Frontal Balding: A Realistic View of the Available Options

Gene_Fighter

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Hey y'all, this post is basically a presentation of my thoughts on the treatment options available for those of us with frontal balding and hairline recession. For years now I've been casually researching/pondering any effective treatment solutions for a receding hairline, and the conclusion I've reached is this:

If you're a receder smitten with true male pattern baldness, you're simply f'd.

Now, obviously, there are many different platitudes of hairloss, and when I say "a receder smitten with true male pattern baldness", I mean a receder that is actually suffering from male pattern baldness and will inevitably become totally bald at a premature age--I don't mean someone that has a natural nw2 hairline or has receded to a nw2 by the age of 30. That type of hairloss can really be better described as natural aging, as it does not result in baldness at a premature age, and therefore should not be considered male pattern baldness. Because such people have only very mild hairloss to begin with, they can expect great results from almost any treatment option they use.

Here's what I've learned about the most standard options available and why I believe they are ineffective at combating hairloss for receders with true male pattern baldness:

Finasteride : Just check out the website for Propecia, one of the first things they state on the homepage is that "There is not sufficient evidence that PROPECIA works for receding hairlines at the temples." It shouldn't be any surprise to learn that Finasteride won't have any effect on the hairline region for those with true male pattern baldness. Just look at the comparison pictures they post on their site of identical genetic twins with male pattern baldness, one using finasteride and the other without. They both have identical hairlines with recession, but the twin on finasteride has slightly more hair on the vertex region (the “crownâ€￾ at the back of the head).

Now, I've read many of the success stories on here from users who say they have stopped recession or regrown some of their hairline on finasteride. I'm not saying that finasteride doesn't work at all on the hairline--I'm just saying that if you're a receder with true male pattern baldness, it won't work for you. Every hairline success story I've read involving finasteride was from a user that was not a receder to begin with, was doubling their treatment with minoxidil, or was suffering from only very mild recession, better described as natural aging.

Final finasteride conclusion: Will almost certainly thicken up or maintain the hair on the top of your head, but won't do a thing for your hairline if you're a receder with true male pattern baldness.

Minoxidil: Unlike Finasteride, I have noticed from my observations of others that Minoxidil does seem to have some effect of regrowing hair on the hairline in certain individuals--although it is stated right on the packaging of certain minoxidil products like Rogaine Foam that it is not to be used for those suffering from frontal baldness. However, despite this, minoxidil does seem to be the most realistic option available on the market for fighting frontal hairloss--but this should not be overstated, as "the most realistic option" still doesn't say much. Once a hair follicle shrinks completely and is gone, no amount of minoxidil in the world can bring it back; I've noticed that only in cases where there are still many miniaturized hairs populating the hairline is any regrowth or thickening possible. Otherwise, you can't expect any results on hairs that aren't there.

Final minoxidil conclusion: Use it if there are still small hairs left or if you're willing to make that sacrifice, but don't expect miracles.

Hair Loss Transplants: HairLossTalk.com is such an unrealistic option on so many levels that I'm not going to spend much time on this. If you are experiencing recession high on the hairline a HairLossTalk.com can work for you, but if you're losing hair from just above the sideburns back, only the best surgeon in the world could effectively transplant hairs there without it looking just awful. Extremely expensive, requires life-long grafting, not effective just above sideburns, modest results.

Final HairLossTalk.com conclusion: Do it if you're independently wealthy and your hairloss pattern is acceptable for a good transplant.

Anything else not FDA approved: If have you have any form of male pattern baldness, don't even bother. If not, and you don't expect much, then go ahead.

Now, I realize that I sound like an arrogant *** and probably the biggest negative Nancy in the world--but that's really not my intent. I never expected this would become a giant essay, but I wanted to list all of the effective options available for a receder with true male pattern baldness, for my own benefit as well as for the benefit of others. I've been searching for some time for an effective treatment against hairline recession, and I suppose I just had to realistically evaluate all of the options like this to fully accept that there are none, and also to honestly and realistically present the information for others out there who are also receders.

But I'm sure some of you have different opinions about this perspective. One argument I can imagine some using would be this: Well if you have any form of TRUE male pattern baldness, you're f'd in any case! But I don't believe that to be true. If you're a general diffuser or balding at the vertex you can typically expect much better results than if you're a receder with true male pattern baldness.

C'mon, fight me! I'm ready for you! :) Hmm, this is good stuff. Consider yourselves lucky to be blessed with my glorious wisdom.
 

somone uk

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even though not FDA approved i regrew my temples with topical caffeine
though it's only vellous hair but still regrowth
and articles on copper peptides and SOD's seem to shine a promising light on frontal baldness
on the other hand i can bet the trials for minoxidil and finasteride were conducted with NW4-7s because it would make analysis easier, i don't see anything significant about the frontal hair that would make minoxidil and finasteride completely redundant for treating it except for maybe the fact that it's much more sensitive to DHT
also people in success stories have shown hair growth on the big 3
 

Thickandthin

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Generally true, but this is a pretty pessimistic view of things....

There are plenty of success stories on here and other message boards of people growing hair - terminal hair - on bald temples. And even more stories where people have grown shorter "minoxidil" hair, which on a hairline makes a big difference.

Usually though you just see a strengthening of the hairline, where it becomes more defined. The real benefit of finasteride and minoxidil in that case is the strengthening of hair that was on its way out. And finasteride pulls double duty because it keeps male pattern baldness hair from ever miniaturizing in the first place - something that is not readily apparent until its pretty significant and a person has lost a lot of hair already (I believe the quoted figure is 50%).
 

hairrific

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I can't stop thinking of the Dominican "pseudohermaphrodites" for which inspired the development of finasteride: Realizing that the pharma industry and doctors would just play it safe and make more money with a one size fits all dosage. Do you always do what your told and fall in line like the others, can you make a production car better and faster? I would up the dosage of finasteride if I was losing ground to hair loss. No 5ar means no dht means full head of hair.
 

JLL

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I don't get this "once the follicle has stopped producing hair, you'll never grow it back" theory. Maybe it's more difficult afterwards, but it's certainly possible.
 

somone uk

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JLL said:
I don't get this "once the follicle has stopped producing hair, you'll never grow it back" theory. Maybe it's more difficult afterwards, but it's certainly possible.
no, you can thicken the miniaturised hair but once the follicle is gone it's gone, normally the hair is not completely lost it just becomes vellous and then dormant and then it's lost
 

Gene_Fighter

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Thickandthin said:
Generally true, but this is a pretty pessimistic view of things....

Well, I didn't want to sound pessimistic, just realistic. I think it's important to fully understand what you can generally expect for results with a certain type of male pattern baldness.

I know now that the finasteride simply isn't going to do enough for the aggressiveness and severity of my receding hairline, so I'm going to start the foam. Yeah--it's a pain in the ***, probably won't work, and might destroy my hairline (for a little while, or permanently)--but I understand now that finasteride simply isn't going to maintain or restore my hairline like I would want it to.

Thickandthin said:
There are plenty of success stories on here and other message boards of people growing hair - terminal hair - on bald temples.

Could you show me a success story like that? I have yet to find one. I've seen stories of people maintaining and thickening the hairline, and even regrowing some hair high up by the widow's peak, where some thin hairs may remain--but I've never seen any regrowth at the temples, just above the sideburns. I've just never seen it. I believe it's because the thin vellus temple hairs are so sensitive to dht, and also, unlike a bald spot or thinning hair, as the hairline recedes it leaves just barren skin without hair follicles, making regrowth impossible.

But I'd like to be proven wrong, anyway.
 

Gene_Fighter

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Yeah a few of those do show some modest regrowth in the temple area. Again I'd have to reiterate that Rogaine Foam really appears to be the only non-invasive option for receders with male pattern baldness--although still, one must be realistic about the results.

It's a tough struggle, and if you really are a receder with a male pattern baldness, you just gotta let it go at some point. I am hoping, however, that I won't have to let my own go until I'm at least 30; depends on how well the minoxidil foam and finasteride maintain my hairline.

I'd like to see some updates on these posts later to track where those people are at now in terms of their hairloss. I don't think the Rogaine Foam is a sustainable option for the long run.
 

dpdr

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I think the best options for the front are Spectral DNC-L, S5 Cream and RU 58841, Propecia, minoxidil and others are ineffective in this area
 

but What about Today

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dpdr said:
I think the best options for the front are Spectral DNC-L, S5 Cream and RU 58841, Propecia, minoxidil and others are ineffective in this area
I wouldnt put ru up there, 300 dollars a month is crazy, you wouldn't even start to see results till 3 months and 900 dollars later.

Spend that 900 on a great combo of stuff and you'd be better off.
 

Gene_Fighter

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Refer to this earlier thread for a brief summary of my thoughts on this subject:

viewtopic.php?f=42&t=48035&st=0&sk=t&sd=a&start=110

"restoring the temples is impossible. Thats one area that treatments just can't cover." I have to agree with Cassin on this issue. Be sure to notice that in the success story Squeegee uses to try and disprove Cassin, the "hair-loss sufferer" is actually only a nw2, slightly thinning; and if you look closely, there is no regrowth, just thickening, as he already has a lot of hair at the temples.

All of this just confirms what I've already stated.
 

Mens Rea

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somone uk said:
JLL said:
I don't get this "once the follicle has stopped producing hair, you'll never grow it back" theory. Maybe it's more difficult afterwards, but it's certainly possible.
no, you can thicken the miniaturised hair but once the follicle is gone it's gone, normally the hair is not completely lost it just becomes vellous and then dormant and then it's lost

Well thats just it. You cant regrow a DEAD follicle but any recent hairloss usually the follicle will be dormant, not dead. It takes years (usually) for a follicle to be outright dead

Hence why some people see amazing regrowth at times even from hairloss from years ago
 

metropolis

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Gene_Fighter said:
[...]

If you're a receder smitten with true male pattern baldness, you're simply f'd.

[...]

"There is not sufficient evidence that PROPECIA works for receding hairlines at the temples."

[...]

True male pattern baldness? I don't know what you mean. I started losing my hair at 17 and, believe me, that was "true male pattern baldness" alright. So much so, that my hairdresser almost had a heart attack when she saw how bad my shedding was. Today I'm 32 y.o. and thanks to finasteride (Proscar 1/4 everyday for the last 13 years) I'm still a proud NW2.

As for the eternal question of frontal hair loss, it's true that finasteride is less effective in this area of the scalp but it's by no means useless. In my case, there was no regrowth in the temples but Proscar has preserved my hairline and I'm more than happy with the results. And my crown is perfect, thank God for that.
 

Gene_Fighter

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metropolis said:
True male pattern baldness? I don't know what you mean. I started losing my hair at 17 and, believe me, that was "true male pattern baldness" alright. So much so, that my hairdresser almost had a heart attack when she saw how bad my shedding was. Today I'm 32 y.o. and thanks to finasteride (Proscar 1/4 everyday for the last 13 years) I'm still a proud NW2.
Well, it's tough to know if you really did have any form of true male pattern baldness, or if you were simply perceiving that you had male pattern baldness at that early age (no offense dude, but at 17 many of us think we are going bald when really we are just insecure and unaware of what male pattern baldness looks like). And the thing is, if you went on finasteride at 19, it's impossible to tell now if the finasteride really did maintain your hair, or if you simply didn't have any real male pattern baldness to begin with. But if you have some pics I'd like to see them anyway.

I started noticing my hairline receding at about 14, probably the second my body went into full blown puberty and started producing more testosterone and dht. I don't think anyone but myself could notice anything until I was around 17-18, but imagine watching your hairline recede an eighth or a quarter of an inch every month or so. That's true male pattern baldness. At 23, I have almost no temple hair left. Check my profile link if you want to see some pics. "My story" link should be in there somewhere.

I'm not saying that finasteride doesn't maintain the hairline for people that have hairloss. I'm just saying that those people aren't receders. In the link I've displayed above, I think Cassin pretty much hit the nail on the head in regards to frontal baldness. I think I've described it pretty well in here as well.

Monty1978--do you have a link with some pics? Your case sounds very unusual. I think it's strange that you were able to notice thickening after just a few months on finasteride and it's also strange that your hairline was able to bounce around on minoxidil, but I'd like to see more. Perhaps you're a rare case.
 

treeshrew

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OP's post is full of contradictory nonsense.

the fact is everyone responds differently to the meds, and everyone's situation is unique. there can be no blanket statements like "true male pattern baldness receders are f'ed". it simply doesn't work that way.

the only reason minoxidil/finasteride have disclaimers about the hair line is because they weren't tested there.

if you've already lost ground on the hair line, your odds of regrowing are slim to none, but if you catch it early it's easy to prevent/stop hair line loss completely with finasteride and minoxidil.
 

Gene_Fighter

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I think I've been pretty clear and consistent from the start. You've actually summed up many of my main points nicely.

One of my primary points is that if you have advanced hair loss in the frontal region, as you've reiterated: most products will be ineffective, and your options will be extremely limited. In fact, it's likely that you will be out of options. But it's important to understand that as a receder you are much more limited in terms of what you can do about than as opposed to say, a diffuse thinner.

I think you're wrong on one issue though: "If you catch it early it's easy to prevent/stop hair line loss completely with finasteride and minoxidil." I don't think that's true for everyone. Many of the people who post success and maintenance stories on here don't really have male pattern baldness to begin with, and so do not qualify.

"the only reason minoxidil/finasteride have disclaimers about the hair line is because they weren't tested there." And also because they were shown to be less effective in this area.
 

Avery

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"the only reason minoxidil/finasteride have disclaimers about the hair line is because they weren't tested there." And also because they were shown to be less effective in this area.

How does one not test something, yet still show it wasn't effective.
 

Oknow

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Gene_Fighter said:
metropolis said:
True male pattern baldness? I don't know what you mean. I started losing my hair at 17 and, believe me, that was "true male pattern baldness" alright. So much so, that my hairdresser almost had a heart attack when she saw how bad my shedding was. Today I'm 32 y.o. and thanks to finasteride (Proscar 1/4 everyday for the last 13 years) I'm still a proud NW2.
Well, it's tough to know if you really did have any form of true male pattern baldness, or if you were simply perceiving that you had male pattern baldness at that early age (no offense dude, but at 17 many of us think we are going bald when really we are just insecure and unaware of what male pattern baldness looks like). And the thing is, if you went on finasteride at 19, it's impossible to tell now if the finasteride really did maintain your hair, or if you simply didn't have any real male pattern baldness to begin with. But if you have some pics I'd like to see them anyway.

I started noticing my hairline receding at about 14, probably the second my body went into full blown puberty and started producing more testosterone and dht. I don't think anyone but myself could notice anything until I was around 17-18, but imagine watching your hairline recede an eighth or a quarter of an inch every month or so. That's true male pattern baldness. At 23, I have almost no temple hair left. Check my profile link if you want to see some pics. "My story" link should be in there somewhere.

I'm not saying that finasteride doesn't maintain the hairline for people that have hairloss. I'm just saying that those people aren't receders. In the link I've displayed above, I think Cassin pretty much hit the nail on the head in regards to frontal baldness. I think I've described it pretty well in here as well.

Monty1978--do you have a link with some pics? Your case sounds very unusual. I think it's strange that you were able to notice thickening after just a few months on finasteride and it's also strange that your hairline was able to bounce around on minoxidil, but I'd like to see more. Perhaps you're a rare case.

Man if my hair ever receeds badly it will definently receed like yours.

Topical spironolactone - has it helped you?
 

Gene_Fighter

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Avery said:
How does one not test something, yet still show it wasn't effective.

C'mon man, I'm sure they've tested both finasteride and minoxidil on the hairline. You're just deceiving yourself if you honestly believe they haven't. Both are clinically proven so they've done plenty of testing. For finasteride it's as simple as observing the effects on the hairline as well as on the crown. Do you realize how much more money they would make if they could tout that their product works on the hairline as well as on the crown? Their consumer base would jump drastically. Yet still they can't claim this. That's simply because neither finasteride nor minoxidil can be proven to be effective on the hairline. Yes, on people who aren't balding to begin with it may cause some thickening, and on others who still have thin hairs left on the hairline (particularly diffuse thinners) they may experience some regrowth, but for everyone else--forget it, you can't regrow hairs that aren't there.

It's like people who claim that certain products such as spironolactone or others are not FDA approved simply because their parent companies can't afford to have them clinically proven. That's a joke. If a company knows that their product works they will have it tested and proven because they know that their sales would sky-rocket if they had a product that was clinically proven to fight hairloss. Having it tested and proven would be a drop-in-the-bucket investment compared to the sales they would make.

Oknow said:
Topical spironolactone - has it helped you?

It's a little hard to come by so I haven't tried it yet. I certainly will in the future only because I'm desperate--not because I hold much hope in it. It's not FDA approved so I wouldn't expect too much from it.
 
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