Frustrated & cannot find a solution

[Raccooner]

I have lost my hair in my right vertex since August, 2020, and have this linear patch I see there. It makes me sick and wish it would go away already. It's like a nightmare for me that never ends and am depressed about it daily. I finally went to a hair surgeon. He looked over my scalp and told me he found no scarring alopecia that I suspect and refused to transplant hairs to add the density I desire. He saw miniaturized thin follicles though in the area I pointed out. I went to a trichologist before, she told me what I have is advanced stages of male pattern hair loss but nothing else and no scarring. I look at my hair in the mirror and think all these people are dead wrong! It to me looks like the "footprints in the snow" one sees in pseudopelade of brocq. So now I am really stuck. Professionals deny I have the problem I think I have and worse yet is the surgeon refuses to transplant, so I'm stuck with having this ugly linear bald spot. Does it pay to get a second opinion?

The transplant surgeon wants me to take a solution mixing topical Finasteride and Minoxidil to treat my thinning crown. Both my family and the transplant surgeon told me I have BDD or body dysmorphic disorder. I know I'm not imaging this though and don't know how I will be able to fix the problem. All I know is the problem I have doesn't look normal. The transplant surgeon (a very well respected one) told me what I'm seeing is due to a natural parting in my hair, which I think is total rubbish. He also thinks I am a Norwood 2, not a Norwood 3 Vertex I would classify my condition as. The trichologists though did acknowledge my hair is thinner on the right side compared to the left. Does it pay to get another opinion who is a scarring alopecia expert?

Interestingly, a doctor who is a neurologist and acupuncturist I showed my issue to thought I had an autoimmune issue causing the scalp to show through the hair in a linear pattern. My internist looked and though I might have alopecia areata, however neither of these doctors are trained to properly diagnose these conditions.

All the dermatologists think I have androgenetic alopecia and one thought I had this condition plus telogen effluvium back last February.

I also would like to purchase a digital microscope to see if what I am seeing is really what I think is there. Where can I get a cheap but good dermoscope that will give me 50 times magnification?

There must be a solution to deal with my scalp showing and I don't want scalp micropigmentation or using a powder to cover it. I mean it's nuts not having enough hair loss to allow for transplantation (I have a huge unused donor reserve) yet there is no solution either to deal with my problem. Is there an answer for this that could resolve the issue for me?

I have not done a scalp biopsy. Rather than that I know it is possible to do full hair analysis by multiphoton microscopy instead to determine the condition of my hair but don't know anyone who does this in New York. Would anyone have a lead for me?

How would you suggest I can deal with this issue at this point? Is there a good hair doctor or surgeon in the New York City area who can find a way to resolve a diffuse patch of hair loss yet manifests itself in linear balding formations?

Basically everyone I have seen has failed to solve my problem. Basically male pattern hair loss is a permanent condition if it doesn't wish to regrow.

So far to treat the condition I have done platelet rich plasma with stem cell transplant over 2 months ago, I started using low level laser therapy this week, taking Nutrafol Men for 2 months and other assorted herbs and vitamins. Everything else I tried like Finasteride and Dutasteride I had a bad reaction to. Minoxidil I haven't given a go yet. However if I have scarring alopecia then nothing will work other than hair transplantation., which isn't being offered to me. I would try microneedling but am afraid it could cause further irreparable damage if I don't know what I'm doing. People who give microneedling sessions want a fortune for their work and time.

So I need to find somebody who can get to the bottom of the situation. Who if anyone would be willing to work with me and transplant into the thin sections which stubbornly will not regrow?

​

 

[whatintheworld]

Without pictures no one can possibly give you useful advice.

 

[Raccooner]

Here are some pictures of what is going on.

 

[whatintheworld]

This looks like diffuse androgenetic alopecia to me.

You have your hair quite long so it's hard to tell exactly, if you were to buzz your hair it would be easier to see.

You can try minoxidil, but without finasteride I do not believe it is very useful. If you cannot take finasteride, then all you can do is wait more until you lose more hair, or at least notice stabilization to be eligible to be a transplant candidate.

 

[Norwoody]

Yep. Topical dutasteride + minoxidil?

 

[infamousrodi]

How old are you? Consider getting an finasteride to save that mane and reverse some damage to a degree as a possible bonus.

 

[Raccooner]

How old are you? Consider getting an finasteride to save that mane and reverse some damage to a degree as a possible bonus.

I'm 42. The thing is I want a beard to scalp hair transplant to get rid of the thinning in the sections that bother me. The main problem with hair transplantation is the process could shock or destroy existing nearby follicles. I'm not an expert but this is probably why the surgeons want areas that are larger and clearly bald to do surgery on so to avoid this possibility. There are diffuse areas where the follicles aren't so dense, so to transplant in these isolated places would be perfect but the problem is locating them all and it is more time consuming for the surgeon than is worth their bother most probably. Also the grafts taken out have to remain fresh in order to survive the transplantation so taking too long will lead to a bad result. The thing I don't get is people get second and third transplants to achieve the density they want in places. If this occurs then why wouldn't the previously transplanted follicles get shocked or destroyed as would native hairs beside transplanted ones? From what I read one hair transplant to an area gives about 50% normal density whereas two procedures to an area gives 80% normal density. It makes sense to me to get two+ procedures if the area is practically hairless. The problem with Finasteride for me is I had a bad reaction to it when I took it internally. It actually made my scalp more itchy, sore and sensitive. Not only that but it didn't help my mood. Taking it topically I have no idea how I would react. If I had a bad result internally I doubt using it topically would be good either.

 

[Raccooner]

So I am frustrated too in that I know transplantation could get rid of these bald scalp lines on my right vertex. The problem is the surgeon I met told me he wouldn't transplant there. Imagine having a physical defect that is obvious but cannot find anyone to help fill in the area with grafts. Worse yet I paid $200 for the consultation. I honestly doubt that taking the topical Finasteride and Minoxidil will do anything to get rid of the problem because if it is at all scarring nothing will work other than a transplant. However I wonder if microneedling the area could trigger new follicles to cover the area of concern? The problem is no studies have been done regarding microneedling over scarring hair loss, outside of CCCA. I think there is something to be said though for making an injury in the pores of the skin and getting hair to emerge. I injured this part of my skin where there was never a hair but one was emerged since the injury and has been with me for 23 years.

 

[20YearsOnFin]

Hi, you are 42, the condition you are suffering is called aging, by the looks of your photos and based on age your density has probably been very slowly decreasing for years. just stick to one of the proven treatments if you want results, rather than keep trying to overthink it.

 

[Raccooner]

This looks like diffuse androgenetic alopecia to me.

You have your hair quite long so it's hard to tell exactly, if you were to buzz your hair it would be easier to see.

You can try minoxidil, but without finasteride I do not believe it is very useful. If you cannot take finasteride, then all you can do is wait more until you lose more hair, or at least notice stabilization to be eligible to be a transplant candidate.

Would you say it is diffuse androgenetic alopecia or diffuse unpatterned alopecia (DUPA)?

 

[20YearsOnFin]

Its just looks like unremarkable androgenetic alopecia, standard male pattern hair loss, the same as usually expected for a man of your age, balding in the crown and hairline and slowly loosing density through out. You can call it diffuse androgenetic alopecia if it makes you feel better.

 

[Here For the Lulz]

Here are some pictures of what is going on.

Dear God man...
Reminds me of the time when I dipped my balls into a chocolate fondue machine at the behest of my old lady. All was good until the chocolate had to be ripped off and caused a mass desolation event that left my manicured ballsack goatee looking a lot like these pictures. i can still hear the heart wrenching swan song let forth by my scrotal pubes as their lives were cut tragically short...
The Horror

 

[Here For the Lulz]

Dear God man...
Reminds me of the time when I dipped my balls into a chocolate fondue machine at the behest of my old lady. All was good until the chocolate had to be ripped off and caused a mass desolation event that left my manicured ballsack goatee looking a lot like these pictures. i can still hear the heart wrenching swan song let forth by my scrotal pubes as their lives were cut tragically short...
The Horror

Forgot to add —- PTSD persists to this very day

 

[hairhelp777]

Here are some pictures of what is going on.

Do you have any photos of your midscalp and front?

 

[losingbattle88]

you need the big guns right off the bat, that includes every tranny drug you can possibly find lol,technically true. But dont play around with a weak drug such as finasteride that wont do you any favors, rather use dutasteride, also add in oral minoxidill.

 

[Raccooner]

M

you need the big guns right off the bat, that includes every tranny drug you can possibly find lol,technically true. But dont play around with a weak drug such as finasteride that wont do you any favors, rather use dutasteride, also add in oral minoxidill.

My hair is finally starting to show progress now. The bald patches are going away. I tried Dutasteride. I had it for one day and felt very off from it and discontinued it. I am going the natural route instead. Taking reishi mushroom, inositol supplement, Nutrafol Men, LLLT, adipose stem cell/PRP therapy. But yes, the idea of taking something to change towards the female sex seems like the way to go in order to stop this condition from striking in the future. Yet with hormones one has to be careful and get the right tests. The thing is one needs a cooperative doctor willing to do it (which can be hard to find) and the other is the body can take anything that brings it out of natural balance and do the exact opposite of what you want it to do, so with hormones one has to really be careful and do everything right to get it right. The thing working against me is my dad is a Norwood 6, so his genetics could hit me like a ton of bricks eventually, so using something to stop this from happening is completely necessary. I need to work out a plan. What I am doing now surely isn't enough when taking a long term approach to the situation.

 

[infamousrodi]

Sorry man but those natural treatments including nutrafol don’t move the needle at all. Have fun wasting your money.

 

[ninarosshairtherapy]

I think you should visit a functional medicine doctor. The doctor will be able to tell you the root cause of your hair problem. He/She will be able to not just look at your scalp but at your entire body to discover what's wrong with the body. When one body part isn't functioning properly, it can affect other body parts too, including your scalp also.

Once the doctor has a clear understanding of what's really going on, they'll be able to create a personalized treatment plan for you that will help you to address those imbalances.

Other than this, take adequate nutrition, eat and drink healthy, live a healthy lifestyle, use more natural hair products, and stay positive Thanks!

 

[Raccooner]

I think you should visit a functional medicine doctor. The doctor will be able to tell you the root cause of your hair problem. He/She will be able to not just look at your scalp but at your entire body to discover what's wrong with the body. When one body part isn't functioning properly, it can affect other body parts too, including your scalp also.

Once the doctor has a clear understanding of what's really going on, they'll be able to create a personalized treatment plan for you that will help you to address those imbalances.

Other than this, take adequate nutrition, eat and drink healthy, live a healthy lifestyle, use more natural hair products, and stay positive Thanks!

Hi Nina Ross, I am going to a naturopathic doctor and they don't know much about hair loss. A functional medicine doctor is pretty similar from what I read to naturopathic doctors. Nina, I've seen you in videos before online and liked what you had to say. Sadly I'm not in the Atlanta area where you're based. I've gotten blood tests. Gone to get chiropractic care. Do you think there is a real difference between holistic doctors and naturopathic ones? I know you're a trichologist. One thing I didn't mention is I had tingling and numbness in my scalp lasting for 4 days followed by 100 days of hair fall immediately thereafter. I didn't have a telogen effluvium that took weeks or months to start after a stressor. A stressful situation, tight muscles from anxiety and depression and physical stress from swift neck movements during the muscle tightness and dull pain I felt in my body. Then I found out from all this stress I had a hyperthyroid condition it caused. My TSH level is off only. I'm a mess and feel I have no way out to resolve this. I am dealing with my thyroid condition using naturopathic medicine. Once the thyroid condition goes back to normal I think nothing other than a hair transplant will get me back to where I want to be. I just have to hope I find someone who has the talent and will make the effort for me. I used Dr. John Cole for hair transplant consultation and he didn't seem to care about what I wanted. Another person on this forum I read said he did terrible work and his body hair grafts didn't grow. Wasted money. I read that in a hair transplant if hairs are the distance of 3 micrometers apart then a follicle can be transplanted without transection if it is done correctly. I want to use beard hairs to transplant the crown and most surgeons don't do this. I think I have enough scalp hair to blend in the beard hair so no need to lose anything from the scalp. Question is will beard hair grow as long as scalp hair? It often does I read but I never grew out my beard to terminal length to find out. Also I read that hairs can change their characteristics based on where they're transplanted to become more like the surrounding area. I hope that might occur in my case.

 

[ninarosshairtherapy]

Hi, Hope you are doing well.

Glad to hear that you know about me. No issues if you're not from the Atlanta area. We also provide an online hair loss evaluation. You can book an appointment on my website. We also have an AT-Home hair therapy program where you will be provided customized kits where you can treat your hair loss at home with custom kits. With advanced lab testing, we can get to the root cause of your health issues, and hair loss is one of them. Sorry, but I am not doing any sort of promotion, so don't get me wrong.

I have been helping people suffering from hair loss for over 16 years, and I understand the stress and anxiety that comes with it. Visit my website or please call me if you have any questions.

Thank you.