Hi, I had posted before under a different name but had to reset things, so here is my story again with a 1 month update in the following post. This is originally from 5/25/2011.
Baseline Posting & Pictures
Topics: The Story, Past Treatments, Pictures, Treatment Plan, The Regimen.
Having recently turned 26 I'm finally ready to do something about my hair loss. I'm an otherwise healthy male with MPB on both sides of the family. I've always had thin, fine light brown hair, and probably noticed it was first going at about age 20 with the thinning of the crown and formation of a dime-sized bald spot that hair just seemed to part itself away from. I didn't let it get to me and have enjoyed the past five years with my head held high, all the while powering through the Norwood scale at lightning speed. Looking back, I was a solid NW3 at 22 years old, an NW4 by 24, and now sit at what I believe is a NW5 since sometime during 25.
Things really accelerated when I entered a PhD program at 21 and spent the next four years just trying to keep up. It meant intense stress, inadequate exercise, and - probably worst - a horrible sleep schedule, usually only 3-4 hours per night and at least one night a week when I "double dip" and don't sleep at all for a night, going from, say, waking up Tuesday morning then working through Tuesday night and Wednesday, then sleeping 10-12 hours Wednesday night to catch up. It seems like the lack of sleep (or some other feature of the lifestyle) has contributed to accelerated hair loss. On the second day of an overnight powersession I tended to notice tons of shedding onto my papers and keyboard, often having to blow dozens of hairs off every half hour or so. The shedding has actually mostly subsided, as there's not much left on top to shed anymore! Unfortunately I'm so committed to finishing strong in this program that the resultant hair loss has been a necessary evil to ensure I don't fall behind. I have been hopeful that most or some of the hairloss is simply tellogen effluvium from a mentally and physically stressful lifestyle that will resolve once I'm done with this academic program, although noting the family history of MPB and the NW-style progression, this may be a fanciful dream.
Since I'm tall enough (6') and only ever see myself from the front I probably haven't noticed how bad it has gotten. Friends and family close to me have started to make small jokes or comments in passing which I don't really mind, I tend to look at it as endearing, but it does make me aware that it is a visible issue and there are probably people not as close to me who think it but just don't say it. And as I'm still single and honestly haven't even hit the dating market much due to my overcommitment to my studies, I'm growing concerned that I'm going to finish school and be set up for lifelong success, yet bear the appearance of a broken man. Like many people have reported, I feel like I've wasted what could have been the best years of my life buried in the books in hopes of providing a better life down the road which I may not be able to fully enjoy due to hair loss.
Ok, enough storytelling, on to the goods: I haven't really done much to treat it to date, I had a roughly two month long run-in with minoxidil (as Rogaine foam) two years ago, at age 24. I used it semi-regularly but not regularly enough; the day-long appearance of a wet spot on the back of my head from the foam prevented me from wanting to use it in the morning, and it was just far down on the list of priorities so, sadly, application just fell between the cracks some days. About a year ago I started with the Nioxin 5 part system: shampoo, conditioner, 'scalp activating treatment', 'follicle booster', and some glorified multi-vitamin. The shampoo and conditioner aren't bad, but even the full system hasn't done anything to noticeably improve the situation or even stop the shedding, so I'll choose not to renew this costly system for another go around. I've been taking 320mg Saw Palmetto for the past six months or so, half in the morning and half at night. I've recently cut back to just 160mg in the morning and will be completely done with my supply by next week. It wasn't good or bad, but I'm no longer throwing time and money at anecdotes, instead opting only for the proven stuff or strongly promising stuff, as I'll explain in the Treatment Plan below.
I looked into finasteride about a year ago but propeciahelp scared me away. I didn't really think of hair loss as a big issue until recently, and deep-down I knew that the worst thing that could happen is the hair loss affect my behavior, so to that extent there was some value in denial. I remember explicitly thinking that the more I thought about hair loss, the more I'd worry and more hair I'd lose, so I did a good job blocking it out for a few years. I wouldn't mind continuing on that path, but it has become unavoidable. I am happy to say though that it still doesn't inhibit me much...it's clear that it's only as big a deal to others as I make it out to be, so I don't let it stop me from going out, being loud, talking to girls, and I just act like I don't know any better.
Even so, it would be nice to actually have some hair up there, or to know I'm stuck with only the Rob Corddry-esque tuft for good at which point I'd probably consider shaving it all. Before getting to the treatment plan let's lay down the baseline photos:
Two overhead shots with flash:
And two without flash:
One from above-front:
Here is a series of five from above, from behind to just forward of 12:00:
You know, I'm not sure if it matters, but I'm taking these with a camera with a 25mm equivalent wide-angle lens. I'm not sure if that distorts the perspective in these pictures, especially up close, but I do have a pretty big head anyway.
Geez I didn't even realize it was that bad until taking these pictures, because I usually only see it from the front, like this:
And it's really a shame because I have awesomely thick hair in the back and on the sides, it's just been total destruction of the hairline, crown, and top of the head. The lack of parity is really becoming striking. I'm not sure if this is indicative of anything or useful information, maybe it would lend itself to a HT down the road, but that doesn't look like a road I'll be taking at this point. Here are two pics of the sides, they don't look as thick in the pictures due to a recent haircut, I'll get better ones sometime:
Finally, a few more candid shots in action, although it's dark and you can't see much. Obviously I can't take candid pictures of myself, and I think the friends who usually do take pics of me consciously try to avoid exposing the bad hair up top, so I don't really have any that highlight the hair:
Ok so that's where I'm starting from. Next:
As the first piece of practical advice I picked up here on HLT, I've been using Nizoral 2-4x per week for a month or two. Haven't really noticed anything but will continue to do so on the good advice of the people on this board.
I saw my GP last week for the first time in years, he took one look, confirmed AGA, and wrote a prescription for 5mg fin with the instructions to take 1/4 pill (1.25mg) for four days and skip the fifth day. I filled the 20-pill prescription (80 doses, ~3 months worth) for $19 at the University's pharmacy. He also ordered blood tests for some things I can't remember, and, as suggested on propeciahelp, I had him add LH, FSH, and free/total Testosterone. I also asked for estrogen, prolactin, and SHBG, but he started to balk, saying it's not necessary and would end up costing me a fortune out-of-pocket. I didn't push the issue. I'll be back in two weeks to discuss the results of those tests and will post them back here.
I dusted off my three remaining cans of Rogaine Foam from my stint two years ago, they just expired last month but, knowing that the expiration date is a minimum effective date, I feel comfortable using them up quickly over the next three months. I started taking the fin in the evening/nighttime and applying the Rogaine Foam twice a day, both on Tuesday, May 24, 2011. I have for a few years taken a daily Centrum multi-vitamin, half in the morning and half at night, each with a Fish Oil/Omega-3 supplement and 500mg Biotin, and plan to continue doing so with the new treatment plan.
I also ordered the S5 5% spironalactone cream from this site for its topical anti-androgenetic properties, and will integrate that into the regimen 2x/day about 10 minutes after applying minoxidil, as indicated by Dr. Lee. It won't arrive til June at best, but I'm not sure when I want to integrate this in. I'd like to see if the fin and minox have any impact first, but know that that could take a year or more. I'm still undecided on when to start using the spiro; my fear is that something works and I'll be locked into using them all permanently for lack of knowledge about what is actually doing what. I'm trading that off with the risk of less-than-effective treatment by leaving out some known solutions in the meantime. So the regimen is as follows:
Nizoral 1% Shampoo, 2-3x/week (began 4/01/2011)
Finasteride 1.25mg/day (began 5/25/2011)
Minoxidil 5% (Rogaine Foam) 2x/day (began 5/25/2011)
Spironolactone 5% with .025% Retin-A (S5) 1x/day (beginning 6/08/2011)
Daily Centrum multi, Omega-3s (600mg), Biotin (1mg)
-Replace Spiro with RU or CB, pending results and availability.
-Integrate ASC-J9, pending results and availability.
-Integrate a Copper Peptide/SOD spray, once thereís something better than Tricomin/Folligen (2.5% AHK-Cu, TEMPO/TEMPOL, and PBN).
-Include Aminexil treatment every 6 months starting in December.
-Replace Rogaine with Spectral DNC, if I get rich.
-Integrate more growth promoters:
TESTING: L'Oreal Pro-Vive Thickening vs.
Aveda Pure Abundance Shampoo + Clay Conditioner
TESTING: different American Crew products, tend to favor Forming Cream.
Tresemme Hair Spray (sometimes)
Have a can of Toppik around I donít really use.
TESTING: Couvre vs Dermmatch
Nioxin 5 part system - Shampoo, Conditioner, Follicle Booster, Scalp Activator, Vitamins (1 year, replaced with Nizoral)
Saw Palmetto 320mg/day (6 months, replaced with Finasteride)
Blind Faith (through 5/24/2011)
Thanks for reading my story. I really appreciate any comments, feedback, advice, or criticism. I'll post back regularly with updated pictures. I'll also keep you posted with the results of the blood tests due back from the doctor in two weeks. Thanks again!
Here is also a timeline for reference that I'll update with each new development. You can see my currently updated regimen using the button below my signature.
5/24/2011: Started Niz, Fin & Minox (had been using Niz for 2 months)
6/08/2011: +Spironolactone 5% with .025% Retin-A
7/02/2011: +MSM 3g daily