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How important a consideration is the length of time an HT candidate has been loosing their hair?

Guest HLBD

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It seems to be that a lot of people either ignore the factor of the time that passes between men going from one NW level to another, or believe that the length of time one has been experiencing hair loss is trivial.


I know that hair loss does accelerate and slow rather unpredictably throughout the lifetime of the MPB sufferer, but I still believe that one can easy graph a steady baseline, if you will, to judge the aggressiveness of the loss. Also, I know hair loss has no certain conclusion or stopping point, but I believe ??“ especially when considering having an HT ??“ the length of time one has been balding can be important.


1. More time allows for a pattern to emerge and for a surgeon or hair loss expert to make an educated guess as to where the pattern will go next. Contrary to the somewhat popular opinion that all hair loss progresses to a NW 7 or beyond with only a "horseshoe", or rim of hair around the ears and above the neck; there are NW variant patterns, diffuse thinners, men that actually have FBP, etc...

2. This time also allows the surgeon or doctor and the patient some idea as to the aggression of the loss, as mentioned above. Basically, if one has progressed to from a NW 1 or 2 to a NW 5 or 6 in a matter of two to three years, then it would be my opinion that this person has a very aggressive loss and should certainly consider holding off on the HT option. If, however, a potential candidate has been balding for 10 to 20 years and goes maybe from a NW 1 or 2 to a NW 3 or 4 during this time, then perhaps this person's loss is not as aggressive and, given that this person is on an effective treatment to help curb future loss, this person might be all the better candidate for an HT.


Some research I've read on the matter recently has reinforced my opinion: basically, from several case studies, the research surmised that if a man goes bald somewhat overnight (a period of two to three years), he is less likely to respond to treatment and more likely to progress quickly to the end stages of MPB and perhaps beyond. Also, any man that goes "slick bald", the condition where in an MPB sufferer has no hair (not even miniaturized hair) in any part of his pattern loss, the more likely that this man will not respond to treatment and will progress to the end stages more rapidly and possibly go beyond the common end stage of a NW 6 or 7.


Of course, if a man begins loosing hair at an earlier age, there is much more time for him to loose more hair than a man who's loss starts later in life; however, I think there is something to be said for the aggressiveness of the loss. For example: I began loosing my hair at 17 ??“ some of this loss might have been kick-started by my over use of dyes (I was a punk kid, after all) ??“ and a 29 I am still a diffuse NW 3 (maybe a 3.5, but it's hard to say as I've just started back on Rogaine foam after three years off the liquid and I'm shedding worse than my dog) and I've been on Propecia for only the last two years with no regrowth, but no significant loss. In contrast, I have a friend that just turned 21 and the poor guy's loss started at 19. He is already a NW 5 working on a NW 6.


I mean, there are certainly other factors; family history, pattern of loss, treatment history and so on and so forth. Given all that, though, what are your thoughts on the importance of the amount of time a sufferer has been loosing their hair as an HT consideration?

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Great thread. I have a HT scheduled in a month and have been in turmoil over this very thing for the past 2 weeks. Like you, I have been thinning since 17-18. I'm 35 now and am somewhere around NW 4-5. I remember that day in college when one of my buddies said, "Hey, you gettin' a little thin?" It has never been the same since. I've tried Propecia/Rogaine several times and can't handle the side effects.


I'm really concerned about how the HT will look in 5-10 years without the aid of meds and continued thinning. My goal was to just have procedure which may be foolish thinking. It seems like it would be easier if I was already shiny bald. I can't get over the fact that I may be wasting a lot of money for my hair to look in 5 years like it does right now.

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Thanks BeHappy and jsam72.




I'm curious about what side effects you were getting with Rogaine and Propecia? Many side effects will fade with time one either of these medications, although some will not - like gyno (to hault this side effect, you'll need to discontinue use of the medication).


You might try saw palmetto. I've seen studies that have said that it does nothing and at least one that it is moderately effective in lowering DHT levels in the body, up to 32% I believe. There are some doctors that believe it is useless and others that actually suggest using it, especially in someone that has experienced side effects on Propecia.


Perhaps you can post some pictures so that we can see your level of loss and take a guess at what the aggression level of your loss maybe. Even if you don't do that, please PLEASE raise this concern with you doctor, if you have not already. They should be able to give you an honest and ethical opinion about where you may be in 5 years after your HT and address your concerns even better than the rest of us. I have faith that, if you are going to a doc that is known for their honest and ethical standards like those of the coalition, that they will give you an insightful and useful opinion.

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