Hey everyone hope your all doing well. I really need everyone's advise.
Ever since I was young I've had nice thick hair for most of my life. I turned 40 this year and over the past 4-5 years I have noticed that the frontal third of my hair has been thinning diffusely and I have had some temporal recession on both right and left sides. As with most diffuse thinners I actually didn't really notice at first as I always styled my hair forward and never slicked it backwards. The first time I actually noticed it I turned around 37 or 38 years old when the front third of my hair started to change consistency and became harder to style.
I've always had a great head of hair and never in a million years thought it would start to thin which is why it kind of caught me off guard. I know that I am 40 years old but to be honest I'm really devastated!
I have attached some photos below of my hair/hairline throughout the years. If you look at my hair from 2004-2015 it was pretty solid - with some slight diffuse thinning starting around 2015 in the frontal third.
If you compare to my hair today in 2020 you can see that the entire frontal third is diffuse and I have lost most of my temporal angle areas. I feel that I'm heading towards an isolated forelock but even the forelock is starting to thin and miniaturize as well (especially in the middle of the forlock).
Behind the frontal third of my head, the hair is just starting to become diffuse very slightly. Only way I can describe it is I can trace the future of my hair loss - I feel I will have "high sides" as these high side areas have not thinned at all and are actually a darker color whereas the top of my hair is lighter brown due to the diffuse thinning.
I feel the diffuse thinning is spreading all the way to just in front of the crown and there is very very slight crown thinning that can only really be seen if I spike the hair up.
For family history my maternal grandfather had lots of hair into his 80s and my paternal grandfather was a slick norwood 7. I feel I have identical to my dad where when he was his mid 50s he lost most of the entire frontal third and was diffuse thinning further back but still had probably 50% of his hair density behind the frontal third. He was probably a norwood 3a to 4a or so. I have attached a photo below of my dad and how I think my hairloss will progress over the next 15-20 years.
Now the only thing that worries me is I feel my hair just keeps getting worse by the month. I have never noticed my hair shedding rapidly or anything, its just a slow progression to becoming less dense. But the thing is, when I look at my hair from 2018 to 2019 to 2020 I feel like Im losing ground more rapidly than from years prior. I can still style it forward and it looks almost like how my hair looked even 10 years ago but its getting harder to do so because the hairline is receding and becoming less dense.
For treatment - I don't currently take any meds and Im scared to take finasteride or minoxidil due to side effects. I understand that in order to keep my hair I need to do something and was considering topical finasteride/minoxidil but would never take anything orally and if I had sides even from this I would stop immediately. I feel my hairline probably wont come back even with meds as I never had a "thick wall of hair" type of hairline anyway. I have consulted online with a few surgeons and most are recommending an FUE in the ~2000 range or so which I believe will bring me back to how my hair was like 15 years ago.
So Im curious as to what everyones thoughts are? What options do I have? Would you recommend I go straight for a transplant since Im 40 and my hair loss progression is relatively slow? Or should I wait until its more pronounced? Here is another photo of my hairline pulled back and my donor area
My final fear is that since the frontal 1/3 is diffuse - that with a transplant I might shockloss the entire thing. Or that over the next 3-5 years if I rapidly thin which I dont believe I will, that the transplant will look silly.
But on the other hand, if I do a 2000 FUE procedure, I think I can get a great result which may last me 10-15 years even without meds based on what I think my hair loss will progress to. And I feel I have a great donor for future FUEs if I need to use it.
Thank you everyone!
How has the experience been for most with topical finasteride?? I feel if I was to do anything it would just be that plus minoxidil. I have read conflicting things on topical finasteride having no side effects.
