Concerned About Potential Hair Loss And Would Like Another Opinion

[Randomguy02]

Hello, i am 25 years old (26 in a month) and recently I have been incredibly stressed and paranoid about hair loss. About four months ago I noticed what looked like defuse thinning at my temples and what I thought was a bald spot on my crown (though I've been told this is just a whorl). I started on biotin supplements and anti DHT shampoo while I monitor things, but I am afraid I should be doing more. I have always had really thick hair and I am just so terrified of losing it.

The thing is that in the past few months I have seen two dermatologists to get my hair evaluated. The first looked for about five seconds before telling me it was nothing. The second one did a scalp biopsy which the results said I had telogen effluvium. Still, I can't stop worrying that they may have missed something and I may be going bald still.

I have attached photos of my crown and my temples later. These from decently recently. Am i just being paranoid and should just relax? Or is there something to my fears.

I guess my fear right now is that while it looks fine at this point, that what I've noticed may be the very early signs of hair loss and I'd hate to sit here and do nothing until its too late.

The logical side of me says I should just listen to the dermatologists and the biopsy results, but yet I can't stop worrying about it. I haven't noticed any real change since I first monitoring it four months ago (with no real change to the temples or crown, so if they have gotten worse its so minimal that side by side picture can't show a noticeable difference). 

At this point the constant stress is probably not doing me any favors. Should I just let it be for awhile, or should I be concerned at all at this point?

[Randomguy02]

Should I just take the lack of responses as meaning it looks fine and that I'm worrying about nothing?

[LaserCap]

Thanks for the photos, this always help.  The first observation is that your hairline is still in the middle of your forehead.  The only patients that tend to keep this "teenage" hairline, (call it youthful hairline), are patients that enjoy a full set of hair.  Looks like your hairline is starting to mature.  This is normal.

The whirl, looks normal as well. 

If you did a biopsy and that's what you were told, I would place my trust on that.  I would not even bother with any medical therapy at this point.  These modalities are such that you need keep up with them for life.  If you stop them, you will resume losing hair, provided you are losing,.  I think this would be just a waste of money and time. (The stress alone that you are putting on yourself may end up causing you to loose. Stop it).

Do nothing?  No.  Take photos.  Put them away.  3 months later do the same. Keep track and then decide if something needs to be done.

Lastly, there are two types of loss.  The type you see and the type you don't.  The hair that you do see on the floor, tub, etc...this is normal.  the follicles on your head get tired.  They need rest.  The hair sheds.  Typically this hair returns.  The hair that does not return is hair that miniaturizes and eventually disappears.  That's hair loss.

 

 

[Randomguy02]

Thank you so much? So the hairline is receding then but since I had a teenaged hairline prior this provably just means my hairline is maturing? In that case I can certainly live with that.

If I recall the biopsy did say there was no sign of minification in the crown, jusy signs of more telogen phase hairs that is typical so they said is was most likely telogen effluvium. I'd actually been noticing a ton if shedding around that time too, though that has stopped as of a month ago, so hopefully that has been cleared up then by now.

In that case I will just stick to the biotin supplements as I can't imagine that would hurt and perhaps keep using the DHT blocking shampoo every other day? Or is that not even worth it at this point? 

 

[LaserCap]

If you have no hair loss, I would avoid anything with DHT blockers.  Consult with your doctor.

Bioting, a vitamin, will help to have the hair look as good as it can.  I don't think it is hurting anything but, again, consult with the derm.

[Randomguy02]

In that case I will just stop with the shampoo until I talk to my derm. It was actually the dermatologist who suggested the biotin supplements to help make sure that the hair that grows back following the telogen effluvium clearing up will be as healthy as possible.

[Randomguy02]

One more quick question. Is it normal for the crown to feel thinner than the top of your head? When I run my hand through my hair there or even just touch my crown it feels thinner.

Sorry, I am just having trouble shaking my worries on this one.

[Randomguy02]

Few more pictures of the crown that concern me. Do these look normal?

[Randomguy02]

I have a few more pictures of the crown that I fear show some defuse thinning. Are these normal?

 

For comparison here are two pictures from about 3 months ago

Edited May 17, 2019 by Randomguy02

[Randomguy02]

I added a few more pictures from today to the above post. Are these of any concern, or no decernable hair loss here?

[Lennney]

Welcome to the forum! 

You have a better hair situation than many of our 26 year old members.

About your question of losing hair- If you are losing hair, you're at the very early stages, so this is great news.

1. Who are you? - What is your history with hair loss? Look at your grandparents and work your way down. Was your mother's father bald? Her brother(s) (uncle of yours)? What about your father's family?

Balding typically follows the mother's line, and I think the consensus is you're a lot more likely to follow your grandfather's path (maternal).

2. Your haircut. - You have a lot of hair length. I used to have a similar hairstyle as a high schooler. It's a mop. Do yourself a favor and go to the barber and use feathering scissors (thinning scissors). They cut away the bulk, which tents to lie flat on your head. You'll still keep the length if you want it. Some of that cowlick area is a function of too much hair in one spot.

I don't want to tell you what to do as far as treatments go, because I'm no doctor and you're uncertain. The good news is: if the hair loss progresses (which may be necessary to determine if you are experiencing hair loss), there are treatments which will either return you to pre-hair loss levels and/or stabilize you.

 

Now, why you're rocking an unprofessional hairstyle at 26 is your business. Do know that you're more proactive than your (balding) peer group, and you have the resources here to help should you need them. Without certain knowledge, we're playing a guessing game. You're in a comfortable position in which your hair loss is starting later in your life, or that you may escape hair loss until old age. Try to avoid paranoia. You're doing everything right. Keep a level head.

[Randomguy02]

8 hours ago, Lennney said:

Welcome to the forum! 

You have a better hair situation than many of our 26 year old members.

About your question of losing hair- If you are losing hair, you're at the very early stages, so this is great news.

1. Who are you? - What is your history with hair loss? Look at your grandparents and work your way down. Was your mother's father bald? Her brother(s) (uncle of yours)? What about your father's family?

Balding typically follows the mother's line, and I think the consensus is you're a lot more likely to follow your grandfather's path (maternal).

2. Your haircut. - You have a lot of hair length. I used to have a similar hairstyle as a high schooler. It's a mop. Do yourself a favor and go to the barber and use feathering scissors (thinning scissors). They cut away the bulk, which tents to lie flat on your head. You'll still keep the length if you want it. Some of that cowlick area is a function of too much hair in one spot.

I don't want to tell you what to do as far as treatments go, because I'm no doctor and you're uncertain. The good news is: if the hair loss progresses (which may be necessary to determine if you are experiencing hair loss), there are treatments which will either return you to pre-hair loss levels and/or stabilize you.

 

Now, why you're rocking an unprofessional hairstyle at 26 is your business. Do know that you're more proactive than your (balding) peer group, and you have the resources here to help should you need them. Without certain knowledge, we're playing a guessing game. You're in a comfortable position in which your hair loss is starting later in your life, or that you may escape hair loss until old age. Try to avoid paranoia. You're doing everything right. Keep a level head.

Thank you for the response.

1) in terms of family history I do at least have genetics on my side. My father has a Norwood 1 hairline into his 50s and only now is starting to have diffuse thinning all over. My paternal grandfather did go bald but not noticeablely so until his late 30s. My maternal grandfather never receded past a norwood 3 with some thinning in the crown.

Sadly I do not have any uncles to compare with and my brothers are all younger than me. That said the eldest of my younget brothers who is 20 actually has a worse hairline than mine. Though he also has finer hair than mine (my hair has always been very thick) and a higher juvenile hairline than I did.

2) as for the hair style, I just badly need a haircut. Its been two months since my last one and have been putting it off for a bit too long 

So at this point should I keep monitoring the situation for now and see what happens? Is there any noticeable difference between the pictures from this week and those from three months ago?

 

The one bright spot I have seen is that from January until the end of March I was shedding a lot of hair, but since then the ammount of hairfall has decreased to less than half. So assuming the Telogen Effluvium diagnosis wasn't incorrect, hopefully that's a sign that had cleared up.

 

[LonelyGraft]

Looks like a normal head of hair to me. Can you compare pics to a few years back and see any difference?

 

i guess if you’re really concerned you can get a miniaturization study done by a good derm/hair transplant surgeon and if it shows u really are losing hair then u can try treatments such as finasteride 

[Randomguy02]

5 hours ago, jj51702 said:

Looks like a normal head of hair to me. Can you compare pics to a few years back and see any difference?

 

i guess if you’re really concerned you can get a miniaturization study done by a good derm/hair transplant surgeon and if it shows u really are losing hair then u can try treatments such as finasteride 

Unfortunately I don't have any pictures of the crown from a few years ago and every picture I have of the front my hair is covering my hairline

[Spanker]

No issues. Check it out every 6 months. 

[Randomguy02]

So my anxiety about this has come back after a few days due to having been finding several small (1 inch long or shorter) hairs laying on my desk? Is this normal? I am starting fear that the I really do have an early stage MPB instead of Telogen Effluvium. Is it possible the scalp biopsy results i had three months ago were wrong

[Dr Blake Bloxham]

Random, 

I see no real evidence of hair loss in any of these images (and I evaluate scalps for a living!). The crown looks very healthy, and I think the only "thinness" you are perceiving is the natural crown whorl (which is often accentuated in patients with finer, lighter hair). You do have some finer hairs on the hairline which may be due to natural follicle cycling or may be some remnants of what was your immature hairline of yesteryear. Either way, these are not indicative of genetic patterned hair loss alone either. And remember that shedding 50-100 hairs a day is perfectly normal. Even people with no hair loss whatsoever shed this many hairs from normal hair follicle cycling. You may be noticing more on your desk simply because you are hyper-aware and looking for it. I think you are in good shape all around. Like Spanker said above: keep an eye on it to make sure nothing really picks up (as the earlier you can address this, the better), but try not to focus on it too much because it all looks great. 

[Randomguy02]

23 minutes ago, Dr Blake Bloxham said:

Random, 

I see no real evidence of hair loss in any of these images (and I evaluate scalps for a living!). The crown looks very healthy, and I think the only "thinness" you are perceiving is the natural crown whorl (which is often accentuated in patients with finer, lighter hair). You do have some finer hairs on the hairline which may be due to natural follicle cycling or may be some remnants of what was your immature hairline of yesteryear. Either way, these are not indicative of genetic patterned hair loss alone either. And remember that shedding 50-100 hairs a day is perfectly normal. Even people with no hair loss whatsoever shed this many hairs from normal hair follicle cycling. You may be noticing more on your desk simply because you are hyper-aware and looking for it. I think you are in good shape all around. Like Spanker said above: keep an eye on it to make sure nothing really picks up (as the earlier you can address this, the better), but try not to focus on it too much because it all looks great. 

Thank you. That helps a lot.

For hairs I am finding they do seem to be a mix of lengths, some longer, some sorter. Thankfully the vast majority seem to be of normal thickness, with only about 1/10 looking to be slightly thinner in diameter and maybe 1 in 39 or 1 in 40 being extremely thin an brittle. Hopefully that's normal but at this point I know I am aggonizing over this and at this point I should probably be spending more time looking for a psychologist than for hair loss doctors 

At this point what Norwood would you say hairline is? My hairline is pretty low still actually, about 2.2ish inches from my eyebrows, with the center looking like it has stayed put from where it was in the single picture I found from a year ago, which I attatched here (i had worried about this a year ago for a few days too, forgot I still had a picture buried on my phone)

 

Really at this point my fears come fron not knowing for certain. Since I di realize if I am balding, I am in the crazy early stages and thus it would be hard to tell. Thus I am stuck in limbo, not wanting to start treatmenrs with side effects that I shouldn't take if I'm not balding, but fearful of letting things get worse when I could have been proactive.

That said I will try my best to relax and check back in the end of June to compare pictures I took back in December, then try to not worry about it for another 6 months.

Edited May 22, 2019 by Randomguy02

[Sean]

Amazing hair.  I do not see an issue at this current time.  Relax and enjoy!  

Do not try to fix something that isn’t broken.  You are lucky you have great hair.

Will it change later? Who knows, but right now, you are good to go and do not need anything.   Best of luck.

[Randomguy02]

Okay I will try to stop agonizing over it best I can.

What sort of things should I look out for before I take further steps? And if my hairline is just maturing, har far would it need to recede from where it is now before I should get concern?

 

That said I did just see something that put the whole thing in bettet perspective: my younger brother who is 5 1/2 years younger than me already has a Norwood 2 hairline. So I guess even if I do lose my hair later down the road, I did dodge a genetic bullet there. Now I just need to pray I hit the jackpot and got my dad's hairloss pattern and kept a Norwood 1 into his 50s where he started to thin defusely

Edit: for the sake of completeness, here are some pictures of the front from today, as the last ones were from over a month ago.

Do these still look normal? What Norwood would you say these are?

Edited May 22, 2019 by Randomguy02

[Randomguy02]

My one remaining concern is that there looks like there are fewer hairs right at the corner of my hairline, going about 1/2 inch up into the hairline, particularly on the right side. Is that normal for a maturing hairline?

Edited May 23, 2019 by Randomguy02

[Randomguy02]

I apologize but I have one last question. Right now the corners of my hairline look a bit thin, as in it looks like there are fewer hairs there and are slightly higher than the center. Is this normal, or should I be concerned about is as a sign of the start 

 

Edited May 23, 2019 by Randomguy02

[Randomguy02]

I'd just like to thank everyone for all the responses. While I have not been able to stop my anxiety on the matter, hearing all of this has made me feel a lot better. My only real concern now is with my temples which I feel may be thinning/recedeing, but I am not sure if that should just be expected at this age.

Are there any preventative steps I can do to stave off hair loss long term. I am really just looking for something to put my mind at ease so I can stop agonizing over this.

[pkipling]

54 minutes ago, Randomguy02 said:

I'd just like to thank everyone for all the responses. While I have not been able to stop my anxiety on the matter, hearing all of this has made me feel a lot better. My only real concern now is with my temples which I feel may be thinning/recedeing, but I am not sure if that should just be expected at this age.

Are there any preventative steps I can do to stave off hair loss long term. I am really just looking for something to put my mind at ease so I can stop agonizing over this.

I remember very well the anxiety I felt in my mid 20s when I first started experiencing the fear of hair loss... And knowing what I know now, the best advice I can give you is to trust that whatever comes your way you can handle it. There's no magic pill or formula to make any hair loss stop completely. There's Propecia and Rogaine, but based on the information you provided above, I'm not sure it's even necessary.

I suggest you look into ways to effectively manage your anxiety and trust that should the time come when you need to look into treatment, you can step up to the plate and take care of it like so many men do - and keep your fingers crossed it never becomes something you need to deal with anyway.  

[Randomguy02]

1 hour ago, pkipling said:

I remember very well the anxiety I felt in my mid 20s when I first started experiencing the fear of hair loss... And knowing what I know now, the best advice I can give you is to trust that whatever comes your way you can handle it. There's no magic pill or formula to make any hair loss stop completely. There's Propecia and Rogaine, but based on the information you provided above, I'm not sure it's even necessary.

I suggest you look into ways to effectively manage your anxiety and trust that should the time come when you need to look into treatment, you can step up to the plate and take care of it like so many men do - and keep your fingers crossed it never becomes something you need to deal with anyway.  

Thank you for the encouragement, as this makes me feel a lot better? Would you say based on the pictures I provided (including the more recent ones I put in my most recent post) that I am safe for now not to do anything drastic like take Propecia or Rogaine at this point? It doesn't don't know if my hair had gotten worse or not in the past year, as the one picture I have on my hairline is only on my right side and is a bit blurry and at a weird angle. I don't remember the temples looking as thin as they do now, but I don't really trust my memory for that.

That said, two dermatologists did tell me I had nothing to worry about for now, so I should probably just trust that. I am actually going back to see the one that did the biopsy in two weeks for a three month followup to see if the telogen effluvium they diagnosed me with has cleared up. I plan to ask them to compare the pictures they took back then with my crown and my hairline to see if they notice any change, as well as inquire about doing a miniaturization study.at some point (since another fear of mine is that there is miniaturization that I'm not noticing due to having always had very thick hair)