Protocols and Attitudes for Optimal Medical Therapy for Hair Loss

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This podcast is dedicated to how to be better compliant with medical therapy. Medical therapy, for me, for hair loss encompasses Finasteride, Topical Finasteride, topical minoxidil at times, oral minoxidil, Nutrifol, laser, and any of those things. So we’re all of those things. So first of all, what I always try to do for my patients is streamline the protocols so that you do as few things as possible because oftentimes doing too many things makes compliance much more difficult. However, if you’re a young gentleman with a lot of hair loss, I do recommend potentially to do more therapies because they’re all synergistic. I really want you to have the right attitude because the right attitude and the right protocol can make the treatment much easier and for people to be on better compliant. So the first thing I tell my patients is, for example, if you’re doing my 82F topical Finasteride minoxidil combination, which it’s done once a day, you have to first think about whether you’re going to do it in the morning or night.

So for example, I’m a morning person. I’m up about five in the morning, five 30 in the morning. I’m really alert doing surgery, but you know, by seven, 8:00 PM, a little more tired, eight or 9:00 PM, I’m really tired at 9:00 PM. Sometimes I’m watching Netflix and I’m falling asleep. If you asked me to do a topical therapy at 9:00 PM every night, I probably will miss half the nights because I’m too tired. However, in the morning I’m totally alert and awake and I’ll do it. Now. The one caveat is you have to do it after you worked out so that you don’t, you know, sweat in it or then take a shower for four hours. So let’s say you’re a morning person. You like to work out in the morning. So I would work out, finish the workout, immediately apply the topical therapy and then not shower again, or get it wet for four hours.

If you’re a night person, some of my friends are creative types. They like to stay up all night and work on things. You do it every night at midnight, 10:00 PM, whatever it may be. The second point of attitude is understanding that it’s not all or all or none. A lot of people that are very obsessive compulsive, their opinion is, Hey, you know what? I really, really need to do it every single day. And if I miss a week, I go to Mexico and forget. I simply don’t want to continue. And that’s a false bad attitude. Think of it this way. If you didn’t go to the gym for a week or two, you should go back to the gym. If you ate fried chicken for two nights and decided, Hey, you know what? I don’t want to get fat. I’m going to start eating right.

Well then eat. Right? And if you do fried chicken, don’t think it’s all, all or none. You’re just going to get back to, it’s the same thing with medical therapy. If you skip two weeks, if you skip a month, get back to it, start again. If you skip three days, doesn’t matter. It’s not all or none. And so just doing the medical therapy is so important. The final part of the attitude is thinking about this idea that, Oh my God, it’s lifetime commitment. If I stop, I’m going to regress it. The way that I would look at that is technology always improves. For example, even topical Finasteride. I didn’t have a few years ago, but technology continues to improve. There’s hopefully a chance of hair cloning where let’s say in 10 years so you stop all the medical therapy and I can give you unlimited hair or transplantations or through injections.

We’re not there yet. But until that day occurs, I would say, continue to do medical therapy. Actually the final part of medical therapy is if you see progression, a lot of people have this attitude that my medicine is not working anymore. And that’s absolutely false as well. It needs to be continued because with ongoing medical therapy you will see some progression because it doesn’t stop hair loss. It just helps regrow some and slow down the progression. But sometimes you need surgery. Sometimes you need to use additional therapies to intervene. But the key is not to give up after a couple of years and say, I had a little progression. I want to stop. So all of these things are just ways to, you really have a positive attitude toward medical therapy and a protocol, and that you can be compliant with.