bismarck

My friend is a police officer in a large city and I asked him how his job had changed over the past few days. He said it was a lot less busy overall but that domestic abuse had gone way way up. Don't let cabin fever get you -- keep things in perspective folks. On the other side of things, the virus seems to kill twice as many men as women for some reason. Remember the good old days when things were normal? You know, like 7 days ago?

Gillenator, you have a gentle way of making insightful comments. It's a fair point. I'll keep an eye out.

Duchaine, thank you. Are you in Italy or somewhere in Europe right now? I heard that Italian doctor in quarantine and it sounded horrific. God bless and stay safe if you are a country that's been hit. Here's the problem: We keep talking about death and don't take into account sickness. The coronavirus literally hijacks your immune system and uses your killer T cells and neutrophils against you. The young may not be dying in the USA just yet, but the scar tissue from the infection can lead to life long restrictive lung disease and chronic heart failure. COVID-19 is truly evil personified in the form of a biological weapon. It has all the infinity gems. And you can be asymptomatic and a carrier. Is it just that people can't put up with a little inconvenience to save strangers? The only way we'll beat this thing is if we, on a societal level, go into sleep mode until the antivirus software updates. Seriously if there's ever been a time we needed to work together.

😞

In a series of studies in 2005 and 2006, researchers at the University of Michigan found that when misinformed people, particularly political partisans, were exposed to corrected facts in news stories, they rarely changed their minds. In fact, they often became even more strongly set in their beliefs. Facts, they found, were not curing misinformation. Like an underpowered antibiotic, facts could actually make misinformation even stronger.

Don't be these guys

Melvin, I appreciate the sentiment but two weeks ..> two months in a best case scenario. Worst case scenario 18 months.

Well, The answer is: Your age roughly parallels the percentage of people who have significant male pattern baldness. At age 50, half of men have significant baldness. Maybe you'll be very lucky and be the 1 out 5 guys that still has his hair at 80, or maybe you'll be very unlucky and die young, but the most likely scenario is that you (and everyone here) will be old with only transplant hairs left. In light of that possibility, I think planning the frontal hairline should be done very carefully. I accept VenMo.

You seem like the kind of guy who would get chest pain and arm numbness and attribute it to a muscle sprain instead of having their heart checked out. Fear isn't always unreasonable. Your philosophy works until shit hits the fan, then it really, really doesn't work. The major difference between Corona and those other infections you mentioned is the incubation period and the mortality. Usually pandemics are one or the other. E bola is very deadly, HIV is very latent and less deadly. The longer the latency, the more widespread; the higher the mortality, the more death. Corona, unfortunately, has a little bit of both -- a decent latency and so far, a 10% mortality in those infected, though probably it will eventually be about 1% as the milder cases are likely not being diagnosed right now. These are two very bad things for which, when combined, there is no reasonable defense in modern healthcare. To use a video game analogy, COVID-19 is OPAF. I can tell you now that every ER in the country is dealing with 100s of additional patients a day, hospitals are at their breaking point and MICUs are spilling over at capacity. In a few months it is projected to be in the 1000s per ER and medical care and ventilators will have to be triaged. If, god forbid, things continued to progress from that point, the elderly will be dying in waiting rooms. In fact, many, many more of those 50+ will die already, regardless of what we do. Not to mention what will happen with the backlog of other illnesses that doctors can no longer treat because they're overwhelmed by COVID. The only chance we have to mitigate things is to shut down and self-quarantine like the Chinese and Italian did. Irresponsibility at this point could turn this thing into years instead of months, and completely make us vulnerable to the next pandemic, which will come when we are weakened. Things are about to spiral out of control and you're worried about your precious hair. You really gotta step back and do a gut check on this one Kramer. Don't be stupid Daniel-sun. Yes, exactly. The rate of testing and virus spread are rising in rough parallel, suggesting that the virus is much more widespread than we believe. However, the good news is if it is really that widespread, we could be closer to the top of the hump than the beginning, as far as disease model predictions. KhanAcademy has a pretty decent analysis of the growth rate and peak for those that are interested. The only way we're going to get through this is together. Hopefully this will only be a warning. Stay safe people.

Gillenator, not quite. Finasteride works to to slow the development of something called benign prostatic hyperplasia. There is no swelling or edema unless it's infected.

It will be akin to a very, very bad flu season. COVID has about 10 times the mortality of the flu, but a much smaller segment of society will hopefully be affected. If people just stay home, we can beat this without too many economic repercussions. It's really a 50/50 chance whether we will do that though though I think we will. Italy and China's numbers are dropping so the time frame appears to be 45-90 days with aggressive measures. I wouldn't even think about getting a hair transplant till the summer though. Imagine how foolish you would feel looking back if something went wrong.

With what has been happening recently, and the fact that things will likely get worse before they get better, I would suggest putting non-emergent travel on hold until we know just far this thing has spread. Hair transplantation is an elective procedure, it can be rescheduled with no major harm to anyone. Getting an infection while trying to recover from a hair transplant? You don't want your immune system to be fighting sepsis at the same time as it is trying to heal your scalp. The media is reacting extremely strong to this, a significant component of the inflation in numbers seems to be related to a shortage of the PCR testing: as the tests become more available, the numbers increase. So the increase is a reflection of testing distribution, not the virus itself. That being said, the numbers are rising dramatically fast. Hopefully it will go the way of SARS, Ebola, etc and not the Spanish Flu or HIV, but really anyone that confidently says they know where this thing will end up is blowing smoke where the sun don't shine. Be safe everyone. Self-quarantine if you can. If you think you may have been exposed, avoid people over the age of 50 or with a pre-existing medical condition as they are at the most risk. We don't know anything for sure just yet. Hopefully, things will be back to normal soon and we'll look back and think 'Man remember when that was a thing?' But until then, don't mess around.

There is a massive shortage of testing right now. As the tests become available, the numbers will shoot up but this is an illusion. I wouldn't mess with a hair transplant right now though, especially if it requires travel. Being severely infected/septic would seriously put your follicles at risk. The real risk is going to be public hysteria resulting in overwhelmed medical systems as well as the economic results of multi-business lockdowns. May change the course of the election, and a democratic president is going to compound the economic downturn even further.

The feeling is mutual on this one. Best of luck whatever you decide.

That's fine and perfectly reasonable. If I were in your situation, I might consider saving up for one of the Spanish or Belgian docs and use Toppik in the interim. It will give you and your hair some time to evolve and reflect.

Where are you finding these instagram posts? I just find ads when I search those hashtags.. I think you're at a point WAY WAY better than where you started but you really lost of a lot of reserve to achieve what you've done so far, and I'm not too sure about the yield at the areas that seem sparse. I would be very careful with where you spend your remaining follicles. I might even hold off altogether on revision and see how the rest of your hair loss sits for a few years. There is no good that comes from making decisions from emotions or too quickly when it comes to hair.

Thank you for sharing your experience and looking forward to those pics! Also I know you mentioned no Propecia or Minoxidil but any other treatments like ketoconazole, etc?

1) Prostate glands are not hair follicles. If they were then we would get hairier as we grew older (or our prostates would fall out of our rectums if you want to go the other direction). There is a lot more smooth muscle and glandular tissue, that's why the alpha blocker mentioned above works for difficulty urinating. In addition, an enlargening prostate is not all healthy tissue. It under goes necrosis, cystic degenerative change and can frequently evolve into cancer. It really looks like hell internally. The part of your scalp that looks like this is the subcutaneous fascia -- if you don't believe this, just feel the evidence. Try probing the skin where you've lost hair and the skin where you still have hair. Do they feel different? A similar process of poorly restricted cell turnover, scar tissue and death has occurred in both, just the prostate is in a less restricted space. 2) Yes, it is not entirely about DHT, it is about something called the dermal papilla, where the stem cell resides. The follicles at the front and dome of your scalp seem to be androgen sensitive, while those in back less so. This sensitivity is impacted by a combination of genetics and environment, but the contribution of environment becomes greater with time. Akin to putting high octane fuel into an old jalopy. Having a healthy dermal papillae is why you can transplant follicles into this fibrosed scalp tissue where you've lost hair and it usually doesn't die. Though it certainly can have difficulty growing, particularly depending on the surgical technique and how much of the bulb was removed without damage. This is a very big discussion and I'm not going to get into it and hijack the thread. The only point I had was that I appreciate TS's original comment about not being able to anticipate future hair loss. Statistically, the majority of men are high Norwoods when they are old, so it stands to reason that the transplanted hairs will be retained to a greater degree while the native hairs fall out around them. For many, by the time you reach old age you will be left with only the transplanted hairs in your reconstructed scalp. So sure, think short term, spots to fill in, etc. But also keep in mind your long term game. Don't fuck your later years up to have a slightly better youth. Life gets a lot harder as you get older. The cost of this trend towards follicle burning with low yield aggressive surgeries will become more apparent in the decades to come. I am sure transplant surgeons and early patients are already well aware of it. A low frontal hairline with a bald top looks bizarre as most men recede to some degree before they lose the hair at the dome of their scalp. That's why guys like Lorenzo start so high; they know where things usually end up. Lorenzo style clinics are sacrificing a slightly more aesthetic short term to save those guys in the long term. The low hairline obsession is getting patients into the door of aggressive clinics, but these guys are really putting themselves at risk of a "Julius Caesar crown" of transplanted hair as things progress with time. Especially if you blow your wad by doing something silly like 4500 FUE to your frontal hairline when you're 22. How many times can you realistically go back into that scalp to fill the dome as it continues to shed? Yes, there are old guys with hair, but it is a small minority. The long term data on finasteride/dutasteride is not complete, but suggests that even with medication, things will get worse for most. This is due to the increasing fragility of hormone sensitive follicles with aging due to mutation accumulation. The cosmetic medical industry is a very bizarre cocktail. "Freedom of choice" and doctor shopping come up against "do no harm" for essentially every patient-surgeon encounter. And there is a constant background of body dysmorphic disorder that has become profound with the influence of social media, though certainly it has always been there. I mean, we live in a society where women are allowed to get breast implants so large they can't walk upright and Michael Jackson was allowed to get nose jobs till he had to pick his nose with a Q-tip. There's a surgeon for every patient if you have the money and a poor instinct for self-preservation. Hair restoration may be a science and an art, but we must keep in mind that it is also a business. And as with any business, there is a tendency to glorify the more extreme results -- availability heuristics are a real problem in this industry. You gotta play like Belichick not Bradshaw.

I would think very carefully before going back to the same place on this one.

Lasercap, the data has been published. The effects of androgens/steroids on older hair follicles is very different than on the young because of the mutations that accumulate with aging. Do the research yourself, I'm not going to waste my time on stuff that has already been extensively discussed. Seriously, your name is LaserCap and you're questioning established studies? Tired of how confrontational this forum has become, understand why so many have left. Follicles become more sensitive to DHT with aging. It does not matter that there is less DHT. Otherwise there would be less balding with aging. If you don't want to google studies just use common sense.

It is an uncomfortable truth that the majority of people that receive transplants, if they live long enough, ends up with retained transplanted hairs in front/at the crown while their native hair balds around it. This is unfortunately true even if on fin/dut. Androgen sensitive follicles become far more sensitive to even the tiniest amounts of DHT with aging -- ie. studies in which older guys receiving anabolic steroids with abrupt sheds vs younger guys who don't usually lose it as abruptly. Unlike breast implants, not a "reversible" procedure in that sense. I guess you gotta ask yourself -- are you willing to burn your boats to win the battle? Or are fears about some future war holding you back? Also are you on fin/dut? You'll never know if you made the right decision, even in retrospect. Kind of the shitty thing about life. Great post.

Great to see you after so long! What a journey! Would love to see how your hair has done in the time since. Please update when you have a moment!

The hair will hopefully continue to thicken and mature and fill. Please keep us updated!

Resveratrol, NMN, metformin, even rapamycin. There are a number of potential targets in terms of slowing aging. Their relationship, if any, to hair loss has not been studied to any degree that I know about. On which subreddit did you see that post?

Interesting point, very interesting point. Let me see if I can find any long term follow up pics. My understanding from the Beehner study was the opposite.