Suggestions on what to do with hair

[actuarialbadger]

Hi All,

I'm a 27M and really struggling with my hair loss lately and wanted to get some advice.

I've been on fin and min for just over 11 months, and my hair appears to be the same (perhaps even worse).  The pic of myself in the green sweater is December 2020, 3 months into fin/min, and the other pic in black is September 2021. I shaved it down to see progress and was really put down to see that it has not improved at all.  Hard to say it's gotten worse since lighting is different and current hair is shorter, so perhaps just maintained.

I have a hair transplant scheduled with  HLC in November, but I'm worried that hair loss is progressing and I won't get good results from a transplant. I don't find too many cases online of non-responders to fin, which is why I think I'm probably just maintaining... Also, I would note my donor area does seem totally fine, so I'm hopeful available hairs for transplant is not an issue.

Just looking for advice/suggestions on what you think I should do.  While I want great hair dearly, I don't want the surrounding non-transplanted hair to die out and my hair to look horrid.  Appreciate any help.

[JDEE0]

4 hours ago, actuarialbadger said:

Hi All,

I'm a 27M and really struggling with my hair loss lately and wanted to get some advice.

I've been on fin and min for just over 11 months, and my hair appears to be the same (perhaps even worse).  The pic of myself in the green sweater is December 2020, 3 months into fin/min, and the other pic in black is September 2021. I shaved it down to see progress and was really put down to see that it has not improved at all.  Hard to say it's gotten worse since lighting is different and current hair is shorter, so perhaps just maintained.

I have a hair transplant scheduled with  HLC in November, but I'm worried that hair loss is progressing and I won't get good results from a transplant. I don't find too many cases online of non-responders to fin, which is why I think I'm probably just maintaining... Also, I would note my donor area does seem totally fine, so I'm hopeful available hairs for transplant is not an issue.

Just looking for advice/suggestions on what you think I should do.  While I want great hair dearly, I don't want the surrounding non-transplanted hair to die out and my hair to look horrid.  Appreciate any help.

Most people do just maintain/slowly gain a small amount of ground from baseline over a number of years, I don't think your hair looks any worse a year later, it's just half the length of the picture on the left.

You're not a 'non responder'. I don't think they actually exist, just that some people are so sensitive to androgenic activity that reducing DHT by 60-70% isn't enough to slow their loss down to a halt, but this is pretty rare and either way as most people maintain just fine and it's still working for these people who lose ground, they'd be much worse off doing nothing. Also, just removing DHT/androgens doesn't do anything to signal re-growth really, extreme examples, but we know that people who are castrated and so on don't just suddenly re-grow their hair, merely they just stop losing it from that point onwards. Other things are needed to aid growth, although just fin alone does help to rejuvenate follicles that aren't too far gone (in some people more than others). 

If your donor is fine I see no issue moving forwards with the HT as long as you commit to fin and don't jump off a year down the line... especially in your case, you overall have a lot of hair left right now, which is good, but it's clear that if you do nothing you're heading towards NW5 territory at some point.

[Dr. Glenn Charles]

I agree that you are probably the same now as in before photo but it looks thinner because of hair length and different photo setting. If you take either Finasteride or Minoxidil or both for a while and your hair looks the same that means it is working. Hair growth or hair looking fuller is only a bonus that a small percentage of patients get.

[actuarialbadger]

Thank you both. Based on your replies, I feel more comfortable pursuing a HT and correcting the temples and mid scalp area.  I did look at the scalp under different lighting and the recession of hair was not as intense as under very harsh lighting, so I feel reassured about the maintenance attributed to finasteride.