At the precipice - Please help

[Daltex]

I feel so ridiculous even joining a group....writing this down, etc. And that is not meant to be a shot at those of you who have done so before me, it's just that I just arrived at this point and all of the feelings are fresh and new.

 

Since college, I have "styled" my hair so as to cover an irregular shaped hairline (it has an upward dip in the center, and my "side head" is big). I have always had extremely fine hair as well. Two not ideal situations.

 

I am 34 now and my hairline has creeped backward at the temples and now my "hair style" is just an obvious complicated comb-over that is a distraction on a daily basis. I will stop there because I'm sure you guys have heard all of this before...but I cannot overstate how this has ruled my life, my mood, my willingness to engage, etc.

 

I have approached the moment where I need to decide to shave my head or get a procedure. I have enough hair to cover whatever procedure I get, for the moment. Money is not an issue. I'm willing to try anything. Currently using rogaine and Nizoral. Have an appt with my doc to get finasteride.

 

I have a few questions -

 

1) I am finding 20-35 hairs a day in my shower. My stylist says I will find more hairs in the shower because I use a lot of product, which holds the falling hairs in place until I wash my hair, and instead of shedding throughout the day, mine comes out all at once. Can you all let me know your thoughts on that amount of hair in the shower?

 

2) I have researched products for years and the options and conflicting opinions appear to be endless. Aside from Rogaine, finasteride and Nizoral, is there anything else I should be taking?

 

3) The big one. For those of you who had a procedure at my age....would you suggest going bald gracefully or taking the plunge? If I were to take the plunge, I have selected Shapiro Medical Group. I've already consulted with Matt Z.

 

I sincerely apologize for the length of this post and the likely redundant nature of the questions. Any help from those on the other side would be so much appreciated.

[TakingThePlunge]

Daltex,

 

Welcome! Yes, your story is one that most of us have experienced to one degree or another and not matter when it happens to you, the effects can be devastating.

 

I have approached the moment where I need to decide to shave my head or get a procedure.

If you haven't yet tried shaving, I'd suggest giving it a shot. Some guys look great with a shaved head. I tried it and it didn't appeal to me so I went the HT route.

 

1) I am finding 20-35 hairs a day in my shower. My stylist says I will find more hairs in the shower because I use a lot of product, which holds the falling hairs in place until I wash my hair, and instead of shedding throughout the day, mine comes out all at once. Can you all let me know your thoughts on that amount of hair in the shower?

A "normal" head with no genetic hair loss loses about 100-150 hairs throughout the day. It's true that using lots of spray, gel, etc. had keep these hairs from falling until you're in the shower making it more difficult to judge.

 

2) I have researched products for years and the options and conflicting opinions appear to be endless. Aside from Rogaine, finasteride and Nizoral, is there anything else I should be taking?

In my opinion, Propecia, Rogaine and Nizoral are the only products worth using. If you've got money to burn you could add low level laser therapy (LLLT) and platelet rich plasma (PRP) to that list. Some top hair restoration physicians contiue to research and support these two procedures.

 

3) The big one. For those of you who had a procedure at my age....would you suggest going bald gracefully or taking the plunge? If I were to take the plunge, I have selected Shapiro Medical Group. I've already consulted with Matt Z.

My first procedure was at age 40. Wish I'd done it earlier. It turned what was a daily cuase of anxiety into a non-issue for me.

 

You can count on SMG to give you great advice and world class results if you choose to go forward with your procedure.

 

Best of luck!

Edited June 30, 2015 by David - Moderator

[Daltex]

Thanks David - I went to my doctor today and got a finasteride prescription. Now I'm reading that dutasteride may be more effective.

 

I'm sure it has been discussed on here before. Do folks in this community have any comparative experiences?

 

Also (given that you are a moderator you probably see people's stories all the time) - Have you seen any people actually regrow any hair by getting on finasteride (or dutasteride)?

[TakingThePlunge]

Most guys are using Propecia (finasteride) for hair loss. Avodart (dutasteride) is typically reserved for the day when finasteride is no longer sustaining hair growth and hair loss once again begins to advance.

 

There are probably a number of reasons for this. First, dutasteride is not FDA approved as a hair loss treatment so many physicians won't prescribe it. Second, dutasteride tends to be more expensive and, lastly, as it inhibits both the type 1 and type 2 alpha-reductase enzyme (the enzyme associated with the conversion of testosterone to DHT), side effects can be more severe.

 

In terms of the effectiveness of Propecia in the treatment of androgenic alopecia, there are three potential outcomes. The first potential outcome is that it regrows hair. This is pretty easy to assess and document photographically.

 

The second potential outcome is that is slows the progression of genetic hair loss, allowing you to retain more of your existing hair over a longer period of time. This outcome is not so easy to measure. If you take the drug for five or ten years and still have most of your hair, how could you know for certain that you wouldn't have had the same outcome without the drug?

 

Obviously, the most desirable effect would be a combination of outcomes 1 and 2.

 

Of course, the final potential outcome is that it does nothing at all and you continue to lose hair until reaching your final stage on the Norwood Scale.

 

There are lots of guys here that have been on finasteride for years and have reported positive results with little to no negative side effects. In generic form, it's so affordable these days that it's certainly worth a try. You'll never know if it will work for you until you try it. Give it 6 months to 1 year before assessing your results and take monthly photos for comparison.

Edited June 30, 2015 by David - Moderator

[Daltex]

Thank you, David. That is very helpful information. I'm still waffling on the HT, though the truth is that my situation has crippled my life for years. I suspect I will end up moving forward.

 

But even if all of my hair falls out and I look like hell and I just have to accept that - my first step into this world has given me a bit better feeling about humanity. From SMG's patient educator, to your thoughtful responses and recent patients chatting with me...wow, what a beautiful show of support for a complete stranger.

[TakingThePlunge]

My pleasure! I wish you luck and if you have any further questions, don't hesitate to ask.

[Daltex]

David - I just started fin. I've been on it for a bit over a week and I've been suffering from some pretty overwhelming exhaustion.

 

Poking around the Internet, it looks like there are a few folks who have had this. I'm wondering in your time of monitoring this forum, whether you've seen people have initial reactions to the drug and then the reactions resolve themselves?

 

While I realize you aren't a doctor, if you were me, how long would you give it before discontinuing use? Also...this is somewhat instructive on the HT issue - If I can't handle the meds then I'm probably not a good HT candidate given that you need to get on meds for retention purposes. Ugh...not feeling great about this.

 

Also, I've seen some of these side effects threads devolve into accusations, etc. I can promise you that this exhaustion is not in my head....posting this from bed.

[ytsejam]

Daltex,

 

everyone has a different reaction to propecia. In my case, I gave it a shot for a few months several years ago, and suffered some serious side effects. If I'd had the chance, I'd have never used it. It took me a lot of time to recover. There are many people who are happy with fin and they get no sides, but remember there are also many people who suffer seriously. There is also a big forum for fin victims. It's up to you and your body. If you have started to feel strange and weak, maybe you should consult your doctor.

 

IMHO the best thing to do is to find a good doc and get HT. I had HT 3 weeks ago, it's not easy to be honest, waiting and all and I may have to wait maybe 4-5 months to see the results but again for me it's way better than taking med which messes with your hormones.

 

wish you all the best

[TakingThePlunge]

David - I just started fin. I've been on it for a bit over a week and I've been suffering from some pretty overwhelming exhaustion.

 

Poking around the Internet, it looks like there are a few folks who have had this. I'm wondering in your time of monitoring this forum, whether you've seen people have initial reactions to the drug and then the reactions resolve themselves?

 

While I realize you aren't a doctor, if you were me, how long would you give it before discontinuing use? Also...this is somewhat instructive on the HT issue - If I can't handle the meds then I'm probably not a good HT candidate given that you need to get on meds for retention purposes. Ugh...not feeling great about this.

 

Also, I've seen some of these side effects threads devolve into accusations, etc. I can promise you that this exhaustion is not in my head....posting this from bed.

 

As you noted, I'm not a physician and the side effects of finasteride very so widely in form and severity from person to person, I can't advise you how long to stick with it. You should definitely discuss your concerns with your physician.

 

However, I can tell you that before quitting I opted to play with the dose until the side effects were significantly reduced. When I was quartering a 5mg tablet, I took 1/4 tablet MWF.

 

Now that I've got 1mg tablets, I'm taking .5 mg daily. Perhaps try reducing the dosage and see if you start to feel better.

 

.

[MAGNUMpi]

Hi Daltex,

I've been using finasteride for around 10 years now and don't have any issues with side effects. I would say talk to your doctor and keep trying it if possible. It really did help me slow the MPB and also filled in my crown.

I would also try shaving your head one time before getting a HT. Who knows it might look fine and you would be out of the weeds. If you do eventually go for a HT please be sure to read up on this forum for a while first so you fully understand all aspects before committing. Take your time and research.