Hi everyone, I am a 40 year old woman experiencing a receding hairline in my temples; my hairloss is not the typical female-pattern hairloss (go figure), and it actually looks like a Norwood II -- not exactly the most attractive or feminine appearance for someone entering her forties. I had some thinning in my temples for about ten or fifteen years already but it wasn't until my mid-thirties when it really became obvious. I always liked to clip my hair up but around that time I stopped doing it as much because it would expose my temples. About two and a half years ago I went to my dermatologist and she conducted a scalp biopsy and sent it to a lab that determined I had androgenic allopecia. She also had me start a Rogaine regimen (I use 5% foam -- yeah I know it's not marketed for women but so what, it works for me) and prescribed Propecia (1mg daily) for me (again not marketed for women, but she strongly recommended it to me on account of my kind of allopecia). I had to go off the Propecia after 2 weeks because of side effects (I was getting daily splitting headaches), but after waiting a month I went back on it and the headaches never returned. So I have been on the Propecia ever since. A few months later I had a 900-graft FUT procedure with a highly recommended surgeon; I notice he is also a Coalition member on this site. It went smoothly and the healing went well too, but there are some issues. On my left temples, most of the grafts have pitting and there are compacted follicles. Oddly enough this isn't so much a problem on my right side. Also the density is much better on my right side than on the left. I think though that might have something to do with the fact that the recession was worse on the left side, and there were more native hairs on the right side than the left. Also the Rogaine really worked well with the front hairline. I know some people say it doesn't work with the front hairline but that's not the case; I was growing hair even on my forehead where it dribbled down where hair never grew before. I think the Rogaine really helped the transplanted hairs blend in well. It would have been thin with the transplants alone, and I understood when I had the procedure that I may need a second transplant. I hoped I wouldn't have another one because it was really uncomfortable having a head wound, but with the Rogaine it looked reasonably thick so I thought I could get by with just one strip procedure. Well then in June of last year I stopped the Rogaine, for various reasons. I feared it was giving me facial hair, it was a pain to travel with the foam (didn't fit in the TSA-required quart bag), and I guess I thought I didn't really need it anymore with the transplants; I underestimated how much the Rogaine hairs gave me density. Plus I didn't want to have to use it twice a day for the rest of my life. It wasn't a decision I thought through; it just kind of happened. Maybe in part due to laziness. Anyway it was a big mistake because then the native hairs started to shed, and in a larger area than the original receded regions. I noticed thinning in July, and then it looked really bad in August. And now in March, I've started the Rogaine again and I'm thinking again about getting that second transplant. I have also had some dandruff/skin flakiness in the temples in the past few weeks (which I've treated with ketoconazole), and I don't know if that contributed further to the appearance of bareness. So now I have a lot of questions and things I'm thinking over. I hope I can get back some of the hairs I lost, but I realize I probably won't get what I had before. I have wondered if the Rogaine made hairs that wouldn't have otherwise been lost dependent on it, such that the area of loss is now bigger than it would have been without it (does that make sense?). I also wondered if this was a shed that would come back on its own but 9 months I don't think that's the case. But right now things are unacceptable, particularly on my left temples where things have always been worst. Now there is much visible scalp, the transplanted hairs are sparse with much space between them, and now they are sort of their own island separated from the rest of the hairline. So I am pretty sure I will need to get the second round of transplants. The next question is...which surgeon? I could go back to the surgeon who did my first transplant (a Coalition member approved by this site) or try someone else. I have read that pitting is due to surgeon error -- is that true? If so, that would be one strike against this person. Also he was very expensive, around $8.50 per graft. I had a consultation with Dr. Pak in LA area and I was very impressed with him, and he charges only $5 a graft. That means with my budget I could have more grafts with someone who, from what I read, has a very good reputation. I would prefer to have just one more procedure to fill out my front hairline rather than needing two more. And I would like to use the smallest strip necessary for my surgery, as I would like to reserve as much donor material as possible for the future if god forbid things get worse. So I would also like to know if what you see in the pictures reflects what I should have received with 900 grafts. And if you all have any opinions on how many grafts I need to get good density, I would also be interested to know. I am open to other hair docs too. What I can't be open to is FUE; it's just not possible for someone with long hair. Oh yeah, and another question I have pertains to the timing of the procedure. I have had bouts of telogen effluvium in the past; it got really bad in 2007 and then improved and then I had a small bout of it last year and now I'm on the mend from that. If I have the procedure done at a time when I am experiencing this excessive shedding, that would result in a lot of wasted folicles, or not? So I am thinking I should schedule HT at a time when I am having minimal shedding (I have a good handle on this -- my dermatologist has gotten me in the habit of saving the shed hairs during each shower, so I can see when I am shedding a lot as opposed to when I am shedding only a little). I am also worried that the Propecia is not doing me any good, as I still seem to be losing hair. I know it doesn't work for everyone. But there is no chance I'm giving that up. Okay, so let me share some pictures of my ongoing hair situation. Let me start with pictures of my hairline from over a decade ago. The quality isn't that good because they were taken with film, but you can see some thinning on my left temple: And this is how it looked about a year before I had the transplants...you can see the thinning quite clearly. And this is how it looked when I went to my dermatologist for the skin biopsy (yuck ): And here are the same areas the day after receiving the transplants: This is at the 7 week mark: Notice the hair going down my forehead! Rogaine really does work on the front hairline (at least it does for me). Okay here I am at the two month mark, and notice the pitting, about the same as it is now: Okay then when the hair grew in, I was pretty satisfied with it, and didn't take any really good closeup pictures. But this is how I looked last March, a year ago: As you can see, the hairline looks smooth, natural, and full. Lots and lots of Rogaine hairs. Here is a closeup of my left temple: Then after ending the Rogaine, the shedding started. I noticed it was looking thinner by July (bear in mind that my fringe is hanging down in this photo as opposed to me holding it up): And it was looking dreadful by August (I know this is a crappy quality picture): And this is how it looks now (I know it looks unhealthy but bear in mind that it is uncombed and some hairs are sticking up due to Rogaine foam): Anyway, I hope that gives you all some good info to start with. I look forward to reading your comments.
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