Diagnose me...please?

[luke77]

Hi everyone,
I've been losing my hair, slowly, for about 4 years now. I've always assumed that it was male pattern baldness but I just wanted some second opinions because my pattern isn't really typical. My hair loss is diffuse, with very little recession in the front. In fact, my hairline had not receded at all until about 1 year ago, and even now it has not changed a whole lot. In addition, my hairline is still strong relative to the rest of my scalp. I seem to have lost much more hair on the top of the scalp than anywhere else, even the typical "bald spot" at the back of the head. Also, I have thinned somewhat on the sides of my head which does not typically happen with male pattern baldness, although I'm much thinner on the top than the sides. The side pic isn't great but you can kind of see the thinning. If you guys would look and tell me what you think I would really appreciate it. I'm 90% sure it's male pattern baldness, just not typical male pattern baldness, but I'm not certain that it isn't something else like Telogen Effluvium. After looking at these pictures I realize how much I have actually lost, but the only thing I have working for me is that with plenty of toppik, my hair loss is still not eveident to those around me. However, pretty soon I'll be too thin for that and I'll probably have to shave it. Oh yeah, is there anything I should be doing differently treatment-wise for my diffuse thinning vs. "regular" male pattern baldness? I'm using minoxidil right now and have previously used both finasteride and dudasteride, neither with any noticeable effect. Thanks in advance for the help.

Here's the link to my pics:

http://pg.photos.yahoo.com/ph/btcarter777/my_photos

Luke

 

[Cornholio]

Looks like male pattern baldness to me... I have similar thinning and will use topik if things progress. Its good to know that works.

Regarding treatments I think that if one doesnt work ADDING another treatment rather than stopping what you were doing and trying something else is the way to go. You seem to suggest you tried finasteride then dutasteride then minoxidil. These groups of meds can have additive effect with oral DHT blockers working to preserve hair (it works especially well on the crown rather than frontal) and minoxidil helping maintenence and regrowth. I would suggest getting back on finasteride or dutasteride AND take minoxidil AND nizoral shampoo. There is always more you can add to that for marginal benefit (tricomin, spironolactone or fluradil) but it sounds like you havent tried any combination of treatments yet. That is worth a try (if you choose) before trying shaving (which isnt a bad thing either : )

 

[TheBaldingMenace]

luke77, it looks more like diffuse thinning to me. I'm not a Doctor but I'd say it looks more like Telogen Effluvium to me than male pattern baldness. Do you have allot of stress type stuff going on in your life?

 

[snap]

go see a doctor.

 

[luke77]

I don't have alot of stress at all...my life is pretty relaxed and has been for a while so I don't think it's stress. In response to the first poster, I don't think I was clear enough - I have been using minoxidil since my hair loss started. I added finasteride soon after that (so I was on minoxidil + finasteride) and then switched the finasteride for dudasteride after about 1.5 years with no noticeable results. I stayed on dudasteride for about 8 months with no niticeable results and then stopped because I could no longer afford it. My doctor tested my testosterone levels at around this time and advised me not to use the finasteride or dutasteride until those improve. I do plan on seeing a derm. but it might be a while until I am able to, that's why I'm looking for advice here in the meantime. Thanks again for the responses thus far.

 

[Cornholio]

My doctor tested my testosterone levels at around this time and advised me not to use the finasteride or dutasteride until those improve.

What did he mean "improve?" One would expect the testosterone to be a little higher than average (20%) with finasteride (but usually within the normal range) and still higher with dutasteride as compensation for a reduced DHT. The testosterone wasn't low was it? If so that would not be explained by finasteride or dutasteride and could be worth looking into.

Oh, and was thyroid function normal?

 

[luke77]

No, actually my testosterone levels were very low. Come to think of it, I had stopped the finasteride/dutasteride a few months before my test. levels tested low, and I don't think the medication had anything to do with it. I had lost some weight and I think the weight loss was the reason my testosterone levels tested low. The hair loss began much before any of the testosterone problems or any of that other stuff, so I think that it is unrelated. The only medication that may have potentially had anything to do with my hair loss was accutane - I finished a course of that about 6 months before my hair loss started. According to all medical sources the accutane had nothing to do with my hair loss, but it seems like others have had very similar experiences to mine...so I don't know. Oh, also, I think my thyroid function tested abnormally once (I have been having blood drawn monthly) but has been in the normal range for a while (although it may be low-normal). I don't think my doctor even tests it anymore - I will ask him about it next time I see him. What would abnormal thyroid function be indicative of?

Thanks,
Luke

 

[wotsthedeal]

That definitely doesn't look like male pattern baldness to me. It looks exactly like female pattern baldness. I'd get everything checked out (iron, thyroid, etc.) and maybe you'll find some reason for the strange pattern.

 

[Goingat20]

It seems to me that you had thin hair before you began losing it. It looks like male pattern baldness to me....

 

[luke77]

No, I didn't have thin hair at all before I started losing it - in fact, it was quite thick. I have had various weird blood levels over the years, and perhaps it is time to ask my doctor to run a complete panel of everything he can think of. I have never been inclined to link my hair loss with accutane, but I've recently been reading through a couple of accutane support groups - an it's eerie how many people have experienced diffuse hair loss that STARTED after coming off accutane...I'm beggining to think that accutane may have screwed me up big time. The problem is, I can't really tell my Doctor this because almost all doctors don't believe the accutane extended side effect claims (and who knows, maybe they are right).

 

[matt_1_]

that's the zidane way...

 

[chew]

luke, i don't know what to tell you. your loss is more than mine, but the pattern sounds familiar. you should read through the two threads "any experience with stress related hair loss" and "new pics of my Telogen Effluvium or male pattern baldness" .

A few folks are definitely dealing with a similar quandry.

 

[The Gardener]

Definitely an Norwood Zidane 2.5

Given the time frames you mention, I think its male pattern baldness. I would see a doctor.

 

[luke77]

Would asking a Doctor to do a scalp biopsy determine whether it is male pattern baldness or some other cause? Thanks.

 

[chew]

i think yes...but i don't know who (what kind of a Doctor) will do one...i have been to few docs and none did

 

[Axon]

Low testosterone levels can only be beneficial to your hair (though not to the rest of you). I would recommend a second opinion.