Rapid Hair Loss / Thinning 2 Years Post Transplant Due to Medication (Telogen Effluvium or MPB Progression or?)

[Vertighost]

Hi all!

I posted 2 years ago after getting my HT for advice when I was freaking out, in the end everything turned out great and I've been enjoying the new hair since. Fast forward to a little over a month ago, I went to see a rheumatologist to rule out arthritis/spondylitis, etc due to chronic back pain. My blood tests/MRI came negative, but he prescribed Sulfalazine to try (many DMARDs have hair loss risk but this one seemed safest so I went with it). He said it takes a month + for the med to have an effect. I've felt increased itching on my scalp since starting, and this past week (1 month mark), I've noticed major accelerated thinning all over, even in the transplanted zones. Even my donor areas got rocked, and it seems like I've lost 20-30% of my hair and is worsening by the day. I've quit the medicine 5 days ago, switched to Nioxin shampoo/conditioner, added multi-vitamins, etc. since.

Other info: a family member also passed away and I flew across the world and back 2 weeks ago to attend their funeral (possible added stress).

I can't take fin/min due to painful sides (pelvic/testicle pain) on both.

It seems that this is overall thinning/patchy donor, I haven't had any recession where the transplanted zones meet native hair. I'm also not a diffuse thinner normally (only got the hairline done), see pic below of 2-3 months post transplant.

BEFORE STARTING SULFASALAZINE PHOTOS

 

 

AFTER ALL THE SHEDDING/CURRENT PHOTOS

DONOR AREAS (CURRENT)

 

Pics were taken few days ago, it's a bit worst now too.

Just want to know whether this sudden loss is reversible  (if it is indeed due to medication/stress)and not progression of MPB or if anyone's had a similar experience. This bums me out greatly!

 

Edited June 18, 2023 by Vertighost

[BaldReaper]

I dont see any difference between these 2 pictures

 

[Vertighost]

Ahh.. that was just the first day of it, it's gotten a good bit worst since (5 days after now) especially in full sun outdoors. I styled it the same way yesterday and the whole hairline was see through. Perhaps, I'll do it again tomorrow and re-post a photo. The after photos where I have the hair down was from yesterday

[HappyMan2021]

1 hour ago, Vertighost said:

I went to see a rheumatologist to rule out arthritis/spondylitis, etc due to chronic back pain. My blood tests/MRI came negative, but he prescribed Sulfalazine to try

if you are 100% certain this is not a placebo/hypochondria effect due to life stressors, my advice is to explain the situation to your rheumatologist

For all you know he has seen hair shedding as a side effect of Sulfalazine, and perhaps that can be replaced with a different medication

[Vertighost]

Thank you. And absolutely, we stopped the medication earlier this week and will wait a few weeks to try something new if needed. Meanwhile trying to get an MRI for my SI joints to work towards a diagnosis regarding chronic pain.

But in terms of hair, I'm seeing a dermatologist later this week. In general, if my transplanted zones + donors are also affected/thinned (and no native hair recession), would you say it's more likely to be from the meds than MPB?

[sunsurfhair]

What about Plaquenil as an alternative? Are you on oral / topical minox/fin?