advice needed 24m

[Charlie]

hi my name is Charlie and im 24, I’d say my hair loss started when I was 18/19. I’d consider myself a nw2.5/3, been thinking about a transplant to fix my hairline for the past couple years and looking to book one in for Jan 2023. I’d appreciate any advice for drs and clinics in the UK as I don’t want to travel abroad for the procedure.

I’ve been on finasteride for 10 months and in the that time I think my hair loss has stabilised as I don’t have much hair fall. Recently started oral minoxidil and currently 2 months in with no regrowth as of yet.

one clinic I have come across is HQ transplant in Cardiff with dr Milin, they seem to be a fairly new clinic with some good results on their Instagram page. The clinic is run by a former all black rugby player (Xavier rush). 

Family history - 

my dad is 55 with a receding hairline (nw3) with some slight thinning on the crown, but overall a decent head of hair for his age.

my maternal grandfather was a nw3/3a? At 60ish (pic included). He was a high Norwood in his late years (80+) with just his forelock remaining.

 

[hairman22]

your hairloss seems like it may well follow your dad's.

 

Yeah i think your good to get a transplant

[Charlie]

I’m confused as my hair is naturally curly/ wavy like my grandfathers whereas my dads is pretty straight. is it possible to have hair characteristics of one relative and follow a pattern of loss with another?

[JoeMan]

Honestly I think your hair looks fine. I'd wait a bit for a HT. Sure it's maturing some but you'll grow into this look by 30. At 35 you don't want a low hairline anymore as it's very uncommon to not have any recession. 

[LaserCaps]

Given your family history and think it's smart to start - or be on - a medical regimen.  Propecia/Rogaine, most believe, are the best meds out there for retention in the crown.  The problem is expectation.  Most people become frustrated when they see no visual change - not understanding - the meds are not intended for you to grow anything.  Rather, they are to help you retain.  If a year later you look the same, the meds did what they were intended to do.

As you know, there are two types of loss. The type you see and the type you don't.  The hair you see on the pillowcase, sink, etc. Normal.  The follicle gets tired of producing hair, and it goes into a resting period.  3-4 months later the hair returns.  This will happen randomly to all the hair in your head.  Hair loss is different, you don't see it.

Go under a bright light and start looking at the hair in your temporal areas.  You'll notice some thick strands.  Others not so much.  The caliber of the hair is so fine in some - eventually the hair withers away and disappears.  That's hair loss.  PRP/Laser can help reverse the thinning. Perhaps adding these modalities would not be a bad idea. All modalities work in different ways and are thus synergistic when used simultaneously.

Give yourself time.  Give the meds time.  With the hair you currently have, I would hold off doing any transplants.

[Mike10]

You are between NW1-NW2. At this young age and that NW class, you should absolutely not have a HT!

I would not even recommend medication. 

[Charlie]

1 hour ago, Mike10 said:

You are between NW1-NW2. At this young age and that NW class, you should absolutely not have a HT!

I would not even recommend medication. 

it’s the unevenness that bothers me. combined with fin and small HT of 1k-2k to create a natural dense hairline, wouldn’t  I be set for 10 years +? 
 

i don’t want to rush into anything so if that’s flawed / stupid let me know 😅

[JoeMan]

Well I'm not sure that you are fully considering the risks involved in such a procedure. Things can go wrong and you can look way worse than you do now. With your level of hair loss, the risk really isn't worth it in my opinion. 

To say you'll be set for 10 years is an unknown. Since your family history doesn't have much hair loss, this might be true but you never really know what will take place. 

If it was me I'd hold off a couple of years at least.

[Dillpickle123]

I would say first get on fin for a year then research clinics enquiring about a ht you probably only need 1000-1500 grafts to fix the unevenness there’s great doctors in Europe 

[Mike10]

13 hours ago, Charlie said:

it’s the unevenness that bothers me. combined with fin and small HT of 1k-2k to create a natural dense hairline, wouldn’t  I be set for 10 years +? 
 

i don’t want to rush into anything so if that’s flawed / stupid let me know 😅

It is flawed but it would take too much time for me to go into the reasons. There is no uneveness, your hair line is natural. Keep in mind that HT will not achieve natural density. You are set right right now as you basically have a full head of time. The issue is in your head and not real.

 

[TheGreatPretender]

No way. 

I wish I had as much as you have at your age. A hair transplant will not make your hair look like it did before or even as good by rule of thumb, a hair transplant is in essence the ilusion of density rather than the density itself. UK clinics are the last place where you want to be for HTs too but at your age you are fine. Also you are already on Finasteride which can even give you improvements until 24 months alongside oral Minoxidil (if you can tolerate). 

Honestly in my understanding if you are on medication at this stage I am prety certain you will be set for life with no need of surgery in one lifetime and if you feel like you lack hair in certain spots you can always grow it longer to conceal it without much effort.

[Charlie]

16 hours ago, TheGreatPretender said:

No way. 

I wish I had as much as you have at your age. A hair transplant will not make your hair look like it did before or even as good by rule of thumb, a hair transplant is in essence the ilusion of density rather than the density itself. UK clinics are the last place where you want to be for HTs too but at your age you are fine. Also you are already on Finasteride which can even give you improvements until 24 months alongside oral Minoxidil (if you can tolerate). 

Honestly in my understanding if you are on medication at this stage I am prety certain you will be set for life with no need of surgery in one lifetime and if you feel like you lack hair in certain spots you can always grow it longer to conceal it without much effort.

If you’re certain I will maintain what’s wrong with touching up the hairline and adding a few grafts?

[TheGreatPretender]

7 minutes ago, Charlie said:

If you’re certain I will maintain what’s wrong with touching up the hairline and adding a few grafts?

I feel like it's to early of a stage for you though even in that aspect. 

For one you mentioned that you have been on Fin for 10 months, I would say it can take until two years to get optimal results. Even if not likely you may even regrow at that time making a potencial surgery pointless. 

But even adding some small grafts does come with a risk not even to mention the cost I'm which the trade-off from pros and cons I think it's not worth taking the surgical route atm. 

Edited March 21, 2022 by TheGreatPretender

[Charlie]

12 minutes ago, TheGreatPretender said:

I feel like it's to early of a stage for you though even in that aspect. 

For one you mentioned that you have been on Fin for 10 months, I would say it can take until two years to get optimal results. Even if not likely you may even regrow at that time making a potencial surgery pointless. 

But even adding some small grafts does come with a risk not even to mention the cost I'm which the trade-off from pros and cons I think it's not worth taking the surgical route atm. 

I understand where you are coming from, I think it’s clear my hair loss will be slow and progressive having no bald relatives. it’s just something that bothers me everyday, when I can use that mental energy to use elsewhere in my life. So if having to pay 5k~ for some mental peace for 5-10 years Id take that 

[TheGreatPretender]

8 minutes ago, Charlie said:

I understand where you are coming from, I think it’s clear my hair loss will be slow and progressive having no bald relatives. it’s just something that bothers me everyday, when I can use that mental energy to use elsewhere in my life. So if having to pay 5k~ for some mental peace for 5-10 years Id take that 

You may not bald at all. My stance on your case is mostly due to the work that goes in getting the right call when doing a surgery. 

Remember that there are no guarantees when doing a HT and if for example it fails that means you have a % of hairs that you would permanently lose as part of that even if the doctor agrees a touch up. 

There is also shock loss which may happen in your donor and/or recipient in which the native follicles get through trauma for a specific amount of time before coming back. If you chose a poor/unethical clinic you may even face serious health issues as this isn't like going to a dentist to get your teeth done. 

I am not obviously trying to fearmonger or force a decision upon you, at the end of the day it's your call. 

If you are looking to do some research for some good clinics look for some recommended names here for Europe and avoid the UK if possible, I know it's hard because I live in there as well but there are far Better options for yourself overseas. Bruno Ferreira/Bruno Pinto for Portugal, Lorenzo, De Freitas, Ximena Villa for Spain just as examples. Turkey has Dr Bicer.

These are just some examples, there are more if you search in this forum. 

[Nw7HPE]

It is always your call and this is a personal thing but If it were me I would wait at least for a couple of more years and monitor the process . 

[Gatsby]

It can take up to two years to see the benefits of Finasteride. You have no fixed future pattern of hair loss for an ethical surgeon to even know where to begin surgery on you? Adding grafts at your age with your hair style doesn’t work like that. A successful transplant is the ability to achieve the illusion of naturalness. You already have that but it’s not an illusion. It’s real. Trust me from my own painful and expensive mistakes. If you try and get a surgeon to agree on cutting you now you will be regretting this for the rest of your life. 

[Ryan Daniel]

Stay on Finasteride, even more if you are fine living with it. The main point of the medication is to completely slowdown hair loss or even stop it for some years

On the rare occasion it may grow hair that was miniaturized and may also thicken up hair that looks like it was thinned or unhealthy

[Charlie]

I appreciate the advice everyone, I think I’ll hold off for atleast another year to give the meds a chance and educate myself a bit more on HTs.

[Mike10]

I do not even think Finansteride should be prescribed in such a case. I really do not

[Charlie]

14 minutes ago, Mike10 said:

I do not even think Finansteride should be prescribed in such a case. I really do not

why do you think this? its clearly receding 

[Mike10]

1 hour ago, Charlie said:

why do you think this? its clearly receding 

Because Fina has sides and you basiscally have a full head of hair. Finansteride works best in the middle and the crown. in a lot of cases  it does not even work for temples recession. 

And based on my experience. Temples started to recede at age 23. At 40 I still only have temples recession, like NW2,5. And I never took Fin

 

[TheGreatPretender]

1 hour ago, Mike10 said:

Because Fina has sides and you basiscally have a full head of hair. Finansteride works best in the middle and the crown. in a lot of cases  it does not even work for temples recession. 

And based on my experience. Temples started to recede at age 23. At 40 I still only have temples recession, like NW2,5. And I never took Fin

 

If one has MPB and is losing hair than Finasteride is an absolute must unless for any reason this is not the case. 

Anyway I am 27, I became prety much a NW5 diffused at 20 so dont count starting later as a guarantee to not lose any further. 

Also, after puberty it is more than safe to start treatment, ideal even especially if you start losing at such an age.

The truth about Hair Loss is that it is unpredictable, it can strike at any age young or old especially with a family history of parents,uncles,cousins that hold such a problem. 

Starting Finasteride is the best thing OP did and the decision to hold on the transplant for now is even better. I am sure he will be more than happy to keep his hair for years to come down the road. 

[Mike10]

21 hours ago, TheGreatPretender said:

If one has MPB and is losing hair than Finasteride is an absolute must unless for any reason this is not the case. 

Anyway I am 27, I became prety much a NW5 diffused at 20 so dont count starting later as a guarantee to not lose any further. 

Also, after puberty it is more than safe to start treatment, ideal even especially if you start losing at such an age.

The truth about Hair Loss is that it is unpredictable, it can strike at any age young or old especially with a family history of parents,uncles,cousins that hold such a problem. 

Starting Finasteride is the best thing OP did and the decision to hold on the transplant for now is even better. I am sure he will be more than happy to keep his hair for years to come down the road. 

Did you even read what I wrote? Well you do whatever you do. I stand by my position.  

[TheGreatPretender]

14 minutes ago, Mike10 said:

Did you even read what I wrote? Well you do whatever you do. I stand by my position.  

Yes I did and my argument stands. 

The process is simple, once you see that you have MPB you start medication and if you find side effects you stop it, its as simple as it is. 

Having MPB at an early age and plan to take it later only increases the risk of being it too late once you start having real trouble to the point you cant even style your hair appropriately while going outside. You would rather start early than late, especially considering that the majority of people does respond well to the medication and barely has any issues while taking it. 

The only reason I find advisable to delay starting is if you still havent matured or havent finished puberty, other than that there arent any good reasons to the point I can recommend people not try it.

Another thing, Finasteride is good for every single part of your hair, not only the crown or Middle and it has been proven time after time that is the best medication available to stop Hair Loss at its tracks. Your case is an optimistic one because you started receding by 23 at the temples, a lot of people lose everything by then in that area from all sides like me. Why run the risk if you are likely to benefit from a medication that is intended to give you the peace of mind that you need for years to come in protecting your hair?

Edited March 22, 2022 by TheGreatPretender