Ironman

I pretty much know my future pattern of hairloss. It'll be like my dad, who's a NW6 I believe. Maybe like my uncle, who's a NW5 or so. Either way I'm not likely to have much hair 10 years from now in my early 30s. As for my medications, I used Rogaine for about 1.5 years starting when I was 21 or so. After consulting with a transplant doctor in Miami I was given a prescription for Propecia. I used both for about 6 months as a transitional period and then just stuck with Propecia. I've been on it exclusively for about a full year now. I found that Rogaine was just too much of a pain to use(I only put it on at night because I hated how oily it made my head and hair). I've thought about using both again, but I doubt any hair will grow and my current pace of losing hair is acceptable to me.

Yeah, I like the wait and see approach too. I've been taking propecia or Rogaine for awhile, and have given some thought to doing both. Dr. Rose told me that my hair loss would be a lot worse if I wasn't taking propecia, but even so I'm still losing hair at a pretty good pace(more in the front than in the crown area though). At some point the benefit from a hair transplant will totally outway the risk since I'll be pretty bald already. At that point I'll make an appointment and get a transplant. But until then I'll just deal with it.

Sounds great. I cut my hair on the back and sides with a #2 also. As for my hair loss progression, it's just a matter of time. Even with propecia I've been losing hair(albeit more slowly than I would have otherwise). I figure that in another 3-4 years I'll be pretty bald(or so see-through where I have hair that I'm more or less bald already). Maybe at that time I'll do something. I think it would be really cool to have a decent amount of hair again, but longterm I'm not sure hairloss will bother me so much(if I was 40 I probably would just deal with it like my dad does).

Ted- Keep me(and everyone else) updated with how the scar looks at a #3 buzz(or even #2 when you venture out to that level). I spoke with Dr. Rose awhile ago and he was very nice(and definitely who I would have a procedure with if I got one). At the time I decided that I could live with my hairloss since I didn't like the idea of exchanging one problem(early hairloss) for another(a scar and even more uncertainty about how to deal with future hairloss seeing that I'm only 23). Having said that, it seems pretty likely to me that I'll eventually get a procedure done, so be sure to keep us informed(with plenty of pics!) as your new hair comes in.

I've been taking propecia since March 2002(so about 15 months now) and I haven't experienced any regrowth whatsoever. At best it's just slowed down my hairloss to a slightly noticable crawl. My hair isn't as thick as it was when I started but after telling a doctor I'd been taking propecia he said that I might be one or two levels worse on the NW scale if I hadn't taken it. That works for me, but I guess I just produce too much DHT for any chemical to counteract(which goes along with the men on my dad's side of the family starting to lose their hair from the age of 17-21).

Honestly, his hairline looks like mine did at 15. If it's similar to my situation he'll notice his temples receeding ever so slightly for the next 3 years(but nothing to get worried over). However, at 18-19 I started to lose my hair a bit faster. I'd say that in the 5 years since I turned 18 I've gone from not being on the NW scale to being a NW3 or NW4(probably closer to 4). Because this kid's dad had hairloss in his early 20s he should be able to tell if he's going to follow a similar path at around 18-20. If so then he should do something about it. Before 18 I wouldn't advise propecia, although rogaine may work in that situation. BTW, my younger brother is only 18 and has had a ton of hairloss in the past 12-15 months. I really feel for the kid, as it's looking like he's going to look like our dad by the time he's my age. On a side note, since there was a discussion of family histories in this thread, my dad and his brother are pretty bald(NW5-6), which they mainly got from their mother. My mom's side is all women, although they're beginning to have thinner hair in their 40s and 50s. I think they got it from their mother(my grandmother), as my grandfather had a pretty thick head of hair into his 70s before some medications caused it to thin greatly.

No, I don't think hair loss is strange. I just think it's weird(and sad) that people can't get past their hair loss and get truly depressed about it. I'm 23 and losing my hair and it sucks, but there are a ton more important things in life than hair on my head. If people want a transplant because they need hair to frame their face and the cosmetic difference is huge then that's a good reason, but if the goal is to pump up their self-confidence then they need some counseling first.

That makes sense. Considering that one day I'll be like my dad(NW6 or so) I don't think that I could go all FUE and get reasonable coverage. I also have lower hair density, although my head is smaller than average(meaning lower needed coverage areas) and my hair is faily thick. So, if I choose to get a transplant done(and if some incredible new breakthrough doesn't happen soon) my only real choice is to get a strip surgery done. At that point(1500-2000 grafts later) I can make a choice between getting another strip surgery done to get better density in my frontal area(even after the 1st surgery I'd only be in the mid-20s for average density) or have some FUE sessions spreading out the donor area through the back and side of my head. Oh well. I guess it's better than being totally bald. BTW, at the point I'm at(NW3 and probably getting worse at only 23) I don't think a transplant is a great option. I'd rather have thinner hair than risk a surgery and get a scar running from ear to ear on the back of my head. I realize that to others the trade-off is easy to make, but I think other issues are at work besides hair loss. One of the best things about reading the message boards(especially the one at hairlosshelp.com) is that it helps me keep things in perspective and realize just how strange some people's view of themself can get.

Every time I think about FUE I can't help but wonder about the donor area. In a strip surgery the doctor cuts out a fairly significant area of skin and then connects the remaining skin to create a seamless(well, mostly) skin layer. This stretches the skin, thereby slightly increasing the distance between the hair follicles throughout the rest of the scalp. The extracted hair is put where needed and the appearance of a fuller head of hair is the result. Now, in FUE, individual follicles are extracted. The remaining skin isn't touched and the distance between follicles left on the head remains the same. Now, in my mind this translates into one major issue. If enough hair follicles are extracted using FUE there will be a noticable density problem relative to after a strip surgery. The same number of hairs are now spaced differently(vs. a strip effect) and the difference will definitely be seen in the donor area. Now, since the skin isn't stretched(and follicles remain the same distance apart), I guess that the same density in the transplant region can be reached with less follicles. Still, I can't imagine that losing 5000-8000 grafts all in the same area(rather than taking a strip and stretching out the affected area) wouldn't have an effect on the visible density, especially for someone(like me) with a large amount of single-hair follicles and lower density. If there were no risks I'd sign up for a transplant tomorrow. The strip scar worries me because a strip of my skin would be removed, the scar is kind of scary, and I believe there are more potential problems regarding the scar. FUE/FIT kind of worries me because it's relatively untested and my donor area could look bad if I get a bunch of follicles extracted over the next couple of years. I'm definitely not going to rush into a decision of this magnitude, but it would be helpful if a doctor(or someone with a lot of knowledge on the matter) could clearly answer my questions.

Every time I think about FUE I can't help but wonder about the donor area. In a strip surgery the doctor cuts out a fairly significant area of skin and then connects the remaining skin to create a seamless(well, mostly) skin layer. This stretches the skin, thereby slightly increasing the distance between the hair follicles throughout the rest of the scalp. The extracted hair is put where needed and the appearance of a fuller head of hair is the result. Now, in FUE, individual follicles are extracted. The remaining skin isn't touched and the distance between follicles left on the head remains the same. Now, in my mind this translates into one major issue. If enough hair follicles are extracted using FUE there will be a noticable density problem relative to after a strip surgery. The same number of hairs are now spaced differently(vs. a strip effect) and the difference will definitely be seen in the donor area. Now, since the skin isn't stretched(and follicles remain the same distance apart), I guess that the same density in the transplant region can be reached with less follicles. Still, I can't imagine that losing 5000-8000 grafts all in the same area(rather than taking a strip and stretching out the affected area) wouldn't have an effect on the visible density, especially for someone(like me) with a large amount of single-hair follicles and lower density. If there were no risks I'd sign up for a transplant tomorrow. The strip scar worries me because a strip of my skin would be removed, the scar is kind of scary, and I believe there are more potential problems regarding the scar. FUE/FIT kind of worries me because it's relatively untested and my donor area could look bad if I get a bunch of follicles extracted over the next couple of years. I'm definitely not going to rush into a decision of this magnitude, but it would be helpful if a doctor(or someone with a lot of knowledge on the matter) could clearly answer my questions.

jrod- We're about the same age as I'm 23. My hair loss is in the NW3/NW4 area and I've considered a transplant, although there are still too many question marks for me. Anyway, my main suggestion would be to look around your family(any immediate male relatives) and see where they are in their hairloss. If they still have full heads of hair then I have no idea what that means, but usually someone who is losing hair in their early 20s will find that their male relatives have also experienced hair loss. In my case my dad and my uncle(dad's side) would both be classified as a NW6(unfortunately I have no immediate male relatives on my mom's side), and I assume that I'll end up somewhere around there when my hair loss has completely run its course(they both lost hair at a young age also). However, you may observe that all of your male relatives have receded temples(a "mature" hairline) and some crown loss but still have a good deal of hair. Ask them and you might find out that they, like you, started to lose their hair in their early 20s but that it just kind of stopped once it reached a certain point. If you'd be content with their hairlines then I suggest to take propecia(which you should take regardless if hair loss concerns you) and forget about a transplant. If even their level of hairloss bugs you then I suggest getting on propecia and seeing what it does for about a year and then re-examining your situation. At that point, and with the right family history, you might be able to go for a more aggresive transplant, but in any other situation I would probably go conservative by thinking about how much more hair you're going to lose before it stops.

When I spoke with Dr. Paul Rose down in Tampa I asked him about Proscar. He said that the negatives were that you can't be sure that the drug is evenly distributed throughout the pill, which I'm sure can't be a positive effect. He also mentioned that insurance companies may see that you have a prescription for Proscar and label you as having prostate problems, which I guess could potentially raise your rates over time. Either way, the concerns were just enough to keep me from getting proscar, but after some time passes I'll probably switch over to keep the costs down.

mehani- I would love to see some pictures if you'd be so kind as to provide them. If not on the board, then maybe through e-mail. Just let me know if that's okay and I'll post my e-mail address on here so you could send me some pics.

ted- You're still going to visit Dr. Nusbaum, right? I don't want you to cement any decisions(I realize that you were already leaning that way) based on my recommendation, as I was somewhat younger and infinitely less aware when I met with Dr. Nusbaum. Still, having met both, Dr. Rose made me feel a lot more comfortable than Dr. Nusbaum(and was even nice about me being a half hour late to my consultation).

Definitely go see a dermatologist. I'm not sure if he can answer your questions about whether or not the drugs were causing some hairloss, but he should be able to point you in the right direction about some of your hairloss issues. If it's indeed male pattern baldness taking propecia isn't a big deal and can significantly slow hairloss down. Of course, a ton of people on this site know a lot more than me about hairloss. BTW, I'm also 23 and dealing with hairloss(although for quite some time now), so you're not alone in that regard.