M22 - need advice for HT - please help:)

[Oscar1212]

Dear community,

 

I am 22 and started loosing hair from the young age of 18. In the past year I have started to loose hair aggressively and thus started to take Finasteride 1mg a day (8 months since start, no side-effects).

I know that 22 is still young (possibly need a second one), however I am not really happy at the moment and hope to get some advice for a possible ht. Especially, in the landscape of ht it is difficult to distinguish between trustworthy doctors and hair mills. Therefore I would really appreciate your advice for possible doctos/clinics suitable for my longer caucasian hair (see picture attached).

What is important for me:

1. Long-term focus of the doctor (No over-harvesting)

2. Experience in restoring a natural hairline (which should also look good in my 40s). Thus, not too agressive.

 

From a geographical perspective I am flexible. 

Offers I have received so far ,mostly from hair mills, talk about 3500-4000 grafts. Is this realistic?

 

Would be super grateful for your feedback and experience!

[donpizmeov]

Stay on fin and consider adding Minoxidil to your regimen. Delay any HT for some years as you are too young at 22 as it could backfire as your hairloss will progress as you are still just 22, potentially ending up in a worse situation that you are in now. 

[Oscar1212]

36 minutes ago, donpizmeov said:

Stay on fin and consider adding Minoxidil to your regimen. Delay any HT for some years as you are too young at 22 as it could backfire as your hairloss will progress as you are still just 22, potentially ending up in a worse situation that you are in now. 

Thank you for your answer. I have started Minoxidil, but had to quit because my skin did not take it well. 
 

What is the biggest risk in your opinion, when doing a ht soon? If I am careful with my donor area and in the worst case ill do a second one?

[donpizmeov]

You are very young, and based on your picture it seems not just to be the frontal region which already have a high degree of hairloss for your age, but also midscalp seems to be affected. You will need to monitor if finasteride completely pauses your hairloss for a longer period or only slow it down as it does for many. For many men hairloss is most aggressive untill their mid 30s, which if is the case with you, might mean you dont have enough donor available to correct it later on. Likewise as you get older, it will be more easy to predict your final NW pattern and a surgeon will be able to tailor a longterm plan for you on how to manage your donor capability to the best extend so it will also look good as you age.  
 

 

[Berba11]

6 hours ago, Oscar1212 said:

Thank you for your answer. I have started Minoxidil, but had to quit because my skin did not take it well. 
 

What is the biggest risk in your opinion, when doing a ht soon? If I am careful with my donor area and in the worst case ill do a second one?

Multiple issues.

First of all, part of growing up is dealing with the challenges and curveballs life will throw at you. For you (and me), one of those things is hair loss. Your first port of call should never be to reach for the big red surgical button, but to try and deal with it in a way that doesn't involve surgery, medication or anything that requires any risk of any kind. So what you should be doing is buzzing it off and trying to move on with your life as step number one (if for no other reason than your hair has degraded to the point that a buzz would just look better anyway).

Young guys pass through the forum saying stuff like this all the time:

20 hours ago, Oscar1212 said:

I know that 22 is still young... however I am not really happy at the moment

Your happiness should not reside in how much hair you have. Losing your hair is, ultimately, not a big deal (unless you make it one). The reason you should bear this in mind is that surgery is not a guaranteed cure. Even in the best hands, things can and do go wrong. If you've made your hair loss a big deal now, consider how you'll feel with a bad outcome from surgery... Point being, you should at least attempt to challenge how you feel and think about your hair loss. No one should get a HT feeling as though they need one, but rather they've decided they want one having done all the necessary first steps.

Quote

and in the worst case ill do a second one?

As above, losing more hair isn't "the worst case". The worst case would be a bad result, or putting yourself in potential financial hardship to fund a HT (good surgeons aren't cheap, and cheap surgeons are often cheap for a reason...) at such a young age (I'm working on the assumption that you're not minted at 22 of course!).

It's good that you're trying finasteride but it's no guarantee, especially at your age. There's also no guarantees you'll be able to take it forever - things can change. You could suddenly get sides for instance.

I'm willing to bet that not single single top surgeon is among the ones who have quoted you for a graft count, because 99.9% of the time top surgeons would refuse a 22 year old patient. That means you're fishing in the hair mill market (as you concede yourself), and will be putting yourself in a vulnerable position.

My honest best advice to do just what I did: buzz it off, move on and enjoy your life and then review it again in the future from a place of want not need. I had similar hair loss levels at 22 and had my first HT at 32. I didn't take finasteride but probably would have benefitted from doing so at your age, but also not having to bother taking medication every day is no bad thing either. But to be getting quotes from clinics before ever truly rocking the buzz cut over a long period of time and working on your mindset and thinking over your hair loss is absolute madness at any age, let alone at 22.

[Worker1212]

I'd hop on finasteride and minoxidil. IF its really aggressive or finasteride doesnt work get on DUT and stay the course. Since you're in the same age bracket as me, a HT perhaps wont be necessary in the future if better/stronger treatments become available (of course thats if they work, most notable could be GT20029, Osteopotin, as well as the thyroid hair growth stimulents).

[MissMyLongHair]

Same age as you OP, my only suggestion would be to consider Dut and min/oral min too. Too young for a transplant. If you have the money, don't discount hair systems either. That's something I will look into if Dut stops working for me.

[Dr. Wipawan Vathananai]

Hello Oscar1212,

From the photo, it seems that your hair loss is quite aggressive and I think it is important to exclude other hair diseases which cannot be fixed by a hair transplant. These are FAPD (Fibrosing alopecia in pattern distribution) and LPP (Lichen planopilaris). I know the chance is not high but it is best that we rule out these conditions first before going any further with AGA treatment.

If you see a specialist and AGA is diagnosed, even though some doctors will deny doing a hair transplant for a patient as young as you are, I think some circumstances should be taken into consideration. My question for you is, "Does the hair loss bother you?", which the answer is "yes" obviously otherwise you would not post on this community. In my opinion (as a hair transplant surgeon), if the hair loss starts to affect your mental health and confidence then the hair loss should be fixed. I think our 20s-30s is the time where we can enjoy our lives the most, I think it's better to enjoy it at your best 🙂

The next question is "How are we going to fix your hair loss?" In your case, the only way to restore the hairline would be a hair transplant definitely. I'm impressed and very happy that you are realistic about having a conservative hairline. 

The most important management in your case would be medications for hair loss which I would choose oral dutasteride 0.5 mg/day and oral minoxidil 2.5 mg/day and start them as soon as possible to maintain your hair both at the recipient and donor sites. You should also continue them even after the hair transplant (if you get one). Recently, topical anti-androgen (Clascoterone) has been reported to be quite effective for AGA. However, it's not available in Thailand yet so I do not have a chance to see it effectiveness by myself.

Regarding your questions;

 

1. Long-term focus of the doctor (No over-harvesting) - I cannot answer this question since I have a conflict of interest because I, myself, am a hair transplant surgeon.

2. Experience in restoring a natural hairline (which should also look good in my 40s). Thus, not too agressive. - YES 🙂

3. Offers I have received so far ,mostly from hair mills, talk about 3500-4000 grafts. Is this realistic? - I would roughly estimate 3,000-3,500 grafts to cover the balding area. However, it would be great to see your donor hair at the back for better evaluation.

I hope this help