500 USD / month budget - maximize hair regrowth

[xapato]

37yo Norwood 2.5 with very slow recession since around 18.

Here are my recent pics:








Here I am 10 years ago:


I believe that my forelock was denser and wider 10 years ago, and my temples had not receded as far back. My goal is to regain some of the lost thickness, widen the forelock, and regrow my temples partially, in the next 18 months. It would be nice to try to figure out which drug does what, but I think the kitchen sink strategy will probably produce a better result.

I am willing to spend up to around 500 USD / month, apply topicals once per day, and use a dermapen once per week. I don't care about laws, insurance, getting prescriptions, etc., but I do want to be able to have kids.

I've been on the following for almost 2 weeks:
dutasteride 0.5mg / day
ketoconazole 2% 3x / week

I'm planning to add:
oral minoxidil 5mg / day
fish oil

Things I'm interested in, from most to least:
topical RU
oral setipiprant
topical PGE2
hGH
valproic acid
cloprostenol
stemoxydine
biotin
multi vitamin
dermapen
lithium chloride

What should I do? I will log my progress and periodically post pics of top (messy, pulled back, slicked back with conditioner in hair), front, temples with hair pulled back. Suggestions on taking photos will be appreciated. I'm looking for a way to position my head the same way relative to the camera every time. I have a ghetto method at the moment.

 

[Felipe302]

CB 03 01 over RU

 

[rambo007]

Just do hair transplant, you are the perfect candidate.

 

[Dench57]

Just do hair transplant, you are the perfect candidate.

Agreed. Literally the perfect candidate for a hair transplant - right type of loss, older, non-aggressive hairloss and on dutasteride. Not sure why you would want to commit to a hardcore regimen that will never yield better results than a hair transplant from a top doctor.

However if you don't want to go hair transplant for other reasons, I would suggest forgetting about oral minoxidil firstly. At 5mg its not strong enough to do anything great for hair, as soon as you start reaching a dose that is useful for hair, it comes with potentially very serious side effects. Just go with topical minoxidil.
Forget HgH, multivitamins, biotin, VPA too. Just not worth it.
Stemoxydine, Seti, PGE2, dermapen (would recommend derminator) are all useful additions. CB would be preferable over RU but it's not easy to come by top quality CB.

 

[xapato]

I want to follow an aggressive treatment regimen, then get a hair transplant if treatment doesn't get me where I want to be. Do you think it makes sense to wait until I've been on treatment for 12-18 months?

I do have have some hope that histogen or some other treatment that comes out in the next few years will be enough, but I'm not going to base my decisions too heavily on that.

- - - Updated - - -

Agreed. Literally the perfect candidate for a hair transplant - right type of loss, older, non-aggressive hairloss and on dutasteride. Not sure why you would want to commit to a hardcore regimen that will never yield better results than a hair transplant from a top doctor.

However if you don't want to go hair transplant for other reasons, I would suggest forgetting about oral minoxidil firstly. At 5mg its not strong enough to do anything great for hair, as soon as you start reaching a dose that is useful for hair, it comes with potentially very serious side effects. Just go with topical minoxidil.
Forget HgH, multivitamins, biotin, VPA too. Just not worth it.
Stemoxydine, Seti, PGE2, dermapen (would recommend derminator) are all useful additions. CB would be preferable over RU but it's not easy to come by top quality CB.

I may do HGH for other reasons. I'll look into those compounds you mentioned were useful.

I was reading that oral minoxidil has been found by some hair doctors to be more effective than topical, even at just 5mg / day. One of those doctors is Pathomvanich. The potential side effects are indeed alarming.

Forgot to mention: I think fullness and thickness is important. My hair in the pic from ten years ago looks thicker, doesn't it? I'm hoping to thicken my hair back up all over the top. That's another reason for the aggressive regimen. I want to save as many native hairs as possible. But if all of these treatments only improve the result by 10 or even 20 percent, maybe it's not worth all of the trouble.

 

[Swoop]

Don't bother with all that. It's pretty much useless, you are already on dutasteride too.

Go to a top notch surgeon and you can go even for a perfect NW1 hairline if you want. Seems you have good hair characteristics too.

Minoxidil is what you can try. However it's extremely unlikely that it will regrow your temple area. Don't try it orally either but topically.

 

[xapato]

Is there any real benefit to waiting to have a hair transplant? I just started dutasteride.

 

[Swoop]

Is there any real benefit to waiting to have a hair transplant? I just started dutasteride.

Yeah avoiding it if you can by hitting the androgen/AR angle first. And trying out minoxidil with that. Perhaps you will be happy with the results so you can avoid a hair transplant.

I didn't see your goal but if it is to regain some thickness, widen the forelock, and regrow your temples partially then continue with dutasteride. At the 12 month mark I would add minoxidil. Don't see results that are cosmetic beneficial with minoxidil within 3-6 months? Drop it and never use it again.

That's what I would do. If you have done that and you don't reach your goal you are already pretty much out of options.

Look the formula for maximizing regrowth is very simple;

You hit the androgen/AR angle preferably as hard as you can and you add minoxidil to that.

Don't see results that please you in 1,5 year? Sorry dude you are pretty much out of options at this point (outside of 17b-estradiol or bio-identical compounds, but that will turn you into a woman).

And by hitting the androgen/AR angle as hard as you can you are limited too actually. Castration is not a viable option, oral spironolactone isn't a option. Leaves us pretty much with compounds like finasteride, dutasteride, RU58841 and CB-03-01.

These other things you talk about? Pretty much useless and not worth it dude dude. I mean remember also man you need to keep up with these treatments too. Do you want to use 6 things daily for the rest of your life? Do you want to apply 4 topicals on your head daily and microneedle your head to sh*t? For what eventually? Marginal beneficial results at best?

So yeah well in your situation, I would just ride with the dutasteride for some time and see how that works out for you. Then add minoxidil at a certain point, if you don't see ​cosmetic improvement due to minoxidil drop it. Don't use oral minoxidil by the way but topical.

If you ain't happy after you have done that just consider or go for a hair transplant. I agree with Dench that you seem a very good candidate for a hair transplant given your age and your not aggressive loss. You are in a great position.