21 and going bald fast

[Rizwan]

It seems I may have finally found the place to talk about my problems and hopefully find some answers.

 

I am 21 years old and suffering badly from MPB. My hairline has receeded quite alot since the age of 18 and in the last 6 months the hair on my scalp has become really thin. I went to my doctor today and he said I should either start using Propecia (which after researching I am very scared to use due to the side effects caused) or go to hair/plastic surgeon and see what they have to say.

 

I really don't know what to do. I have also shaved my hair off recently to see how my hair looks but as I don't have a full hairline and my face is rather long and egg shaped it doesn't suit me, but I am willing to try it out again and go for a number 1 or 0.5 blade so its not completely bald.

 

I'm seriously thinking of having a HT done. At first I thought of just getting my hair line restored but now I want to have a full HT. I am looking for short term results (5-10 years) thereafter I won't be too bothered of losing my hair again. After looking at the Norwood scale for hair loss I seem to be a 3.

 

Please have a look at my pictures and all feedback is appreciated.

 

Thank you.

[Thehairupthere]

Your doctor is correct. You really need to start propecia or rogaine to stop any further hair loss. Someone as young as you needs to be on one of those medications for at least 1 year before considering hair transplantation because the surgeons need to feel secure that you won't continue to lose a significant amount of hair as you age. These medications will also limit you from needing many procedures to compensate for the loss you would otherwise experience. You should start one, but if you can try both for one year and then go see a specialist recommended by this forum to see about next steps. Propecia does have side effects but they are rare.

[rich91403]

Hi Rizwan,

 

The pictures were very helpful and some of the well intentioned members on this site should have some good recommendations for you.

 

Your photo presentation indicates that you may be a more advanced Norwood class than the III level.

 

You should consider the medication that Hairupthere mentioned and it would not hurt to have a professional evaluation to assess your family history, miniaturization study, donor density and hair characteristics so that a plan can be instituted.

 

The oblong facial length is exacerbated by the receding hairline. It is important to have a hairline that keeps your face in symmetry ie: chin to nose/nose to eyebrows and eyebrows to approximately beginning of hairline. This is referred to as Rembrant thirds.

 

The medication may help defer a hair transplant procedure to your top and crown but it is important to be evaluated systematically so you can make an informed and prudent decision.

 

These are the prime years of your life and we understand the full spectrum of concerns that a young man facing this situation experiences.

 

You've taken a good first step. Consider some of the opinions that you are sure to receive on this forum.

Best of health!

[Dr. Timothy Carman]

Rizwan-

Welcome to the forum.

From your photos, I would concur that you appear to be heading toward advanced hair loss as you age. At 21, and with this advanced degree of loss, it is my opinion that you are too young for a transplant procedure. The artistic creation of a natural, long term solution depends upon the surgeons ability to optimally utilize the limited supply side of the "lifetime supply-demand balance" as I like to call it. Although you want to restore a lower hairline, with an advanced degree of loss behind that hairline would require more supply than you have available in your lifetime. I realize you think that in a few years you "won't care" about any short-sighted surgical plan, but believe me- you will. There is only one thing I see that is worse than the feeling patients have when they are facing thinning/loss of their hair: that is having "something" done on their heads from years ago that looks anything but normal. These patients are very distressed. Be wise, take finasteride (the side effects are very very low indeed) and give that a year to judge the results. At your age conservative medical management is all I would recommend for you so that you and your surgeon can get a better idea of your long term prognosis.

[Rizwan]

Thanks for your replies guys. As you know I am really concerned about everything but I am prepared to give the Propecia/Minoxidil/Nizoral treatment a go for at least 6 months.

 

However I do have a few questions I would like to be answered. Sorry if they are long but I would extremely appreciate it if they were answered so things can become more clearer for me, thank you.

 

1. Is there hope for me or am I fighting a lost cause with regards to my hair situation?

 

2. What will using Propecia, Minoxidil and Nizoral do for my hair in the short term and long term (what should I expect) and does the treatment work?

 

3. What dosage do I take for Propecia and how many times can I use Nizoral in a week?

 

4. Where is the best place to buy the products and should I get a private prescription from my GP for the medication?

 

5. Do you have to use Propecia, Minoxidil and Nizoral forever once you start treatment?

 

6. What happens if I stop using them after 6 months to 1 year, and will they cause long term side effects?

 

7. Do you shed a lot of hair when you start the treatment and how long is it till you start to see results?

 

8. Am I allowed to wear a hat and wet my hair when I use Minoxidil and how often should I wash my hair?

 

9. What is the difference between Propecia and Proscar?

 

10. Is it worth me using Toppik?

 

Once again, sorry for the length of these questions, if they can be answered in as much detail as possible then the feedback would be invaluable to me in my decision making.

 

Regards

Rizwan

[Spanker]

You can search all of those answers on the site. I only use propecia and I highly reccomend it for you. It will most likely give you several more years of hair, bt six months of taking it is not enough. You should take some good befores, then take propecia (actually I take generic finasteride) for a year and compare.

[TakingThePlunge]

Rizwan,

 

You've got some excellent advice here. I agree that your best option at this time, given your age and degree of hair loss, is to try and medically stabilize your balding with a combination of finasteride and minoxidil.

 

It's a sad truth that male pattern hair loss is progressive for most men. I understand your desire to restore your juvenile hairline but, as Dr. Carman stated, doing so will likely deplete your available donor supply leaving you unable to address further balding.

 

Please see my responses to your questions below:

 

1. Is there hope for me or am I fighting a lost cause with regards to my hair situation?

There are no guarantees but, in my opinion, you have enough existing hair and you are at the right age that starting medical treatment immediately will likely slow the progression of your hair loss and perhaps regrow some of your hair.

 

2. What will using Propecia, Minoxidil and Nizoral do for my hair in the short term and long term (what should I expect) and does the treatment work?

You will need to use the medications for between 6 months and one year before assessing your results. You will likely see increased shedding in the first few months. Thus, you may look worse before you look better. Treatment works for a large percentage of men but for some that only means holding on to the hair they still have while others may see increased density.

 

3. What dosage do I take for Propecia and how many times can I use Nizoral in a week?

Propecia is 1mg finasteride and is taken once daily. It is recommended that patients use Nizoral two to three times per week.

 

4. Where is the best place to buy the products and should I get a private prescription from my GP for the medication?

You will require a prescription for Propecia. Minoxidil is available over the counter.

 

5. Do you have to use Propecia, Minoxidil and Nizoral forever once you start treatment?

Yes! If you discontinue use of Propecia and Rogaine you will experience "catch-up" hair loss. Your hair will rapidly develop the hair loss pattern you would have had if you had never taken the drugs to begin with.

 

6. What happens if I stop using them after 6 months to 1 year, and will they cause long term side effects?

Again, if you stop using them your hair will develop the hair loss pattern it was programmed for. Your hair loss will not be any worse for having used the drugs. The side effects of these drugs are considered temporary and should subside upon discontinuation. However, a small percentage of men have reported long term side effects.

 

7. Do you shed a lot of hair when you start the treatment and how long is it till you start to see results?

See my response to question 2.

 

8. Am I allowed to wear a hat and wet my hair when I use Minoxidil and how often should I wash my hair?

Minoxidil should be applied to a clean, dry scalp. Liquid minoxidil takes up to 4 hours to dry while the foam dries very rapidly. You should avoid wetting your hair fur at least three hours after application. It is fine to wear a hat.

 

9. What is the difference between Propecia and Proscar?

Both of these medications contain the same active ingredient. Propecia is 1mg finasteride while Proscar is 5mg. Is is considerably more affordable to purchase generic 5mg finasteride and quarter the pill resulting in a 1.25mg dose.

 

10. Is it worth me using Toppik?

Some men like the added appearance of density that concealers provide. I myself prefer not to use them. It's really a personal choice. You've got nothing to lose by trying it.

 

 

Hope this helps! Best of luck!

[Pat - Community Publisher]

Taking the Plunge, Thanks for giving Rizwan such indepth feedback on his thoughtful questions!