Hello again. So I spoke with Dr. Konior's office and they referred me to a dermatologist who specializes in hair loss (Dr. James Feinberg). The problem is, it doesn't come cheap for the consultation: $425 + $325 for the consultation and biopsy, respectively. Does this sound normal? Is there any way to get insurance to cover this (if you can't answer that, that's okay)?

I guess I just want to make sure that I'm making the right decisions with my time and money. Dr. Konior's office spoke highly of Dr. Feinberg and said that if I'm looking to get a detailed assessment of my hair/scalp, Dr. Feinberg is the person to go to.

What do you suggest I do? Do you believe this consultation/biopsy would be worth the cost? My number one priority right now is determining if my hair is indeed thinning and if I'm experiencing the early stages of MPB (and if I am, to seek treatment). I do want someone who knows what they are doing and will give me a high quality assessment.

Could anyone provide any insight on this? I scheduled an appointment in a few hours but I just want to make sure it's the right move.

TIA

spending 425$ for a consultation seems a bit ridiculous to me.... I would think any good derm. can tell you if you are balding or not.

Tony:

I was in your exact same place 25 years ago. I saw a little recession in my temples and worried not so much what it looked like then, but where it might be headed. I went to a dermatologist and he was somewhat amused at my concerns and just told me it was natural.

However, just because you *might* be seeing a bit of hairloss doesn't mean you are headed for baldness.

For example, my temples, hairline and forlock area have thinned and receded only a little bit more than what it was 25 years ago. In my case it was my crown area that took the hit.

On a final note, you appear to have a nice full head of hair. If any hair surgeon suggested transplants on you right now I would run like the wind in the other direction.

Also keep in mind that minoxidyl will work the best in the early stages. When I was about 28 and started to thin in the crown, it was thinning much more than yours. I used the 2% minoxydyl and it brought ALL of it back but lost its effectiveness after about 3 years.

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My Hair Loss Web Site - Dr. Ron Shapiro

Hi Severn and thank you for your response.

After my consultation this evening (the dermatologist surveyed my scalp and took a biopsy), he concluded that I have:

1) Folliculitis
2) Androgenic alopecia

He says that the Folliculitis is curable and prescribed some meds and recommended a shampoo to aid in the destruction of the bacteria on my scalp causing red bumps (pimple-like) and itching. I've had this for as far back as I can remember and always thought it was just acne. He said it is possible that it may have contributed to my hair thinning. Like I said, I've had this for a long time now (at least 5 years). Is anyone aware if this going untreated for so many years could be a primary factor in my thinning hair, or a factor at all?

He took a biopsy of my scalp and we will be waiting for results in the coming weeks. I also am going in to get blood work done tomorrow and will bring that with me to the follow-up session where he will discuss the results of the biopsy and lay out the most appropriate methods of treatment.

He said that my is not bad and is in the early stages. He kept telling me not to worry. Well, I can't help but worry. I'm really sad right now. I love my hair. I can't imagine myself without it.

That being said, I was reading up on Androgenic alopecia this evening (Androgenic alopecia - Wikipedia) and it appears that if the condition is caught early enough, hair loss can be reversed entirely. The question is: how often does this happen (a complete reversal when caught in the early stages), and how "early" does it need to be caught? Do my pictures look early enough to halt this or reverse it?

I know I probably sound like a baby right now considering some of the horrible suffering that some of the guys on this board must have experienced, however, being 25 I'm just having a hard time dealing with this. I would be indebted to anyone who could provide me with any form of consolation, advice, or insight.

I just can't help but think about the painful years ahead. I already have a few insecurities which cause me a lot of anxiety, I just can't bare to think of this one added to the list.

Thanks guys...

Tony,

Nobody likes the thought of losing their hair. That's why we're all here. I remember what it was like when I was 21 and I noticed first signs of thinning in my crown. I was in denial for awhile until it got worse. I hated it. I wore a hat everywhere and tried Rogaine 5% which worked for awhile until I foolishly stopped it. When I resumed over a year later, I had lost a lot more hair and the Rogaine irritated my scalp. After trying a number of "miracle cure" lotions and potions, I found this community when I was 27 years old and started to do something about my hair loss.

There are solutions out there but there are no cures.

You shouldn't lose a lot of hair over the next several weeks while you await the results of your test. Since he's already concluded that you have folliculitis however, did he start you on any medication to treat it? Or is he waiting for the test results first?

Androgenetic alopecia (genetic pattern baldness) is the most common form of hair loss. It's progressive and there is no cure. It's not considered a desease and won't harm you in any way other than cause hair loss. You can begin reading more about hair loss by visiting "What Causes Hair Loss?" on the Hair Loss Learning Center.

The first step in your case should be treating the folliculitis and/or whatever other scalp condition you have.

However, if you've been diagnosed with androgenetic alopecia (which looks correct from your pictures), you may want to start researching proven treatments like Propecia and Rogaine. These two treatments are often highly effective in helping balding men retain the existing hair they have. It may also help strengthen miniaturizing hair giving it more thickness and density. These treatments are optimal for men like you who only just started to lose their hair. Those with extensive hair loss usually don't experience the same kind of benefit since no non-surgical hair loss treatment is proven to regrow hair.

These medications do come with potential side effects. So be sure to read and consult a doctor about the benefits, limitations, and potential side effects of these drugs.

Later down the road if your hair loss worsens, you can always consider surgical hair restoration.

Try to hang in there and don't lose sleep over it. As we age, we all get to experience all sorts of wonderful issues, many of which, experience hair loss.

Know that you are not alone and we'll be here to support you.

Best wishes,

Bill

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Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

Thank you very much Bill, both for sharing part of your own story and for admitting that there is hope.

Yes, the dermatologist started me on treatment for the folliculitis - he prescribed an anti-fungal medication, and also told me to use a shampoo called T/Sal by Neutrogena. He said this should be cleared up within a month's time unless the fungus is stubborn and it might take a little bit longer. Anyways, I'm not at all concerned about this.

Regarding researching proven treatments for androgenetic alopecia: that is quite literally all I have been doing the past few days as I await the biopsy results and the treatment regimen based on those results and my blood test results.

Based on my research, here is what I have determined may be best for me (I still am hoping for feedback/suggestions from others as well as the professional opinion of my dermatologist): truth be told, Propecia scares the heck out of me. I really feel uncomfortable ingesting something into my body that 1) could mess with my hormones permanently over a long period of time and 2) could inevitably cause ED problems. I simply do not trust drug companies and there have been no long term studies (from what I have seen) indicating what percent of people develop ED problems. I know the short term is roughly 2%, but even those odds scare me. That being said:

<UL TYPE=SQUARE> <LI>Nizoral (topical shampoo) seems to be something that should be included in every regimen due to its ability to control both the DHT sensitivity and the calming of the scalp <LI>Revivogen seems to be the second best thing to take next to Propecia for a DHT inhibitor; I like the fact that Revivogen is topical and thus will not mess with my hormones nor cause ED in the long term; from what I understand, a DHT inhibitor essentially halts the cause of hair loss <LI>Rogaine (foam) seems to be the best growth stimulant to use which, from what I understand, stimulates new hair growth and aids in thickening the hair follicle by increasing the size of the shaft; in addition, from what I've researched, it seems that using a DHT inhibitor and a growth stimulant is the best way to go if you're looking to halt hair loss and thicken/regrow hair. Now, I'm not sure if I've actually lost any hair yet, or if it's just thinned; when I touch the top of my head, I don't feel any bald patches, it just looks thinner. That being said, from what I've read, the general rule of thumb for hair loss is that hair can be thickened anywhere it is still growing. So, based on my pictures, I feel as though I have a good chance for the hair to regrow back to a more fuller state, especially if I am consistent with my regimen. Do you feel that I am getting my hopes up, or does that all sound reasonable? What are your thoughts on Tricomin? I like that is natural, however, I need it to work, too. <LI>Finally, Topical Spironolactone S5 Cream seems to be a good product to use as an antiandrogen treatment which, from what I understand, aids in blocking DHT from reaching the hair follicle. <LI>In addition, I've read that methylsulfonylmethane (2000 mg daily) might be a good thing to take orally as well since it has been proven to increase hair/nail regrowth and it is generally good for the body.[/list]
I'd appreciate any feedback from you about my research and the regimen which I have constructed. If you see anything that is inaccurate or unnecessary, please let me know. I've taken about 20 pages of notes thus far so I feel fairly confident in my assessment of the problem and also the best ways to combat it for someone in my particular situation.

Finally, what would you classify me at on the Norwood scale? Also, based on my pictures, how far along in the balding process would you say I am? I have yet to wake up with hairs on my pillows, and I don't see clumps of hair coming out in the shower yet. My hair just feels thinner in general. I'm not quite sure what that means, but I have to assume it means I'm still in the beginning stages of the process. But hey, what do I know?

Thanks in advance, this really means a lot to me.

Tony,

Without a doubt, Propecia and Rogaine are the most effective non-surgical hair loss treatments. I understand why Propecia scares you, but do know that it's not "inevitable" that you'll experience ED issues. These side effects are considered rare, and though they can happen, it's said that stopping treatment will reverse any side effects.

That said, here's a list of treatments that I'd personally consider based on my research. Note that I'm not suggesting all of them at once as they're all topicals.

If you're completley against taking Propecia, I'd suggest considering the following regime

Rogaine foam
Revita shampoo (ketoconazole 1%) daily
Extina (ketoconazole foam - leave in treatment) - discuss treatment with a doctor/dermatologist

Other treatments to consider:

S5 Cream (topical spironalactone) - seems to suggest some evidence as a potential DHT blocker

Nizoral (2% ketoconazole) - The only reason I suggest Revita over Nizoral is because Nizoral can dry out and irritate the scalp and hair if used too frequently. If you use Nizoral, don't use more than twice a week.

Personally, I'm not real keen on Revivogen. This product contains topical saw palmetto which is not proven to treat hair loss orally let alone topically. I'm not saying it won't work, only that there's no proof. I personally tried this product for about a year with no success.

The above regime does not include a oral solution. Personally, I don't have a lot of faith in any of the herbal oral treatments, but if you want to try one, consider oral saw palmetto as a adjunct to some of the proven methods above.

I hope this helps.

Bill

__________________
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and the Hair Loss Forum and Social Community

View our hair loss articles on EZineArticles.com

Follow us on Facebook | Twitter | YouTube

Subscribe to our Newsletters | How We Recommend Physicians

-----

To learn about how I restored my hair, view my my hair loss website.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.