Should Finasteride be taken before a Hair Transplant?

Finasteride before hair transplant

The often-repeated phrase ‘making hair stable before a hair transplant’ is a MYTH.

For it never lasts even a month after stopping Finasteride.

Taking Finasteride before hair transplant is like flogging a dying horse.

Finasteride is of utmost importance for 6 months after a hair transplant.

To know why taking Finasteride before a hair transplant is against your interest, please stay on.

In a previous video, link to which is in the description below, we discussed about the mechanism of action of Finasteride. To refresh our memory and in short, Finasteride, is a DHT blocker and the benefit is regrowth of hair and decrease of the number of miniaturized and miniaturizing hair and at the same time increase in the hair shaft diameter.

Many reputed hair transplant doctors would see your scalp donor and feel it is weak or miniaturing and would recommend the use of Finasteride before a hair transplant.

However, this is at variance to my philosophy at Darling Buds Clinic where we harvest just Anagen hairs using our trademarked Anagen Q+ Technique.

And this is the reason why I have objections to the use of Finasteride before a hair transplant.

So to understand this we need to know what are the 5 reasons some doctors & clinics believe in prescribing Finasteride, 1-3 months before a hair transplant.
1. To increase available grafts.
2. Those who believe in extending the scalp donor in FUE and getting as many grafts as possible even from outside the permanent zone. Votaries of ‘Extended Scalp Donor Zone’.
3. To prevent shock loss
4. People with diffuse hair loss or thin caliber hair who are desperate for a hair transplant
5. To decrease hair shedding in the growth phase

Many times this approach is dictated by patient pressure, with more and more people seeking hair transplants across borders, travelling long distances, and who do not want to travel repeatedly for hair transplants wanting to get full coverage done in one go.

This is helpful no doubt in decreasing shock loss and minimizing shedding in the first month but in many important ways works against the patient’s interest. And these are-
1. It is merely flogging a dying horse. Hair in the resting phase or those that are miniaturized as part of the baldness process is merely kickstarted by the Finasteride push.
2. The gains that we get due to Finasteride are lost if we have not counselled the patient that Finasteride will need to be taken for a long long time to maintain and support these poor qualities of grafts.
3. If Finasteride is stopped, those hair that were not anagen hairs to start with will fall off soon, affecting hair transplant density and as a corollary, the result the person would have got if the hair transplanted were the only anagen in nature by selection.

In short, taking Finasteride before a hair transplant will momentarily make a Catagen hair look like Anagen lair.

I wonder if ever the patient would have consented to take Finasteride if he was counselled about what effect it has on transplanted miniaturizing grafts which were merely kickstarted to increase grafts numbers.

So in short, the take-home message from the video is, if you are on Finasteride, stop the medication before you come for counseling for a hair transplant since it will not give your doctor the requisite information about the permanence of your scalp donor and plan your hair transplant better for,