Gyno from finasteride/dutasteride, 32...any options left? (Photos)

[Red Floyd]

Hi everyone. I am a 32 y. o. male with a Norwood 1.5. Started balding at 27 (diffuse thinning), but jumped on finasteride right away and recovered all my density. However, in the last 2 years, finasteride stopped working for me and also gave me gyno, so the Dr tried other drugs, such as:

- Topical finasteride
- Dutasteride (tried for only a month)
- Dutasteride mesotherapy

They all doubled my estrogen levels and gave me gyno as well, and on top of that, only oral dutasteride was strong enough to halt hair loss. I am struggling a lot in my personal life due to a crippling chronic pain condition that has me practically bedbound, and one would think that hair is the last concern of someone in my situation. While that may be true, it's still a terrible blow. Disease fucked up my worklife, and the physique that I had built after years of exercise, Androgenetic Alopecia now destroys my hair, and my self-steem might be approaching an all-time low (and I have gone through some serious sh*t).

I shared a photo where you can see my receding hairline. It's not too much but please bear in mind that 80% of that thinning has taken place in the last 3-4 months, since Androgenetic Alopecia is now reaching godspeed without any antiandrogens in the way.

My pattern is diffuse thinning all over the scalp, but I'm specially worried about the hairline. I have a big forehead and any recession would mean I'd have to shave it all right away, as the forehead would look extremely unnatural. I can bear temples receding, but not the widow's peak.

I'm using only topical minoxidil now but I don't think it's ever done much, used oral in the past but it made me dizzy even at 0.5 mg, so I had to stop it after 2 weeks. I don't know what other options I have left. CB sounds like an overpriced treatment atm and very weak. RU sounds stronger, but I don't know about the cardiovascular sides. Fluridil may be the weakest treatment of all, I haven't heard of anyone having positive results with it. Alfatradiol is also weak and I've heard it has a higher chance of causing gyno, so that's off the table.There's also the possibility of adding tretinoin to minoxidil, but I heard that this would be ineffective by itself (without antiandrogens).

Of course I can also keep taking dutasteride and add an aromatase inhibitor such as exemestane to keep my estrogen at bay, but no Dr recommends to do this long term...

I'm also having an evaluation of my donor area in order to see if I'm a viable candidate for a hair transplant in the future. I know I will be a Norwood 7 eventually (my father's gift), so, assuming my follicles will be limited, I wouldn't mind having some temple receding and crown balding, as long as everything else looks decent.

Any comments or opinions would be highly appreciated. Thank you all for putting up and amazing community.

Photos: hairy one is right after my dutasteride mesotherapy session, the other one is from last year when I shaved it all during the pandemic (I was still on finasteride, the hair looks a lot worse now but I haven't shaved).

 

[jazz1]

You switched Finasteride brands when you noticed the decline?

 

[Red Floyd]

You switched Finasteride brands when you noticed the decline?

When I first noticed the decline, I went to a compounding pharmacy to get 1 mg dailly. However the gyno was still there even when I went back to the previous brand. Topical finasteride also worsened it although it was also compounded.

My only chances are a topical antiandrogen like CB or RU, which I doubt will be more effective than finasteride, or getting gyno surgery removing the whole gland so I can switch to dutasteride. But it's not that easy apparently and surgeons recommend against it.

Last option is accept it or "just shave it bro". Which I would absolutely hate as it doesn't look good (big forehead) and I already have other physical shortcomings, and a crippling chronic condition, baldness would be the icing on the cake.

 

[Red Floyd]

If you should really reach the "just shave it bro" stage, another option would be a hair system.

You're right, but I don't have the money for maintenance and also dislike hair systems, I hate the feeling of something that's not "mine". Reminds me of being a teenager and having to use dentures for a couple teeth I needed implants for, it felt horrible. I would go for SMP if I had the money, although I don't like that too much either. The best possibility would be a hair transplant good enough to at least "frame" my face. I don't care too much about temples receding and having a moderate crown, but the widow's peak is something I'd like to maintain. My donor however will be a Norwood-7 so not many follicles available...but maybe enough for what I want.

 

[Red Floyd]

Alright, that fair. Depends a lot on your personal situation and preferences. When I was doing my estimates, it seemed to me that realistic looking hair systems can be purchased and maintained for around 100 dollars per month, and less than that for people who can do a lot of DIY.

Agree, in my eyes it's not just the price, but hey, kudos to whoever wants to use them, it's a legitimate choice. In my case I'd rather have something more natural, as a well done hair transplant, even if that means leaving crown and receded temples untouched. The problem is that it might not be possible (depends on amount of donor surviving the Norwood-7) and even if it were, you still have to go bald first, damn

 

[Micky_007]

Hi everyone. I am a 32 y. o. male with a Norwood 1.5. Started balding at 27 (diffuse thinning), but jumped on finasteride right away and recovered all my density. However, in the last 2 years, finasteride stopped working for me and also gave me gyno, so the Dr tried other drugs, such as:

- Topical finasteride
- Dutasteride (tried for only a month)
- Dutasteride mesotherapy

They all doubled my estrogen levels and gave me gyno as well, and on top of that, only oral dutasteride was strong enough to halt hair loss. I am struggling a lot in my personal life due to a crippling chronic pain condition that has me practically bedbound, and one would think that hair is the last concern of someone in my situation. While that may be true, it's still a terrible blow. Disease fucked up my worklife, and the physique that I had built after years of exercise, Androgenetic Alopecia now destroys my hair, and my self-steem might be approaching an all-time low (and I have gone through some serious sh*t).

I shared a photo where you can see my receding hairline. It's not too much but please bear in mind that 80% of that thinning has taken place in the last 3-4 months, since Androgenetic Alopecia is now reaching godspeed without any antiandrogens in the way.

My pattern is diffuse thinning all over the scalp, but I'm specially worried about the hairline. I have a big forehead and any recession would mean I'd have to shave it all right away, as the forehead would look extremely unnatural. I can bear temples receding, but not the widow's peak.

I'm using only topical minoxidil now but I don't think it's ever done much, used oral in the past but it made me dizzy even at 0.5 mg, so I had to stop it after 2 weeks. I don't know what other options I have left. CB sounds like an overpriced treatment atm and very weak. RU sounds stronger, but I don't know about the cardiovascular sides. Fluridil may be the weakest treatment of all, I haven't heard of anyone having positive results with it. Alfatradiol is also weak and I've heard it has a higher chance of causing gyno, so that's off the table.There's also the possibility of adding tretinoin to minoxidil, but I heard that this would be ineffective by itself (without antiandrogens).

Of course I can also keep taking dutasteride and add an aromatase inhibitor such as exemestane to keep my estrogen at bay, but no Dr recommends to do this long term...

I'm also having an evaluation of my donor area in order to see if I'm a viable candidate for a hair transplant in the future. I know I will be a Norwood 7 eventually (my father's gift), so, assuming my follicles will be limited, I wouldn't mind having some temple receding and crown balding, as long as everything else looks decent.

Any comments or opinions would be highly appreciated. Thank you all for putting up and amazing community.

Photos: hairy one is right after my dutasteride mesotherapy session, the other one is from last year when I shaved it all during the pandemic (I was still on finasteride, the hair looks a lot worse now but I haven't shaved).

Try Microneedling once a week or once every two weeks and use topical Minoxidil 5% twice a day, everyday (but skip Minoxidil on the day you Microneedle)

Thread 'Microneedling Photo Results Summary' https://www.hairlosstalk.com/interact/threads/microneedling-photo-results-summary.121072/

 

[Red Floyd]

Try Microneedling once a week or once every two weeks and use topical Minoxidil 5% twice a day, everyday (but skip Minoxidil on the day you Microneedle)

Thread 'Microneedling Photo Results Summary' https://www.hairlosstalk.com/interact/threads/microneedling-photo-results-summary.121072/

Thanks for the suggestion. I actually bought the dermaroller and started doing it, but stopped after Kevin Mann made a video exposing worries that the scarring could cause some kind of long-term damage to the scalp, and make it less suitable for a Hair Transplant in the future (hair doesn't grow on scarred tissues). I'm also concerned that repeated damage could activate any lurking conditions such as Lichen Planus, which could also kill my hair. There are reports (case studies) of autoimmune conditions showing up and scarring taking place in people who have undergone mesotherapy, it's not common but can happen...

PS: I have been on minoxidil 5% for 4 years, though I never was a good responder. Recently I'm using it also in the morning in the patches where the thinning is more visible.

 

[Red Floyd]

I suppose if you are concerned about donor hair, and you don't seem to be too worried about a "perfect" head of hair anyway, one option would be something like a beard transplant. If your donor zone is depleted, you can keep your beard hair in mind as an additional source of grafts.

Yes, I saw a hair restoration surgeon and he said that currently they could get 4000 grafts from my donor hair, probably 6000. But this amount is surely going to decrease since I'll have a big crown. He said that my beard could also give 500 additional grafts. I'm having laser body hair removal, but I've kept my chest and beard untouched thinking long-term...BHT is extremely expensive though.

 

[jazz1]

When I first noticed the decline, I went to a compounding pharmacy to get 1 mg dailly. However the gyno was still there even when I went back to the previous brand. Topical finasteride also worsened it although it was also compounded.

My only chances are a topical antiandrogen like CB or RU, which I doubt will be more effective than finasteride, or getting gyno surgery removing the whole gland so I can switch to dutasteride. But it's not that easy apparently and surgeons recommend against it.

Last option is accept it or "just shave it bro". Which I would absolutely hate as it doesn't look good (big forehead) and I already have other physical shortcomings, and a crippling chronic condition, baldness would be the icing on the cake.

RU can give side as well, why not try low dosage Topical Finasteride every third day as this will still work, due to the half life being 72 hours.

 

[Red Floyd]

RU can give side as well, why not try low dosage Topical Finasteride every third day as this will still work, due to the half life being 72 hours.

Topical finasteride caused gyno at 0.25% and didn't even work. Oral finasteride isn't strong enough either. I would need something like dutasteride, but with gyno...

At this point I'm considering full breast gland removal and going on dutasteride.

 

[Norwoody]

I would add tretinoin and I would try topical dutasteride because it has a large molecular weight and is much less likely to produce side effects compared to any oral treatment.

 

[Micky_007]

Thanks for the suggestion. I actually bought the dermaroller and started doing it, but stopped after Kevin Mann made a video exposing worries that the scarring could cause some kind of long-term damage to the scalp, and make it less suitable for a Hair Transplant in the future (hair doesn't grow on scarred tissues). I'm also concerned that repeated damage could activate any lurking conditions such as Lichen Planus, which could also kill my hair. There are reports (case studies) of autoimmune conditions showing up and scarring taking place in people who have undergone mesotherapy, it's not common but can happen...

PS: I have been on minoxidil 5% for 4 years, though I never was a good responder. Recently I'm using it also in the morning in the patches where the thinning is more visible.

It is called Microneedling for a reason, the punctures are microscopic and yes there may be some micro skin tearing due to bad technique or using a low quality needling device, that's the reason using a DermaPen type Microneedling device is far better than using a Dermaroller or Derma stamp type Microneedling device.

The ideal DermPens in order:

1) Derminator 2
2) Dr Pen

If you can get that and change needle cartridges at most once a week, provided you microneedle once a week, you will probably see optimum results.

Also, you can't compare normal Minoxidil to Minoxidil + Microneedling.

Minoxidil alone is almost useless for most people, but Min + Microneedling is a different beast. There were studies which showes it had 3 to 4 times more hair growth than Minoxidil alone.

And you should be using it twice a day. Unless you're a hyper responder to Minoxidil you shouldn't be using it only once a day.

 

[Merckilled]

I had the same issue

 

[chrismadsen]

I don''t think that nowadays there is such a shame to be bold.