Am I out of luck?

[Oliver510]

I'm a 22 year old male, my hair has been thinning on the top of my scalp diffusely but I have all of my hairline, the area of thinning would be either Norwood 5A or 6. After evaluation by a transplant surgeon that's recommended here, Dr. Bernstein, I was told that my hair has thinned and/or miniaturized, but I haven't lost follicles completely, just the hairs have thinned to the point of showing noticeable scalp. I've been on finasteride for 4 weeks. He said my donor appears unstable but I'm too young to make a definite diagnosis, and therefore I'm not a good candidate for a transplant right now.

 

I've read about permanent shockloss being a risk for diffuse thinner like me. But I've also read this isn't as bad an issue in modern times with a good surgeon, and how diffuse thinners can actually be the best candidates. And I've also seen many great transplant results on diffuse loss patients like me on this site, and have yet to see a bad one from shockloss with people mentioning it so often . When I asked Dr. Bernstein about shockloss as it would relate to my case if I were to get a transplant in the future, he said a transplant would give more hair being that most shockloss is temporary.

 

As far as the possibility of my donor area being unstable, this is a risk I don't see as not worth taking because if the transplanted hair was to thin eventually than I wouldn't be any more upset than I am now and I would know I at least gave it a shot. I imagine the finasteride could help me with the stability as well. And as for scarring on the back becoming visible, I keep my hair a few inches long, and if it were to show I'd be bald anyway so who cares.

 

So I've looked at diffuse loss patients Erdogan, Shapiro, Hasson, Wong, Lorenzo, Arocha, and I'm impressed. I'm gonna stay on finasteride but would I be able to get a transplant if I want more coverage, and if not, why after the reasons mentioned above? I'm not even asking for the fullest head of hair for my age, just an increase like these guys have gotten:

 

http://www.hairrestorationnetwork.com/eve/181146-fue-hair-transplant-dr-marwan-saifi-wroclaw-poland-fue-2050-grafts-2-10-15-diffuse-norw.html

http://www.hairrestorationnetwork.com/eve/180319-3-900-grafts-norwood-6-7-dr-diep-dr-behnam.html

http://www.hairrestorationnetwork.com/eve/180471-dr-koray-erdogan-asmed-clinic-5006-grafts-manual-fue.html

http://www.hairrestorationnetwork.com/eve/179262-4000-grafts-fue-dr-koray-erdogan-asmed-clinic.html

Before and after surgical hair transplantation procedure with 4603 grafts

Diffused Thinning 1 Yr Post Op w/ Dr. Paul Shapiro - Dr. Paul Shapiro - Hairtransplant Doctors - Click on a Doctors name to view their results - Hairloss Experiences Hair Loss Forum

http://www.hairrestorationnetwork.com/eve/173899-dr-koray-erdogan-3124-grafts-fue.html

Edited July 22, 2016 by Oliver510

[bitethebullet]

Don't jump into surgery or you may regret it for the rest of your life. Stay on the meds, take your time, research, develop other aspects of your life and revisit the question in a few years. It's probably not what you want to hear but 22 is far too young for a transplant

[Bill - Seemiller]

Oliver,

 

I understand your concern but you've Artie been given some good advice. I understand inclination to want to jump into surgery but that may not be the best idea for you at this time. You are 22 and have an advanced hair loss pattern as you said. I would honestly give the finasteride a good year or so to see how it works for you before deciding to take the plunge into surgery. Meanwhile, continue to research and explore your options and any year, you can make a decision at that point. Ever you do, don't be impulsive, take your time and make a well-thought-out decision.

 

Best wishes,

 

Bill

[mlc2010]

I've read that diffuse thinners respond best to medication?

[Oliver510]

Don't jump into surgery or you may regret it for the rest of your life. Stay on the meds, take your time, research, develop other aspects of your life and revisit the question in a few years. It's probably not what you want to hear but 22 is far too young for a transplant

 

My hairline is still there so I'm not looking to lower it or anything, I just wanted some more coverage throughout the top. Why would I regret it?

 

Oliver,

 

I understand your concern but you've Artie been given some good advice. I understand inclination to want to jump into surgery but that may not be the best idea for you at this time. You are 22 and have an advanced hair loss pattern as you said. I would honestly give the finasteride a good year or so to see how it works for you before deciding to take the plunge into surgery. Meanwhile, continue to research and explore your options and any year, you can make a decision at that point. Ever you do, don't be impulsive, take your time and make a well-thought-out decision.

 

Best wishes,

 

Bill

 

I forgot to mention that my hairline has not receded at all and is still there, so I'm not looking to lower it. I just wanted some more coverage throughout the top.

[mlc2010]

let fin and maybe minoxidil do its work for a bit

[E39]

let fin and maybe minoxidil do its work for a bit

 

I agree 100 percent. Give the meds a year or two and take it from there

[bitethebullet]

My hairline is still there so I'm not looking to lower it or anything, I just wanted some more coverage throughout the top. Why would I regret it?

 

You might regret it Oliver because you'll continue to lose native hair and end up chasing your hairloss in a never-ending series of expensive and psychologically draining surgeries. Your donor could become depleted as a result and you may end up with something that looks off and unnatural. I'm not saying "don't ever get a transplant" but I am saying to take a step back, consider the fact that you're only 22, to plan this long-term and think about 10 or 20 years down the road and how you want to look. You might think you won't give a toss how you look at 40 but the reality is that you'll care then about how you look just as much as you do now. You can listen to the advice of those in the forum who know the pitfalls and limitations of surgery and want to spare you the hassle and heartache of ending up scarred, out of pocket and emotionally battered...or you can hop on a plane to Turkey and have a technician poke 5000 grafts out of your head and hope for a result that will buy you a couple of years (if you're lucky). Honestly, the best advice is take the meds, stabilize your hairloss, consult with some reputable docs and think again if you'd still like to proceed in a few years. It's too important a decision to rush into, no matter how tempted you might be by the allure of a quick fix transplant. Best of luck to you anyway whatever you decide

[Oliver510]

You might regret it Oliver because you'll continue to lose native hair and end up chasing your hairloss in a never-ending series of expensive and psychologically draining surgeries. Your donor could become depleted as a result and you may end up with something that looks off and unnatural. I'm not saying "don't ever get a transplant" but I am saying to take a step back, consider the fact that you're only 22, to plan this long-term and think about 10 or 20 years down the road and how you want to look. You might think you won't give a toss how you look at 40 but the reality is that you'll care then about how you look just as much as you do now. You can listen to the advice of those in the forum who know the pitfalls and limitations of surgery and want to spare you the hassle and heartache of ending up scarred, out of pocket and emotionally battered...or you can hop on a plane to Turkey and have a technician poke 5000 grafts out of your head and hope for a result that will buy you a couple of years (if you're lucky). Honestly, the best advice is take the meds, stabilize your hairloss, consult with some reputable docs and think again if you'd still like to proceed in a few years. It's too important a decision to rush into, no matter how tempted you might be by the allure of a quick fix transplant. Best of luck to you anyway whatever you decide

 

The situation your describing where I would continue to lose native hair, end up doing a series of surgeries, depleting my donor, end up with something that looks off, could also happen if I wait and get a transplant 5 - 10 years later could it not? I apologize and don't mean to seem stubborn but if we're saying wait so we can plan for when I'm 40, which I'm not saying is bad advice, later we could say lets wait some more so we can plan for when I'm 50, 60, and so on, and that's the same advice for the same reasons for the same risk. Seems like your saying I'm more likely to experience failure at this point than in the future, which I know for many young patients is certainly true, particularly as it pertains to classic Norwood style balding and receding hairline, the 22 year old who wants to be a Norwood 1, etc. But I was trying to understand how could this be true for some whose pattern is already well defined, diffuse, non receding, and Ludwig style rather than the Norwood style.

 

And I will continue the meds for a while before I do anything.

[Mikey1970]

Hi Oliver.

 

You are fortunate that from everything I have read online, you visited one of the best & most ethical surgeon's in the world. I would hate to think of what could have happened to you if you had seen a less ethical surgeon. You also wrote that you have thinned or miniaturized follicles but you haven't lost them completely.

 

Do you believe you have any type of scalp condition that causes excessive itching, dandruff and/or psoriasis? If you do a tar based shampoo like Ionil T will greatly overcome those problems and I think can possibly assist in slowing further hair loss.

 

It is possible that given your situation you could be a fantastic responder to medication. Dr Bernstein has a place on his website that gives before/after photo's of people that were good responders and treated ONLY with medication.

 

Propecia Rogaine Results Before After Photos | Bernstein Medical

 

Given that you say you have not yet lost follicles completely you could be really pleased how you go with the medication without having to go through the risks of surgery at this time. Good luck, I wish you the best.

[Oliver510]

Hi Oliver.

 

You are fortunate that from everything I have read online, you visited one of the best & most ethical surgeon's in the world. I would hate to think of what could have happened to you if you had seen a less ethical surgeon. You also wrote that you have thinned or miniaturized follicles but you haven't lost them completely.

 

Do you believe you have any type of scalp condition that causes excessive itching, dandruff and/or psoriasis? If you do a tar based shampoo like Ionil T will greatly overcome those problems and I think can possibly assist in slowing further hair loss.

 

It is possible that given your situation you could be a fantastic responder to medication. Dr Bernstein has a place on his website that gives before/after photo's of people that were good responders and treated ONLY with medication.

 

Propecia Rogaine Results Before After Photos | Bernstein Medical

 

Given that you say you have not yet lost follicles completely you could be really pleased how you go with the medication without having to go through the risks of surgery at this time. Good luck, I wish you the best.

 

Hey Mikey, thanks for the response. I am prone to dandruff, flaky/crusty scalp. I told Dr. Bernstein about it and if any scalp condition could have contributed to my hair loss and he said no, and didn't mention mention that I have any scalp/skin problems after examining me. I use Neutrogena T/SAL, salicylic acid shampoo, which seems to help, although I wonder if a tar based shampoo is better. I also plan on trying 2% Ketoconazole shampoo.

 

Those before after photos are the reason why I'm on finasteride lol. I really hope it works, I need thicker follicles not more, Dr. Bernstein feels that I haven't really "lost" hair, it's just thinned a lot. I figure thickening is the least I could ask for from finasteride but I don't know what to expect.

[robc]

I would keep with the fin/ maybe get on some biotin type supplements.

Hairmax Laser comb is perfect for your case to improve hair health and thickness

[Oliver510]

I would keep with the fin/ maybe get on some biotin type supplements.

Hairmax Laser comb is perfect for your case to improve hair health and thickness

 

Hello robc, thanks for the response. Have you used the Hairmax laser comb? If so, what has been your experience with it?

[mlc2010]

I would keep with the fin/ maybe get on some biotin type supplements.

Hairmax Laser comb is perfect for your case to improve hair health and thickness

 

I'm yet to see any picture evidence that these laser systems do anything at all

[Louisjams]

Bernstein himself has written that miniaturized hair that is shed due to shock loss may never come back and I believe it. Do not count on miniaturized hair in the recipient area being around after HT.

[bitethebullet]

The situation your describing where I would continue to lose native hair, end up doing a series of surgeries, depleting my donor, end up with something that looks off, could also happen if I wait and get a transplant 5 - 10 years later could it not? I apologize and don't mean to seem stubborn but if we're saying wait so we can plan for when I'm 40, which I'm not saying is bad advice, later we could say lets wait some more so we can plan for when I'm 50, 60, and so on, and that's the same advice for the same reasons for the same risk. Seems like your saying I'm more likely to experience failure at this point than in the future, which I know for many young patients is certainly true, particularly as it pertains to classic Norwood style balding and receding hairline, the 22 year old who wants to be a Norwood 1, etc. But I was trying to understand how could this be true for some whose pattern is already well defined, diffuse, non receding, and Ludwig style rather than the Norwood style.

 

And I will continue the meds for a while before I do anything.

 

Hi Oliver, no need at all to apologise my friend - we're all in the same boat fighting this curse the best way we know how. I take your point that there's a certain moment in time where you have to pull the trigger and that you can't wait eternally to try to improve the situation. I'm simply saying wait a bit and continue with the meds. 22 is too young to pull that trigger. Keep a photo log for yourself with baseline pictures. If in a couple of years you see that things have not got worse and you still want to proceed I figure you'll be in a much better position. You'll have had more time to research, to step back and consider it from all angles, to find a surgeon who has consistently good results with diffused patients and you'll have the comfort of knowing that you didn't rush headlong into it. Moreover, if the meds work well, you may not even need surgery and save yourself a lot of $$ and donor hair in the process. And don't forget there are other exciting treatments coming down the pipeline so we may have other options in two to five years with CB, Replicel, Follica, JAK inhibitors, Histogen, Brotzu's lotion and, of course, the holy grail in Dr Tsuji's stem cell regeneration technique which may offer the closest thing we've seen to a full-blown "cure" for this generation of Norwoods.

[robc]

Hello robc, thanks for the response. Have you used the Hairmax laser comb? If so, what has been your experience with it?

 

Hi Oliver,

Yes I started using the original laser comb about 8 years ago when it fist got FDA approval. Unfortunately I had already been losing my hair for about 28 years at that point, you are in a much better position and smart to be looking at solutions at a young age.

 

It is not a miracle cure and want grow a bunch of new hair on your head, but for me it helped with miniturization in the hair and I feel it stopped any further hair loss. I started in Fin a few years later just be in the safe side as I had no sides, but I think I could likely go off and have no further hair loss.

A few years back the cord in the comb broke and I didn't use it for about 3 weeks, my scalp started feeling itchy and uncomfortable even though I was still using minox. Felt much better instantly when I started using the comb again.

I'm not a rep for any company, just sharing my experience...I paid about $500.00 form mine back n the day and I think you can get the basic model for under $200 now.

Nothing really grows new hair on your head except a HT, so I'm not sure why the laser comb gets no love. Laser therapy applications are used extensively by dermatologists.

 

Link to Bernstien site with technical information about how it works.

Laser Therapy for Hair Loss (LLLT) | Bernstein Medical

Hope this can help

[Oliver510]

Hi Oliver,

Yes I started using the original laser comb about 8 years ago when it fist got FDA approval. Unfortunately I had already been losing my hair for about 28 years at that point, you are in a much better position and smart to be looking at solutions at a young age.

 

It is not a miracle cure and want grow a bunch of new hair on your head, but for me it helped with miniturization in the hair and I feel it stopped any further hair loss. I started in Fin a few years later just be in the safe side as I had no sides, but I think I could likely go off and have no further hair loss.

A few years back the cord in the comb broke and I didn't use it for about 3 weeks, my scalp started feeling itchy and uncomfortable even though I was still using minox. Felt much better instantly when I started using the comb again.

I'm not a rep for any company, just sharing my experience...I paid about $500.00 form mine back n the day and I think you can get the basic model for under $200 now.

Nothing really grows new hair on your head except a HT, so I'm not sure why the laser comb gets no love. Laser therapy applications are used extensively by dermatologists.

 

Link to Bernstien site with technical information about how it works.

Laser Therapy for Hair Loss (LLLT) | Bernstein Medical

Hope this can help

 

That's odd that your scalp got itchy/uncomfortable after stopping the laser comb. Sounds like it thickened your hair though? And would you recommend it over minoxidil in terms of thickening?

[robc]

Oliver,

 

Yes the laser comb made my hair thicker. I always has thin fine hair blonde/ lt brown hair, but when I did my HT, the doctor told me my hair was medium texture and he used a .85 punch for extraction when he typically uses .80 for majority of patients.

 

Personally if I had to choose minox vs laser comb, I would use the comb, but I still do both. Minox is cheap and takes 20 seconds to rub on your head at night after you brush your teeth so why not, it cant hurt.

 

I don't want to contradict your doc. Other than that just common sense stuff, multi vitamin and hair supplement, good diet and keep physically fit/ heathy.

Don't let work, life or women stress you out