Extremely depressed

[Hairlossingfast]

I was on oral finasteride and topical minoxidil for years and gradually kept losing erection quality to the point of impotency.  I have since quit both meds for the past 3 months and my erections are back (although not 100%).  I am depressed that I will lose my hair unless I hop back on finasteride or give dutasteride a try but am afraid of impotency.  Am only 29 years old.  SMP is not an option due to personal reasons and don't want a toupe.  Is multiple hair transplants possible with verteporfin yet?  Am so depressed and can barely function day to day because of this.

[Al - Moderator]

Do you have any pictures of your current hair situation? You may still be a candidate for hair transplants even if you can't use meds. If you have a lot of body hair you can try using some of that mixed in with scalp donor. If you are prone to eventual donor thinning, the body hair grafts should last much longer than scalp grafts , so that is something you can try doing if you went with a hair transplant. Beard hair is in a much safer zone that the back and sides of the head. Even if you lose a lot more hair, the beard grafts should have a much better chance at continued growth. 

 

[Berba11]

6 hours ago, Hairlossingfast said:

Am so depressed and can barely function day to day because of this.

Sorry to hear you’re feeling this way. At the end of the day though, it’s just hair. Nothing really happens whether you have it or don’t. 
 

I think what you need to do right now is speak to a medical professional who can help with your depression and it sounds quite severe and needs to be addressed asap. 

[Ian.]

Many of us can get in a major funk where our situation feels hopeless. Whether it's about our hair, or the hair more of a metaphor for our life in its current state. But a successful hair transplant wouldn't necessarily alleviate your anxiety/depression. A bad one would only make things much, much worse.

All is not lost my friend, you're not out of options for your hair yet. But Berba11 is right. If your depression is that crippling, before delving into strategies of keeping/improving your hair, try to find someone you are willing to talk to one on one about your situation in person if possible. I'm not trying to stop you from getting hair advice here or anything, because it's clearly bothering you. I'm sure we all can empathize as it bothers everyone on here to a degree, so I encourage members to chime in with suggestions. That said, depression can be a multifaceted problem where the root cause might not necessarily be what you think it is. 

Best, 

Ian
 

[BurnieBurns]

Don't hedge any bets on verteforfin just yet and I think holding out for it won't do you any good for your wellbeing. From the sounds of things you may well still have options. 

Restoring hair loss isn't as simple as 'oral finasteride or bust'.

Depression from hair loss is awful and crippling, but please know that so many of us have been there and understand. I second what Al said, how about you post some pictures and we can see if we can help you on a path forward?

Edited March 27 by BurnieBurns

[Hairlossingfast]

On 3/24/2024 at 5:50 AM, Al - Moderator said:

Do you have any pictures of your current hair situation? You may still be a candidate for hair transplants even if you can't use meds. If you have a lot of body hair you can try using some of that mixed in with scalp donor. If you are prone to eventual donor thinning, the body hair grafts should last much longer than scalp grafts , so that is something you can try doing if you went with a hair transplant. Beard hair is in a much safer zone that the back and sides of the head. Even if you lose a lot more hair, the beard grafts should have a much better chance at continued growth. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Edited March 26 by Hairlossingfast

[Hairlossingfast]

16 hours ago, Al - Moderator said:

Do you have any pictures of your current hair situation? You may still be a candidate for hair transplants even if you can't use meds. If you have a lot of body hair you can try using some of that mixed in with scalp donor. If you are prone to eventual donor thinning, the body hair grafts should last much longer than scalp grafts , so that is something you can try doing if you went with a hair transplant. Beard hair is in a much safer zone that the back and sides of the head. Even if you lose a lot more hair, the beard grafts should have a much better chance at continued growth. 

 

Here is the current situation.  Some pics are combed.  Others are not combed.  My body hair is pretty much non existent.  I also sent pics of donor area but it was a fade haircut so not sure if it's reliable.  I just don't know what I will do if I get the transplant and can't take meds.  Beard is not very good I don't think I have much there to work with.  

[Hairlossingfast]

15 hours ago, Berba11 said:

Sorry to hear you’re feeling this way. At the end of the day though, it’s just hair. Nothing really happens whether you have it or don’t. 
 

I think what you need to do right now is speak to a medical professional who can help with your depression and it sounds quite severe and needs to be addressed asap. 

 

10 hours ago, Ian. said:

Many of us can get in a major funk where our situation feels hopeless. Whether it's about our hair, or the hair more of a metaphor for our life in its current state. But a successful hair transplant wouldn't necessarily alleviate your anxiety/depression. A bad one would only make things much, much worse.

All is not lost my friend, you're not out of options for your hair yet. But Berba11 is right. If your depression is that crippling, before delving into strategies of keeping/improving your hair, try to find someone you are willing to talk to one on one about your situation in person if possible. I'm not trying to stop you from getting hair advice here or anything, because it's clearly bothering you. I'm sure we all can empathize as it bothers everyone on here to a degree, so I encourage members to chime in with suggestions. That said, depression can be a multifaceted problem where the root cause might not necessarily be what you think it is. 

Best, 

Ian
 

Thanks for your concerns I appreciate it.  I have a bad history with mental health professionals.  Speaking to someone is OUT of the question for me.  Especially medicaitons for mental health.  Bad experience with all of that. I've written it off.  I am stuck and don't know what to do about my hair.  I just don't want it to fall out in the next 2 months because I've stopped the meds 3 months ago.

[Hairlossingfast]

6 hours ago, BurnieBurns said:

Don't hedge any bets on verteforfin just yet and I think holding how for it won't do you any good for your wellbeing. From the sounds of things you may well still have options. 

Restoring hair loss isn't as simple as 'oral finasteride or bust'.

Depression from hair loss is awful and crippling, but please know that so many of us have been there and understand. I second what Al said, how about you post some pictures and we can see if we can help you on a path forward?

Thanks for the info and thanks for the support.  I went ahead and posted some pics, not sure if they are helpful because my phone camera is terrible.  I took the pics with flash and back facing camera.  I am seriously hoping that verteporfin will do something, anything, in terms of regrowing donor hair.  I have no idea what else to do.

[BurnieBurns]

2 hours ago, Hairlossingfast said:

Thanks for the info and thanks for the support.  I went ahead and posted some pics, not sure if they are helpful because my phone camera is terrible.  I took the pics with flash and back facing camera.  I am seriously hoping that verteporfin will do something, anything, in terms of regrowing donor hair.  I have no idea what else to do.

Thanks for uploading the pictures. I'm not a doctor but here is my advice. 

It's too hard to tell unless magnified, and I know it's cut very short, but there may be signs of miniaturisation in the donor area. This should definitely be checked out by someone qualified to detect whether you have diffuse unpatterened alopecia.

It could just be the lighting and the angle combined with below average density, but this needs to be confirmed one way or the other before thinking about surgery, 

Given your age and degree of loss, you'd be strongly recommended in my opinion to try oral minoxidil 5mg. This has no affect on libido.

From there, it's worth trialing topical dutasteride once or twice weekly, ideally a formulation designed to limit absorption like Xyon. 

For consulting with clinics, I don't believe someone being depressed should rule them out, however you still need to be level headed, have a mature outlook, and not make any rash decisions. 

If I were your case I would consult with clinic specialising in high norwoods and have experience with beard hair. I know you said yours is non existant, but I have seen cases which have been able to extract a surprising amount.

Eugenix or Dr Felipe Pitella. They may be able to to extract more beard grafts than you would assume. It's worth noting that Dr Pitella does not use finasteride on his patients 

If your scalp is very loose, FUT may be worth considering. Hattingen hair / Hasson & Wong come to mind. 

Lastly, you will need to have your expectations managed. Most patients with a NW6 + pattern in their 20s will need to forgo filling up the crown in favour of addressing the front where the the grafts will have more visual impact. You would also likely need a higher conservative hairline to allow adequate density behind it. 

This is my two cents. There will be well intentioned people who will believe the depression is caused by a deeper issue than hair loss, but if you are absolutely, 100% sure that this issue is the driver, then it may be worth sensibly investigating all the options with good information before throwing in the towel.

[Hairlossingfast]

52 minutes ago, BurnieBurns said:

Thanks for uploading the pictures. I'm not a doctor but here is my advice. 

It's too hard to tell unless magnified, and I know it's cut very short, but there may be signs of miniaturisation in the donor area. This should definitely be checked out by someone qualified to detect whether you have diffuse unpatterened alopecia.

It could just be the lighting and the angle combined with below average density, but this needs to be confirmed one way or the other before thinking about surgery, 

Given your age and degree of loss, you'd be strongly recommended in my opinion to try oral minoxidil 5mg. This has no affect on libido.

From there, it's worth trialing topical dutasteride once or twice weekly, ideally a formulation designed to limit absorption like Xyon. 

For consulting with clinics, I don't believe someone being depressed should rule them out, however you still need to be level headed, have a mature outlook, and not make any rash decisions. 

If I were your case I would consult with clinic specialising in high norwoods and have experience with beard hair. I know you said yours is non existant, but I have seen cases which have been able to extract a surprising amount.

Eugenix or Dr Felipe Pitella. They may be able to to extract more beard grafts than you would assume. It's worth noting that Dr Pitella does not use finasteride on his patients 

If your scalp is very loose, FUT may be worth considering. Hattingen hair / Hasson & Wong come to mind. 

Lastly, you will need to have your expectations managed. Most patients with a NW6 + pattern in their 20s will need to forgo filling up the crown in favour of addressing the front where the the grafts will have more visual impact. You would also likely need a higher conservative hairline to allow adequate density behind it. 

This is my two cents. There will be well intentioned people who will believe the depression is caused by a deeper issue than hair loss, but if you are absolutely, 100% sure that this issue is the driver, then it may be worth sensibly investigating all the options with good information before throwing in the towel.

Thank you for your reply.  This hair loss is definitely causing my depression 100%.  I do not think I have DUPA and think it may just be the lighting and the way in which my hair was cut.  If I grow it out, maybe covers fully, I will see if I have a pic.  Would oral minoxidil stave off more hair loss for a few more years if I also incorporate microneedling?  At this time I want to save up to maybe go to Dr. Zarev since he is the best in the business but also has extremely long wait list and he is the only one with the vacuum FUE approach.  

So you would take oral minoxidol and not take any fin?  And do a consultation with Dr Pitella?  I am looking up Dr. Pitella and it says he has an online consultation form to fill out.  I was thinking about buying the Xyon Dutasteride foam but am worried about sides because of systemic absorption that occurs when administered to the scalp.  But maybe I can try and see what happens.  

[Hairlossingfast]

On 3/25/2024 at 1:17 AM, BurnieBurns said:

Thanks for uploading the pictures. I'm not a doctor but here is my advice. 

It's too hard to tell unless magnified, and I know it's cut very short, but there may be signs of miniaturisation in the donor area. This should definitely be checked out by someone qualified to detect whether you have diffuse unpatterened alopecia.

It could just be the lighting and the angle combined with below average density, but this needs to be confirmed one way or the other before thinking about surgery, 

Given your age and degree of loss, you'd be strongly recommended in my opinion to try oral minoxidil 5mg. This has no affect on libido.

From there, it's worth trialing topical dutasteride once or twice weekly, ideally a formulation designed to limit absorption like Xyon. 

For consulting with clinics, I don't believe someone being depressed should rule them out, however you still need to be level headed, have a mature outlook, and not make any rash decisions. 

If I were your case I would consult with clinic specialising in high norwoods and have experience with beard hair. I know you said yours is non existant, but I have seen cases which have been able to extract a surprising amount.

Eugenix or Dr Felipe Pitella. They may be able to to extract more beard grafts than you would assume. It's worth noting that Dr Pitella does not use finasteride on his patients 

If your scalp is very loose, FUT may be worth considering. Hattingen hair / Hasson & Wong come to mind. 

Lastly, you will need to have your expectations managed. Most patients with a NW6 + pattern in their 20s will need to forgo filling up the crown in favour of addressing the front where the the grafts will have more visual impact. You would also likely need a higher conservative hairline to allow adequate density behind it. 

This is my two cents. There will be well intentioned people who will believe the depression is caused by a deeper issue than hair loss, but if you are absolutely, 100% sure that this issue is the driver, then it may be worth sensibly investigating all the options with good information before throwing in the towel.

Here is a pic I took from march 7th.  Hair was grown out for maybe a couple months (2-3) and combed before taking pic. The angle isn’t the best but it’s hard to take pics from behind my head by myself 

Edited March 26 by Hairlossingfast

[Hairlossingfast]

8 hours ago, BurnieBurns said:

Thanks for uploading the pictures. I'm not a doctor but here is my advice. 

It's too hard to tell unless magnified, and I know it's cut very short, but there may be signs of miniaturisation in the donor area. This should definitely be checked out by someone qualified to detect whether you have diffuse unpatterened alopecia.

It could just be the lighting and the angle combined with below average density, but this needs to be confirmed one way or the other before thinking about surgery, 

Given your age and degree of loss, you'd be strongly recommended in my opinion to try oral minoxidil 5mg. This has no affect on libido.

From there, it's worth trialing topical dutasteride once or twice weekly, ideally a formulation designed to limit absorption like Xyon. 

For consulting with clinics, I don't believe someone being depressed should rule them out, however you still need to be level headed, have a mature outlook, and not make any rash decisions. 

If I were your case I would consult with clinic specialising in high norwoods and have experience with beard hair. I know you said yours is non existant, but I have seen cases which have been able to extract a surprising amount.

Eugenix or Dr Felipe Pitella. They may be able to to extract more beard grafts than you would assume. It's worth noting that Dr Pitella does not use finasteride on his patients 

If your scalp is very loose, FUT may be worth considering. Hattingen hair / Hasson & Wong come to mind. 

Lastly, you will need to have your expectations managed. Most patients with a NW6 + pattern in their 20s will need to forgo filling up the crown in favour of addressing the front where the the grafts will have more visual impact. You would also likely need a higher conservative hairline to allow adequate density behind it. 

This is my two cents. There will be well intentioned people who will believe the depression is caused by a deeper issue than hair loss, but if you are absolutely, 100% sure that this issue is the driver, then it may be worth sensibly investigating all the options with good information before throwing in the towel.

Do you reccomend I do a scalp biopsy?

Edited March 25 by Hairlossingfast

[Al - Moderator]

Your donor doesn't look bad based on that last picture from the back and the sides seemed to be OK from the earlier pictures. You should consider having a consultation with one of the recommended hair transplant Drs listed on this site. That will at least give you a better idea of where you stand and if you can move forward with a HT. See the link below

https://hairtransplantnetwork.com/best-hair-transplant-surgeons

 

[Hairlossingfast]

2 hours ago, Al - Moderator said:

Your donor doesn't look bad based on that last picture from the back and the sides seemed to be OK from the earlier pictures. You should consider having a consultation with one of the recommended hair transplant Drs listed on this site. That will at least give you a better idea of where you stand and if you can move forward with a HT. See the link below

https://hairtransplantnetwork.com/best-hair-transplant-surgeons

 

Thank you I will do , I am just very worried about not taking fisasteride and if I should take Xyon or not.  And now am worried maybe I have DUPA or not.  What would you do in my situation?  My hair definitely used to be much more curly everywhere.

[Hairlossingfast]

I just sent consultations to a few online hair surgeons and am waiting for their advice and feedback

[BurnieBurns]

21 hours ago, Hairlossingfast said:

Do you reccomend I do a scalp biopsy?

I don't see cause for the scalp biopsy from these pictures in my opinion.

I understand how overwhelming it all must be but first and foremost you need to be seen by a qualified and recommended surgeon.

What area do you live? You could start by going to someone closer to you

[BurnieBurns]

14 minutes ago, Hairlossingfast said:

I just sent consultations to a few online hair surgeons and am waiting for their advice and feedback

That will be a good start, in person is best but it's worth seeing what they come back with

[BurnieBurns]

10 hours ago, Hairlossingfast said:

Thank you I will do , I am just very worried about not taking fisasteride and if I should take Xyon or not.  And now am worried maybe I have DUPA or not.  What would you do in my situation?  My hair definitely used to be much more curly everywhere.

It's understandable to be worried, maybe wait until you're seen by a doctor you trust before trying medication again so you receive proper guidance. 

Sometimes hair texture can change just with age but we can only speculate at the end of the day. It will first need to be seen by a doctor who knows what to look for with the right equipment, so he/she can give you a better idea of the circumstances.  

[Hairlossingfast]

5 minutes ago, BurnieBurns said:

I don't see cause for the scalp biopsy from these pictures in my opinion.

I understand how overwhelming it all must be but first and foremost you need to be seen by a qualified and recommended surgeon.

What area do you live? You could start by going to someone closer to you

I bring up scalp biopsy b/c I thought it would give definitive cause for my hair loss and rule out DUPA or not.  I also have lots of scalp itching and painful red bumps that I never addressed and thought it was due to the topical minoxidil but since stopping that, I still get these symptoms.  So maybe autoimmune hair loss like diffuse alopecia areata?  I have scheduled an appointment with my dermatologist for later today and will be asking about the scalp itchiness and possible causes.  I am in USA midwest, I can start looking for someone to consult with about HT and see what they say.

[BurnieBurns]

22 minutes ago, Hairlossingfast said:

I bring up scalp biopsy b/c I thought it would give definitive cause for my hair loss and rule out DUPA or not.  I also have lots of scalp itching and painful red bumps that I never addressed and thought it was due to the topical minoxidil but since stopping that, I still get these symptoms.  So maybe autoimmune hair loss like diffuse alopecia areata?  I have scheduled an appointment with my dermatologist for later today and will be asking about the scalp itchiness and possible causes.  I am in USA midwest, I can start looking for someone to consult with about HT and see what they say.

I see. For regular androgenic alopecia, even if it's DUPA, is identified by hair miniaturisation rather than biopsy. However if you're getting those symptoms as well that could suggest something else, in which case a doctor might refer for a biopsy. Sounds like you're taking the right steps.

If helpful, recommended surgeons in or near the midwest would include:

Drs Ron Shapiro & David Josephitis in Minnesota

Drs Raymond Konior or Vladimir Panine in Chicago  

Dr Robert Haber in Ohio (also specialises in dermatology)

Dr Jerry Cooley in North Carolina

Edited March 26 by BurnieBurns

[Hairlossingfast]

5 minutes ago, BurnieBurns said:

I see. For regular androgenic alopecia, even if it's DUPA, is identified by hair miniaturisation rather than biopsy. However if you're getting those symptoms as well that could suggest something else, in which case I doctor might refer for a biopsy. Sounds like you're taking the right steps.

If helpful, recommended surgeons in or near the midwest would include:

Drs Shapiro & Josephitis in Minnesota

Drs Konior or Panine in Chicago 

Dr Robert Haber in Ohio

Dr Jerry Cooley in North Carolina

Very helpful, thank you very much.  Also have lots of allergies to molds, pollen, etc that I never addressed and saw a video by Dr Gary Linkov on YouTube saying a theory could be immune system attacking hair follicles b/c of allergies and need to retrain body to attack allergins by getting allergy shots so that maybe a solution if that is the cause.  Or maybe just wishful thinking and I'm delusional

[BurnieBurns]

8 minutes ago, Hairlossingfast said:

Very helpful, thank you very much.  Also have lots of allergies to molds, pollen, etc that I never addressed and saw a video by Dr Gary Linkov on YouTube saying a theory could be immune system attacking hair follicles b/c of allergies and need to retrain body to attack allergins by getting allergy shots so that maybe a solution if that is the cause.  Or maybe just wishful thinking and I'm delusional

It's possible there could by an autoimmune component of what your experiencing. There are ways of testing for these things and I'd be confident one of those doctors could get to the bottom of it or at the very least refer you to someone who could. 

Nothing is going to stop depression over night and battling hair loss is a marathon not a sprint. But if you set yourself up to see the best people, you can at least reassure yourself for the time being you've done the most proactive thing possible for your situation.

Feel free to update the forum with how you get on. 

Good luck!

Edited March 26 by BurnieBurns

[Gatsby]

On 3/24/2024 at 2:35 PM, Hairlossingfast said:

I was on oral finasteride and topical minoxidil for years and gradually kept losing erection quality to the point of impotency.  I have since quit both meds for the past 3 months

I would jump back on minoxidil. I'm not a doctor but I would consider seeing one to get a referral to a dermatologist for a script for oral minoxidil. Minoxidil is not the culprit. Oral minoxidil will also benefit all of your scalp hair and beard (not just where topical minoxidil is applied). Also when I was 18 and I began to see my hair begin to recede I went from being a party animal to sinking into a deep depression that nearly took my life. Even ten years later with scars from botched hair transplants and a hair piece I was a thousand times happier. I respect your decision not to see a professional for depression. For me though it literally did save my life. I later shaved my head and had SMP which improved the scars quite a bit. The thought of shaving my head at 18/19 was an impossible thought to entertain. Yes hair loss is dictating your depression as it was mine. However I got to a point where I could deal with fighting the MPB. Today I am a different person and it was worth it. Feel free to DM if you like. All the best and you are not alone.

[Hairlossingfast]

8 hours ago, Gatsby said:

I would jump back on minoxidil. I'm not a doctor but I would consider seeing one to get a referral to a dermatologist for a script for oral minoxidil. Minoxidil is not the culprit. Oral minoxidil will also benefit all of your scalp hair and beard (not just where topical minoxidil is applied). Also when I was 18 and I began to see my hair begin to recede I went from being a party animal to sinking into a deep depression that nearly took my life. Even ten years later with scars from botched hair transplants and a hair piece I was a thousand times happier. I respect your decision not to see a professional for depression. For me though it literally did save my life. I later shaved my head and had SMP which improved the scars quite a bit. The thought of shaving my head at 18/19 was an impossible thought to entertain. Yes hair loss is dictating your depression as it was mine. However I got to a point where I could deal with fighting the MPB. Today I am a different person and it was worth it. Feel free to DM if you like. All the best and you are not alone.

Thank you, I appreciate your words.  Am definitely considering oral minoxidil.  Losing hair is definitely depressing and I cannot function like this.  I can understand why someone would be deeply depressed by it and suicidal.  I just can't get out of the depression if there's no light at the end of the tunnel.  And if I truly have DUPA or retrograde alopecia and cannot use any meds or if HT is not possible, idk how I will ever be not depressed and live a life.