Hair has recently began to thin for first time in years - risky to get a HT?

[HelpfulFriend]

Hey guys,

My hair has recently started to noticeably thin for the first time in a long time.

I've been on Finasteride and monoxidil for 5 years, and microneedling for a few months - but noticed the temples starting to go not too long ago.

Ive attached some photos. The thinning bits on the side used to be uniform like the rest of my hair, and my dermatologist confirmed under magnification it's thinning there.

My question: is it risky to undergo a HT when we're actively thinning?

Cheers.

 

[NARMAK]

I would say if you are on medication and Minoxidil alongside Microneedling and noticing it thinning, you might benefit from trying to now switch to Dutasteride 0.5mg on some days. Some people introduce it 1x to 2x a week alongside Finasteride. 

Firstly, what is your Finasteride dose? 1mg everyday? 

Microneedling also will take longer than 2 months to show up as effective. You need to really allow a similar timescale of 12+ months to let results fully manifest. 

Overall you look like a Norwood 2, very early stages of hair loss and since you been on medication and stuff for 5 years, you done well to catch it where you did. 

If you haven't been using 1mg of Finasteride every day, then increasing the dose might help and you should be able to check in 3-6 months time, but you may be ready to switch to Dutasteride. 

[gillenator]

Based on the pics, there is diffused loss taking place in those areas and the most obvious risk as it relates to surgery would be shock loss.

[Mike10]

I would say it depends. How old are you now? Can you uoload some overhead pics? 

By the way, Fin often does not work in the temples area, works best for the middle and vertex.  

[Melvin- Admin]

How old are you?

[thetdog666]

I would look into starting avodart

[Ryan Daniel]

Finasteride for 5 years? Hmmm. 

Would like to know how old you are....  

I was going to say give the medication another year and then pull the trigger for transplantation..

[HelpfulFriend]

8 hours ago, Melvin- Moderator said:

How old are you?

 

6 hours ago, Ryan Daniel said:

Finasteride for 5 years? Hmmm. 

Would like to know how old you are....  

I was going to say give the medication another year and then pull the trigger for transplantation..

Forgot to mention, I just turned 31

[HelpfulFriend]

9 hours ago, gillenator said:

Based on the pics, there is diffused loss taking place in those areas and the most obvious risk as it relates to surgery would be shock loss.

Hey Gill, when you say diffuse, does this mean something different to normal androgenic alopecia? Or just localised thinning?

[HelpfulFriend]

10 hours ago, NARMAK said:

I would say if you are on medication and Minoxidil alongside Microneedling and noticing it thinning, you might benefit from trying to now switch to Dutasteride 0.5mg on some days. Some people introduce it 1x to 2x a week alongside Finasteride. 

Firstly, what is your Finasteride dose? 1mg everyday? 

Microneedling also will take longer than 2 months to show up as effective. You need to really allow a similar timescale of 12+ months to let results fully manifest. 

Overall you look like a Norwood 2, very early stages of hair loss and since you been on medication and stuff for 5 years, you done well to catch it where you did. 

If you haven't been using 1mg of Finasteride every day, then increasing the dose might help and you should be able to check in 3-6 months time, but you may be ready to switch to Dutasteride. 

I was thinking about adding DUT, just a bit hesitant to be honest. I have no FIN sides, but I'm unsure about suppressing so much DHT. Have you tried it? I've seen people have amazing results on it 

The pictures are kind in a way, because I cut off most of my head you can't see, but I'm probably closer to a NW3.

If anything dermarolling seemed to have accelerated the loss on my temples, but I may have done it too hard and caused a mini shed. I started after I was told it was thinning.

[Gatsby]

If this is the only hair loss you are experiencing then I would consider consulting with a good dermatologist on the benefits of either increasing your finasteride dose and/or using dutasteride. I think at this point surgery would be a big mistake. All the best.

[NARMAK]

17 minutes ago, HelpfulFriend said:

I was thinking about adding DUT, just a bit hesitant to be honest. I have no FIN sides, but I'm unsure about suppressing so much DHT. Have you tried it? I've seen people have amazing results on it 

The pictures are kind in a way, because I cut off most of my head you can't see, but I'm probably closer to a NW3.

If anything dermarolling seemed to have accelerated the loss on my temples, but I may have done it too hard and caused a mini shed. I started after I was told it was thinning.

In terms of Dutasteride. I actually skipped Finasteride entirely and went nuclear off the bat with 0.5mg everyday of Dutasteride. 

My primary reason was that my research led to me checking studies where scalp DHT was reduced 41% on Finasteride 1mg/day and 51% on Dutasteride 0.5mg/day. The difference in body serum DHT though is like 90% reduction which is why its probably got more side affects for a lot of people sensitive to those changes. 

Personally speaking i had sides that i was willing to tolerate. Those included lower libido, some brain fog and i would say my mood changed and this probably took my a month or so to start levelling off due to the reduced body serum DHT but now as i come to around Month 10 of using Dutasteride i would say things have rebounded a fair bit. I wouldn't say i have brain fog anymore really, not exactly the most remembering even before use so i'd say i'm back to that sorta ballpark. Libido definitely tracked back towards baseline. Not 100% there at all and probably won't be but between 70-80% now. Sometimes i think as we get older, we naturally have a reduction compared to our late teens and 20s though, so that's something to be mindful of too. That said, maybe i'd even say as low as 50-60% at times if i have stress in my life. Everything in terms of the plumbing however seems to work fine as they would say. However, i would strongly urge guys to workout and eat well, i'm trying to do that because it's also a big factor in that area. 

Overall, going nuclear with Dutasteride seems to be working out. I think i even saw some regrowth and managed to save hair that might have been on the cusp albeit i wish i had started on Finasteride maybe 10+ years ago and i wouldn't have been trying to play catch up with Dutasteride. 

Microneedling also requires time to work just like Finasteride and Minoxodil so should be evaluated over a 12+ month period. I would however say the positive thing about it is that you are more likely to get more "permanent" results that stick around once you stop using Microneedling unlike stopping Minoxodil i guess as long as you block DHT on the scalp. 

I would say to anybody coming from Finasteride. Taper the dosage. Start at 1x per week replacement and then 2x and so on, till you feel your body has levelled out and slowly adjusted to the reduced DHT and you can get a feel for any potential side affects. 

[Melvin- Admin]

51 minutes ago, HelpfulFriend said:

 

Forgot to mention, I just turned 31

At 31 it’s okay to proceed with an HT, but I would be careful being overly aggressive, especially if you’re losing ground on fin. Have you considered topical dut?

[Mike10]

It would be good to have some photos showing the top of the head and back of the head. It is necessary to determine whether you only have local thinning. 

[gillenator]

21 hours ago, HelpfulFriend said:

Hey Gill, when you say diffuse, does this mean something different to normal androgenic alopecia? Or just localised thinning?

Not different from AA, it’s just that those of us who have MPB (AA) experience hair loss primarily by either a diffused pattern of loss “or” by a recessionary pattern...ultimately it's the DHT that attaches to hair follicles and starts the miniaturization process thereby decreasing hair caliber (diffusion)...and as this progressive decrease in hair caliber continues, the hair shafts look thinner and thinner...this is what I see in your frontal zone, a diffused pattern of loss.