StillHaveHair

Thanks, Dr. Simmons (still getting good advice here two years later!). I actually just ordered some Rogaine foam to try out. I initially wanted to see how I would respond to the finasteride, since I was concerned about keeping up the use of minoxidil. I do understand that I may have had TE as well, especially given the brushloads of hair I remember combing out months before realizing what was going on. The point is that if even one of the doctors I saw had taken a look at my scalp for miniaturization, it would have been obvious there was a genetic factor at work too, and I wouldn't have waited eight months to start treatment. I can recall spending quite a while explaining to the second dermatologist about "diffuse patterned alopecia" and again being refused a Propecia prescription because "it's only for certain patterns". At the moment I'm not doing so well. I've been on Concerta for a couple of months, and a few weeks in I noticed quite a marked difference in my hair even compared to photos from a month previously. Two months in and I seem to have lost a lot more hair. Since "scalp hair loss" is a possible side effect, and there are a number of reports of this on the internet, it's hard not to draw the conclusion. I've discontinued the Concerta because of the possible hair loss (and other side effects). Unfortunately, not much chance of growing it back, I suppose I can at least see how things go for a few months before evaluating my options.

I was looking around for my old posts on hair loss and remembered this thread and how it documents what I originally went through. I use a different nickname on other hair loss sites, but I remember getting lots of helpful advice here along the way. I thought you guys might appreciate an update. It's pretty clear at this point that I have MPB in a diffuse pattern all over the top of my head. I ordered finasteride online right around the time of my last post in the thread (Nov 2007). I've been taking it since then, and I thought it was at least maintaining my hair. Unfortunately, that's not the case, and I recently noticed it has thinned dramatically since I started. I have long hair I haven't cut since the haircut I got to confirm my suspicions back in 2007. I can still pull it off, but the parting is getting thinner and wider, and I'm rapidly approaching the point where I'll have to shave it all off. I am pretty attached to my long hair, since I know I'll never be able to grow it again, so I'm hanging onto it as long as I can. I'm now thinking of adding minox to see if I can at least get a bit of regrowth, though I am afraid what effect shedding would have on my ability to maintain my current hairstyle. I'm still really angry about how long it took to sort things out. I wasted nine months of shedding and thinning because the doctors I went to see knew barely anything about MPB. I honestly expected to go see my family doctor, be told it was MPB, and get a prescription for Propecia. Instead, I went through him and two dermatologists telling me it was TE and flat-out refusing to prescribe Propecia, a miniaturization "examination" by one of Armani's assistants that was obviously complete bullshit to humour me, and finally got the actual diagnosis from a hack transplant doctor who was only interested in pushing laser combs until he retired. It really bothers me that regular doctors know so little about this stuff. If anyone knew even the basics of how genetic hair loss works, they could have taken a look at my scalp, seen the telltale signs of hair miniaturization, and put me on treatment right away. As I posted before, even the transplant doctor I saw wouldn't check this, and told me he'd have to do a punch biopsy! I don't feel as bad when I see people posting about going to their doctor and immediately having Propecia pushed on them. I'd take that over what I went through any day. I'm also really bothered by all the bald guys on hair loss forums who tell people with minor hair loss to get lost. I was too embarassed to post any photos back when I first noticed thinning, because I'd seen what happened when people like that asked about MPB. It's really important to get on treatment at the first sign of hair loss, so this sort of thing is very counterproductive. Anyhow, I got a lot of good advice here that I obviously should have listened to sooner, and I just wanted to say that I appreciated it. Thank you to everyone who replied.

Well, I went to see Dr. Unger today. He had a quick glance at my scalp, said there was some thinning in the crown (more than 50% loss!), and diagnosed it as MPB. He couldn't see anything in any of the other areas where I've noticed thinning. He doesn't do miniaturization studies or anything like that, which was quite disappointing. If I do have MPB, I wanted to get some proper metrics on what state I'm in now to see if any treatment really helps. All he said was "50% hair loss = 50% miniaturization" and that punch biopsies were the only way to examine the hair for miniaurization. The rest of the appointment was pretty much a sales pitch for the Laser Comb. He apparently believes it is significantly more effective than Propecia, and recommends it as the #1 treatment for hair loss. His clinic is sort of a cosmetic surgery spa type place. He still does procedures like scalp reductions. He's retiring in January, so he didn't want to write me a prescription for Propecia. He was a nice enough guy, but I obviously wasn't terribly impressed with the visit. I'd really like to see another doctor who could actually give me a better idea of what's going on up there. The other doctor I found online apparently works with Dr. Unger's brother, Dr. Walter Unger. The two of them appear to be heavily involved in the whole low level laser treatment thing, and neither has a very good reputation as a surgeon. Even if he was a hack, it seems my hair loss is likely MPB at this point. I'm going to look for another hair doctor, but I'm considering ordering some finasteride online for now. I guess I'll have to deal with being jerked around by dermatologists and doctors for six months for the rest of my life. I would have been in a much better position in March, when I first noticed very slight thinning, or May, when I first went to see a doctor.

You do know what smegma is, right?

I'm really sorry, I didn't mean to offend you I just got caught up replying to TheEmperor's post and forgot about the points you made. The problem for me is that I have doctors telling me over and over again that it's just stress, and I get online and everything I read points to the contrary. I've spent the last 8 months feeling miserable and depressed because I believe my hair loss is probably genetic, but I'm unable to treat it or get a doctor to give a reasonable opinion. So, I haven't even even been able to deal with the idea of MPB yet. How did the biopsy confirm your AGA? I will give this a try. Believe me, I have spent lots of fun time counting falling hairs. I still count every time I brush, which is depressing enough. I didn't mention it in my original post, but the major sources of stress have been trying to meet crazy study deadlines, the hair loss itself, and my parents' ridiculously messy divorce that's been going on all year. I am actually taking a year off school because I was so stressed out at the end of the Summer. I wasn't eating properly for months, but that's improved quite a bit recently. My sleeping has been pretty spotty -- I often sleep well past 8 hours, and still feel fatigued all day. I'm not sure there is a real medical cause, as the blood tests I had done in July were all normal. It is hard to keep upbeat with all that's been going on this year. Thanks. It is nice to know there are other people out there who can sympathize with me. It's like talking to a brick wall trying to let my family members know how worried I am about the hair loss itself, let alone the idea that it's been going on for so long without treatment. They have all been in denial about the possibility of MPB from the moment I mentioned it. I thought I was the one who's supposed to be in denial! Again, I'm not even considering the possibility of a hair transplant. The only reason I put the post here was because I thought I would have a better chance of finding a good local doctor to see for a diagnosis.

Thanks for all the replies. After seeing two local dermatologists, I've pretty much given up on getting any answers locally. I'll make appointments at the two doctors I mentioned in my previous post and see what they have to say (neither will cost me anything). Unfortunately, the only doctor in my province on this site's list of specialists is Dr. Rahal, who's more than six hours from here. The particular pattern of genetic loss I'm concerned about is called "diffuse patterned alopecia" on some sites:

Yup. I was prepared to accept it was MPB from the beginning, and never tried to attribute it to stress. One of the first things doctors ask me is whether I had a significant stressor before the hair started falling out. My hair loss is not in a typical MPB pattern, so they won't diagnose it as that, which means they won't prescribe anything to treat it. I've seen four doctors, and none of them would prescribe Propecia. Even Rogaine Foam requires a prescription in Canada. I could try ordering generic stuff online and hoping customs doesn't seize it. It's really hard to get around the idea of taking Propecia for the rest of my life after being told repeatedly I don't have MPB and denied prescriptions. When I went to see the person at the hair clinic, I was fully expecting to be diagnosed with MPB, and had told him that up front. Instead I got another "it's just stress, don't worry about it" diagnosis. The main thing I got out of it was the knowledge that my hair is not thinning evenly everywhere, which just makes me even more concerned that it's probably genetic. It's not fair for you to say my hair loss is minimal. It was minimal in March, when I could barely even tell myself. It's been thinning rapidly since then. I keep it very long, which covers the loss. I'm not an idiot, and it's fairly easy for me to tell I've lost a significant amount of density. I'd like to clarify that I'm not seeking a hair transplant in any way at this time. I only put the original post here because I thought I'd have a better chance of finding a good doctor/surgeon to see for a consultation to diagnose the hair loss.

Well, it's been a couple more months, and I'm still working on this step. I have been looking for reputable hair places in Toronto who could do a consult and proper diagnosis. I spoke to one of Dr. Armani's consultants in Toronto. He examined my hair, and noted that the density was higher in the donor area than the rest (20% difference, but I would have guessed higher). He also said he could see some extremely limited signs of miniaturization. His conclusion was that my hair loss was stress-related and it would grow back, just like everyone else keeps telling me. This seems to go against everything I've read on the internet. Diffuse patterned non-genetic stress-related hair loss? Huh? I thought it would help me, but it's just made me even more worried about what's going on. What he told me sounded more like what I've seen called "diffuse patterned alopecia", minus the extreme signs of miniaturization. I've been convinced my hair loss was genetic since I noticed it in March. I've lost a ridiculous amount of density since then, and it's not stopping. It just makes me feel sick to think I've lost so much without treating it, and that I'll probably never get it back. I've resorted to e-mailing anyone I can find in Toronto on the ISHRS web site. I only received two replies, and I don't know whether they are worth seeing. Dr. Martin Unger has a terrible reputation online for surgery, and Dr. Marla Rosenberg is barely mentioned at all. They both say they do regular hair loss consultations, and can even claim it on the provincial health insurance here. Is there anywhere else with a good reputation in Toronto? I really, really need to get this resolved.

The blood tests came back normal other than a slightly elevated platelet count. The only thyroid test they did was TSH, and I'm not sure if more extensive tests would prove anything. I went to see my family doctor to discuss the results, and he was very reluctant to prescribe propecia (I had to specifically mention it to him by name). I got him to refer me to a second dermatologist. I explained everything in great detail to that guy, and after a quick look at my scalp, he told me specifically that it was telogen effluvium. I also discussed propecia with him, and he told me that he could not see any sign of MPB, and there was no way he would prescribe propecia. He said he couldn't even tell that I'd lost any hair. This is becoming one of the most frustrating experiences of my life. If I knew for sure I was losing my hair, I would be able to start dealing with it and accept it. In my case, I've been in limbo for 4 months, not knowing what's going on. If I'm losing my hair, I will fight it tooth and nail, but I can't even get a bloody propecia prescription or definitive diagnosis. I tried e-mailing Dr. Rassman of baldingblog.com and didn't get anything back. I was hoping he might offer some insight (even "it looks like you may have MPB" would be helpful). It seems the only option left is finding a transplant doctor in Toronto who might be able to do a more extensive examination of my hair. I would really appreciate some suggestions. I will try to post the full text of the e-mail I sent, along with the photos I included.

Note: I just bumped the thread for an update here, please don't reply to the original post. I'm 23, and I've been going through a truly awful period at home and school. Added to all of that, my hair has been thinning quite drastically over the past few months. I went to see my family doctor in early June, and he told me it was likely related to the situation at home. I had him refer me to a dermatologist, who asked various questions, examined my scalp, did a couple of pull tests, and agreed with him. I have not had any recession, but my hair is noticeably thinner all over. I have absolutely no family history of early hair loss. My grandfathers both lost their hair in their late 60s to 70s, but every other male relative I know still has a full head of hair. However, I am not naive enough to believe my hair loss couldn't be MBP, and I gather stress is pretty unlikely to be doing anything other than help along genetic hair loss. The dermatologist recommended some blood tests which I am going to have done. Assuming they come back negative (or really, either way), I would like to find a doctor who can actually examine my scalp for miniaturization and give me a definitive diagnosis before I decide to take Propecia for the rest of my life. I seriously doubt I will be able to find a dermatologist able to do this locally, but I am not too far from Toronto. I'm not really sure who I would see for this sort of thing. I suppose a hair transplant doctor would be the obvious choice, but will they typically do consultations for patients who don't actually need hair transplants? What sort of cost would I be looking at? Thanks so much

Note: I just bumped the thread for an update here, please don't reply to the original post. I'm 23, and I've been going through a truly awful period at home and school. Added to all of that, my hair has been thinning quite drastically over the past few months. I went to see my family doctor in early June, and he told me it was likely related to the situation at home. I had him refer me to a dermatologist, who asked various questions, examined my scalp, did a couple of pull tests, and agreed with him. I have not had any recession, but my hair is noticeably thinner all over. I have absolutely no family history of early hair loss. My grandfathers both lost their hair in their late 60s to 70s, but every other male relative I know still has a full head of hair. However, I am not naive enough to believe my hair loss couldn't be MBP, and I gather stress is pretty unlikely to be doing anything other than help along genetic hair loss. The dermatologist recommended some blood tests which I am going to have done. Assuming they come back negative (or really, either way), I would like to find a doctor who can actually examine my scalp for miniaturization and give me a definitive diagnosis before I decide to take Propecia for the rest of my life. I seriously doubt I will be able to find a dermatologist able to do this locally, but I am not too far from Toronto. I'm not really sure who I would see for this sort of thing. I suppose a hair transplant doctor would be the obvious choice, but will they typically do consultations for patients who don't actually need hair transplants? What sort of cost would I be looking at? Thanks so much