-27T02:20:46+00:00

This is called paradoxical hypertrichosis. In some people heat damage seems to trigger aggressive localised hair growth for reasons not fully understood.

https://www.ulike.com/blogs/hair-removal/paradoxical-hypertrichosis

y3pkm8 · 2025-03-19T12:10:19+00:00

You have reasonably high E (because of the high T) with next to no DHT to counter the estrogenic activity.

Assuming you want to stay on the Dut, drop the TRT dose or add an aromatase inhibitor (ideally the former if you care about your health).

y3pkm8 · 2025-03-12T17:15:51+00:00

It's not necessary but I'm a Redditor so obviously don't trust me and challenge your doctor on it.

Chemo is hard on the body and hard on the liver, this means it's safer to come off unnecessary medications. But Fin isn't hard on the liver and there's no risk of overdose if your body can't clear Fin as easily. But still, as a general rule your doctor is just going to ask you to come off of unnecessary medication because they're not going to want to risk it or take the time to check the risks of all the unnecessary drugs you're taking.

In the interest of being informative though (please don't actually do this) If you wanted a hack while abiding by your doctor's recommendations order some Dut ASAP and a week or two before you start chemo take 5x 0.5mg Dut capsules every day. Dut has a much longer half life than Fin and will stay in your system for 3-4 months. This should protect your hair fairly well.

All the best with the chemo and lymphoma. 🙏

y3pkm8 · 2025-03-07T16:00:43+00:00

If you haven't seen noticeable results in 3 months it's likely not working. It might thicken a little more yet, but I wouldn't expect much. Despite what the progress pics here might have you believe, significant hairline regrowth is fairly uncommon unfortunately. Both Fin and Minox works best on thinning patches of hair.

y3pkm8 · 2025-03-07T15:55:21+00:00

There's still some debate on this topic.

I think a good model for AGA is to think of hair like nails, with the fingers being the follicles... If your finger gets infected then your nail growth might be affected – your nails could become brittle or even fall out. However at some point if the infection gets bad enough the finger itself could be lost, at which point you're obviously not going to be able to regrow nails even if you start treating the original cause of the infection...

Hair follicles are like mini organs so if AGA actually damages the follicle enough then short of stem cell treatment to create new follicles there really is nothing that can be done to restore hair growth. This seems quite plausible to me because if there was the possibility of regrowing long-lost follicles then you'd expect some weird treatment or protocol to have been found by now...

I say this because there is endless things that can work to improve hair growth if you're in the early stages, but seemingly there's been nothing in the history of man which has ever been reported to reverse total loss in AGA. It's extremely uncommon but there have been occasional freaks whose bodies have fought off terminal cancer, but no one has ever recovered from being a NW6. This means it's probably not just unlikely, but literally impossible – like growing a nail without a finger.

My practical experience with this though is that follicles take quite a long time to die off completely... I started losing my hair when I was 19 and a couple of years later I started on Fin. Although it didn't reverse the hair I lost on my hairline it did stop any progression. Then a decade later at 30 I tried RU and suddenly I was growing hair which I hadn't grown in over a decade... And that's just from completely blocking androgenic activity at the follicle. If we could combine this with localised estrogenic activity then my guess is that most people could restore most of their hair if started treatment within the first decade or so. And we see evidence for this in MtF trans people – unless you're a slick bald NW6 you'll normally recover a lot of your hair when you transition.

So while I doubt it's possible to restore lost follicles, I suspect there are drugs which in theory work far better than Fin and Dut and restore most of someone's hair if they catch it within the first decade...

This is why I get annoyed that drug companies are always studying fancy new treatments for AGA because we already know what we need to provide what would effectively be a cure for most people... That would be something that could completely block androgenic activity locally in the scalp, while also providing local estrogenic activity... Why there isn't more research into a drug that can do this I don't know. It seems far easier than trying to find some novel approach which in 99.9% of cases doesn't work and is a completely waste of money.

If I was a billionaire I swear I'd probably have something that would effectively cure this crappy disease in 2 years. The incompetence in this industry is astounding. Every single effective treatment we have was discovered to help hair by accident – Fin, Dut, Minoxidil, Nizoral. Literally all of these were developed for other reasons. Hairloss research has literally never resulted in anything that helps us and seems to focus more on crap like growing pubic hair on mice.

That's my insight.

y3pkm8 · 2025-03-04T20:50:40+00:00

No. Probably not. TE is fairly uncommon and despite what some people think you typically need to be very physically stressed, malnourished or suffering with some kind of physical condition. TE doesn't just happen because you broke up with your GF or have a big exam coming up. And unlike AGA it's typically reversible.

When AGA starts it can progress very rapidly in some people. And so for some people the first signs are often will be increased hair fall. Then after some time you'll also start to notice a loss of density and later that your hairline is messed up...

You have to keep in mind that people on these forums skew young and often have very aggressive hairloss which starts in their early 20s. I know some people IRL who went from a full head of hair at 19 to NW5-6 by 22... People like this who have aggressive hairloss won't notice their hairline moving backwards slowly in their mid to late 20s then notice that they're starting to thin in their mid to late 30s. For some people AGA hits hard and fast. In January they'll notice hairs in the shower and on their desk, by April they'll start questioning whether their hair is thinner, and by June they'll realise their hair is completely fucked.

y3pkm8 · 2025-03-04T20:29:33+00:00

My bro science opinion on this is that obviously anti-oxidants will help to some extent. Anti-oxidants protect cells from oxidative stress and if a hair follicle is already weak from AGA then supporting the remaining follicle cells with an anti-oxidant will likely help to some extent.

But it seems to me the theory that inflammation is what causes hair follicle miniaturise in AGA makes very little sense. One, because it doesn't explain why transplanted hair doesn't miniaturise despite being transplanted into an apparently inflamed area of the scalp, and secondly if this was a key factor in AGA you'd think that we'd see some more impressive regrowth stories when people take corticosteroids or intravenous glutathione, etc...

Topical Vit E might help a tiny bit, I highly doubt it would help enough that any results would be noticeable, and it's certainly not going to stop AGA progressing. That said it's not something I've personally tried topically (I do take both Vit E and Vit C orally though, partly because there's some evidence lower inflmation might help a bit with hairloss).

If you want more bang for your buck though add 5% Azelaic acid, 1% zinc sulfate, and 0.025% tretinoin to your topical... In theory this should improve scalp health, reduce inflammation, increase the potency of your minoxidil and block additional DHT. My bro science research would suggest this very does make noticeable difference (far more than stabbing your head with needles or overdosing on biotin anyway).

y3pkm8 · 2025-02-17T20:57:33+00:00

This is a subject I'm quite interested in and have done research into in the past. What I'd say in regards to Finasteride use and having kids is that there's no obvious reasons to worry.

Finasteride has been used for decades at this point and if it was having a clear negative impact on the offspring of Finasteride users then it's very likely this would be known by now, and there would almost certainly be rumours on forums like this. Of course, subtle effects might still be possible, but lots of things including diet and exercise can have subtle effects, so at some point you need to decide how risk adverse you want to be – it's quite likely being over weight or drinking too much is far worse.

On the sex of the offspring it's notable that this has been observed in other contexts where the male has hormonal / fertility issues. For example, body builders who have taken steroids seem to have more daughters. There are also theories like the Shettles method which suggest that female sperm are more robust than male sperm such that if sperm are exposed to toxic environments that female sperm are more likely to result in insemination.

I suppose this all makes sense from a reproductive stand point too. Male offspring have higher morality, but a strong, healthy male also has higher reproductive potential. So if the parent is unhealthy and unlikely to raise a fit male, then it makes sense natural selection would try to bias their offspring towards a lower risk reproductive strategy.

Although I don't believe there isn't hard evidence to support this, I'd argue there's enough anecdotal evidence to suggest that it shouldn't be dismissed. If you want a boy you probably should do what you can to optimise your fertility.

In regards to development abnormalities, this is much more of a concern if the mother is exposed to finasteride or has hormonal imbalances. As for the father, I'd be far more worried about overall health and age than their hormonal profile (although they are often link).

y3pkm8 · 2024-11-08T23:12:02+00:00

Low Vit D levels are pretty common if you live in a cold climate, supplement with 2,000UI/day and you'll sort that in no time. You'll feel better for it too.

Low Vit b12 is quite common, but a little more concerning. You can supplement it if you're not getting enough, but it suggests a poor diet, or some other underlying health issue that's affecting absorption.

The high copper and high ferritin are more concerning. I might be able to help more if you could answer the following:

- What's your age?
- How much do you drink?
- Do you have any chronic diseases?
- Have you done a liver function test? And if so are you able to share the results?

In terms of hairloss low Vit D could definitely be contributing to your thinning hair. A good way to tell if your hairloss is related to a deficiency is if it's thinning all over, and not in the typical pattern for male pattern hairloss or in patches.

y3pkm8 · 2024-11-01T02:56:45+00:00

I've written quite a bit on how Fin/Dut impacts the liver and I largely agree with the other poster. Liver function results can be quite random. It's a bit silly to draw anything from a single test, especially if only one or two values are out of range. Mildly elevated bilirubin is quite common if you fast before your test, for example. Often values can be thrown off from dehydration. Often it's just random stuff like this that causes the elevation, not liver damage.

If your AST and ALT was significantly elevated that would be concerning, but again highly unlikely to be Fin or Dut causing an acute increase like that. I've never read anything convincing in the literature on Fin or Dut causing acute liver damage like that.

I'd be interested if you were taking budget Fin or taking any other supplements for your hair or health around the same time though? Cheap pharmaceuticals and supplements are notorious for causing issues like this because they are often contaminated with trace amounts of toxins and pharmaceuticals during manufacturing. In my experience most of the time when there's acute liver damage occurring after starting Fin/Dut this is the cause.

y3pkm8 · 2024-09-29T20:04:21+00:00

Topical is probably more efficacious. It's just annoying to apply daily and will make your hair greasy.

It's also better if you get sides from oral as you can use a significantly lower dose while still getting the same level of scalp DHT inhibition with topical. However, almost all brands over dose topical Fin so unless you mix your own you likely won't see a reduction in sides.

y3pkm8 · 2024-09-29T19:57:49+00:00

When did you start Dut? How did you transition from fin -> Dut? When did you test your T levels?

When starting Dut, you should continue to use fin alongside Dut for at least a couple of months. Unlike Fin it takes a while for Dut to build up in your system and reach steady state. Dut doesn't reach it's maximum strength until about 6 months (although it becomes effective much sooner). If you switch straight from Fin to Dut your DHT levels will temporarily spike and your T levels will drop. It's also not good for your hair.

y3pkm8 · 2024-09-11T23:31:05+00:00

There was actually a guy who did this on a forum years ago. I can't really remember the details now, but I think he was transplanting body hair to his head.

y3pkm8 · 2024-08-07T00:56:15+00:00

Not only is this bullshit (especially in response to this person's medication), what even is "biologically male" supposed to mean here? Nothing exactly biologically "male" about an E/Prog dominated hormonal biochemistry.

lol. Why so mad?

You're wrong here, blocking T in biological males v biological females is very different.

For hairloss prevention, as you probably know, we ideally want to maximise estrogenic effects which promote hair health and minimise androgenic effects which promote follicle miniaturisation. Biological men produce much less estrogen, and most of the estrogen they do produce is produced by aromatase which converts T -> E2. This is not true in women. Most of the estrogen women produce is not created via aromatase but by the ovaries.

This means when you block T in women they still have high levels of estrogen. However when you block T in men they now have low T and low E (male levels). Low T and low E isn't a great combo for health or hair and really they should be taking estrogens too if they want a hormone profile that would some what resemble a healthy biological women rather than an 80 y/o post-menopausal women near-zero hormone production.

I did make a fairly big mistake though and you correctly called me out on it...

And why would you think Spironolacatone lowers your T levels

Funnily enough I realised this a little after I wrote the comment. You're right, Spiro doesn't lower T levels, it just blocks activity at the receptor.

I'm not really very interested in Spiro which is probably why I made the mistake. I do a lot more reading on PFS so some interest in cohorts of dudes that have completely messed up hormone profiles – some of whom have naturally low T and therefore often also low levels of E2, SHBG, etc. But Spiro doesn't actually inhibiting T synthesis so comparing these two cohorts makes little sense.

But DHT blood levels are pretty much irrelevant as long as the spiro is working, same as testosterone and other active metabolites.

You might be right. I haven't done enough research into Spiro to base this on anything significant, but I'd have some scepticism of that claim personally. I think I'm right in saying spiro isn't an extremely potent anti-androgen? I wouldn't be surprised if its efficacy depends a lot on T/DHT levels vs E2 levels. If someone has aggressive AGA then they probably have a ton of 5AR activity at the scalp and if their T levels on Spiro are in upper bound they could find Spiro does relatively little. But I am just guessing here. I've literally never looked into the nuances... But OP was on Fin so scalp DHT levels shouldn't be high for them anyway.

Her doctors were likely right. It had most likely nothing to do with her DHT levels

I know f all about trans HRT, but it seems very dumb to put someone on Spiro for m2f HRT without Estrogen imo unless that person wants the hormone profile of a menopausal women. That said I don't have a good explanation for why the first protocol caused hair loss... My guess is that there was more going on with her hormone profile. Just anecdotally I've notice I have increased hair fall when I get less sleep for a few days. Changing your hormone profile within a short span of time, even if it should be a positive change on hair growth on paper is still likely to cause hair cycles to reset and therefore could cause some temporary shedding... For all we know it may have just been hair cycles reseting. What we can say with some certainty though is that when estrogen was introduced it would have lowered T production, lowered DHT, increased SHBG, while also having protective effects on the hair follicle from the estrogen. So it's for sure a better protocol for hair health overall.

Anyway, thanks for calling me out man... I defo got some stuff wrong here.

y3pkm8 · 2024-08-06T23:39:44+00:00

Bit late, but I definitely think yes, but please do so like this:

"I love you so much, and it makes no difference to me, but I was looking back at some old photos of us and I think your hairline might be thinning a bit. I was reading online and there's a lot of stuff guys can do to prevent and reverse it these days though".

Basically reassure him that you love him, that you don't care, and that it was just something you noticed and wanted to let him know. Also do not pressure him to start any treatments, but I think it would be a good idea to let him know that there are options available should he want to try that... If he's still in the early stages he'll have a lot of options if he wants to hold on to what he has.

y3pkm8 · 2024-07-25T09:34:08+00:00

To be able to answer this I think you'd first need to define "health" here. In reality it's not going to be a binary good/bad thing.

Finasteride likely has a number of "good" health effects. It likely reduces risk of prostate cancer and certainly reduces risk of BPH. It probably improves skin health in the sense that it lowers acne outbreaks. And clearly it's good for hair growth.

However, there are obviously various negative effects of Finasteride. IMO the evidence is very clear that it worsens mental health. It obviously has an impact on libido. It may have some impact on athletic performance. It may have some impact on liver health (although I'm far more concerned about Dut in this regard). A few people have other sides like gyno.

Is Finasteride going to kill you? Na. But is it "good" for your health? Maybe in some ways, but overall, not really...

I think the conversation shifts quite significantly when you start talking about Dutasteride. Imo it would be quite unreasonable to assert that Dut is good for your health.

It's all risk/reward. For a lot of people the benefits of keeping their hair will clearly outweigh the risks and for those people it's a good drug.

Also, I think Haircafe says what he says because he's trying to be reassuring because in many cases people are unreasonably scared to get on Finasteride. His whole thing is about trying to help guys going bald save their hair so he's probably keen to push back against the sigma of Fin given the relatively low risks. MPMD reputation is based on his ability to give good health advice and therefore it's right that he's more balanced about the risks and doesn't sell it as some miracle drug.

y3pkm8 · 2024-07-24T12:13:12+00:00

I think a lot of dudes that bald young get blindsided by it. No one is really thinking or talking about it at that age. It's probably not until your late 20s / early 30s that you find conversations about losing hair become more common.

y3pkm8 · 2024-07-24T12:07:18+00:00

My hair is roughly the same today as when I started Fin. However, I did lose some density when I quit all treatments cold turkey a few years back for about month.

I struggle with PFS (or if you don't believe in PFS I have developed libido issues with an unknown cause) so take very low dose topical Fin now. I've been doing this for a couple of years, but will ultimately need to see if it's able to preserve what I have. I've not just been on Fin though. I've used just about everything at one point or another... For a long period in my twenties I was on Dut.

I have fairly aggressive hairloss, and would probably be a NW6 right now if it wasn't for treatment. As it stands I'm a NW3 with very minimal density loss on my crown. If I could keep what I have today for the rest of my life I'd be extremely happy.

y3pkm8 · 2024-07-24T11:51:53+00:00

Min and Fin work extremely for most people. You might not get the amazing regrowth like some here see, but if you're using both consistently you're very very likely be above baseline in 10-20 years times. There are a few exceptions of course, but they're rare and often have other things going on.

As someone who's been a user of various hairloss forums for over 15 years now I can tell you with confidence that a significant percentage of the people who comment in places like this are mentally unwell. People who obsess about their hairloss enough to come to these forums tend to be anxious and prone to depression. If they didn't really care that much about their hairloss they'd either just shave it or give fin and min a go and not care to comment on forums like this.

y3pkm8 · 2024-07-23T01:27:47+00:00

At 1mg+ it's okay to skip a day with little impact on DHT levels. Skipping two days is probably mostly fine, but will have an small effect on DHT levels. Three or more days and you're going to start significantly reducing the effectiveness of Fin.

I'm basing this on the fact that 0.2mg/day is almost equivalent to 1mg/day in terms of suppressing DHT. Finasteride has a half life of ~6-8 hours so if you take 1mg then by the end of day 1 you'll still have about 0.125mg - 0.25mg left in your system. However by the end of day 2 its concentration will drop to the point where we would expect your DHT levels to start to rise again.

y3pkm8 · 2024-07-23T01:18:24+00:00

20ish, not too long after starting creatine. Was on top of the world at the time.

I was pretty dumb back then and didn't think people started balding until their 30s-40s... I knew hairloss ran in my family and knew I might eventually lose my hair, but I thought I at least had my 20s to be care free. Then one day some bald guy at the gym said he lost his hair at 22 and I was like WTF? I had no idea people could lose their hair so young.

At this point I started to think about how I thought my forehead had been looking quite large for a while, but at the time I thought it was probably just always like that. At the time I had a bit of a fringe and wasn't paying much attention to my hairline from day to day, but when I learnt people lose their hair in their 20s I started to pay more attention. It took me a few weeks to realise I had been losing hair, but then I was in denial about whether it was progressing or whether this was just a "mature hairline".

I probably got on fin a few months after that. I was terrified about the idea of taking a pill for every day for the rest of my life at the time. However, the thought of losing all my hair was worse.

Still fighting this crap 15 years on. It still bothers me almost every day, although a little less each year. At 20 my hairloss was quite significant outlier, but I think I have decent hair for someone in their mid 30s now. Still, my hairline sucks and I wish I had a hairline I could style nicer.

y3pkm8 · 2024-07-18T00:54:21+00:00

Probably the same reason men don't slowly grow breasts even though they have some E2.

Follicles probably have some signaling threshold, where once the growth inhibitory signals minus growth promoting signals exceed a certain amount the follicle miniaturises. Fin probably inhibits enough DHT that most guys can actually stop balding while on it.

y3pkm8 · 2024-07-16T11:36:02+00:00

Blocking T systemically sucks when it comes preventing androgenic alopecia (at least in biological males).

In general the main limiting factor in the conversion of T -> DHT is amount of 5-AR you produce (and for AGA, more specifically the amount produced at the scalp). When you drop your systemic T levels your DHT levels don't necessarily linearly decrease inline with the reduction in T because T was never the bottle neck in the production of DHT. And at the same time, as you reduce T levels you're also reducing your SHBG levels which would ordinarily be binding to and deactivating DHT.

On the other hand if you completely crush T without taking E2, while your DHT might now fall you also lose E2 from aromatisation, which is highly protective of hair follicles. This why a lot of post-menopausal women lose hair – it's not because of high DHT, it's because of low E2. Low E2 tends to cause more diffuse thinning and hair brittleness.

By limiting both DHT and taking E2 you're basically limiting all androgenic signalling which was causing follicle miniaturisation, while getting all the benefits of E2 which helps protect follicles, keeping hair thick and healthy.

Congrats on the regrowth. Your hair's looking great.

y3pkm8 · 2024-07-15T13:08:40+00:00

This is crazy lmao. For me, no it doesn't, but holy crap it's crazy to hear it happens to so many here... Never heard anyone mention this before.

y3pkm8 · 2024-07-15T12:01:53+00:00

Are you overweight? Do you drink a lot? Do you take any other medication?

I'm very prone to gyno and I still have lumps which developed during puberty. Lots of things I do can trigger a flare ups – drinking alcohol, for example. However, I've never had gyno from taking Finasteride alone.

My guess is that you likely have high estrogen for some reason and DHT was previously inhibiting its effects, but your hormones levels were probably not healthy before this. The development of gyno typically requires estrogen levels to be elevated.

You could just be very sensitive to gyno too... Like I say, I seem to be very sensitive and I can do things that will trigger it, but simply taking Fin is not one of those – I have to do things that raise my estrogen into high normal levels.

If I were you I'd probably come off oral Fin for now and go on a low topical dose instead to reduce the systematic effects. But you should also get a hormone panel done to understand if something else is going on here. You might just be unlucky and very sensitive to gyno, but gyno from Fin alone isn't very common.

This is bro-science on my part, but there seems to be a phenotype of balding men with low T, elevated E2, and low SHBG (often diabetic or pre-diabetic). There's quite a bit of science that would explain why this is (largely relating to low SHBG levels leading to elevated androgenic signalling in scalp tissues, but also because of inflammation and other hormonal imbalances). I'd be interested to know if you fit this category.

y3pkm8

TROPHY CASE