Opinions and advice regarding my hair loss situation and possibility of a transplant in future

[Drish]

Hello all,

This is my first post on this amazing forum. I have been lurking here for a few months and needless to say that one cannot get a better advisory guidance regarding fighting hair loss and hair restoration anywhere else. I've been aware of hair transplants and hair restoration for quite some time, since even before discovering this forum, and have done considerable research regarding the same. Joining here has definitely helped me enhance my knowledge and better asses my situation going into the future.

A little background on myself: I'm a 27 year old guy from India with a Norwood 1.5-2 ish hairline at present. I started noticing my receding hairline starting from the fronto-temporal angles at a very early age of 16, but never really cared to do anything about it till the age of 25. Quite evidently my hairloss progression hadn't been aggressive till then.

At the age of 25 I had noticed my hairloss had gathered a bit of pace and I was losing more hair than before. Just 2 months after that I had a terrible episode of Telogen Effluvium which absolutely stripped me off from all over my head. I had read somewhere that although hair lost in Telogen effluvium do essentially come back after few months, the condition can fuel the progression of MPB. And this is what exactly happened to me. I lost considerable ground w.r.t. my hairline within a very short period which has never really recovered. It was then when I started doing yoga and taking care of my diet that I showed the first signs of recovery from TE. Gradually the diffuse loss started to recover but that rapid recession of hairline had me worried and made me hop on finasteride. Since then I've been taking the drug 1mg EOD. Haven't had any side effects till now. It seems to be working very well.

I'm find myself fortunate enough to have the conscience to be aware about my hair situation. But if you ask me I wouldn't say I'm happy with the hairline I have tbh. My right corner has receded more than the left. But my temples have slightly washed off which doesn't complement my sharp features. I always have to be wary of how my hair is holding on top of my head which I find really annoying.  A little wind or sweat can make it look bad, especially when it is cut short.

But I'm not contemplating a transplant anytime soon, at least not until I reach 30. I fully understand that hair transplant is rather a marathon and not a sprint. I wouldn't want to compromise my donor for a hasty move that I might regret in the future. On top of that I only have an okay donor. My hairs are pretty thin, one of the thinnest you can find meaning more grafts needed for more optimal coverage. My skin being on the fairer side, the contrast between my dark brown hair and the scalp is also not helping the cause. There is a bit of retrogradation in my nape as well. Therefore, it is very important that I be sensible with my future plan. I do have a good, thick beard though it is quite different in texture and colour from my scalp hair.

For now I'm happy to maintain whatever I have with medication. I continue to do yoga and maintain a healthy lifestyle. I do not have an active social life at present as most of my time is spent in my research studies. I'm not active on any social media as well. So, I don't feel the need to flaunt a good hairline for the time being.

Hair situation during Telogen effluvium onslaught:

Recovery from TE and just before starting finasteride:

My hair now, right temple:

Left temple:

Front on:

Some of the questions and doubts that I have are:

1. Can temples be restored using minoxidil? How effective is it on the same? Personally I'm not a big fan of minoxidil as a long term treatment since I find many people to develop tolerance to the medication after some time. 

2. Is microneedling effective in the temples? If so, what do you feel should be the frequency?

3. How will a transplant to refine my hairline and temples after few years place me in the long haul? If I do it, then it will be Eugenix since I found no other clinic in India to be trustworthy as per my research.

I would greatly appreciate some sage advice here.

[NARMAK]

16 minutes ago, Drish said:

Hello all,

This is my first post on this amazing forum. I have been lurking here for a few months and needless to say that one cannot get a better advisory guidance regarding fighting hair loss and hair restoration anywhere else. I've been aware of hair transplants and hair restoration for quite some time, since even before discovering this forum, and have done considerable research regarding the same. Joining here has definitely helped me enhance my knowledge and better asses my situation going into the future.

A little background on myself: I'm a 27 year old guy from India with a Norwood 1.5-2 ish hairline at present. I started noticing my receding hairline starting from the fronto-temporal angles at a very early age of 16, but never really cared to do anything about it till the age of 25. Quite evidently my hairloss progression hadn't been aggressive till then.

At the age of 25 I had noticed my hairloss had gathered a bit of pace and I was losing more hair than before. Just 2 months after that I had a terrible episode of Telogen Effluvium which absolutely stripped me off from all over my head. I had read somewhere that although hair lost in Telogen effluvium do essentially come back after few months, the condition can fuel the progression of MPB. And this is what exactly happened to me. I lost considerable ground w.r.t. my hairline within a very short period which has never really recovered. It was then when I started doing yoga and taking care of my diet that I showed the first signs of recovery from TE. Gradually the diffuse loss started to recover but that rapid recession of hairline had me worried and made me hop on finasteride. Since then I've been taking the drug 1mg EOD. Haven't had any side effects till now. It seems to be working very well.

I'm find myself fortunate enough to have the conscience to be aware about my hair situation. But if you ask me I wouldn't say I'm happy with the hairline I have tbh. My right corner has receded more than the left. But my temples have slightly washed off which doesn't complement my sharp features. I always have to be wary of how my hair is holding on top of my head which I find really annoying.  A little wind or sweat can make it look bad, especially when it is cut short.

But I'm not contemplating a transplant anytime soon, at least not until I reach 30. I fully understand that hair transplant is rather a marathon and not a sprint. I wouldn't want to compromise my donor for a hasty move that I might regret in the future. On top of that I only have an okay donor. My hairs are pretty thin, one of the thinnest you can find meaning more grafts needed for more optimal coverage. My skin being on the fairer side, the contrast between my dark brown hair and the scalp is also not helping the cause. There is a bit of retrogradation in my nape as well. Therefore, it is very important that I be sensible with my future plan. I do have a good, thick beard though it is quite different in texture and colour from my scalp hair.

For now I'm happy to maintain whatever I have with medication. I continue to do yoga and maintain a healthy lifestyle. I do not have an active social life at present as most of my time is spent in my research studies. I'm not active on any social media as well. So, I don't feel the need to flaunt a good hairline for the time being.

Hair situation during Telogen effluvium onslaught:

Recovery from TE and just before starting finasteride:

My hair now, right temple:

Left temple:

Front on:

Some of the questions and doubts that I have are:

1. Can temples be restored using minoxidil? How effective is it on the same? Personally I'm not a big fan of minoxidil as a long term treatment since I find many people to develop tolerance to the medication after some time. 

2. Is microneedling effective in the temples? If so, what do you feel should be the frequency?

3. How will a transplant to refine my hairline and temples after few years place me in the long haul? If I do it, then it will be Eugenix since I found no other clinic in India to be trustworthy as per my research.

I would greatly appreciate some sage advice here.

Welcome to the forum and hopefully you find it continues to be as helpful as i have found it. 

Regarding things you could try. 

Increasing Finasteride to 1mg/day or just adding it 1x more till you notice a slow down. 

Onto the thing about Minoxidil. It's not that it stops working for people per se. It's actually to do with a progression of male pattern hairloss. So if you are using Finasteride, then use topical Minoxidil on the temporal areas and points as well as a bit on the frontal area, you can probably target those areas better. Also, adding Microneedling can help stimulate growth into those areas at 1-1.5mm 1x a week. 

If you have telogen effluvium, and are suffering from MPB, this means you still lose ground and what you think was just telogen effluvium is lost because of the progression of the hair loss at the same time. 

It's good that you don't want to rush into anything, but you can try treatments for perhaps 12 months before seeing what final results you can maximise from those and if your hair loss progression has stopped or slowed. 

Edited January 23, 2022 by NARMAK

[Drish]

9 minutes ago, NARMAK said:

Welcome to the forum and hopefully you find it continues to be as helpful as i have found it. 

Regarding things you could try. You never mentioned about Finasteride. Are you using it at all? If not, it's probably the very first thing you should be using. 

Onto the thing about Minoxidil. It's not that it stops working for people per se. It's actually to do with a progression of male pattern hairloss. So if you are using Finasteride, then use topical Minoxidil on the temporal areas and points as well as a bit on the frontal area, you can probably target those areas better. Also, adding Microneedling can help stimulate growth into those areas at 1-1.5mm 1x a week. 

If you have telogen effluvium, and are suffering from MPB, this means you still lose ground and what you think was just telogen effluvium is lost because of the progression of the hair loss at the same time. 

It's good that you don't want to rush into anything, but you can try treatments for perhaps 12 months before seeing what final results you can maximise from those and if your hair loss progression has stopped or slowed. 

Hi. Thank you for your feedback. I have recovered from TE a while back and have been taking finasteride 1mg EOD for about 1.5 years as I have mentioned in my post (3rd paragraph). My hairloss is currently stable. I just wanted some improvement in my hairline, fronto-temporal angles and my temples. My forehead looks big when it is not camouflaged properly or when I have my hair short.

Edited January 23, 2022 by Drish

[gillenator]

Based on the photos, you have very mild recession on your hairline…actually, it looks more like a progression into an adult hairline, nothing more…what condition is your crown?

[NARMAK]

1 minute ago, Drish said:

Hi. Thank you for your feedback. I have recovered from TE a while back and have been taking finasteride 1mg EOD as I have mentioned in my post (3rd paragraph). My hairloss is currently stable. I just wanted some improvement in my hairline, fronto-temporal angles and my temples. My forehead looks big when it is not camouflaged properly or when I have my hair short.

You said that you noticed hair loss progression despite the Finasteride. Because you are taking it EOD, maybe increasing it by 1 more day could help but it is a wait and see approach because hair cycles have a 3 month cycle. Personally i think if you can handle 1mg/day without noticeable side affects, it is better to take that dosage because you will be blocking as maximum DHT as possible with Finasteride. 

Your picture where you furrow your brow and show your top hairline where it naturally will look realistic. It's usually maybe 1 finger/half inch above in a mature hairline. For you, any future transplant if you are stable around 30 and stay lookinh like now, they could maybe lower and fill in the temporal angles and the frontal hairline to be done a bit. 

Ultimately everybody has a different natural position for hairlines. Some are low, some are medium and some are high. All determined by the frontalis muscles as to how much you should lower it. 

You look like a Norwood 1.5 but since that's not an official classification they'll say Norwood 2. I'd just recommend adding Microneedling to your routine and maybe leave Minoxodil for just some areas if you want and decide whether you want a hair transplant when the age comes. 

[Drish]

30 minutes ago, gillenator said:

Based on the photos, you have very mild recession on your hairline…actually, it looks more like a progression into an adult hairline, nothing more…what condition is your crown?

The angles at which I took the photos might be deceiving but it is certainly a bit more than mild recession. Here is how it looks when I pull my hair back. Crown is fine as of now.

Edited January 23, 2022 by Drish

[NARMAK]

33 minutes ago, Drish said:

The angles at which I took the photos might be deceiving but it is certainly a bit more than mild recession. Here is how it looks when I pull my hair back. Crown is fine as of now.

Stay on the medication, maybe increase to 1mg/day and see how things progress over the next few years. For what you want, to re-frame the frontal hairline and essentially to have hair where there isn't any, it needs to be a transplant. 

Wait about 6 months or so and see how the hair loss situations changing and maybe start saving. Eugenix Hair Sciences is on your doorstep and probably the best place for you to head. 

[AlexMeister21]

Minoxidil or microneedling probably won't do much for your temples. Your hair's in good shape at the moment and you'd probably be fine by the time you're 30, when you indicated you would be considering a transplant. It looks like you'd be able to get some grafts from your beard as well if you're considering a transplant in the future.

[gillenator]

Ok, now I see more recessionary loss.