28 with receding hairline... advice please?

[28andbalding]

Hello,

 

Appreciate the forum and have done a fair amount of reading. I am hoping to get a little advice from you HT vets.

 

I first noted hair loss at age 18. I jumped on the situation pretty quickly and started using Rogaine, which I have continued ever since (10 years). I tried Propecia for 6 months or so 6 years ago, but when I tried to discontinue the Rogaine for a month or two I noted quite a bit of shedding, so restarted Rogaine and quit Propecia (I also seemed to have weaker erections and lower sex drive, though not sure if that was just 'in my head').

 

Over the last 5 years my hairline, particularly the temples, has slowy been receding; probably an inch at the temples and a half inch at the center. That doesn't sound too bad, but I am tall and thin with a long, thin head and a long nose, which means both that I could never pull off the shaved head look and also that the receding hairline accentuates the length of my head/nose and really does look pretty bad as a result. I also have some diffuse thinning over the top of my head, which is not yet super noticeable. My crown is OK.

 

My father and paternal grandfather both have pretty bad MPB (pretty much bald across the top) which started about the same time mine did. I of course wonder if that is my fate as well and that the course of my baldness has been different only because of the Rogaine (I suspect that is the case).

 

I am still single and have noticed that my receding hairline has affected my looks and my confidence. Thus, I have started to consider transplantation. I have seen many threads advising against HT for young people, with many stating you should be 26-28 before you consider it. Being right at the end of that cusp I am wondering what to do. Ideally I would like to avoid going really bald and then getting a big transplant, I would much prefer to fill in and keep a decent head of hair if it is possible, even if multiple procedures are required. Cost is not a factor.

 

My main concerns would be (1) that I will later lose the rest of my hair and not be able to fill it in because I started transplanting too early, (2) that getting transplants might actually cause enough of my existing hair to fall out that the net effect is negative, and (3) that there will be noticeable or nasty scarring. Weighed against this is that I am young and single now, and that the hair issue seriously detracts from my looks (I otherwise take good care of myself) and my confidence.

 

Another question is whether transplantation into areas where you only have mild-moderate thinning (over the top of my head) is ever advisable?

 

Being single and balding in my 20s is a bummer. Any advice would be greatly appreciated. Thanks a lot!

[28andbalding]

Hello,

 

Appreciate the forum and have done a fair amount of reading. I am hoping to get a little advice from you HT vets.

 

I first noted hair loss at age 18. I jumped on the situation pretty quickly and started using Rogaine, which I have continued ever since (10 years). I tried Propecia for 6 months or so 6 years ago, but when I tried to discontinue the Rogaine for a month or two I noted quite a bit of shedding, so restarted Rogaine and quit Propecia (I also seemed to have weaker erections and lower sex drive, though not sure if that was just 'in my head').

 

Over the last 5 years my hairline, particularly the temples, has slowy been receding; probably an inch at the temples and a half inch at the center. That doesn't sound too bad, but I am tall and thin with a long, thin head and a long nose, which means both that I could never pull off the shaved head look and also that the receding hairline accentuates the length of my head/nose and really does look pretty bad as a result. I also have some diffuse thinning over the top of my head, which is not yet super noticeable. My crown is OK.

 

My father and paternal grandfather both have pretty bad MPB (pretty much bald across the top) which started about the same time mine did. I of course wonder if that is my fate as well and that the course of my baldness has been different only because of the Rogaine (I suspect that is the case).

 

I am still single and have noticed that my receding hairline has affected my looks and my confidence. Thus, I have started to consider transplantation. I have seen many threads advising against HT for young people, with many stating you should be 26-28 before you consider it. Being right at the end of that cusp I am wondering what to do. Ideally I would like to avoid going really bald and then getting a big transplant, I would much prefer to fill in and keep a decent head of hair if it is possible, even if multiple procedures are required. Cost is not a factor.

 

My main concerns would be (1) that I will later lose the rest of my hair and not be able to fill it in because I started transplanting too early, (2) that getting transplants might actually cause enough of my existing hair to fall out that the net effect is negative, and (3) that there will be noticeable or nasty scarring. Weighed against this is that I am young and single now, and that the hair issue seriously detracts from my looks (I otherwise take good care of myself) and my confidence.

 

Another question is whether transplantation into areas where you only have mild-moderate thinning (over the top of my head) is ever advisable?

 

Being single and balding in my 20s is a bummer. Any advice would be greatly appreciated. Thanks a lot!

[tisab]

hello and welcome to the forum 28andbalding,

 

you said you took propecia 6 years ago for 6 months, are you on it currently?

i know you said that u felt like you had some negative side effects, but i do agree with you , sometimes it really is all in the head.

 

when you think about it normally, a normal person doesnt think about sexually things 24/7, he probobly only thinks about it for a small fraction of the day. so when people are on propecia and they are constantly thinking "did i lose my sex drive, or is this drug doing something bad to me", you get the point if your thinking about it all the time and ur only suppose to "feel sexual" for a small ammount of time it can get in your head.

this paragraph was a big confusing hope u caught the drift

 

but then some people do actually feel the side effects, they say it is reported in 2% of people who use it. im not sure of this statistic and many people on this board beleive it is higher than this number

 

now lets move on

 

even though it is not guaranteed that you will have the same case of MPB as your relatives or even if you may catch it if they can, some people do develop similar traits of MPB as their relatives.

 

a more better way to see how far along your baldness will go along is to see your age, when you started to develop MPB, and the rate of you losing hair over that period of time.

for example if you started losing your hair at 18 and you are a norwood 3 at the age of 28, you may end up along a norwood 5-6 later on in life. one thing about MPB is it is tricky and unpredictable.

 

you said you have been on rogaine. i also use rogaine and find it to be fascinating. eventhough it is to regrow hair(i never heard of it actually maintaining the hair that you aqtually have) it may have ended up with more hair than you would normally have if u were never on the medication.

 

i also want to comment on other things.

 

you said you were tall, thats a wonderful thing, people cant directly see the top of your head and people wouldn't notice your hair first.

 

also you said you were skinny. this is just a comment of mine but why not try to bulk up, hit the gym, it can take away from your negative thoughts about hair loss

 

your view can be "hey im losing my hair, but im strong as Sh*t, i can prolly get some girls cause im so diesel"

tall and diesel is a strong combination against the ladies.

 

now onto your questions

 

well you said you are concerned about losing the rest of your hair and not being able to fill it in later on.

 

well the average male has a donor supply of 6000-8000 grafts, some have more, some have less.

 

now depending on your age, considering you have lose hair later on, you want to take the conservative route. the conservative route is normally multiplying 1000 by your norwood scale. for example norwood 3 would need 3000 grafts for a conservative route.

just for reference multiplying 1500 by your norwood scale is more of the route if your hairloss is set and u are not too far in the norwood scale

 

question 2

well hairtranplants have come along way. there are two types of hair transplant phsyicians, good ones and bad ones. the bad ones dont go to, but the good ones will take care of this problem for you, they will be able to plan on where to place the grafts which will minimize any fear of permanent shockloss. i think this concern of yours is being asked less and less as these physicians take a good care of it.

 

question 3

again, the coalition doctors(good doctors) have been doing ht's for a while and have mastered the minimization of scaring, you can check the gallery of many patients of many of the coalition doctors for the small scars.

 

to your last question

 

yes people have had transplants into area of moderate thinning, i have seen some good results , you might experience some shockloss, but most doctors like i said avoid this by shaving down the area and placing the grafts in the right place which leads to a net positive outcome

 

 

 

hope i helped

[Bill - Seemiller]

28andbalding,

 

Welcome to our community.

 

We can certainly understand your frustration with losing your hair. You have come to the right place for research.

 

A few questions...

 

Do you have any pictures you can post of your hair loss situation? Where are you on the Norwood scale?

 

Though medication is the best line of defense to potentially protect yourself from future loss, it seems like finasteride was giving you side effects. Keep in mind, however, that a common occurence when starting finasteride OR minoxodil (Rogaine) is shedding which can happen in the first 3-6 months of taking the medicine. Believe it or not, this is a GOOD sign of the medicaiton working. So you might want to consider trying it again. Medication should typically be tried for 12 months before determining its effectiveness. IN the case of side effects, however, I can understand your reluctancy to continue finasteride.

 

Pictures will really help give us a clear idea of where you are - but unfortunately, hair loss is unpredictable - so the younger one is, the more conservative one should be when planning for surgery.

 

Read the following thread which might help you in your research:

 

What should I consider when researching hair transplantation?

 

http://hair-restoration-info.com/eve/forums?a=tpc&s=569...071019713#5071019713

 

You might also want to read this thread about shockloss:

 

http://hair-restoration-info.com/eve/forums?a=tpc&s=569...1094723&r=2421094723.

 

Selecting a quality physician will minimize the risk of bad scarring. But scarring from surgery is inevitable. However, with the trichophytic closure technique, many clinics can mimimize the appearance of the strip scar which will be approximately from ear to ear on the sides and back of your head. Wearing the sides and back of your hair, however, extremely short (2 clip, 1 clip, etc) will most likely be out - however I've seen some cases where even at these lengths, the scar has been well concealed.

 

I hope this helps get you started.

 

Bill

[calvinmd]

This one hits close to home. It's not that far off my own situation at all.

 

 

28andbalding:

 

If you're never gonna want a buzzed-down head, no matter what? Then there really isn't a "starting too early" problem. It's only a matter of being too aggressive with the early HT work. You can get a lot or a little, but you've got nothing to lose (at least from the decent HT docs) if you won't ever consider the shave-down.

 

 

You're gonna get a certain amount of hair loss that continues to worsen independently of whatever HT work you have done. In that sense, it really doesn't matter whether you get the transplants done at 28 or 48.

 

. . . But that's IF you were going to seek out exactly the same density & hairline regardless of the age you had those HTs. The potential trouble comes when you start estimating how aggressive you can be about the transplanted hairline & density at a relatively young age. Just don't over-reach at the density & temples at 28. Your current hair loss severity & pattern is irrelevant to the overall HT plan. The eventual FINAL loss severity & pattern is what the decisions have to be built around.

 

 

You're especially safe with good FUE work, if money's no object. Even a medium-short buzz down is usually still an option after the first few thousand grafts.

 

 

-------------------------------------------------

[28andbalding]

ticab, Bill and calvinmd-

 

wow! i did not expect such well thought out and insightful answers. your replies are much appreciated.

 

i am no longer on propecia. i would consider starting it again, though i was a little put off by perceived side effects.

 

i am closest to a norwood 2. really not that bad in an absolute sense, it is just that my long head accentuates the backward-moving hairline. it is not terrible, but it is definitely noticeable, and i would kind of like to keep it from getting terrible.

 

thank you all so much for your replies. i think i will give it a little time and maybe add propecia to the rogaine. if things continue to progress i will strongly consider having a procedure with one of the coalition docs, but i don't want to rush into anything.

 

again, thank you guys very much. any other advice is welcomed.