HT at 24m , diffuse thinner, need advice

[Danzig323]

Hi my name is Josip and I am from Croatia.

I'm 24, diffuse thinner and been thinning for 2 years, have been on 0.5mg oral Dut and 2.5mg oral min for last 3 months, no side effects, I don't find hairs in sink anymore.

I know that I am very young for HT especially because I am diffuse and thinning trough whole scalp area. 

I lost a lot density on scalp but don't have bald areas. 

Hair specialist told me that he can do HT when I will be 30. Problem is that I really need at least decent hair now and for the next 5-6 years. 

Can anybody give me some more advice, what to do, what options I have.

I put pictures of my hair, it's cut on 3 mm, two white dots on the back are from child accident.

Thank you.

Edited July 9, 2022 by Danzig323

[THE TRUTH]

 

Hello Croatia ! 

You really do not need a hair transplant.  

You might have a pinch of miniaturization that only a hairloss geek like myself could notice under extremely harsh lighting but other than that you still have 99% of your hairs. 

Your head looks NORMAL. I mean really. 

You have solid head of hair and you caught it very early with medication. 

You crown looks full even with a buzzcut and your hairline is just fine. 

A hair transplant would do nothing at this stage for you except create permanent unecessary scarring in your donor area and destroy your native hairs in between the implants...

Honestly I think it would be a big mistake getting a hair transplant. 

You'd get some ugly little white dot scars at the back of your head and wouldn't be be able to rock a buzzcut anymore. 

Just stay on medication. 

[Danzig323]

Thank you for answer. I can't express you how much my hair loss kick me, I felt in massive depression because one day I have normal hair and feeling great and the other my whole scalp is thinning. I lost my job, social life, college, I got body dysmorphia and feeling like ugliest men on the planet, I am going to psychotherapist. Now I am in vicious circle, If I make HT now I will probably have good hair for the next few years but after that look like clown with thousands of white dots on the back. 

[Danzig323]

I will ask probably the stupidest question ever on this forum. 

Let say I will probably stop the further hair loss and thinning with all available medication and treatments  (pills, mesotherapy, prp, topical solutions etc.), I highly doupt I can recover holes in temples. Is it somehow possible that exists hair doctor who will transplant maybe about 100-150 grafts from Body Hair from chest (I have it a lot and it's really similar to my head hair)  I will buzz my hair on 2-3mm to recover temples without touching donor hair on the head back because maybe one day I will give up on all this medications and HT, I am ready to pay probably 1000-1500 euros for that. My beard is ginger I don't know can I use it on head.

Red lines are my receded temples, Green lines where less thinning occurs. 

[Rahal Hair Transplant]

Danzig,

My first question to you is why you’re saying that you “need” to have “decent hair now and for the next 5-6 years”.  

There are many reasons why young men are not good candidates for a hair transplant surgery. One is that their expectations are simply too high.  For example, when I look at your pictures, I see a young man in the very early phases of hair loss with a substantial amount of hair remaining.

Your hairline includes very mild recession and the top of your scalp is still very dense and frankly, you hair only looks a little thin because you are wearing your hair cropped short.  While I’m not negating that you are experiencing early onset of male pattern baldness, most men on this forum would literally love to have your head of hair. 

in my opinion, this is what you should be doing at this stage.

1. As long as a doctor has approved your hair loss treatment regimen, go ahead and stay with that since it seems to have stopped your hair loss even at only three months. It’s typically recommended to be on either of those treatments for at least a year before evaluating its efficacy. And the fact that it’s already working for you might mean that it could help even reverse some of the effects of your hair loss. In other words, it might thicken some of the miniaturizing hairs, making your overall appearance of your hair thicker.

on the other hand, it’s not typical to be on both finasteride and dutasteride especially if you’re taking them both daily. Please consult a doctor to discuss this if you haven’t already. If a doctor is not approve this treatment plan I’m concerned about long-term effects of such a young man being on such a strong treatment regimen.

2. if you really insist on an immediate appearance of thicker hair, you might want to try growing your hair a bit as it will likely not look as thin. Alternatively, you can try using hair loss concealers such as Toppik, DermMatch, Couvre, etc.   these concealer‘s will make your hair appear thicker but because it’s made of synthetic hair fibers, it must be applied on a semi regular basis and there will be a learning curve on application. All of them are applied differently.  experiment with each of them and see which one works best for you.  

3. Over the course of the next couple of years, spend some time researching hair transplant surgery, what it canon and can’t accomplish, developing realistic expectations and learn about the importance of physician selection.

4. in 2 to 3 years, reevaluate your hair loss condition and determine whether or not you want to move forward with considering hair transplant surgery. I don’t think you necessarily have to wait until 30. I had my first hair transplant at 27.

I hope this helps. 

Rahal Hair Transplant 

[THE TRUTH]

I know exactly what you mean bro.

I feel you and I am sorry you feel that way. 

But let me tell you. 

Yor hair is better than 99% of guys on this forum. 

Guys like myself with severe and diffuse disgusting baldness would all kill to have your hair 😂

That said, I agree that there is SOME very slight early DHT-caused thinning going on but with a stack as strong as oral Dutasteride and minoxidil it's likely gonna be stopped dead in its tracks for the next 20-30 years or so. 

So why worry ? 

Just curiously who prescribed them to you  ? Are croatian docs open about writing Avodart/Loniten prescriptions ?

Spend time on the forum. Research a lot. The majority of guys on this forum regret their hair transplants... 

And remember FUE is by no means scarless. 

As for beard hairs on scalp it can be used only 3 cms behind the hairline.

Not directly on the hairline except in some very rare cases. 

Body hair is very tricky. It has relatively low survival rate compared to scalp/bears hairs and you always need to make a small test surgery first to see how it goes. 

I have never heard of anyone using body hairs on the hairline and I am unsure how it would look in terms of naturalness. Also body hairs are genetically different. They don't grow to the same length and have shorter anagen phases. 

Best doctors in Europe for body hair are Bisanga and Mwamba in Brussells. They are expensive but not crazy expensive. They are worth consulting. 

In the US, Dr. Umar is the most experienced guy with body hair. His prices are ridiculous though. 

If you really want a touch-up on the hairline, I would go for a very small scalp hair procedure of like 500-800ish grafts maximum with an expert such as Freitas/Pinto/Couto. They are also excellent when it comes to hairlines. That would cost you about 3000-4000€ and you would be good to go. 

Edited July 9, 2022 by Let me botch you

[Danzig323]

Thank you all for efforts you put to answer me, I really appreciate It! 

First answer to dr.Rahal 

I said that I need hair for next 5-6 years because maybe It is more common to se bald guy in his 30s,40s then 20s.  I know I have a lot of native hair that is miniaturized on top and that is why dermatologist prescribe me oral dutasteride and oral minoxidil to take daily, she said all about side effects but also said that this is best medications to stop hairloss and even little bit of regrowth. On the other hand I also visited two hair transplant doctors and they strongly insist on using topical instead of oral, that is what they usually gives to their patients. Problem is that I am really afraid to become slick bald like me uncle, he was probably nw5-6 at age of 35, but have awful scalp inflammations and drinking acne pill for a lot of years, his brother have moderate receding on front and crown at 35. I will be very happy to at least repair hairline and It will give me strength to continue on medications because It's not really really bad like this. I read a lot about people who are not helped with fin or dut, and those who maintain what they have but start losing after few years, I am afraid I will be one of them, actually I buried myself with negative thoughts. 

Once again thank you dr.Rahal. 

Answer to Let me botch you

I know what you mean, trust me It's really obvious thinning on whole scalp , especially on different lightening , but still fuzz everywhere. It's frustrated because I am in not good not terrible position, how to explain perhaps girlfriend that I am not bald now, but will be in few more years. I am sad that body hair is not good option  .. 

If I can somehow repair temples, I will wait to 27yo for HT. 3000-4000e honestly is at the moment too much for about 10cm2 area that still has hair, but in the future try to be ready to pay 5-10 euros per grafts if I want best possible results.

If I can go trough my 30s and 40s with hair like David Beckham will be wonderful https://prnt.sc/-bM9734A476A 

Thank you very much for effort. 

ps. Sorry for my bad English.

Edited July 9, 2022 by Danzig323

[Danzig323]

I took a picture with phone microscope app, it's taken from middle of scalp where I have most loss. 

I am planning to book for a consultation with dr.Zarev, Sofia is very close to Croatia and I have really cheap flights to there. I will probably go there and get appointment in person, because it is very difficult to get an appointment with him over email/phone.

 

Edited July 10, 2022 by Danzig323

[THE TRUTH]

Like I said, you have some very early signs of ongoing miniaturization for sure but you need to give oral Dutasteride and oral minoxidil some time. 

AT LEAST a good 6 months and preferably a year. Due to the nature of the human follicular growth cycle, these drugs do not work overnight. 

I am sure you will get a good response from medication since you started earlier than anyone else here. 

So really no need to worry. 

Dutasteride 2.5mg supresses follicular DHT levels over 90+. 

Oral minoxidil is a very potent anagen stimulant. 

This is the best combo that exists. 

I know Dr. Zarev is not a big fan of finasteride unlike other surgeons but I guess he will tell you the exact same thing. 

Just stay on a strong pharmaceutical protocol and give it some time. I don't think any reputable doctor he would agree to transplant in between so many existing native hairs and I honestly  really do not think it would be in your best interest. 

I have seen many diffuse thinners get really bad results from  hair transplants. 

You can also throw in some topical anti androgens like RU, CB, eucapil  microneedling etc...Check out Kevin and Derek's channels. 👍

Dr. Oscar Muñoz and Dr. Sergio Vaño also have some content regarding those topics. 

All the best 

[Danzig323]

I will stay on this protocol for sure, I put myself 6-7 month mark and then sum up results. I am considering dr.Zarev because I am hoping he will examine my scalp situation and give me at least approximate image of what awaits me if I become nw6-7. Honestly even this regime with dut & min gives me anxiety after I read all sides and I don't know if all of that is wasted effort if I will lose everything I have kept if I stop with the treatment at any time. 

I am also doing microneedling and using biotin pills with ketoconazole shampoo.

Thank you, Josip.

Edited July 10, 2022 by Danzig323

[Danzig323]

I find another picture when my hair is little longer so you can see what I am talking about. Its whole scalp thinning from nw1 to nw7, it's really curse. If I am not on this regime I know what I can expect for 5-6 years. Last two pic is my uncle hair at 30yo. 

Edited July 13, 2022 by Danzig323

[hairman22]

does looks like your thinning alot in that pic. But your hair longer will make your hair look better

Good idea to go to Zarev in the future. But i would only do a small procedure for hairline atm.

[Danzig323]

I don't want my hair longer, I am buzzing it my whole life. I don't know what damage could perhaps 500 grafts do to my native hair in this area. 

[Danzig323]

If I can repair hairline with few hundred grafts, I would also consider sparse SMP to give me little more density, and eventually wait for the next few years how would my hair loss progress considering I am on treatment. 

What do you think about this?

[THE TRUTH]

10 minutes ago, Danzig323 said:

If I can repair hairline with few hundred grafts, I would also consider sparse SMP to give me little more density, and eventually wait for the next few years how would my hair loss progress considering I am on treatment. 

What do you think about this?

I think SMP is the way to go for you bro ! 

Now beware SMP tattoos are a minefield industry too so you gotta do your research diligently before choosing a clinic of course.  The last thing you want is a botched SMP cuz it can be a pain in the butt to remove... But if you go to the right clinic you can get a good result and it will allow you to achieve your goal which is, from my understanding a homogenous juvenile and dense-looking buzzcut. 

There are several main issues  with hair transplants in your case specifically (but also generally speaking) 

A. Hair transplants are not meant for wearing very short buzzcuts. They are just a way to camouflage baldness...They are simply a foundation for adding Toppik and Hair Fibers... Transplants will always look crap especially under harsh lighting and if you had extensive baldness to begin with. It does sound a bit pessimistic but it is the reality. 

That's why they are often refered to as "the illusion of density".  Generally a hair transplant is 50% of your native hair density. Most reputable doctors will graft the hairline with  around 50 grafts per cm2. That is sufficient to make it look good if you let grow longer but if you buzz your head then you might be disapointed because you'll be able to tell the difference of density between transplanted hairs that look weaker and native hairs that look denser.  If are a only Norwood 2 and get a 3000 grafts a dense packed hairline at 60+ grafts per cm2 then you may get away with it. But anything beyond Nw 3 or diffuse thinning forget about it... It'll never look good. And dense packing is always risky because of the risk of poor survival. 

If you want to have a decent looking and homogenous buzzcut then SMP is the way to go. A hair transplant cannot match the density of native hairs. 

Also the risk of shockloss is high especially when the native area still has a lot of hairs. 

Last but not least, an FUE is by no means a scarless procedure. 

If botched then it may look overharvested and patchy. Almost like if you have alopecia areata.

But even when done with a worldclass doctor  it is important to understand that anything below 1cm length is highly likely to expose the white-dot scars. 

It can look pretty weird sometimes. 

I suggest you have a look at patients who got several hair transplants for example. 

When they shave their head again before their 2nd procedure , you can really spot the FUE  scarring in the donor and the density issue. 

It is a popular misconception that you can just shave your head after a failed FUE without any consequences. 

With all that being said, I didn't mean to be negative or pessimistic but I just wanted to provide some insight on the reality of hair transplants. 

In my opinion and based on your goal, you would be better suited for SMP. 

[Danzig323]

Thank you very much for the time you took to explain me all this. 

The best thing at the moment is that I didn't do any repair and really don't want to do something and regret it for the rest of my life. I think to do smp touch ups to fill and give little density is muuuuch less invasive approach if done right instead HT, and after all yes it can be pain in the ass to remove It if I don't like it, but at least it can be removed. 

The main problem at the moment is that I have this area with very little hair (it's like that for the last 5 years), I want to somehow fill it and probably only HT can repair It. But I doubt that any surgeon will do anything after I tell him my crazy idea. The dots of ht from my donor area will hopefully mask with smp??

I really hopes that one day in the future I will be candidate for the HT at Zarev or another high class surgeon.

Edited July 13, 2022 by Danzig323

[THE TRUTH]

Yeah maying filling in the outside corners on each side with 200-300 graft each side.

That would make sense if it really bothers you. 

I'd rather do that than trynna graft the midscalp or crown where you still have lots of hairs...I think medication will probably improve that enough to the point that it doesn't bother you anymore. 

Yes sure !  It is possible to get SMP into the FUE scars at the back in order to camouflage the scars. 

That's also a good option. Just keep in mind any SMP will require touch-ups. They do tend to fade away. Sometimes even faster than you'd expect. 

Btw you caught your hairloss early like REALLY early. Congratulations. You did a great job.

Just curiously how exactly did you notice it ? 

Did someone point it out to you ? 

Or did you know if it was inevitably gonna happen to you at some point based on your family history ? 

[Danzig323]

Thank you for answer.

Actually I know it's not scientifically proved but after few months of huge stress my hair was just disappearing. First time I notice that I am 100% balding is last year in April, but probably thinning sooner then that.. I am very angry on my family who was trying to convince me that I am not balding and because of them I didn't take medication sooner. But It's better later then never.

[THE TRUTH]

16 minutes ago, Danzig323 said:

Thank you for answer.

Actually I know it's not scientifically proved but after few months of huge stress my hair was just disappearing. First time I notice that I am 100% balding is last year in April, but probably thinning sooner then that.. I am very angry on my family who was trying to convince me that I am not balding and because of them I didn't take medication sooner. But It's better later then never.

Check out Kevin Mann.

He is literally the Jesus Christ of hairloss