Defuse patterned alopecia

[Dello]

Hi I’m suffering from defused patterned alopecia thinning on top of my scalp n crown area. I need recommendation on which doctor/surgeon I should go to that has experience and is good with my type of hair loss In the USA or preferably Turkey 

 

Edited January 8, 2021 by Dello

[UnbaldEagle]

I've got DPA too so when I was shopping around for a clinic I've got flat out rejected by a few, others were too cautious suggesting multiple sessions with a small number of grafts. The main concern (as you may already know) is shock loss to the natives, which, if occurring and if you have a high number of very miniaturized hairs makes them permanently vanish. I know some clinics treat such vellus hairs as intermediate, so they'll transplant on them as they deem their cosmetic value insignificant. I'd be wary of this last approach in your case as you have a large area to cover. 

Are you on finasteride? It is highly recommended if you want to avoid permanent shock loss to the natives. Also, which area you'd like to address first? It is generally recommended you rebuild the frontal third first as that would have the highest cosmetic impact + it's well integrated in your future plan. You still have some hair in the midscalp, when that's gone too you could have a 2nd round. As for the crown, I think it depends on your donor assessment. It looks thick to me, but on a relatively modest area as you've got some thinning there. Better have those hairs checked for any miniaturization. But you could throw in some body hair too at some point, works great when mixed. 

I would suggest contacting a fair number of top clinics (there's a recommended list on the top right corner), see what they suggest and what is achievable. It is very important to have realistic expectations too. If you stay in the US (or hop across the border to Canada) you've got the best FUT clinics, which may be considered to maximize your donor area.  

[Dello]

Unbaldeagle thank you for the reply I have contacted several clinics yes some of them have rejected me n some suggest I do a few sessions starting with the frontal area. I’m not taking any medicine such as finasteride as I have seen it pop up but I’ve also read about the side effects of it that’s what kinda kept me away from taking it. I honestly would love to add density all over crown area, mid and the frontal but as you mentioned I have to b cautious not to damage the natives. I’m still searching for a good affordable clinic in the US or Turkey that could give me good results! Again thank you for the reply! 

[Gatsby]

@Dello I would seriously consider taking finasteride to try and stabilize your hair loss and strengthen your donor. I can understand your reluctance though. I would also consider contacting Eugenix as they produce excellent results which can include the use of beard grafts to blend in with scalp grafts. Keep researching other clinics and take your time. Wishing you all the best!

[Crickhair]

 

@DelloYou can always try propecia and if you get sides you can quit. The odds of getting sides are like 1% and the odds of sides continuing after you quit are like .000000000000000001%.

I worry that your loss is aggressive and finasteride might not help. Have you ever shaved your head? Or buzzed down to a 1? Maybe you'll like the look. But I would try the propecia.

[UnbaldEagle]

I'm an ardent finasteride fanboy, but I also fully respect if someone doesn't want to take it. Yes, it somewhat changes the game plan for a HT, but it's not impossible with realistic expectations. If you leave your crown to fully thin out and adopt a hairstyle that would be compatible with that, or use concealers, it's achievable. Only real concern is if you're headed for a high NW, that area will keep growing and your sides will drop too. It's really important to know how much donor you've got and plan for the future accordingly. 

I've also noticed throughout the years that the guys who were reluctant to take fin because they were so scared of the sides almost always did experience sides when they were peer pressured to take them eventually. That's not to say fin side effects are "all in your head", but nocebo is a real thing too. 

Why not try a topical antiandrogen then? You can get topical finasteride (Morr F or the more expensive ones from minoxidilmax), slightly less efficacy but clearly with a higher safety profile. Or topical dutasteride if you want to be certain you won't have any sides at all. 

[deitel130]

With diffuse thinning and transplanting between them without stabilizing loss via meds can be a potential risk for permanent shock loss. Any doctor who says otherwise and does not discuss meds with you is being unethical. Finasteride sides can happen but are rare and stop once the medication is stopped. Anything you read online about permanent sides have not been proven as far as I know and if it ever did happen is even more rare. A lot of people start with micro dosing, taking the tablet once a week, then twice a week and gradually building up to daily or every other day allowing your body to adjust. 

Edited January 8, 2021 by deitel130