Is it possible to be a candidate with my donor?

[eccoj]

There's a lot of area to cover, especially considering I'm only 26, and the donor area looks very thin, probably because of retrogade alopecia. I just want to know if there's any possibilities of getting a healthy hairline and healthy looking hair with what I have. If not, I'm comfortable shaving it. I've come to terms that it's probably not in the cards for me, but I'd like some opinions before writing it off completely. Thank you!

 

 

 

 

Edited February 25, 2022 by eccoj

[NARMAK]

Are you actively taking any medication? 

The retrograde alopecia isn't probably a great sign for any potential hair transplant but if you hope on medication and add some Microneedling into the mix, you can probably get some solid regrowth on the top of the scalp. Give it circa 12 months and you'll probably be able to get some consultations with some of the forum recommended doctors and save up if it is potentially possible for you. 

Medication is definitely step 1 though. 

[JoeMan]

I'd also add that if you are comfortable shaving then this is certainly the best solution. 

[eccoj]

@NARMAKI have been on and off of minoxidil for about 7 years now. There have been 4-5 times where I completely stopped applying it for months or years at a time and my situation worsened, and any application after that didn't really seem to help that much. Right now, I've been using it 1-2 times a day for a few months, but I'm convinced there's no difference, and that there probably won't be any either.

I've been told I could try fin, but my worry is that if I manage to get a decent hair state with it, and then get a HT I will be dependent on continuing to take it. If there are any side effects and I have to stop taking it, and then my RA worsens, leaving no donors left, while my transplant area thins as well... I am scared of being left with a bad looking result. I am open to changing my mind on this, it's just a fear of mine.

I haven't tried microneedling, I might look into it if it's going to give me results.

Edited February 25, 2022 by eccoj

[eccoj]

I am comfortable shaving it @JoeMan, I've tried the look and it looks decent on me. It's just that because of my age I do thing that hair would look better. If anything I just want to get some closure on this, so that if there's nothing to be done I can shave without any second thoughts.

[JoeMan]

Unfortunately you're very young for such aggressive hair loss. Medication should be tried 1st to at least stabilize your hair. After about a year on medication, I'd reach out to Eugenix as they seem to be the best for difficult cases. All of that being said, obviously you need to balance the risk/reward though. Shaving is always a cheap and easy option. 

If you go the surgery route, shaving may not be an option anymore so you really need to stabilize your hair loss before looking for surgery. 

[NARMAK]

11 minutes ago, eccoj said:

@NARMAKI have been on and off of minoxidil for about 7 years now. There have been 4-5 times where I completely stopped applying it for months or years at a time and my situation worsened, and any application after that didn't really seem to help that much. Right now, I've been using it 1-2 times a day for a few months, but I'm convinced there's no difference, and that there probably won't be any either.

I've been told I could try fin, but my worry is that if I manage to get a decent hair state with it, and then get a HT I will be dependent on continuing to take it. If there are any side effects and I have to stop taking it, and then my RA worsens, leaving no donors left, while my transplant area thins as well... I am scared of being left with a bad looking result. I am open to changing my mind on this, it's just a fear of mine.

I haven't tried microneedling, I might look into it if it's going to give me results.

I would honestly say to try Finasteride firstly and if no sides, then you can evaluate in 12 months. With Minoxidil, the key is consistency and its usually harder to adhere to with for most people i think but if you are going to commit, it has to be fully. 

To start Finasteride, maybe 1mg every other day and see how you get on. You can increase the dosage later. 

Ultimately it is something you use for as long as you want to maintain your hair. Same with Minoxodil. Adding Microneedling with a derma pen into the mix with Minoxidil and Nizoral should give you a better chance. 

Also, as a final note, hair shedding and regrowing is common which is why you should be consistent, stay the course and evaluate monthly with progress pics/video and hopefully it will show you improvements even little by little. 

I just looked at my own progress pictures/video from Month 1 to Month 9 and there was definite signs of improvement. Even if they seem marginal in some cases. 

[eccoj]

That is a worry of mine @JoeMan, on a scale of 1-10 it would be:
1-botched transplant
2- HT that looks thin and unhealthy (which is very possible given what I have),
3-having to shave with scars from HT
7.5-shaving
10-good HT results

if the last one is impossible or too much of a gamble, I'd rather stick with shaving. It's not the best, but that's the hand I've been dealt.

[Bandit90]

Feel your situation being in your mid 20's and bald. I would certainly stress the following points. 

1. Get on finasteride and stableize the hair loss. Being aged 26 you still have potential to lose more. 

2. Educate your self, get a realistic expectation of what can be achieved with a HT. Look at forum members who have had to use beard hair in combo with scalp hair. 

3. Reach out to a reputable surgeon. One who has a proven track record of restoring higher norwoods. 

You may not be the most ideal candidate for a HT, but we have seen plenty of forum members who have gone to achieve amazing results. There has been a paradigm shift in recent years, with surgeons utilising beard hair in higher norwoords, to get much more coverage. From your pictures it looks like you have a strong beard, which can only work in your favour (under a good surgeon). 

 

[eccoj]

@NARMAKI am open to trying this, if maintaining my current hair state, or making it slightly better (which is the most I can hope for from what I understand) puts me in a good place for a HT that will look healthy and full. I'd honestly prefer not to put myself through some of these risks if all I can hope for is a subpar result.

I am not going to lie and pretend some of the stories about post finasteride syndrome haven't scared me, but I understand the research isn't that conclusive on this.

[Bandit90]

2 minutes ago, eccoj said:

@NARMAKI am open to trying this, if maintaining my current hair state, or making it slightly better (which is the most I can hope for from what I understand) puts me in a good place for a HT that will look healthy and full. I'd honestly prefer not to put myself through some of these risks if all I can hope for is a subpar result.

I am not going to lie and pretend some of the stories about post finasteride syndrome haven't scared me, but I understand the research isn't that conclusive on this.

i'm 32 I've taken Propecia for six years (so would have started at roughly your age). I've never had any side effects and also had two healthy baby boys with my wife. That't not to say that you wont get any side effects. But I just thought i'd say that many men of your age take the medication daily without any issue. 

You could start taking a microdose of 0.25mg  every other day, see if you don't get any sides and then taper up to 0.5mg a day. If your really set against taking oral finasteride then there are topical versions you can purchase. 

[eccoj]

Thank you @Bandit90, I've been snooping around hair loss forums for years now, so I have seen some of these amazing results you mention. The thing is I don't remember ever seeing anyone who has achieved those having my level of retrograde alopecia. This does bring my expectations quite a bit lower than what they would be. If I were to get it done it would be by a reputable surgeon with experience with similar cases, because I do think I would need every bit of help I could get.

Finasteride is a touchy subject, like I mentioned previously. I do worry about its side effects, but even more than that I worry about them appearing after I've had my HT, and having to stop using it then, which would mess up the whole transplant. Even if they never appear though, I'm doubtful of whether my RA (assuming it doesn't get better somehow, but I doubt it because I understand fin mainly restores and maintains the crown area) would allow me to have satisfactory results, even with beard hair in the mix.

Edit: I realize I might sound like I'm in denial about some of the advice I get here. That is not the case, I am  considering everything I read. I just have a lot of doubts of the kind of results I can achieve.

Edited February 25, 2022 by eccoj

[Fue3361]

Take Fin and see if you even have side effects.  Maybe you won’t and you’ll be fine with taking it long term.  That would be the first step.

[Bandit90]

4 minutes ago, eccoj said:

Thank you @Bandit90, I've been snooping around hair loss forums for years now, so I have seen some of these amazing results you mention. The thing is I don't remember ever seeing anyone who has achieved those having my level of retrograde alopecia. This does bring my expectations quite a bit lower than what they would be. If I were to get it done it would be by a reputable surgeon with experience with similar cases, because I do think I would need every bit of help I could get.

Finasteride is a touchy subject, like I mentioned previously. I do worry about its side effects, but even more than that I worry about them appearing after I've had my HT, and having to stop using it then, which would mess up the whole transplant. Even if they never appear though, I'm doubtful of whether my RA (assuming it doesn't get better somehow, but I doubt it because I understand fin mainly restores and maintains the crown area) would allow me to have satisfactory results, even with beard hair in the mix.

The way I see it is that you need get stable on fin ASAP. Then when donor is stable the surgeon will know what they have to work with. There are plenty of forum members that have retrograde and have had HT.

I personally think you should consult with a surgeon who can handle higher norwoods and get their thoughts, they will give you a clear cut plan going forward. 

In terms of fin, why don't you just start really low dose at 0.25mg every other day. Evaluate at one month, Then if no sides do 0.5 every other day. Evaluate in one month again. I was like yourself got myself caught up in knots delaying taking Fin and as a result lost valuable hair. If you want to have a HT you need to let you mind be at ease with taking Fin.

[NARMAK]

13 minutes ago, eccoj said:

@NARMAKI am open to trying this, if maintaining my current hair state, or making it slightly better (which is the most I can hope for from what I understand) puts me in a good place for a HT that will look healthy and full. I'd honestly prefer not to put myself through some of these risks if all I can hope for is a subpar result.

I am not going to lie and pretend some of the stories about post finasteride syndrome haven't scared me, but I understand the research isn't that conclusive on this.

I was exactly where you are, probably even younger than where you are when that thought hit me. From 21ish i knew a bit about Finasteride but then people talking about sexual side affects and how as a young guy in my mind i was like, "I'd rather be bald than my penis stop working" and so those scaremongering stories kept me away. It's only from when i was finally 31ish, that i saw my brother had been using Dutasteride for a year, had no sexual sides and basically started doing my research again. 

Finasteride specifically has a safety profile tracked over 20+ years now, prescribed to millions of men yearly and the sides are probably manageable for 98% of users. By that i mean you may experience mild symptoms and then over time these can abate or be within a tolerance. 

Personally i went nuclear and straight to Dutasteride which is 90% serum DHT reduction in the body and circa 51% for scalp DHT. I felt like i was already gonna be playing catch up so probably went to the strongest option off the bat. Now, i will admit i did have some side affects. Slight brain fog, lower libido and probably a little bit more irritated with things resulting from slight mood changes. However, bear in mind i went straight to 0.5mg/day rather than taper in the use. After about 2-3 months and especially now at 9 months later, i can confidently say my body has levelled out and libido has probably rebounded a bit, mood does not really change the same way but tbh, it's not 100% to separate things because i was dealing with stress in my life initially around that time too. Brain fog i would say was mild but i'm fairly confident to say its mostly cleared. 

I've kept progress pictures for a bit monthly and then switched to videos and last one had maybe a 2-3 month difference because i started taking em less. I definitely had improvement but just be aware, the primary goal of Finasteride is to stop you losing what you have, save what it can and if you're lucky to regrow bits. Minoxidil in combination with Microneedling however is the real growth protocol alongside Nizoral shampoo which contains 2% ketoconazole. 

As i said, being committed is the first step to a proper regimen for as long as you actually want to maintain. 

Also, i do think you have a few things going against you atm which are your age of 26 and the aggressive hair loss mixed with retrograde alopecia from what i can see. So it's best to maybe try medication for a solid straight 12 months, save up and do consultations. If at the end of the 12 months you decide to rock a buzz cut/shaved look, at least you got a nice pot of cash to do something with too. 

[eccoj]

4 minutes ago, NARMAK said:

I was exactly where you are, probably even younger than where you are when that thought hit me. From 21ish i knew a bit about Finasteride but then people talking about sexual side affects and how as a young guy in my mind i was like, "I'd rather be bald than my penis stop working" and so those scaremongering stories kept me away. It's only from when i was finally 31ish, that i saw my brother had been using Dutasteride for a year, had no sexual sides and basically started doing my research again. 

Finasteride specifically has a safety profile tracked over 20+ years now, prescribed to millions of men yearly and the sides are probably manageable for 98% of users. By that i mean you may experience mild symptoms and then over time these can abate or be within a tolerance. 

Personally i went nuclear and straight to Dutasteride which is 90% serum DHT reduction in the body and circa 51% for scalp DHT. I felt like i was already gonna be playing catch up so probably went to the strongest option off the bat. Now, i will admit i did have some side affects. Slight brain fog, lower libido and probably a little bit more irritated with things resulting from slight mood changes. However, bear in mind i went straight to 0.5mg/day rather than taper in the use. After about 2-3 months and especially now at 9 months later, i can confidently say my body has levelled out and libido has probably rebounded a bit, mood does not really change the same way but tbh, it's not 100% to separate things because i was dealing with stress in my life initially around that time too. Brain fog i would say was mild but i'm fairly confident to say its mostly cleared. 

I've kept progress pictures for a bit monthly and then switched to videos and last one had maybe a 2-3 month difference because i started taking em less. I definitely had improvement but just be aware, the primary goal of Finasteride is to stop you losing what you have, save what it can and if you're lucky to regrow bits. Minoxidil in combination with Microneedling however is the real growth protocol alongside Nizoral shampoo which contains 2% ketoconazole. 

As i said, being committed is the first step to a proper regimen for as long as you actually want to maintain. 

Also, i do think you have a few things going against you atm which are your age of 26 and the aggressive hair loss mixed with retrograde alopecia from what i can see. So it's best to maybe try medication for a solid straight 12 months, save up and do consultations. If at the end of the 12 months you decide to rock a buzz cut/shaved look, at least you got a nice pot of cash to do something with too. 

Thank you for the advice, seeing as many people have recommended this route I will look into starting taking fin and tapering to a normal dose. One question i have though, do you know of cases that have had side effects appear years after they started taking it? That is what really worries me, that I'll have to stop using it after getting a HT.

[NARMAK]

5 minutes ago, eccoj said:

Thank you for the advice, seeing as many people have recommended this route I will look into starting taking fin and tapering to a normal dose. One question i have though, do you know of cases that have had side effects appear years after they started taking it? That is what really worries me, that I'll have to stop using it after getting a HT.

I will not lie to you, i think there are cases that have happened but they're probably very rare and it's also worth noting sometimes the side affects are usually an indication something else is awry. 

Before i started Dutasteride, i had a blood test done close to that time which picked up a Vitamin D deficiency which also plays a part in hair loss. I had an inflamed itchy scalp and Nizoral may have helped a bit but T-gel seems to have been the real catalyst in treating it more effectively. 

The horror stories are firstly to put it into perspective from 2% of patients of which the vast majority once they discontinue Finasteride return to normal within 12 months or much sooner. Usually the guys who also get side affects tend to have other issues too it seems although to get PFS levels of sides you'd have to be extremely unlucky. That said, another HUGE factor imo of people getting sides is probably how if you focus enough to expect them mentally, you will probably manifest some things. That's why i would say having confidence and positivity in it as a treatment is firstly important. The US lawsuits as well claimed from an emotional PoV which is why they succeeded it seema rather than fully scientific backed merits where PFS is concerned too imo. 

The BS around Finasteride etc. usually is followed by an attempt by a lot to try sell you alternative "natural" products which is basically snakeoil sales man BS and they dress it up using weak scientific studies. 

[Rahal Hair Transplant]

Eccoj,

Given the Area of balding and the thinner looking donor area, even if you are a candidate for hair transplant surgery, I’m not sure that you will be satisfied with what can be accomplished.  Some of this will pass of the tens I’m gonna not you’re currently using hair loss medication and if it is working to stabilize its progression.

Assuming that you’ve been able to stabilize your hair loss and that you have enough donor hair, you would have to have realistic expectations as a what can be accomplished. For example, I would suggest re-creating a mature looking hairline and focus most of the procedure on the front and midsection.

I hope this helps.

Rahal Hair Transplant 

[TorontoMan]

I agree with the comment above. In my opinion you should avoid surgery as it won't match your expectation and you will be left with scars. 

[eccoj]

4 hours ago, NARMAK said:

I will not lie to you, i think there are cases that have happened but they're probably very rare and it's also worth noting sometimes the side affects are usually an indication something else is awry. 

Before i started Dutasteride, i had a blood test done close to that time which picked up a Vitamin D deficiency which also plays a part in hair loss. I had an inflamed itchy scalp and Nizoral may have helped a bit but T-gel seems to have been the real catalyst in treating it more effectively. 

The horror stories are firstly to put it into perspective from 2% of patients of which the vast majority once they discontinue Finasteride return to normal within 12 months or much sooner. Usually the guys who also get side affects tend to have other issues too it seems although to get PFS levels of sides you'd have to be extremely unlucky. That said, another HUGE factor imo of people getting sides is probably how if you focus enough to expect them mentally, you will probably manifest some things. That's why i would say having confidence and positivity in it as a treatment is firstly important. The US lawsuits as well claimed from an emotional PoV which is why they succeeded it seema rather than fully scientific backed merits where PFS is concerned too imo. 

The BS around Finasteride etc. usually is followed by an attempt by a lot to try sell you alternative "natural" products which is basically snakeoil sales man BS and they dress it up using weak scientific studies. 

I also have a very serious vitamin D deficiency that I actually only noticed and started treating a month ago, but that I suspect has been there for years. I didn't know of its effect on hair but thinking back it could be another reason how I got here. I had like 8ng/mg which I think is like 1/4th of the lowest levels of what is considered "normal".

You have picked my interest a bit on what will happen if I take medication seriously. I wonder what results I could see in a year. Obviously nothing mind blowing, but I wonder if I could go around without shaving my head. I guess it will depend on how I respond to minoxidil, since I have messed up using it. I imagine I cant regain long lost hair, like I had when I first used it, but hopefully there will be some progress.

Edited February 25, 2022 by eccoj

[NARMAK]

Just now, eccoj said:

I also have a very serious vitamin D deficiancy that I actually only noticed and started trating a month ago, but that I suspect has been ther for years. I didn't know of it effect on hair but thinking back it coul dbe another reason how I got here. I had like 8ng/mg which I think is like 1/4th of the lowest levels of what is considered "normal".

You have picked my interest a bit on what will happen if I take medication seriously. I wonder what results I could see in a year. Obviously nothing mind blowing, but I wonder if I could go around without shaving my head. I guess it will depend on how I respond to minoxidil, since I have messed up using it. I imagine I cant regain long lost hair, like when I first used it, but hopefully there will be some progress.

Give a go with the following:

Finasteride, Minoxidil and Microneedling 1x a week at 1-1.5mm with Nizoral shampoo 1-3x a week. You leave the Nizoral on the area for like 5-10 mins and it should be fine. 

Vitamin D being addressed will definitely help but you definitely need to give the above a full 12 months. Take a repeatable picture from multiple angles of the frontal hairline, temple points, crown etc. 1x a month and hopefully at the end of the 12 months there's an appreciable difference. 

If not, at least you tried and gave it your all. You never know how you might respond until you try. I have seen some ridiculously hopeless looking cases that regained in areas i thought hair didn't even exist anymore. 

[eccoj]

2 hours ago, Rahal Hair Transplant said:

Eccoj,

Given the Area of balding and the thinner looking donor area, even if you are a candidate for hair transplant surgery, I’m not sure that you will be satisfied with what can be accomplished.  Some of this will pass of the tens I’m gonna not you’re currently using hair loss medication and if it is working to stabilize its progression.

Assuming that you’ve been able to stabilize your hair loss and that you have enough donor hair, you would have to have realistic expectations as a what can be accomplished. For example, I would suggest re-creating a mature looking hairline and focus most of the procedure on the front and midsection.

I hope this helps.

Rahal Hair Transplant 

Thank you for your input! My expectations were always that I would try to get a mature hairline, but it would also be important for me to have full coverage. If I udnerstand correctly your opinion is that this wouldn't be possible, or that the hair on the crown would be very thin and the scalp would be visible, correct?

[eccoj]

29 minutes ago, TorontoMan said:

I agree with the comment above. In my opinion you should avoid surgery as it won't match your expectation and you will be left with scars. 

That has been my gut instinct as well for the past couple of years. You see a miracle transformation every now and then and think that maybe there's hope, but if it's too much of a gamble,or if that kind of result is unrealistic, I'd ratheravoid it alltogether.

[TorontoMan]

1 hour ago, eccoj said:

That has been my gut instinct as well for the past couple of years. You see a miracle transformation every now and then and think that maybe there's hope, but if it's too much of a gamble,or if that kind of result is unrealistic, I'd ratheravoid it alltogether.

Yeah I’m sorry that this is the case, but it’s best you’re realistic. You’ll save yourself a lot of time, money, and emotion.. it’s just not worth it. Besides you have a great head shape and you mentioned you’re okay with the shaved look.. IMO that’s already a win.. move on from this 

[NARMAK]

1 hour ago, eccoj said:

That has been my gut instinct as well for the past couple of years. You see a miracle transformation every now and then and think that maybe there's hope, but if it's too much of a gamble,or if that kind of result is unrealistic, I'd ratheravoid it alltogether.

Don't imagine yourself as getting a miracle result and don't set any specific goals. Give it a total 12 month time frame to use medication etc. in the routine i mentioned and just get some advice from recommended surgeons who specialise in high Norwood cases and see what they say at the time. You should still actively save up though and if as i said you don't end up getting the transplant, you have a bunch of money to do whatever you want instead.