34 y/o male exploring options & seeking feedback

[exswimmerD]

Hello!

Long time lurker, first time poster. I'm a 33 y/o (soon to be 34) male who has been experiencing various degrees of hair loss since my early 20s. I've been on finasteride off and on since then (currently been using standard dose for about 5-6 years) and same with Minoxidil (currently using the foam product from Keeps). It seemed to be much worse than it is in my mid 20s before I was consistently using any medication, and I've been using DermMatch to fill in some of the thin spots for the last couple years. I've been noticing my hairline thinning out a bit more recently and was curious what suggestions anyone might have for where I am. We are our own worst critics so it'll be helpful for me to hear perspective from any of you that wish to share similar experiences. 

If you were in my shoes, would you consider a frontal hair system or am I a good candidate for a transplant? Or is it not bad enough and I should continue with DermMatch (or another product if there's something out there better)?

Any thoughts or feedback is appreciated!

- D

[AB2000]

It appears that you are close to being Norwood 4.  Having your hair out longer probably conceals the amount of thinning going on up top.  You are a better candidate for a HT than many of us who have gone ahead anyways.  In your case, since you are continuing to lose while on meds you have to expect that even with surgery you will just be making up ground that you are losing.

Edited April 11, 2022 by AB2000

[exswimmerD]

55 minutes ago, AB2000 said:

It appears that you are close to being Norwood 4.  Having your hair out longer probably conceals the amount of thinning going on up top.  You are a better candidate for a HT than many of us who have gone ahead anyways.  In your case, since you are continuing to lose even on meds you have to expect that even with surgery you will just be making up ground that you are losing.

Thank you for the quick reply! I’m hesitant to say I’m still thinning or if it’s just seasonal shedding (which does seem to happen to me every year). The guy who cuts my hair says it’s not gotten worse, but hard to say when I look at it & over analyze every day lol. 
 

What makes me a good candidate for HT?

I’m in Kentucky. Where do people typically start when looking at consultations? 

[NARMAK]

Hey OP, 

I would probably consider getting onto Dutasteride at least a few times a week instead of Finasteride or completely switch over. As for Minoxodil, i would urge you to start combining that with Microneedling once a week at 1mm to 1.5mm depth with a derma pen. 

Also consider adding in Nizoral for mild Anti-Androgen properties that can help in a small way. 

I personally wouldn't wear a hair system but a partial hair system and more hair fibres etc. on the back could conceal the issue. The potential issues with a partial hair system is wearing it too low and getting a false image of where potentially you should have your hairline when you get a hair transplant. 

I would probably say if you monitor consistently over the next 12 months how your hair loss situation is doing and if it's stable, consider going for a hair transplant. 

Save up and do your research. There's many great information pieces and people willing to help here. 

[Rahal Hair Transplant]

ExswimmerD,

Based on everything you’ve shared, I believe you are very likely a good candidate for hair transplant surgery. You’ve been experiencing hair loss since your early 20s and you are now 33 years old. That means you’re not likely going to lose all of your hair and you seem to be taking steps to slow down its progression. Is there a reason you’re not also using finasteride?  Though not overly common, I know there is a possibility of side effects but they typically go away once the medication is stopped for those who experience them.  

Considering your hair loss is not real advanced, I would think you would be a good candidate for both frontal and crown hair restoration. Even 3000 to 4000 grafts could provide you with a substantial difference and give you what would appear like a completely full head of hair.

With approximately that many follicular units, you could restore a relatively youthful looking hairline, restore your temple points, thicken up areas in the midsection and give your crown a touch up to restore the natural whorl pattern without using too many grafts - all while leaving plenty of donor hair available for subsequent procedures if necessary. Of course, a lot of this depends on your available donor which ultimately is best assessed in person by an experienced hair surgeon. Of course, seeing photos and videos of your hair can be useful in approximating what can be done  

I hope this helps.

Rahal Hair Transplant 

Edited April 11, 2022 by Rahal Hair Transplant

[Rahal Hair Transplant]

P.s.  What was your best stroke in swimming? I was a swimmer too. 

[AB2000]

2 hours ago, exswimmerD said:

What makes me a good candidate for HT?

The hair loss progression appears to be limited to up to, with your donor area still looking strong, so there should be adequate supply to backfill your thinning areas.  People who are not good candidates are when the temples are receding back and the loss up top is such that it's thinning out the sides into the typical donor area.  Those who need HT's the most are simultaneously the ones who have the least to work with, and you don't look like that in your photos.  Though if you did buzz down your hair you'd probably find more miniturization up top than you might think.

This forum is a good place to search for clinics.  There are hundreds of posts from patients and doctors alike to give you a good idea of what is possible.

[exswimmerD]

1 hour ago, NARMAK said:

Hey OP, 

I would probably consider getting onto Dutasteride at least a few times a week instead of Finasteride or completely switch over. As for Minoxodil, i would urge you to start combining that with Microneedling once a week at 1mm to 1.5mm depth with a derma pen. 

Also consider adding in Nizoral for mild Anti-Androgen properties that can help in a small way. 

I personally wouldn't wear a hair system but a partial hair system and more hair fibres etc. on the back could conceal the issue. The potential issues with a partial hair system is wearing it too low and getting a false image of where potentially you should have your hairline when you get a hair transplant. 

I would probably say if you monitor consistently over the next 12 months how your hair loss situation is doing and if it's stable, consider going for a hair transplant. 

Save up and do your research. There's many great information pieces and people willing to help here. 

Thank you for the response! This is the first I've heard of dutasteride, but I will look into that and microneedling as well. Hair system is not something I'd really like to do if possible, was just curious what led people to choose one over the other. I don't think I'm there yet. 

[exswimmerD]

1 hour ago, Rahal Hair Transplant said:

ExswimmerD,

Based on everything you’ve shared, I believe you are very likely a good candidate for hair transplant surgery. You’ve been experiencing hair loss since your early 20s and you are now 33 years old. That means you’re not likely going to lose all of your hair and you seem to be taking steps to slow down its progression. Is there a reason you’re not also using finasteride?  Though not overly common, I know there is a possibility of side effects but they typically go away once the medication is stopped for those who experience them.  

Considering your hair loss is not real advanced, I would think you would be a good candidate for both frontal and crown hair restoration. Even 3000 to 4000 grafts could provide you with a substantial difference and give you what would appear like a completely full head of hair.

With approximately that many follicular units, you could restore a relatively youthful looking hairline, restore your temple points, thicken up areas in the midsection and give your crown a touch up to restore the natural whorl pattern without using too many grafts - all while leaving plenty of donor hair available for subsequent procedures if necessary. Of course, a lot of this depends on your available donor which ultimately is best assessed in person by an experienced hair surgeon. Of course, seeing photos and videos of your hair can be useful in approximating what can be done  

I hope this helps.

Rahal Hair Transplant 

Very helpful to know - thanks!! I apologize if my original message was not clear. I have been taking finasteride for several years now. As far as swimming goes, I was breastroke and IM

[exswimmerD]

22 minutes ago, AB2000 said:

The hair loss progression appears to be limited to up to, with your donor area still looking strong, so there should be adequate supply to backfill your thinning areas.  People who are not good candidates are when the temples are receding back and the loss up top is such that it's thinning out the sides into the typical donor area.  Those who need HT's the most are simultaneously the ones who have the least to work with, and you don't look like that in your photos.  Though if you did buzz down your hair you'd probably find more miniturization up top than you might think.

This forum is a good place to search for clinics.  There are hundreds of posts from patients and doctors alike to give you a good idea of what is possible.

Got it! Makes sense. Yes I do feel like I have substantial hair in the donor areas, so that is promising should I decide to go this route in the future. I'm sure you're right about miniaturization on top unfortunately. 

[MAIZE1694]

You still have plenty of hair left so I'd try and stay on FIN.

[Rahal Hair Transplant]

17 hours ago, exswimmerD said:

Very helpful to know - thanks!! I apologize if my original message was not clear. I have been taking finasteride for several years now. As far as swimming goes, I was breastroke and IM

Sorry if I missed that but it’s a good thing that you’re taking finasteride. And yes I do believe that you are a good candidate for the reasons I described above. When are you considering undergoing hair transplant surgery if at all?  Have you researched surgeons and who are you considering?  Just be sure to do your due diligence to select the surgeon you are impressed with based on a proven ability to produce outstanding results and not strictly price and location.

And I was a butterflyer and a backstroker 🙂.  Feel free to PM me with your best events and times, I’m always interested to speak with other swimmers 🙂.

Rahal Hair Transplant

[exswimmerD]

58 minutes ago, Rahal Hair Transplant said:

Sorry if I missed that but it’s a good thing that you’re taking finasteride. And yes I do believe that you are a good candidate for the reasons I described above. When are you considering undergoing hair transplant surgery if at all?  Have you researched surgeons and who are you considering?  Just be sure to do your due diligence to select the surgeon you are impressed with based on a proven ability to produce outstanding results and not strictly price and location.

And I was a butterflyer and a backstroker 🙂.  Feel free to PM me with your best events and times, I’m always interested to speak with other swimmers 🙂.

Rahal Hair Transplant

I have not yet! But that’s what I’m gearing towards. So many choices it’s hard to know where to start and who to trust. Me posting on this account was a step in the right direction. 

[LaserCaps]

23 hours ago, exswimmerD said:

Hello!

Long time lurker, first time poster. I'm a 33 y/o (soon to be 34) male who has been experiencing various degrees of hair loss since my early 20s. I've been on finasteride off and on since then (currently been using standard dose for about 5-6 years) and same with Minoxidil (currently using the foam product from Keeps). It seemed to be much worse than it is in my mid 20s before I was consistently using any medication, and I've been using DermMatch to fill in some of the thin spots for the last couple years. I've been noticing my hairline thinning out a bit more recently and was curious what suggestions anyone might have for where I am. We are our own worst critics so it'll be helpful for me to hear perspective from any of you that wish to share similar experiences. 

If you were in my shoes, would you consider a frontal hair system or am I a good candidate for a transplant? Or is it not bad enough and I should continue with DermMatch (or another product if there's something out there better)?

Any thoughts or feedback is appreciated!

- D

A couple of things I gather from your post.  First, you're not a novice.  You'd been at this for a while and are very aware of all that's going on.  Despite this, you are on and off the meds.  Why? Consider a patient who has been on Propecia for years.  The meds have helped him retain.  He then gets off and loses all that he would have lost.  As soon as it becomes noticeable, he resumes the use of the meds.  At this point he will never recoup what's lost.  And the cycle continues.  If you're going to be on the meds, stay on them.  

You are well demarcated in the crown and does not seem the pattern is expanding.  That's a good thing. 

You seem to be thinning in a class 5 with a stronger forelock and the inverted U.  

I'd like you to consider why we place so much emphasis to the frontal area. It is the area you see when looking at yourself.  It is also the area others see when they interact with you.  Having hair there will always serve you well.  When is the right time to tackle the crown? When you're happy with the results in the front AND confirm the meds are helping retain the native hair.  

The other concept, which we all fail to mention, is enjoying your age.  Sometimes it's OK to wait, mainly because the meds are doing an exceptional job.  Other times it's because the patient is very young, and we have no idea what pattern he'll develop.  At your age, however, why not enjoy the youthful look for as long as you can? In my view, go ahead and get this done, (provided you've done the research). 

With regards to the crow, we all share a whirl.  It is the weakest point for all of us.  Perhaps the only thing you need is a "dusting." Better to look thin than empty.  (Pls don't get off the meds any more).

Who do you trust? A great question which should be on everyone's mind.  Ask doctors where they learned to do hair restoration.  Did they go to their local library to read about the subject? Ask if they have a Fellowship in hair.  Have them show you results of cases similar to your own.  

[exswimmerD]

6 hours ago, LaserCaps said:

A couple of things I gather from your post.  First, you're not a novice.  You'd been at this for a while and are very aware of all that's going on.  Despite this, you are on and off the meds.  Why? Consider a patient who has been on Propecia for years.  The meds have helped him retain.  He then gets off and loses all that he would have lost.  As soon as it becomes noticeable, he resumes the use of the meds.  At this point he will never recoup what's lost.  And the cycle continues.  If you're going to be on the meds, stay on them.  

You are well demarcated in the crown and does not seem the pattern is expanding.  That's a good thing. 

You seem to be thinning in a class 5 with a stronger forelock and the inverted U.  

I'd like you to consider why we place so much emphasis to the frontal area. It is the area you see when looking at yourself.  It is also the area others see when they interact with you.  Having hair there will always serve you well.  When is the right time to tackle the crown? When you're happy with the results in the front AND confirm the meds are helping retain the native hair.  

The other concept, which we all fail to mention, is enjoying your age.  Sometimes it's OK to wait, mainly because the meds are doing an exceptional job.  Other times it's because the patient is very young, and we have no idea what pattern he'll develop.  At your age, however, why not enjoy the youthful look for as long as you can? In my view, go ahead and get this done, (provided you've done the research). 

With regards to the crow, we all share a whirl.  It is the weakest point for all of us.  Perhaps the only thing you need is a "dusting." Better to look thin than empty.  (Pls don't get off the meds any more).

Who do you trust? A great question which should be on everyone's mind.  Ask doctors where they learned to do hair restoration.  Did they go to their local library to read about the subject? Ask if they have a Fellowship in hair.  Have them show you results of cases similar to your own.  

Thank you for the reply. I stated I was on and off meds in my mid 20s (I thought I was experiencing some sexual side effects and panicked), but I have been on the standard dose for about 5-6 years now. 

What do you mean well demarcated? Glad to know it's a good thing. I hope it's settled as well. 

I am definitely finding this forum helpful in beginning my research. These are good questions to consider as I consider options.