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Struggle

What I have to do? My situation

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Posted (edited)

Hello to everyone, I'm new to this forum and I want to introduce myself. I hope the section is correct.

I'm a 24 old guy who has suffered from hair loss since he was 17. For years I did nothing to fight against hairloss, because I wasn't aware of treatments, and so I gradually became NW2, then NW3 and NW3A, time where I had to shave my entire head to look fine. In April 2018, mentally exasperated from alopecia,  I became aware of medications: so I went to my dermatologist who prescribed me Finasteride 1mg daily and Minoxidil 5% to treat my NW3A alopecia: in less than six months I had great results, regaining a lot of miniaturized hair. I was very happy, but after one year of therapy I began to lose all the benefits, and now - another year later - I think I'm at the starting situation.

 I don't know if Finasteride stopped working or if there are other reasons, because I suffer also from severe anxiety and depression which probabily gave me an effluvium in the last three months - I lose hundreds of hairs daily, after a shampoo last week I counted more than five hundred hairs fallen in my washbasin. 

I must confess you that my hair situation worries me a lot: I'm obsessed by hair loss and by the thought I might get bald one day. I cannot stand my actual situation, if I get bald I think I will not live anymore.

 I'd like to get an hair trasplant because, like I said earlier, I can't stand my situation anymore. I'd like to have a FUE because I want to buzz my hair on the side, but I don't know if this is a wise choice if I'm intended to lose my hair on mid and vertex. I had virtual consults with Lupanzula and De Freitas, who told me I need around 2500-2600 grafts to rebuild my hairline. Pekiner suggested me to wait because I'm young.

My father didn't suffer from hairloss, while his brother and his dad are NW4; it seems that I look like my maternal grandfather, who probably had my hairloss pattern: NW3A when he was young,  always NW3A or maximum 4A when he was forty  years old. I have to find other pictures of when he was sixty to have an idea of what my alopecia will probably be.

I'll put as soon as photos of my journey with hair loss.

I wish an happy easter to everyone who read my words. Thanks.

BEFORE FINASTERIDE AND MINOXIDIL

https://ibb.co/RvVLTwz
https://ibb.co/8cdCpVB
https://ibb.co/JttpqY3
https://ibb.co/NZ2hMk1
https://ibb.co/R9pynhJ
https://ibb.co/FHjG8hW
https://ibb.co/D7sHfgt
https://ibb.co/N6Q2Brw
https://ibb.co/8DGtbyN
https://ibb.co/qdGwrv5

AFTER THREE MONTHS OF TREATMENT

https://ibb.co/LrhWmCt
https://ibb.co/Stwnbff

AFTER EIGHT MONTHS OF TREATMENT

https://ibb.co/8NfFYFR
https://ibb.co/74RCt0P
https://ibb.co/hV9Qz8q
https://ibb.co/FhCckh1
https://ibb.co/K0s32Gp
https://ibb.co/V3pL9Vh
https://ibb.co/5vTqJxc
https://ibb.co/LRCSkTR
https://ibb.co/YyrKQC3

AFTER ONE YEAR OF TREATMENT

https://ibb.co/SVGQbv3
https://ibb.co/ZmBhhyJ
https://ibb.co/PWV6tf7
https://ibb.co/dPpfDGQ
https://ibb.co/ZXkZSSg
https://ibb.co/9h9Bv5Y

AFTER ONE YEAR AND FIVE MONTHS

https://ibb.co/xqHyddg
https://ibb.co/T2PrZJW
https://ibb.co/0DdqNmv
https://ibb.co/rbvYZLq
https://ibb.co/n0G85M9
https://ibb.co/KVQSx93
https://ibb.co/HNB0gjF
https://ibb.co/D9Jzs9t
https://ibb.co/gdFKD8v
https://ibb.co/2Y4GtTw
https://ibb.co/nfkB9s4
https://ibb.co/2s4wMj4
https://ibb.co/bmpdKVq

AFTER ONE YEAR AND EIGHT MONTHS

https://ibb.co/MhF5xJF
https://ibb.co/2cNqM2s
https://ibb.co/zxkZBZz
https://ibb.co/rmthf3T
https://ibb.co/mJb3wyB
https://ibb.co/HYL8k2q
https://ibb.co/XjT3Lbt
https://ibb.co/QdRJmm9
https://ibb.co/CnWK7m2
https://ibb.co/Jx2LGFZ

AFTER ONE YEAR AND TEN MONTHS

https://ibb.co/jb4jJwS
https://ibb.co/s62PZwV
https://ibb.co/zmrRMjT
https://ibb.co/BV76R8w
https://ibb.co/qsz5kj1
https://ibb.co/f26fhq5
https://ibb.co/T2DH08D
https://ibb.co/Qf6wxwC

AFTER ONE YEAR AND ELEVEN MONTHS

https://ibb.co/thjvGk8
https://ibb.co/bjVKRss
https://ibb.co/GHKt90Y
https://ibb.co/frgfXxY
https://ibb.co/9scg4G4
https://ibb.co/Fw1xc8q
https://ibb.co/3yhgLy2
https://ibb.co/2MD6DGB
https://ibb.co/BCJGNfF
https://ibb.co/Wz7PCBJ
https://ibb.co/FqqN07y
https://ibb.co/4mPBJ3h
https://ibb.co/Xj8dGPP
https://ibb.co/Lgr7h8j

Edited by Struggle

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Hello @Struggle  thats a great honest write up, sorry to hear of your situation.

You are shedding hair at present as you can see it in the wash basin. There is a good chance it will grow back. You are doing the right thing by talking to doctors to get advice on your situation. Don't make any rush decisions and take your time. You are still very young, so you will still probably lose more hair. You will want more than 1 HT if you do decide to go down that route. You don't want to be in a situation where you are chasing your hair loss and run out of doner . Hold off for as long as possible , a decision to have a HT is a major one.

If you do decide to look deeper only consider the top doctors, don't let price or distance be an obstacle . You need a good doctor who has your interests and long term plan. Your expections should also be realistic, HTs are an illusion of density, not like for like. Do plenty of research and ask plenty of questions.

All the best, Happy Easter

Paddy

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Whatever you do, don't stop finasteride. I have taken finasteride for 20 years. I have undergone many shedding events. While on occasion you will lose some ground during these events, most of the hair will come back. I know how you're feeling. During these shedding events you feel like there's no point in taking the meds and all hope is lost. Believe me, however, that you need to trust the process. If I were you, I'd also try throwing in 1 dutasteride 1x per week [check with your doctor first]. Take biotin. Use Nizoral 1%. Get a transplant if you want one. Understand, however, that hairloss will continue. You'll need to go back to get touched up in all likelihood. That's why the meds are so important. Keep what hair you can. 

Best of luck, friend. 

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I would definitely continue the finasteride, the reality is that hair shedding doesn't equal hair loss. As long as DHT is not attacking those follicles, they will grow back. Now is the time to submit as many online consultations as possible. Make sure you get as many professional opinions as possible to draw a general consensus.  

  • Like 1

I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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Posted (edited)

Thanks for the answers, they help me a lot. A doctor told me that effluvium/hair shedding in presence of hair loss worsens incredibly the situation. In the last two months my hairs got worse quickly, as I've seen in the photos I took. Can't wait for the end of this.

For surgery, I'm considering only top doctors,  I think everyone has to do it in this sector. 

@Fluffhead did you progress on the norwood scale despite finasteride during these years?

I attached three photos of my frontal line: the first was taken in December, when the shed began, the second in February, the last yesterday. 

IMG_20200412_230725.jpg

IMG_20200412_230701.jpg

IMG_20200412_230546.jpg

Edited by Struggle

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The pictures can be deceiving, the top picture is taken in dim lighting, and the bottom under bright lights. Honestly, the loss looks the same, just under different lighting conditions.

  • Like 1

I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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On 4/11/2020 at 7:27 PM, Struggle said:

Hello to everyone, I'm new to this forum and I want to introduce myself. I hope the section is correct.

I'm a 24 old guy who has suffered from hair loss since he was 17. For years I did nothing to fight against hairloss, because I wasn't aware of treatments, and so I gradually became NW2, then NW3 and NW3A, time where I had to shave my entire head to look fine. In April 2018, mentally exasperated from alopecia,  I became aware of medications: so I went to my dermatologist who prescribed me Finasteride 1mg daily and Minoxidil 5% to treat my NW3A alopecia: in less than six months I had great results, regaining a lot of miniaturized hair. I was very happy, but after one year of therapy I began to lose all the benefits, and now - another year later - I think I'm at the starting situation.

 I don't know if Finasteride stopped working or if there are other reasons, because I suffer also from severe anxiety and depression which probabily gave me an effluvium in the last three months - I lose hundreds of hairs daily, after a shampoo last week I counted more than five hundred hairs fallen in my washbasin. 

I must confess you that my hair situation worries me a lot: I'm obsessed by hair loss and by the thought I might get bald one day. I cannot stand my actual situation, if I get bald I think I will not live anymore.

 I'd like to get an hair trasplant because, like I said earlier, I can't stand my situation anymore. I'd like to have a FUE because I want to buzz my hair on the side, but I don't know if this is a wise choice if I'm intended to lose my hair on mid and vertex. I had virtual consults with Lupanzula and De Freitas, who told me I need around 2500-2600 grafts to rebuild my hairline. Pekiner suggested me to wait because I'm young.

My father didn't suffer from hairloss, while his brother and his dad are NW4; it seems that I look like my maternal grandfather, who probably had my hairloss pattern: NW3A when he was young,  always NW3A or maximum 4A when he was forty  years old. I have to find other pictures of when he was sixty to have an idea of what my alopecia will probably be.

I'll put as soon as photos of my journey with hair loss.

I wish an happy easter to everyone who read my words. Thanks.

BEFORE FINASTERIDE AND MINOXIDIL

https://ibb.co/RvVLTwz
https://ibb.co/8cdCpVB
https://ibb.co/JttpqY3
https://ibb.co/NZ2hMk1
https://ibb.co/R9pynhJ
https://ibb.co/FHjG8hW
https://ibb.co/D7sHfgt
https://ibb.co/N6Q2Brw
https://ibb.co/8DGtbyN
https://ibb.co/qdGwrv5

AFTER THREE MONTHS OF TREATMENT

https://ibb.co/LrhWmCt
https://ibb.co/Stwnbff

AFTER EIGHT MONTHS OF TREATMENT

https://ibb.co/8NfFYFR
https://ibb.co/74RCt0P
https://ibb.co/hV9Qz8q
https://ibb.co/FhCckh1
https://ibb.co/K0s32Gp
https://ibb.co/V3pL9Vh
https://ibb.co/5vTqJxc
https://ibb.co/LRCSkTR
https://ibb.co/YyrKQC3

AFTER ONE YEAR OF TREATMENT

https://ibb.co/SVGQbv3
https://ibb.co/ZmBhhyJ
https://ibb.co/PWV6tf7
https://ibb.co/dPpfDGQ
https://ibb.co/ZXkZSSg
https://ibb.co/9h9Bv5Y

AFTER ONE YEAR AND FIVE MONTHS

https://ibb.co/xqHyddg
https://ibb.co/T2PrZJW
https://ibb.co/0DdqNmv
https://ibb.co/rbvYZLq
https://ibb.co/n0G85M9
https://ibb.co/KVQSx93
https://ibb.co/HNB0gjF
https://ibb.co/D9Jzs9t
https://ibb.co/gdFKD8v
https://ibb.co/2Y4GtTw
https://ibb.co/nfkB9s4
https://ibb.co/2s4wMj4
https://ibb.co/bmpdKVq

AFTER ONE YEAR AND EIGHT MONTHS

https://ibb.co/MhF5xJF
https://ibb.co/2cNqM2s
https://ibb.co/zxkZBZz
https://ibb.co/rmthf3T
https://ibb.co/mJb3wyB
https://ibb.co/HYL8k2q
https://ibb.co/XjT3Lbt
https://ibb.co/QdRJmm9
https://ibb.co/CnWK7m2
https://ibb.co/Jx2LGFZ

AFTER ONE YEAR AND TEN MONTHS

https://ibb.co/jb4jJwS
https://ibb.co/s62PZwV
https://ibb.co/zmrRMjT
https://ibb.co/BV76R8w
https://ibb.co/qsz5kj1
https://ibb.co/f26fhq5
https://ibb.co/T2DH08D
https://ibb.co/Qf6wxwC

AFTER ONE YEAR AND ELEVEN MONTHS

https://ibb.co/thjvGk8
https://ibb.co/bjVKRss
https://ibb.co/GHKt90Y
https://ibb.co/frgfXxY
https://ibb.co/9scg4G4
https://ibb.co/Fw1xc8q
https://ibb.co/3yhgLy2
https://ibb.co/2MD6DGB
https://ibb.co/BCJGNfF
https://ibb.co/Wz7PCBJ
https://ibb.co/FqqN07y
https://ibb.co/4mPBJ3h
https://ibb.co/Xj8dGPP
https://ibb.co/Lgr7h8j

So I think I can speak for all of us here when I say we know how you feel.  I started balding at 20 and it was f***ing terrible, so I totally get what you're going through.  Hair loss is a slow, torturous, and emotionally exhausting experience that takes a massive toll on confidence as your appearance seems to erode before your eyes.  I'm sorry to hear that you're going through this as well.

Now, concerning what you mentioned above:

- If you're not experiencing any negative side effects from finasteride, you may as well stay on it.  If you stop, you'll definitely lose a lot of hair.  For me, finasteride did slow the loss substantially, but I had to stop because of side effects; when I did end up stopping, I experienced significant catch-up loss.  Now, I also think it's important to mention that finasteride will not work forever; as you indicated, it loses effectiveness to some extent over time, though the time span over which it holds the line varies from person to person.  In the end, short of going nuclear (i.e., hair transplant), everyone ultimately loses this battle.

- There's also really no downside to continuing your use of minoxidil (and ketoconazole shampoo if you weren't using it already).  They're generally a lot less effective than finasteride, but they have very low side effect profiles.

- Talking to hair loss surgeons is a very good idea, in my opinion.  You can get a sense now of the level of work that would need to be done to restore your hair enough to make you feel more comfortable, and you can start saving money and weighing various factors that will likely play a role in your final decision (including logistics).  I finally pulled the trigger on an FUE procedure at the end of 2018, after nearly 10 years of hair loss, and I don't regret it one bit.

- Some people (and doctors) argue that one should wait until they're a bit older than you are (30+) before deciding to move forward with a hair transplant.  For people with very early stage hair loss (like NW2), who don't yet know how their pattern will develop, I'd agree.  However, if your hair loss is already sufficiently advanced and you think you know how it'll ultimately play out, you may as well get ahead of it now.  One factor you should probably consider is the loss of quality of life in your youth... honestly, we really shouldn't have to worry about things like this in our 20s.  We should be in our prime, enjoying the hell out of life.  If you feel like hair loss is hindering your ability to do this, then waiting may not be in your best interest.

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Thanks to everyone.

@LordBaldwin I agree with you: if hair loss doesn't allow you to enjoy your youth, hair trasplant is a valid choiche even in the 20s. Nobody will give you back these years.

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@Struggle Hey my man, you wrote up your paragraph like its all gloom, but I see a lot of opportunity in your situation. You still have a considerable amount of hair to work with, your loss is something a top doctor does in one session and you're doing whats necessary for prevention. In fact, you are ahead of your father and the rest of your family who likely didn't have all these opportunities to combat their loss. 

Talk to your family, make your problems clear to them. Make a financial plan, set a timeline and choose a doctor. You're 24 and I sympathize with you (I'm 27 similar situation) but tough luck. Hair loss really tests all of our characters but in a couple years time when you look back at this you'll laugh that you ever got so worked up about it. 

1) Our hair goes through phases, the shedding is likely a phase your'e experiencing. The medication is statistically effective among the majority of men, you're not excluded from this. So you need to stay patient. 

2) You already mentioned it, but your only major concern now is to find a top doctor, and there are plenty. This decision is also one that comes with its own fill of anxiety, because you want to mitigate as much risk as possible. However I believe you need to aggregate some of the mentions from this forum and make a top 5 list, and from there just make a decision based on other factors personal to you. 

3) Get healthier. If you don't like the feeling of your present hair loss, imagine what it would be like to suffer something life threatening. No excuses right now to cook healthy meals at home and workout at least 4x a week. It seems like a hair transplant gives a pretty good timeline as well. Within a years time, you could build some muscle, develop a skill and get your hair back.. in that time you'll feel renewed completely. Set the goals

4) and do yourself the favor of not looking in the mirror and phone camera every second. That shit is debilitating. 

 

 

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Posted (edited)

Thanks @TorontoMan. Now i'm in a not so bad situation, but my fear is that my hair loss goes on even if on Finasteride. I saw some pics of me years old ago shaved, before medications, and I looked like I had a diffuse thinning on the top of my scalp. However, my doctor told me I was NW 3A.

Now I see again thinning on the scalp with wet hair, I hope it's due to shedding and not to hair loss

I'm looking for a top surgeon to contain the risk of a bad result, which would be a waste of grafts that I cannot afford

Edited by Struggle

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Posted (edited)

I'm fairly confident your hair will rebound like mine did. and believe me I know how hard the waiting game is after you've seen a lot of good regrowth before.

hang in there. I would use the next year to research doctors. If your hair has continued to shed and get worse after a year, you can think about pulling the trigger, but if your hair is anything like mine, it will come and go in waves. but I'm hoping mine is starting to stabilize after 2 years on fin.

Please take a look at this video/thread. I think it applies to our finasteride regrowth as well:

https://www.hairrestorationnetwork.com/topic/56559-anagen-synchronisation-did-you-know-about-this-phenomenon-in-hair-transplantation/

 

Edited by hairlossPA
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Where do you live? Do you have access to a good surgeon or even a dermatologist to take a look at your situation? I think they would be able to assess the future pattern of your head better. The truth is we will all obviously continue to lose hair as we get older, but your fear is you believe you’re losing too fast now. If you’re judging your hair under harsh light and especially wet.. then you’re not being fair to yourself entirely. I’ve had girlfriends with good hair obviously and at time’s when light was shinning direct on the head I could see through to some scalp.. I remember the first time I realized that I was shocked. 
 

yes I completely agree, the most important game is the yield and donor management. Don’t settle for anyone less than who you think is great. 

As for shedding, I experienced shedding from minox when I started, and again from fin when I eventually began that. It took about 3 months for the shedding to stop after fin. I think you should give yourself more time to assess it, but if you’re still worried, considering trying dutasteride 1X a week, I’ve read some guys do that here, as a little insurance policy. However please research and consider jt well before you do that 
 

 

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Posted (edited)
On 4/15/2020 at 4:01 PM, hairlossPA said:

I'm fairly confident your hair will rebound like mine did. and believe me I know how hard the waiting game is after you've seen a lot of good regrowth before.

hang in there. I would use the next year to research doctors. If your hair has continued to shed and get worse after a year, you can think about pulling the trigger, but if your hair is anything like mine, it will come and go in waves. but I'm hoping mine is starting to stabilize after 2 years on fin.

Please take a look at this video/thread. I think it applies to our finasteride regrowth as well:

https://www.hairrestorationnetwork.com/topic/56559-anagen-synchronisation-did-you-know-about-this-phenomenon-in-hair-transplantation/

 

Your shed lasted eight months, didn't it?

I'm at four months now

On 4/15/2020 at 4:09 PM, TorontoMan said:

Where do you live? Do you have access to a good surgeon or even a dermatologist to take a look at your situation? I think they would be able to assess the future pattern of your head better. The truth is we will all obviously continue to lose hair as we get older, but your fear is you believe you’re losing too fast now. If you’re judging your hair under harsh light and especially wet.. then you’re not being fair to yourself entirely. I’ve had girlfriends with good hair obviously and at time’s when light was shinning direct on the head I could see through to some scalp.. I remember the first time I realized that I was shocked. 
 

yes I completely agree, the most important game is the yield and donor management. Don’t settle for anyone less than who you think is great. 

As for shedding, I experienced shedding from minox when I started, and again from fin when I eventually began that. It took about 3 months for the shedding to stop after fin. I think you should give yourself more time to assess it, but if you’re still worried, considering trying dutasteride 1X a week, I’ve read some guys do that here, as a little insurance policy. However please research and consider jt well before you do that 
 

 

I live in Italy and there aren't good surgeons, but after lockdown I'll go to a dermatologist to understand if it's a finasteride shedding, telogen effluvium or hair loss. The one I went to said I was a Norwood 3A. I never took photos to the upper part of my scalp before last month because I thought there were no problems, so I can't say that before I couldn't see my head... I hope it's normal, however with clean hair I can see nothing. 

Thanks for the tip I think that I'll insert dutasteride only if hair got patently worse, after blood and semen analysis

Edited by Struggle

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yes it was basically 8 months. started noticing shedding in December 2018, constant shedding each month up until July 2019 and it stopped. Then I had regrowth

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13 hours ago, hairlossPA said:

yes it was basically 8 months. started noticing shedding in December 2018, constant shedding each month up until July 2019 and it stopped. Then I had regrowth

Did you shed miniaturized hairs? 

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It could be a seasonal shed as others have suggested. Here's something to try. Keep using minoxidil and finisteride, but cut your hair very short again the way it was in your first set of pictures just before you started using them. This will get your mind off of it as you won't have much hair to look at in the mirror or to comb every day and it will also let the minoxidil get onto the scalp better. Then let your hair grow for a few months. Once it grows long again you can compare what you look like at that point to what it is now. This just mostly gets your mind off of worrying about how to style your hair everyday and looking at it all the time. It may be very good for your anxiety and depression.

 

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6 hours ago, Struggle said:

Did you shed miniaturized hairs? 

it’s hard to tell, but yes most likely miniaturized hairs. considering most of the hairs i regrew were gone at one time 

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On 4/18/2020 at 11:55 AM, BeHappy said:

It could be a seasonal shed as others have suggested. Here's something to try. Keep using minoxidil and finisteride, but cut your hair very short again the way it was in your first set of pictures just before you started using them. This will get your mind off of it as you won't have much hair to look at in the mirror or to comb every day and it will also let the minoxidil get onto the scalp better. Then let your hair grow for a few months. Once it grows long again you can compare what you look like at that point to what it is now. This just mostly gets your mind off of worrying about how to style your hair everyday and looking at it all the time. It may be very good for your anxiety and depression.

 

Thanks for the suggestion, it would be ideal for my situation but I think I couldn't cope now with a buzz cut

On 4/18/2020 at 6:04 PM, hairlossPA said:

it’s hard to tell, but yes most likely miniaturized hairs. considering most of the hairs i regrew were gone at one time 

100% same situation so

Update: In May I'll have a consult on Skype with Dr.Lupanzula 

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Posted (edited)

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Update in the day light.

I hate so much my hairstyle, however it's the only one I can get besides buzzcut due to the baldness in the front area

What do you think about my mid?

Edited by Struggle

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