White patches all over

[Quasar]

Hi,

 

Its come to my notice, that in the past 1 month after starting Minox and Finasteride, I have lost hair from a number of places, at some places my hair was very thin, others normal, with the result that the scalp is easily visible there. This includes some frontal hair on the hairline too!

 

Is this the effect of drugs working(hair shedding) or aggressive MPB? Any way to tell? 28, NW 5 diffused, hairline intact.

[Blake Bloxham]

Quasar,

 

Both minoxidil and finasteride are associated with an initial shedding phase. This normally lasts 3-4 months and results in the regrowth of thicker, more terminal hair between months 5 and 12. I hope this helps!

[Quasar]

Yep, will continue religiously with the treatment, just that when I see healthy hairs fall, it worries me. I'll wait it out!

 

One last question, how do I make out its working?

[Blake Bloxham]

Quasar,

 

It generally takes 6 months to determine whether or not you are a responder. This represents the time it takes for the now "resting" or telogen phase follicles to transition into an anagen - or "growth" - state and produce visible hairs. However, most recommend taking the medication for a full 12 months before determining whether or not it works for you. This obviously does not take intolerance from side effects into account.

 

Good luck!

[Quasar]

Thanks a tonne! No sides as such even from Fin! Also, some times panic sets in for me, when I see more scalp. Would that cause more hair fall?

[KO]

Quasar....look at my signature to see the effect of meds.

[peterith]

Do you have a close up pcture

[Quasar]

Quasar....look at my signature to see the effect of meds.

 

@Ko, amazing to see Dut (DHT Blocker) at work. I'm entirely convinced about the efficacy.

 

@Peterith, posting one month(28 days) pics (Fin 1mg/day + Minoxidil twice a day 5%). Both with hair straight and combed. If you see in the frontal half, I've shed some hair, which was there earlier before starting Fin+Min.

 

A funny thing happened though - a very thick facial hair emerged on my face today! While applying Minoxidil, a lot of the liquid sometimes drips over the face. I have never seen a hair as thick as that!

 

@Future_HT_Doc - I've read that Minoxidil also synchronizes the cycle of hair growth of the hair that has thinned out(by making them go early into the dormant phase and therefore shed them) with those hairs which are healthy and thick. Is that correct?

 

Thanks all for the good words and advise.

[KO]

That is the strangest balding pattern I have seen, and not in a bad way. Thick hairline and thin behind. Crazy lol.

[KO]

You should try a concealer like Toppik, I think it will help you out a lot.

[Quasar]

@Ko - yes, sooner or later I want to try Toppik. Having said that, some hair on my hairline have fallen over time(maybe an year). So, it's not as dense as it used to be. I've had hair fall all over the top in fact. I even shed some hair in my donor area - as you would have seen, it is dense in the middle, but sparse towards the end(where most people have very high density). My donor has stayed pretty much the same ever since. I don't know, what pattern it is! Also, my dad and mum still have a good head of hair (atleast longer than mine). It surely doesn't run in my family.

 

Also, post-meds, the hair I am shedding right now is mostly thin. I don't see much of thick hair falling. I don't know, if that's a positive thing or good sign. I will just wait and watch!

 

I would like to post a pic at the age of 21, just to give you an idea my hair density.

Edited October 19, 2014 by Quasar

[Quasar]

Donor area "as-of" date - dense in the middle, sparse at the end

 

Should I also get myself tested for thyroid? I have never given it a thought. But, since hair fall has happened for me, in a gradual fashion all over, this even includes my sides, area which is supposed to be DHT resistant. Again this has remained the same over a period of time. I just suspect. Not that I am a medical expert.

 

I would really like to know the real cause of my hair loss - whilst I have started taking general treatment for it.

Edited October 19, 2014 by Quasar

[KO]

You can get yourself tested, but typically the most common reason for hair loss is MPB. There does seem to be a pattern for your loss. When you lose hairs from the side, it is called diffused unpatterned alopecia, which may not respond to meds, and rules out a transplant.

 

What I would do is stick with the meds, and see what happens, if you want, you can get your thyroid checked.

[Quasar]

:eek: Posting pics of sides. Is there a pattern or do you think its DUPA? Is it possible to firmly determine this Ko? Yes, I will continue on meds and evaluate after 6 months. I must say that although somewhat sparse, the hair on my sides appears thick and strong atleast now!

[Quasar]

Do you think I am doomed for life? I saw some pics of DUPA, and it feels I am headed for the same. Some part of my sides in that pic are less dense or see-through-ish!

[Blake Bloxham]

Quasar,

 

I'm not 100% sold on the idea of DUPA and DPA.

 

Traditionally, non-scarring alopecia is broken down into several categories: focal, patterned, and diffuse. Focal alopecia includes conditions like alopecia areata; patterned includes androgenic alopecia and female pattern hair loss; and diffuse covers conditions like telogen effluvium, anagen effluvium, loose anagen syndrome, atricia, and hyoptricia. However, it does not - traditionally - include "DUPA" or "DPA." Maybe the categorization is out of date, but I generally try to stay away from these terms, or at least from DPA. I do understand that "DUPA" is a good description for one clinical picture - which I will explain below.

 

I would classify your hair loss as follows:

 

Either: Diffuse androgenic alopecia that is best described by the Ludwig and not the traditional Hamiltion-Norwood hair loss scale (and I would say you are a Ludwig II-III); OR you could call it diffuse unpatterned alopecia if you are experiencing thinning in the donor region (which is the only time I really think this term is appropriate).

 

Generally, DUPA patients aren't the best surgical candidates. The only caveat to this is when preventive medications like minoxidil - and your description of the drug's mechanism in an earlier post seemed mostly correct, by the way - are used to stabilize the donor and allow for transplantation.

 

Look forward to your reply!

[Blake Bloxham]

I also agree with KO: this is a good example of when an analysis from a hair loss physician is necessary. I highly recommend seeing a doctor - with experience in alopecia - and undergoing an evaluation.

[Quasar]

Yes, can someone recommend me a good hair-loss physician in Bombay, India. I really can't tell the reputed ones from those only running a shop!

[Blake Bloxham]

Recommended hair loss physicians in India.

[sfp]

Hi,

I am wondering if there are enough good doctors in India.

There are only 3 recommended doctors in this network.

2 of these doctors use FUT method which leaves a linear scar behind so you cannot have very short hair.

The last one left is Dr. Bhatti who is getting some negative comments from different patients.

 

Have booked an appointment with Dr Bhatti but looking at options available in India ,it makes me sad and choice less.

Thanks

Saiyed

Edited October 19, 2014 by sfp

[Quasar]

Hi,

I am wondering if there are enough good doctors in India.

There are only 3 recommended doctors in this network.

2 of these doctors use FUT method which leaves a linear scar behind so you cannot have very short hair.

The last one left is Dr. Bhatti who is getting some negative comments from different patients.

 

Have booked an appointment with Dr Bhatti but looking at options available in India ,it makes me sad and choice less.

Thanks

Saiyed

 

All the best Saiyed!

 

@Future_HT_Doc - Thanks a tonne! I have e-mailed them with my pics. One question, how do these guys actually determine it? I mean, do they use a capilloscope/densitometer?

 

Anyone having consulted a good hair-loss physician in Mumbai, India?

[Blake Bloxham]

Quasar,

 

It will likely come down to a good history of the hair loss and physical examination of the scalp. They may use something like a trichoscan to get an enhanced view of the scalp, but I don't think a lot of tools or tests will be necessary.

[Quasar]

Future_HT_Doc -

 

Going to this place tomorrow to get a basic hair/scalp analysis done, check it out - Skin City India | Hair Analysis in Pune | CAS Lite Hair Analysis. Also, will get my TSH levels checked tomorrow.

 

Also, got a photo consultation done over e-mail with Dr. Sandeep Sattur, a hair-restoration surgeon practising at Mumbai, India. Here's what he had to say -

Hello,

 

The pictures do depict a diffuse pattern hair loss. Does not appear to be DUPA but would like to reserve my opinion after a formal assessment in person.

 

You are indeed on the the best possible option for your kind of hair loss. Since you haven't loss the framing of your face, a transplant may not be the right solution for you. After using this treatment for a year, the results should be assessed. If further improvement is desired, then we could look at off label use of Dutasteride.

 

Have you checked your TSH levels? If not please do so. Hypothyroidism can contribute to diffuse thinning.

 

Regards,

 

Dr Sandeep Sattur,

MS, M Ch (Plastic Surgery)

Hair Restorative Surgeon

 

I plan to pay him a visit in Mumbai. I am meticulous, detail-oriented and try to educate myself as much as I can. So, lets see what the doc has to say.

[KO]

Here is the deal, I don't believe that medical science knows all that much about DUPA vs MPB etc. It definitely looks like you have MPB, but even in DUPA, the patient exhibits a "horseshoe pattern" and the donor hair thins out over time.

 

So in a sense, what I am saying is that DUPA and MPB are not necessarily mutually exclusive....we just don't know much about it.

 

However, regardless of what the diagnosis is, transplants depend on two things - supply and demand. At this point it doesn't look like you have enough supply, so just be patient with meds, and see what happens. Some people's donors have improved on meds and were eventually transplanted. But take it one day at a time, and I would keep the sides very short.

[Quasar]

@Ko, interesting to learn that. Ask a guy like me - I'll be just more than happy to keep/maintain my existing hair with meds! I think Finasteride and Minoxidil should do a decent job at that.

 

Hair Transplant - I am totally cool with what I look and a hair transplant at present is not even on my mind!