Going Bald In Less Than A Year, Need Advice

[MKP05]

After adding the Duta the shed and itch got much worse. I’m fucked my density is about 20% of when this all started and the temples are GONE. Sides thin with a noticeable increase in density in the back aside from the nape.

I either destroyed my own head or it was too aggressive to slow despite just about every f*****g option. I am too afraid to stop everything. Rather die than lose my hair.

Hang in there man. I feel very similarly so I know how you feel. It’s an absolute nightmare that you can’t wake up from. My dermatologist is one of the best in NYC and in my two visits and one phone call she mentioned 4 different possible types of hair loss and 3 different treatment options. So she clearly has no clue what’s going on with me. In fact during my last visit she said she’d bet a month of her salary that it would not get much worse which totally contradicts the progression I’ve experienced over the past 2 years. There hasn’t been one month in the past two years where my hair loss has stabilized and yet she’s betting that it just magically stops on its own as if I have nothing to worry about. Meanwhile my hairline has been decimated (almost a full inch now. My temples are receding to the middle of my scalp. My forelock has a bald spot which gets more sparse by the day. She prescribed Zyrtec 3 times a day of all things. So my fate is down to dutasteride, minoxidil and an antihistamine. I know I’m doomed. There are days when I feel like the meds contributed to this and others which I feel like I would’ve ended up in the same spot albeit years later. My hair has the thinness of my 80 year old father when less than 2 years ago it was thick and full. My twin brother has no hair loss at all. It feels like a sick joke to lose this much density this quickly. But I’ll live. I might be miserable for a while but I’ll live. And you’ll be fine too. This is not easy. That’s for sure. I’ve been taking ashwagandha for my stress level and Ativan for anxiety. They have both helped my mood tremendously. Hopefully the reduced stress will have a positive impact on my hair. But I’m trying to come to grips with the fact that I’ve had great luck up to this point compared to my male peers but unbelievably bad luck relative to my own gene pool. I have friends who are clearly balding worse than i am but their hair has not changed much at all in 3 years. The pace and trajectory of my hair loss is what bothers me the most as I’m destined to be far more bald far quicker than any of these guys. Keep fighting and try to limit your treatment to a couple of things or else you’ll have no idea what is working and what isn’t. And try to address your stress and anxiety. Those are things you can at least control. And they are very bad for hair loss.

 

[MKP05]

Are we still pretending this guy has male pattern baldness?

He has hair loss. And is in obvious distress over it. Probably not male pattern baldness. He’s just looking for answers like all of us are.

 

[MKP05]

Everyone has some thinning as they get older. He's not going bald. Can't expect your hair to be as thick and healthy at 40 as it was at 20. It's just aging.

Maybe. And maybe not. Take my situation. As we’ve discussed I started rapidly losing my hair at 45. 2 years have passed and while I’ve been on medication the entire time I continue to rapidly thin in overall density and - most notably - recede from the temples and hairline. And not at a normal pace. If this was “just aging” then my identical twin brother would be experiencing something similar or at least showing an indication of it. But he’s not. If this was just genetics then I wouldn’t be on a path to vastly surpass my 80 year old father’s hair loss. Up until 2 years ago I was following the same trajectory as my father and my brother. And then something happened and I’m still trying to figure out what it is and how to slow it down.. Perhaps my something was compounded by the hormonal imbalance introduced by the medication. But maybe not. My point is that sometimes it’s not just genetics and aging even though that might seem like the easiest explanation. I’m not going to pretend I know what’s causing the OPs hair loss. He’s not “going bald in less than a year”. But there’s definitely something happening and it’s progressively getting worse although not nearly as bad or as quickly as he believes it is. Maybe it is just aging. But maybe it’s not. The one thing I’ve learned the last two years is that there are no absolutes to this sh*t.

@bluecyclone has any doctor suggested that you may have scarring alopecia? Perhaps frontal fibrosing? Is it possible that you have a combination of alopecias occurring simultaneously? The reason your situation is so difficult to determine is that you’ve jumped on so many different treatments in such a short time so it’s probably impossible to tell whether you’re coming or going at this point. That’s why I had suggested a reset for you. Maybe you need to stick to one or two proven treatments instead of throwing the kitchen sink at it. But I agree with Pegasus that if you’ve taken all the anti hair loss drugs you’ve claimed to take then I think you have to consider that you don’t have pattern hair loss.

 

[MKP05]

You have some sort of autoimmune disease like alopecia areata. Your father's hair has little to do with yours. You are not your father's twin, and even identical twins have different genes, and don't necessarily bald at the same rate. I'd be curious to know if the patches of loss in the rear started before the hairline recession or vice versa? I wonder if in your case taking medication for Androgenetic Alopecia when you only had alopecia areata actually triggered your Androgenetic Alopecia early. You really aren't rapidly losing your hair compared to others with Androgenetic Alopecia. It tends to progress rather quickly once it begins. You're only about a norwood 2, so 2 years to lose one norwood is actually a slow pace. There is often an environmental trigger that starts the process. The baldness gene doesn't just turn on at a certain age. It turns on under the right conditions.

As for the OP, I really don't think it's getting worse at all which is amazing considering the number of treatments he's been on and off on a whim. You have it exactly right, the best advice anyone can give him is to chill out and give a treatment some time. This is a years long battle to figure out what's going on. He's too impatient, and wants to try everything in a matter of months. That's never going to work. Personally, I think he should just take dutasteride once a day and forget it. Reassess in one year.

My (high level) timeline is this:
Alopecia areata active 1997-2007
Alopecia areata remission 2007-2018
February 2018 - areata returns (back of head)
April 2018 - areata treatment starts (corticosteroids injections)
May 2018 - left temple starts rapidly receding
June 2018 - right temple starts receding
July 2018 - start finasteride after 3 different drs clinically diagnose frontal hair loss as Androgenetic Alopecia plus bloodwork to rule out other issues
September 2018 - areata patch which had grown to 4 inches in diameter is growing back in completely but Diffuse hair loss across Norwood region. Temples and hairline still receding but slower.
September 2019 - dime size areata patch on back of head. Treatment starts.
November 2019 - areata patch filled in
December 2019 - stop finasteride and start dutasteride
January 2020 - diffuse hair loss on back and sides of head. Frontal third recession slows dramatically.
February 2020 - back and sides still thin but stabilized. Front third starts thinning aggressively.
March 2020 - who the f*** knows anymore.

I do agree that my areata and pattern loss is connected somehow. @Anatoly theorizes that my hair loss could’ve been switched on due to corticosteroid dependency. Seems about as logical as any other reason and fits precisely into when I started receding (exactly one month after starting injections for areata in 2018). Is it possible that my frontal loss is autoimmune related? Maybe. Is it areata? I’d have to say almost definitely not. I’ve had areata for over 25 years. The loss in the front is nothing like I’ve ever experienced from areata both in presentation and progression. But who knows at this point. The only thing I know for sure is that I have drastically thinner, finer hair than I had a year ago let alone 2 years. It may seem like a slow progression to you but to me it feels rapid. Especially since I know that the front third is on its last leg. It’s just a matter of months now and my hairline will soon be approaching my mid scalp. I’m not willing to go beyond dutasteride so I guess time will tell.

 

[DoctorHouse]

@bluecyclone, you have been on here 3 years and you are still not bald. You can't keep the same density as you had in your 30's. And you won't keep the same density you have in your 40's when you are in your 50's. Just simplify your life. Either use finasteride orally or topically. Use minoxidil and shampoo with a Nizoral shampoo a few days per week. You don't have aggressive balding because in 3 years, you would have way more loss than you do. I have been using the same treatments for over 15 years and I have a great head of hair still because I don't overthink this. I never had as good hair as you either. My density was nothing great all my life. Get used to shedding the amount of hairs you do. It's your new norm since you started treatments. Eventually it will slow done but it will take a few years.

 

[bluecyclone]

Hang in there man. I feel very similarly so I know how you feel. It’s an absolute nightmare that you can’t wake up from. My dermatologist is one of the best in NYC and in my two visits and one phone call she mentioned 4 different possible types of hair loss and 3 different treatment options. So she clearly has no clue what’s going on with me. In fact during my last visit she said she’d bet a month of her salary that it would not get much worse which totally contradicts the progression I’ve experienced over the past 2 years. There hasn’t been one month in the past two years where my hair loss has stabilized and yet she’s betting that it just magically stops on its own as if I have nothing to worry about. Meanwhile my hairline has been decimated (almost a full inch now. My temples are receding to the middle of my scalp. My forelock has a bald spot which gets more sparse by the day. She prescribed Zyrtec 3 times a day of all things. So my fate is down to dutasteride, minoxidil and an antihistamine. I know I’m doomed. There are days when I feel like the meds contributed to this and others which I feel like I would’ve ended up in the same spot albeit years later. My hair has the thinness of my 80 year old father when less than 2 years ago it was thick and full. My twin brother has no hair loss at all. It feels like a sick joke to lose this much density this quickly. But I’ll live. I might be miserable for a while but I’ll live. And you’ll be fine too. This is not easy. That’s for sure. I’ve been taking ashwagandha for my stress level and Ativan for anxiety. They have both helped my mood tremendously. Hopefully the reduced stress will have a positive impact on my hair. But I’m trying to come to grips with the fact that I’ve had great luck up to this point compared to my male peers but unbelievably bad luck relative to my own gene pool. I have friends who are clearly balding worse than i am but their hair has not changed much at all in 3 years. The pace and trajectory of my hair loss is what bothers me the most as I’m destined to be far more bald far quicker than any of these guys. Keep fighting and try to limit your treatment to a couple of things or else you’ll have no idea what is working and what isn’t. And try to address your stress and anxiety. Those are things you can at least control. And they are very bad for hair loss.

Dr. Unger? Got a similar narrative from her.

 

[bluecyclone]

Everyone has some thinning as they get older. He's not going bald. Can't expect your hair to be as thick and healthy at 40 as it was at 20. It's just aging.

Everyone has some thinning as they get older. He's not going bald. Can't expect your hair to be as thick and healthy at 40 as it was at 20. It's just aging.

Not expecting it too stay like it was when I was 20 but from 40 to 43 to loose 70% sucks.

 

[MKP05]

Dr. Unger? Got a similar narrative from her.

Not Dr Unger. This was a dermatologist not a hair transplant specialist. She has mentioned pattern baldness, Telogen Effluvium, areata and frontal fibrosing alopecia as possibilities but does not seem overly certain on any one of them. If she can’t determine the cause of my hair loss then how do I expect her to be able to treat it? What was most frustrating was that she glossed over how much it has thinned out and said I’ll be fine as if it was just going to suddenly stop as quickly as it started.

 

[Anatoly]

She has mentioned pattern baldness, Telogen Effluvium, areata and frontal fibrosing alopecia as possibilities but does not seem overly certain on any one of them. If she can’t determine the cause of my hair loss then how do I expect her to be able to treat it?

Do stick to her expertise. This is another example that she is a good dermatologist. A good researcher is never certain about anything, universal scepticism is a key to resolving a puzzle. A researcher says a conclusion is correct to a certain extent under dozens of known conditions plus an unknown number of unknown variables. Being knowledgable means that one is very reluctant to give a definite assessment because the window of possible variables is very wide.
An antihistamine is a good add-on btw. It contributes to lowering inflammation caused by histamine release (which in turn has an endless number of causes...)

 

[bluecyclone]

Just to clarify. Despite some early back and forth I have been on stable treatments for year(s)

Topical Finasteride 1% 20 months
Oral Minoxidil 5mg 30 months
Supplements 36 months

Crazy increase in thinning shedding in October that has not slowed. I started looking into another Propecia two week trial (immediate sides), RU January and topical Dutasteride once a week.

the latter could impact shedding but it’s overall just accelerating.

...so now as I head into April crazy loss of density I’m again looking for answers. I have thinned I’ve the last few years but this again feels like the first huge shed. Pattern is very very obvious. Temples gone and overall density at 20%, long hair covers a lot.

 

[TomRiddle]

Just to clarify. Despite some early back and forth I have been on stable treatments for year(s)

Topical Finasteride 1% 20 months
Oral Minoxidil 5mg 30 months
Supplements 36 months

Crazy increase in thinning shedding in October that has not slowed. I started looking into another Propecia two week trial (immediate sides), RU January and topical Dutasteride once a week.

the latter could impact shedding but it’s overall just accelerating.

...so now as I head into April crazy loss of density I’m again looking for answers. I have thinned I’ve the last few years but this again feels like the first huge shed. Pattern is very very obvious. Temples gone and overall density at 20%, long hair covers a lot.

"Crazy loss of density" and puts a picture with a full head of hair. I pity you and feel good about myself when i look in the mirror with my Norwood 2.5 almost 3. I never took BDD very serious and i don't have that much information on it, but i strongly suggest you go and seek some professional help, and i'm not saying with any hate or tone of superiority or whatever you could think when you will see my suggestion. It could really help friend and make your life much easier, you only have one, don't trow it like this, your obsession is getting out of control..

 

[DoctorHouse]

@bluecyclone, just curious how much do you think about your hair in day on the average?

 

[DyingOfTheLight]

Just to clarify. Despite some early back and forth I have been on stable treatments for year(s)

Topical Finasteride 1% 20 months
Oral Minoxidil 5mg 30 months
Supplements 36 months

Crazy increase in thinning shedding in October that has not slowed. I started looking into another Propecia two week trial (immediate sides), RU January and topical Dutasteride once a week.

the latter could impact shedding but it’s overall just accelerating.

...so now as I head into April crazy loss of density I’m again looking for answers. I have thinned I’ve the last few years but this again feels like the first huge shed. Pattern is very very obvious. Temples gone and overall density at 20%, long hair covers a lot.

To jump on the bandwagon, bruh you have a perfect head of hair for a 20ish y/o guy, let alone one in his mid 40s who has been ' aggressively balding' for over 3 years. Reflect on this for a second: you're a middle-aged dude who has been tortured by imaginary hairloss for over 3 years despite having 99.9 percentile hair genetics

Temples are gone? Mate, EVERYONE, has thinner hair on the frontal temple zones you zoomed in on. Men with straight nw0 hairlines, even girls, have thinner hair on those spots at the front of their temples. Look at the Norwood scale, even nw1 has lightly recessed temples and those hairs you're panicking about are gone, yet you still have them and are in your mid forties...

Mind-boggling stuff really. Noone should entertain the idea that this guy is balding btw. Seems borderline enabling at this point

 

[DyingOfTheLight]

To cap it off: you're needlessly poisoning your body. You're taking minoxidil which has shown an increase in LV mass, orally. And are on potent AAs that have myriad side effects, probably-long term ( e.g, on cognition, mood by inhibiting neurosteroids). And could leave you worse of in the end, depending how you react on them.

Obviously I'm not against medication but it's a trade-off, a risk and decision not taken lightly. One you made just to have a mental safety-net against the angst of the inevitable decay that's aging. A broken one as well, btw, seeing as you keep fretting and posting.

Get some help man.

 

[TomRiddle]

I really don't get people who are enabling him also, i saw a guy telling him to not listen to "these guys" and that he is heavily balding, i was left mute, i don't even understand how to process some of the people's attitudes, advises and behaviors and not just around here, but in general lately, especially on the internet...

 

[DyingOfTheLight]

I really don't get people who are enabling him also, i saw a guy telling him to not listen to "these guys" and that he is heavily balding, i was left mute, i don't even understand how to process some of the people's attitudes, advises and behaviors and not just around here, but in general lately, especially on the internet...

Yeah at this point they should reschedule finasteride as a psych drug, Merck probably makes more money of delusional fullheads than actual balding people. No but srs, this site is somewhat of an echo chamber of BDD suffers. Sad more than anything. Most are young. Social media really puts a magnifying glass on your flaws , self-perceived or otherwise

 

[TomRiddle]

Yeah at this point they should reschedule finasteride as a psych drug, Merck probably makes more money of delusional fullheads than actual balding people. No but srs, this site is somewhat of an echo chamber of BDD suffers. Sad more than anything. Most are young. Social media really puts a magnifying glass on your flaws , self-perceived or otherwise

Very true and very sad at the same time and it seems many people are getting more affected by these things on the daily basis, very sad...

 

[DyingOfTheLight]

Very true and very sad at the same time and it seems many people are getting more affected by these things on the daily basis, very sad...

Yeah, it's a tragedy.

I'm only in my mid twenties, but when I'm on campus and I see the first years I get the feeling something went truly, terribly wrong in that gap of five/six years. The loneliness is palpable

 

[MKP05]

Do stick to her expertise. This is another example that she is a good dermatologist. A good researcher is never certain about anything, universal scepticism is a key to resolving a puzzle. A researcher says a conclusion is correct to a certain extent under dozens of known conditions plus an unknown number of unknown variables. Being knowledgable means that one is very reluctant to give a definite assessment because the window of possible variables is very wide.
An antihistamine is a good add-on btw. It contributes to lowering inflammation caused by histamine release (which in turn has an endless number of causes...)

I am following her advice. She also told me to stay on dutasteride for now which I was secretly happy to hear her say. I’m not doubting her expertise. Her knowledge is impressive. I wish I’d started with her from the beginning. I’m just frustrated that there’s no certain diagnosis yet.

I can tell you this. For 10 days prior to seeing her the itch I had on my head was like nothing I’d experienced during the last two years. I’d had random itches previously but this was constant and persistent and came out of nowhere. Since starting certirizine it is now almost non existent. I’ll also say that mentally I’m in a much better place. Taking Ativan for anxiety, melatonin for sleep and ashwagandha for stress seems to have taken me from a state of constant panic and sleeplessness to a much better mental state. I don’t think my hair has gotten any better and I’m quite certain it’s still likely to eventually end in a bad place but for whatever reason I’m not as hyper focused on it as I was even two weeks ago. That could all change tomorrow. Lol. Thanks for the encouragement as always.

 

[MKP05]

@bluecyclone, just curious how much do you think about your hair in day on the average?

This is such a key question which needs to be answered. @bluecyclone you have spent so much time over the past few years looking for the “cure” but it’s very possible that the best medicine you could possibly take right now is to control your anxiety. You need to get a hold of yourself. Quite frankly you should take a sticky note out and write yourself a prescription which reads “I will not obsess over my hair”. Stick it on your fridge as a constant reminder. I’m being serious. Your worst enemy right now is very likely yourself. Chronic stress will impact your hair. If that doesn’t work look into prescription and non prescription forms of anti anxiety meds . Until you get your anxiety under control you will never feel good about yourself no matter how your hair looks. And I have to agree with the others that your hair looks 99% better than anyone else your age. But you have to add stress control to your regimen ASAP.