Could anyone please help me and my hair?

[ajsr8]

In a really bad place at the moment. My hair loss is horrific and its much worse than what I thought a few years back. I thought I had normal MPB but I have a feeling its also retrograde alopecia and DUPA (diffuse unpatterned alopecia), not sure if any experts on here can help based on the photos?

In January of 2019 I started finasteride due to some thin spots in my hair that were not very obvious but you could tell that they were there. I feel like it stabilized my hair loss. 

Then in August of 2020, I started using topical foam minoxidil to see if I could get growth on these thin spots. I used it for about a year and I don't think I got any results and I felt like my hair loss was still regressing. Starting minoxidil was a mistake as I got side effects from it (puffy eyes, dark circles, puffy face and fatigue but I still persisted using it for about a year). 

By 2022 I was just on finasteride and I was slowly losing ground throughout the year. By Christmas of 2022 I decided to go back on topical minoxidil for some thin spots near the front of my scalp (I know this was stupid as I had a bad experience last time). Since restarting it I have lost a significant amount of density and my front area of the scalp and the hairline is thinner than ever.

As of June 2023, I was prescribed dutasteride and told to take it every day 0.5mg and drop finasteride. I was also given a very low dose of oral 0.45mg sublingual minoxidil and I used it for 3 days but I had a shortness of breath (anyone else experience this)? So basically, I can only use dutasteride now unless I force myself to use minoxidil and deal with the side effects when I'm not sure if it is doing more harm than good for me. I really just want to stop using minoxidil but I know that by stopping it completely I will never ever get the shed hairs back.

Does anyone have any advice to offer? It seems I've lost the battle against hair loss and I probably would never be able to get a hair transplant because of how bad it is at age 22. I'm not sure if its even worth using dutasteride because of how bad it is, when I can't use a growth stimulant like minoxidil. I really don't want to give up but I feel like I have to just cut everything off now. 

I would appreciate any replies. The psychological torture of this is unreal and involves having a crying episode in the car every single day. 

 

[Turkhair]

I know it feels horrifying but STOP inducing sheds. Minoxidil is especially brutal at inducing sheds but any hair loss treatment that WORKS will cause a shed even hair transplants.

Also stop playing with your heart. If you can’t tolerate minoxidil, stop using it. It’s not the end of the world. 

You should’ve stuck to finasteride but now that you’re on dutasteride, stick with it and ride it out. You’re young, you’re not going NW7, it’s very rare but you’re on treatment so it’s stopped. 

The hairs shed from minoxidil do come back but after a LONG time, minox increases hair cycles and when you stop it, it’s all out of whack so it takes time to readjust. What doesn’t help is hair cycles are like months long. 

[Turkhair]

Also start using ketaconazole shampoo. 

[AB2000]

57 minutes ago, Turkhair said:

Also stop playing with your heart. If you can’t tolerate minoxidil, stop using it. It’s not the end of the world. 

What affect does it have on heart health?

[ajsr8]

1 hour ago, Turkhair said:

I know it feels horrifying but STOP inducing sheds. Minoxidil is especially brutal at inducing sheds but any hair loss treatment that WORKS will cause a shed even hair transplants.

Also stop playing with your heart. If you can’t tolerate minoxidil, stop using it. It’s not the end of the world. 

You should’ve stuck to finasteride but now that you’re on dutasteride, stick with it and ride it out. You’re young, you’re not going NW7, it’s very rare but you’re on treatment so it’s stopped. 

The hairs shed from minoxidil do come back but after a LONG time, minox increases hair cycles and when you stop it, it’s all out of whack so it takes time to readjust. What doesn’t help is hair cycles are like months long. 

Thanks for the response. 

Yeah I can't really tolerate minoxidil but at the same time I'm desperate to get some of my hair back. If I'm not on minoxidil then I don't have anything to stimulate hair growth.

My dermatologist put me on dutasteride as the photos clearly show that finasteride no longer works for me. 

[StillAlive]

You can try taking rosemary leaf tablets, there is a study comparing it to minoxidil. Lower efficacy of course, but no side effects to speak of. Keto shampoo doesn't hurt either.

[EricEdwards]

2 hours ago, StillAlive said:

You can try taking rosemary leaf tablets, there is a study comparing it to minoxidil. Lower efficacy of course, but no side effects to speak of. Keto shampoo doesn't hurt either.

I started using rosemary essential oil. I mixed it with a carrier oil (almond oil). Options below:

➢Mix 19 Rosemary oil drops to 30ml carrier oil to give 3% potency 

➢Mix 25 Rosemary oil drops to 40ml carrier oil to give 3% potency 

➢Mix 30 Rosemary oil drops to 50ml carrier oil to give 3% potency

➢Mix 60 Rosemary oil drops to 100ml carrier oil to give 3% potency 

[ajsr8]

Thanks I'll look into that.

Would dermarolling provide similar regrowth benefits as minoxidil?

[A_4_Archan]

Don't use minoxidil as you are not able to tolerate it and you have tried it enough ...there are some natural substitute to minoxidil though their efficacy aren't proven but sometimes some people get some benefits from that so you can try it and the good thing is that it won't harm you..

Dutasteride is a potent drug and i guess it would stabilise your hairloss....do take it religiously if you don't find any side effects and if your body tolerate it....even you may ask your doctor about prp or some mesotherapy and see if it works for you or not..if it works for you than it would make your hairs fuller and thicker and specially make those baby hairs fuller which will help you with coverage and you are already on dutasteride so that will help to preserve them ..

[Rahal Hair Transplant]

@ajsr8,

Thanks for sharing a detailed account of your hair loss history and what you’re currently going through.  And the good news is, you still have a lot of hair. Based on everything I was reading, I expected to see a lot less hair then I’m seeing in the photos. So that’s definitely a plus.

All that to say, you do certainly seem like a good candidate for non-surgical hair loss solutions. Now, I assume that you’ve been on finasteride for quite some time prior to switching over to dutasteride?  I only ask because it’s usually a good idea to give a finasteride a good solid year before drawing any conclusions as to whether or not you need something stronger.

While your hair loss situation certainly sounds like it calls for a stronger nonsurgical treatment, there’s always that concern about potential side effects. Therefore, I personally feel it’s always better to start with the recommended dosage under a doctor’ advice and supervision and then if the doctor feels more is necessary, to go ahead and switch.  Mikd you, that may be very well what happens I’m just clarifying and giving my opinion.  

Keep in mind that dutasteride blocks both type one and type 2 5-alpha-reductase enzymes whereas finasteride only blocks the second type. Therefore as a whole, dutasteride is likely going to be a more effective treatment and if not strive it also comes with a potential for stronger side effects.

What you said about your hair is likely  possible in that you do appear to have some thinning on the sides and back of the scalp a.k.a. the donor area for hair transplant surgery. Because of this, I do recommend undergoing testing by a dermatologist to see if you have DUPA. I’m not sure if I see signs of retrograde alopecia in the pictures but since you have concerns about that I suggest getting tested for that as well.

In my opinion at this current point, you don’t seem like the best candidate for a hair transplant. But that could change depending on how effective dutasteride is for you.  But given that you are a diffuse thinner and possess some thinning on the signs back on the scalp, it may simply be too risky to proceed with hair restoration surgery at this time. Now, please understand that I am not Dr. Rahal and this is just my opinion as an educated patient and patient advisor.

I hope this helps.

Rahal Hair Transplant 

[ajsr8]

12 hours ago, Rahal Hair Transplant said:

@ajsr8,

Thanks for sharing a detailed account of your hair loss history and what you’re currently going through.  And the good news is, you still have a lot of hair. Based on everything I was reading, I expected to see a lot less hair then I’m seeing in the photos. So that’s definitely a plus.

All that to say, you do certainly seem like a good candidate for non-surgical hair loss solutions. Now, I assume that you’ve been on finasteride for quite some time prior to switching over to dutasteride?  I only ask because it’s usually a good idea to give a finasteride a good solid year before drawing any conclusions as to whether or not you need something stronger.

While your hair loss situation certainly sounds like it calls for a stronger nonsurgical treatment, there’s always that concern about potential side effects. Therefore, I personally feel it’s always better to start with the recommended dosage under a doctor’ advice and supervision and then if the doctor feels more is necessary, to go ahead and switch.  Mikd you, that may be very well what happens I’m just clarifying and giving my opinion.  

Keep in mind that dutasteride blocks both type one and type 2 5-alpha-reductase enzymes whereas finasteride only blocks the second type. Therefore as a whole, dutasteride is likely going to be a more effective treatment and if not strive it also comes with a potential for stronger side effects.

What you said about your hair is likely  possible in that you do appear to have some thinning on the sides and back of the scalp a.k.a. the donor area for hair transplant surgery. Because of this, I do recommend undergoing testing by a dermatologist to see if you have DUPA. I’m not sure if I see signs of retrograde alopecia in the pictures but since you have concerns about that I suggest getting tested for that as well.

In my opinion at this current point, you don’t seem like the best candidate for a hair transplant. But that could change depending on how effective dutasteride is for you.  But given that you are a diffuse thinner and possess some thinning on the signs back on the scalp, it may simply be too risky to proceed with hair restoration surgery at this time. Now, please understand that I am not Dr. Rahal and this is just my opinion as an educated patient and patient advisor.

I hope this helps.

Rahal Hair Transplant 

Thanks Rahal.

I did consult with a dermatologist and was given dutasteride and oral minoxidil. I cannot tolerate the side effects of minoxidil so I've dropped both the topical minoxidil and won't take the oral one. I'll just take dutasteride. However, it seems like I won't be able to do anything with my type of hair loss. I asked my dermatologist about DUPA but I don't think he was too familiar with DUPA as he just said it was thinning. 

I have been on finasteride since 2019 and I still ended up like this. 

Edited June 6, 2023 by ajsr8

[ajsr8]

14 hours ago, A_4_Archan said:

Don't use minoxidil as you are not able to tolerate it and you have tried it enough ...there are some natural substitute to minoxidil though their efficacy aren't proven but sometimes some people get some benefits from that so you can try it and the good thing is that it won't harm you..

Dutasteride is a potent drug and i guess it would stabilise your hairloss....do take it religiously if you don't find any side effects and if your body tolerate it....even you may ask your doctor about prp or some mesotherapy and see if it works for you or not..if it works for you than it would make your hairs fuller and thicker and specially make those baby hairs fuller which will help you with coverage and you are already on dutasteride so that will help to preserve them ..

Do you think I should try the 2% minoxidil once a day?

[Gatsby]

If you were getting side effects from low dose sublingual minoxidil then it's probably best to pass on minoxidil.

[ajsr8]

2 hours ago, Gatsby said:

If you were getting side effects from low dose sublingual minoxidil then it's probably best to pass on minoxidil.

Yeah its extremely disappointing. I am completely screwed now. 

I used 0.45mg for 3 days and had a shortness of breath. 

[A_4_Archan]

3 hours ago, ajsr8 said:

Do you think I should try the 2% minoxidil once a day?

Your body can't tolerate minoxidil and imo you have tried enough...even topical will give you the sides...better to be on just dutasteride as of now and consult a good surgeon and see other medical therapy which can promote your growth ...you are using dutasteride which is potent and you are likely to be not loosing more ground in near future if your body adapts it well...

[EricEdwards]

On 6/5/2023 at 10:17 AM, ajsr8 said:

Thanks I'll look into that.

Would dermarolling provide similar regrowth benefits as minoxidil?

There is some research to suggest that micro needling is just as effective as PRP. Micro needling can be a fraction of the cost. PRP can cost thousands but you can buy a surgical grade micro needle roller for and 15 euros on Amazon.

https://youtu.be/thQ1taoKoo4