I am moved to India and I was thinking of using the Finpecia manufactured by Cipla which seems to be same as propecia. But I need your advice regarding this. Finpecia is easily available in India rather than shipping the propecia from US. Can you please suggest weather it is safe to switch to Finpecia or not?

Unless Merck has sold the licensing rights to another company to make the exact same thing as Propecia, this is not the same as Propecia.  There are many companies in India that make knock off drugs that are supposed to be the same thing, but you really have no idea what you are taking.

Merck is not likely to allow another company to copy their brand anymore than Microsoft would allow another company to make a knock off version of Windows.  Keep looking for Propecia.  You can buy generic Proscar if you can find a brand that is the real thing.  This is 5 mg of finasteride so you just break the tiny pills into 4 equal pieces and take 1/4 pill each day. This will really reduce your cost.  You might be better off brining that in from a reilable source such as the USA.  The laws here really are intended to protect both the manufacturer and, more importantly, the consumer.

I commute between Japan and Singapore and I’m interested in getting treatment for my hair loss using Acell and PRP.  What do you recommend for me as I am trying to postpone hair transplant surgery.

I began using Acell in combination with PRP long before anyone else considered this combination.  The rationale was quite simple.  PRP is loaded with growth factors and Acell provides a scaffold with stem cell attraction for these growth factors to set up on and provide a potential sustained release of growth factors to newly activated stems cells that migrated to the region.  I based my rationale on the work that Joe Greco was doing with a natural ECM that he had manufactured from his patient’s blood.  Joe was seeing a positive influence in terms of improved coverage from existing hair due to hair shaft thickening in up to 70% of his patients.

The treatment appears to improve coverage of existing hair by thickening the hair shaft diameter.  It works well on up to 70% of patients, but not so well in the remainder.  It carries no known risks other than a potential sensitivity reaction risk to the thrombin or the Acell, which are derived from mammalian xenogeneic collagen sources.    We are yet to see such a reaction.

Currently you can get an Acell/PRP treatment in our office located in Atlanta, GA.  We do have affiliate offices located in Seoul, South Korea, and in Singapore.  Neither office currently offers Acell in their office.  Dr. Tyng Tang http://hairandlaserclinic.com runs the hair transplant office in Singapore.  We hope that both offices will soon offer PRP, Acell, and Thrombin activation soon.

This is a 3 months post-op results from a medical management that includes Platelet Rich Plasma (PRP), Acell, and thrombin. The patient is 32 years old with an unusual Norwood 3V pattern of hair loss. The patient had thinning in the frontal hairline, mid-scalp(top) and crown.
The patient had a successful FUE (CIT) hair transplant procedure, We placed 1992 grafts to the hairline and top.
In most cases grafting into the crown normally requires more donor hair to cover the crown than any other recipient area on the scalp.
We decided to start treatment in this crown with Platelet Rich Plasma (PRP), Acell, and thrombin therapy. The patient had a great response to medical management alone.
As you can see from the photo, At 3 month follow-up we noticed that he had more coverage in the crown where we used the PRP, Acell, and thrombin therapy.

(Click On the image to view full size)

I find this interesting.  This is another FUE extraction site treated with ACEll in a hyaluronic acid mixture after 5 weeks.  It is still too early to tell if the hair might regrow in the extraction site though I have seen this.  It does appear that a single hair is forming in the extraction site, which appear as a black nub.  What is interesting is the appearance of a capillary in the skin.  These are usually missing following FUE and help lead to the loss of pigment in the extraction site.  I’ve done enough FUE to spot extraction sites anytime I look at a donor area even when no hypopigmentation occurs.  It is an observation based on experience with FUE.  With this donor area, I could not find any evidence that FUE was performed.  The red circle is where I would expect a follicular unit to be.  The entire donor area looked like this.  The black circle is 10 sq mm.  I had the dermlite people make this reticule for me.

The long hair after 5 weeks is a result of a completely non-shaven procedure of 1464 grafts.  I call this C2G.  It is still to early to say for sure because I need more results, but this is an example of what I have seen in donor areas treated fully with ACELL with my method of FUE where I use minimal depth control.  The initial problem was treating all the extraction sites with a powder.  I overcame this with mixing it in a viscous hyaluronic acid.  More recently I have been mixing in a more viscous cellulose.  I have a few comparative examples where I am looking at powder, hyaluronic acid, and cellulose.  Time will hopefully tell. I think the minimal depth incision technique along with Acell may result in better healing than a full depth incision.  Maybe we will see more hair regrowth over time.   Maybe not.  Still no one could comb through this donor area and find any evidence that a hair transplant had been done.  It appears that we really are coming full circle today.  Not only have we produced optimal results in the recipient area such that you cannot tell that a hair transplant has been done.  Even the trained eye cannot see evidence that a hair transplant was done in the recipient area.

I am now 29 and have been using propecia for around 6 years and my hair sitution has now got worse.
I was wondering With your expertise and vast knowledge if you would recommend me trying avodart to help my situation alongside propecia or take it by itself?

The studies that have been performed show that Avodart does work better than Propecia. The only problem is that we don’t know the long term consequences of taking it. You are blocking both forms of 5 alpha reductase. We don’t know if this will produce problems later on such as depression.

The other problem is we don’t know the proper dose because it has not been studied. People take it once a day or as little as once a week because it has a long half life. There are many patients on it because it works better than Propecia, but I’ve heard a few say that the Propecia worked better than the Avodart.

Shedding probably means it is working for you because hair shedding occurs when resting hairs return to the growing phase and push the old resting hair out. This means that the drug is stimulating growth or Anagen. Of course it could take up to one year before you see a noticable improvement. I think it will always work best when you have some existing hair. If your hair line is bald, don’t expect much benefit. If the hair line still has hair, then the Avodart could stimulate new growth. The main thing all these products do is prolong the life of hair. It is actually rare to see a significant improvement in coverage, but when it occurs, it can be amazing.