Thinning on top + FUE implant

[jfede]

Hey guys

I have been searching for hairloss treatments since 22 and was able to stablize for 2 years thanks to finasteride (no side effects)

Now I am 26 and i had left Finasteride for almost 2 years but two months ago I  started to see some thining on the crown...so back on finasteride

*Photo before re-starting finasteride*

As you can see it was not really concerning but a had kind of a pool on the back.

Photo below is after being back on finasteride for 2 months ( I noticed a big shed so I decided to shave during first months)

 

The point is that I decided to start on Minoxidil but it was too agresive for my skin so I had to leave it (anyways it left some blanks of shed hair )...will it grow back? I experience some shed on minox too despite of using it only a few days.

*Actual situation*

Would you recommend to make a FUE procedure? 

I believe I can add some strength to front line with some grafts and make it look better but don't want to risk coverage for future.

Edited October 20, 2020 by jfede

[Raphael84]

It would appear from your photos as though you may be experiencing a diffuse pattern of loss. This basically means that you are experiencing thinning throughout your scalp.

In your first photo that I understand is representing "pre shed", the photo is taken indoors so lighting may have been that little but kinder, the crown and moving into the mid scalp appears to show some thinning and lower quality of hair. The following photo which is outdoors and therefore potentially more harsh, reinforces this.

You must have felt that you were losing hair early to have begun finasteride at 22. Upon discontinuing, your rate of loss most likely accelerated somewhat. The positive thing  in terms of retaining native hair/slowing down your rate of loss, is that you are taking finasteride again. It is quite common for individuals to not be able to tolerate topical minoxidil, it can be rather aggressive to the scalp and cause some irritation. Oral minoxidil is something that you may want to research and consider.

Minoxidil increases vascularity in the body. In terms of hair cycles, as the healthy new hairs grow, they push out the older, weaker hairs, resulting in shedding. When you start Minoxidil treatment, the hair follicles can be pushed from the telogen (resting) phase into the anagen (growth) phase, which often results in a temporary increase in shedding. 

In terms of surgery, that would be a definite no right now. You are 26, with what would appear to be a diffuse pattern of loss. The key is to stabilise your native hair and hopefully experiencing some strengthening over the next several months through medication. Surgery at a young age with diffuse loss can have risks in terms of future loss and unstable donor. 

Wait and see how you respond to finasteride again in terms of hair quality, potentially consider oral minoxidil, and wait a few years to see how things may or may not evolve.

[jfede]

Thank you Raphael, 

First photo is pre-shed before start finasteride again...that's the difference between first and second pic..

I will research on oral minoxidil but I think that I have enough material to stay out of transplants for a few years...

 

[Melvin- Admin]

It will grow back if you maintain the minoxidil, the shedding is a sign it’s working for you, it basically sheds weak miniaturized hair and regrows thicker stronger hair. Is FUE a good idea now? No, give the medication a full year before thinking of surgery.

[Bill-Dr-Rahal]

Jfede,

I agree that it’s possible that you are experiencing diffuse hair loss.   However, you could also be experiencing an initial shed from restarting finasteride which is just a sign of the medication working.  

As for whether or not you should undergo hair transplant surgery, personally, I think it might be wise to try both Propecia and minoxodil for a solid year before making a decision to undergo surgery. Frankly, You have a lot of natural hair left and medication might help to stabilize your hair loss and even possibly re-grow some hair. If that’s the case, you might not ever need to get a hair transplant or, if you do decide to undergo surgery, the transplanted hair can be used to thicken things up.

Best wishes,

Bill

Edited October 23, 2020 by Bill-Dr-Rahal

[Curious25]

 

46 minutes ago, Bill-Dr-Rahal said:

Jfede,

I agree that it’s possible that you are experiencing diffuse hair loss.   However, you could also be experiencing an initial shed from restarting finasteride which is just a sign of the medication working.  

As for whether or not you should undergo a hair transplant surgery, personally, I think it might be wise to try both Propecia and minoxodil for a solid year before making a decision to undergo surgery. Frankly, You have a lot of natural hair laughed and medication might help to stabilize your hair loss and even possibly re-grow some hair. If that’s the case, you might not ever need to get a hair transplant or, if you do decide to undergo surgery, the transplanted hair can be used to thicken things up.

Best wishes,

Bill

Off topic Bill - do you write your posts with some form of dictation setting? I've noticed this before in previous posts of yours, where incorrect words have been used out of context, however could potentially sound similar if being interpreted by a device - in this case it is 'laughed' instead of 'left'. 

Anyway - OP there is no room for any transplanted hair to go at the moment. And even if a surgeon was able to squeeze some grafts in somewhere, you would likely end up with no net gain within a few years down the line, as your miniaturising follicles may shed permanently from the trauma of the procedure. 

Throw in some PRP and laser for an extra added boomf to your regime - both elements tend to work better for diffuse cases. 

 

Edited October 21, 2020 by Curious25

[Bill-Dr-Rahal]

Curious25,

yes, a lot of times I use speech to text which is a built-in dictation tool with the iPhone. Unfortunately, I don’t always catch all of my mistakes but I’m gonna make sure I’m more careful in the future. Sorry about that 🙂. 
 

Bill