Help please! *Pics*

[nastyman33]

Hey guys, first post. Thanks for helping. 23 years old, Caucasian. Some hair loss in my family on both sides but nothing past a Norwood 3/4.

I am worried about hair loss. I have seen my dermatologist, but he was not very helpful. So, I'm turning to you.

Below are some pictures. I fear that my temples are thinning and receding inward to the top of my head, especially my left one pictured below. I am also concerned that the front is thinning and receding backwards, also pictured below. I am currently NOT experiencing any thinning on the vertex (as far as I and my family can tell).

Ideally, I would like to fill in those areas that I mentioned above. What should I do? Should I use Rogaine first and see if it works? Or should I go straight to Propecia? Mind you, I am leery of taking a hormone-altering drug, but if it is the only thing that will "fix" my hair loss, then I will do it.

I'm sure this is extraneous information, but you can click on the pictures to see them bigger.

Thank you so much for your kind and enormously helpful words!

 

[kalbo]

I'm also interested in what everyone else has to say.... my hairline is almost exactly like yours with the receding temples.... and my left side is also much worse than the right for some reason...

 

[hairhaircomeagain]

Does not look bad at all. So dont panic. You can start taking the meds now and you will be good for later too.

Yeah my derm was a pain in the *** too. She refused to do any tests for DHT, gyno and stuff and gave me Rx for Propecia and Rogaine. I wanted to get some tests done so that I can have a before/after picture but she said it was not necessary.

Anyways, Most of the people here will recommend the Big 3

Finasteride (spelling ? ), Nizoral and Minoxidil. finasteride and MIN are the only FDA approved hairloss treatments. Before you start with it, make sure you read about the sides. Although many people believe that it affects only 2% of the people. There are many other treatments. You have come to the right place. There are many highly knowledgable people here

 

[nastyman33]

Yeah, I read a little bit here and found this place to be excellent.

Any other opinions? Thanks a ton guys!

 

[Goingat20]

propecia should stop your hair loss, so you should certainly consider it. Minoxidil should help your hair line, but if you start minoxidil you have to stay on it, and be strict with your applications. Nizoral shampoo either 1 or 2 % should be used a couple of times a week. If you dont want to use propecia look into other topicals which could help.
Goodluck

 

[socks]

nastyman33,

I have good news and bad news. I like to start with the bads news so I can end on a high note

Ok, the bad news is it is very unlikely anything short of a hair transplant (short for Hair Transplant) is going to fill in those skin bald receded areas with anything other then 'peach fuzz'. You look to be about a NW2.5 with some diffused thinning in your hairline. Now the good news! Using a combo of Finasteride and Minoxidil will likely both halt any further loss as well as thicken up the hair you already have.

As far as the treatments
With the Finasteride, you want to see if you can get a doctor to write you a prescription for Proscar instead of Propecia. Both Proscar and Propecia are EXACTLY the same drug (Finasteride). The difference is Propecia is a 1mg tab FDA approved for Androgenetic Alopecia and Proscar is a 5mg tab FDA approved for Benign Prostate Hyperplasia (BPH). What you then do is cut the Proscar into 1/4ths or 1/5ths. This way you get 4months or more out of a bottle rather then just one month. Sexual side-effects are exceedingly rare and if they do occur will usually subside with continued treatment (if not, discontinuing treatments will fix all but the very rare gyno side-effect).

Minoxidil is a topical NON-HORMONAL treatment that will help induce dormant hair follicles to grow, thicken up existing hair follicles that have been miniaturized by Androgenetic Alopecia (androgenetic alopecia), and hold the hair in the anagen phase longer (anagen refers to the growing stage of a hair whereas telogen refers to the resting stage). It is IMPORTANT to note that Minoxidil does NOT interrupt the core cause of Androgenetic Alopecia: Hormones acting on genetically sensitive hair follicles cells. Therefore, it is VERY important to use Finasteride (or Dutasteride) as the backbone to any hairloss treatment.

As an optional addition Nizoral 1% or 2% shampoo is a good addition (read more about why by CLICKING HERE). Nizoral 2% is prescription in the USA. You will either need to get a doctor to write you a prescription for the nizoral, buy the 1% OTC version, or buy the 2% on the Internet from Canada where the 2% in non-prescription.

 

[Follically Challenged]

finasteride is generic in a month (June 16), so if you're gonna go the proscor route don't get anymore than u have to.

Socks is right, you won't get your highschool hairline back. Without plugs.

If your derm won't write u a script, go to a walk-in clinic or your family doctor.

 

[nastyman33]

Thanks for the responses!

I'm not concerned with getting my high school hairline back. Frankly, I've never had a NW1 hairline. I've always had a more NW1.5-2 hairline, even in high school. Old pictures tell that tale. In other words, I've always had what some would call a "mature" hairline, going back to my teen years (Is that unusual?).

What I AM trying to do is fill in/thicken the small inward temple recession that is moving toward the middle of my head, the part that the arrow is pointing to in the 3rd picture, as well as the diffuse thinning in the very front. That part is NOT skin bald yet, though thinning, as appears to be the very front. That's the hair I am trying to save and hopefully regrow.

Socks, is that what you mean by the ".5" in your NW2.5 assessment? Is a combo of the Proscar and the Minoxidil a good choice for trying to achieve what I desire? Again, I understand that the skin bald areas in my temples won't regrow. They haven't had hair there for years. I'm trying to regrow/thicken where hair still exists in my temples and along my hair line, where it seems to have gotten worse in the last 1 year or so.

Also, my dermotologist did write me a prescription for Propecia. How hard is it to have him switch it to Proscar?

Thanks all!

 

[Aplunk1]

Socks left you with some genuinely GREAT advice.

I would categorize you at a Norwood 2... but I'm not a doctor

In any case...

Propecia (finasteride)
Rogaine (minoxidil)
Nizoral (ketoconazole)

Are the BIG 3... They are likely to (1) Maintain what you have, (2) Regrowth is more than likely to occur, (3) Thicken up existing hair shafts, and revitalize existing follicles.

They all work synergistically together... Propecia (finasteride or dutasteride) holds down male pattern baldness at its "root" cause... Rogaine (minoxidil) provides an extra offset of regrowth and revitalization of hair follicles... Nizoral (ketoconazole) has anti-androgenic and anti-inflammatory properties which help to benefit both treatments.

You are about 99% likely to receive benefit from the BIG 3.

Do some research

Some people prefer to start off with *just* Propecia... It's your choice.

But for me, my results were only kickstarted when using the Big 3.

Goodluck.

Andy

 

[socks]

Socks, is that what you mean by the ".5" in your NW2.5 assessment?

My subjective ranking you as a 2.5 comes from how far the temple recession has moved into frontal vertex. The slight diffused thinning in the center of your hairline is too slight, at this time, for me to take it into account on the Norwood scale.

Is a combo of the Proscar and the Minoxidil a good choice for trying to achieve what I desire?

Absolutely! I think your hair is still in great shape. Assuming you respond to treatments (which involves a religious commitment to your treatments along with consistent use) I think your prognoses is excellent.

Also, my dermotologist did write me a prescription for Propecia. How hard is it to have him switch it to Proscar?

Sadly, some doctors will give you a hard time about prescribing off-label. When it comes to hairloss many doctors (even dermatologists) can be blissfully ignorant about hairloss treatments. I suggest when asking your physician for a Proscar prescription to go prepared with some medical literature indicating Propecia and Proscar are exactly the same drug but in different dosages. I would also make it a point to stress you do not intend to take the whole Proscar tablet at once but instead intend to cut it so that you are taking near the same dose as what Propecia gives you. Make clear your only reason for asking for Proscar over Propecia is the cost of the medications. Encourage your physician to look up the information in their PDR if there is any doubts as to Proscar and Propecia being the EXACT same drug.

That wont guarantee you success but it will greatly increase your chances of getting the Proscar prescription. Also, Merck is losing it patent on Proscar this summer so the generic will be available making Finasteride cheaper then it ever has been (as Follically Challenged said in his last post)!!!

 

[nastyman33]

Aplunk and socks, you guys are amazing. Thank you so much for your advice. I'm calling my dermatologist in the morning to hassle him about the Proscar prescription.

Aplunk, one quick question: You say your results only came after getting on the Big 3. Does this mean you experienced regrowth? Is there a percentage of people who see regrowth as part of their results?

Any other suggestions still welcome!

Thanks everyone!

 

[Aplunk1]

Yes, I have visible regrowth, mostly on the temples and hairline... which is unfortunately, at present, shedding.

As far as getting Proscar goes, don't be discouraged if your derm. or general pract. doesn't prescribe it to you.

Propecia is pricey, but dammit! It gets the job done...

As far as regrowth goes--

On Propecia alone, 66% of men regrow cosmetically noticeable amounts of hair.

83% of men maintain their hair.

For the other 17%, it slows down hairloss.

With the addition of Minoxidil to a regimen including finasteride, you are putting yourself in a 50-60+ percentage range of regrowing hair... Minoxidil alone regrows hair on about 50%+ people... I forget the exact number... But with Propecia, you WILL likely increase your chances of regrowth.

Add Nizoral shampoo to help combat DHT locally, provide sustained anti-inflammatory benefits of the scalp, and a general "freedom" on the scalp...

(Don't forget that Nizoral ALONE has hair regrowth benefits similar to 2% minoxidil - Booyeah - )

AND YOU'RE READY TO START THE FIGHT!

 

[nastyman33]

Are you saying that your new, regrown hair is falling out?

How common is shedding? If I'm not a diffuse thinner (at least not in the vertex and the middle of the top of my head), can the Proscar/Propecia turn me into a diffuse thinner through shedding?

 

[Aplunk1]

http://www.hairlosstalk.com/discussions/viewtopic.php?t=22728

Shedding for Dummies

http://www.hairlosstalk.com/discussions/viewtopic.php?t=12865

What is a shed? Diagram plus an explanation.



(Note-- HairLossTalk.com or Freestyle, Moderator?-- can you guys fix the classic image that freestyle made in Shedding for Dummies?)

Read these articles. They are great information. A lot of people, as their hair cycles through various treatments, go through periods of shedding... When it grows back, it grows back slightly thicker (or thinner) depending on whether or not you're using treatments.


To answer your question... you're are likely to benefit from Propecia treatment... You might see an initial increase in hairloss within the first three months of therapy. But it should be welcomed, as a sign of regrowth is to come.

 

[Primex]

Hey dude, your hair looks pretty good, so at least you're starting early on. Like everyone has said, the big 3 are the best route to go. I just started Propecia myself so I'm hopefully gonna stop my hair loss soon, or just waste a lot of money, but at least I'll know for sure whether or not I'm a candidate. Have you started anything yet or do you have an idea what you want to do?

 

[Deaner]

Socks, the problem, at least in Canada, is that if any questions are raised as to why a young man is using Proscar vs. Propecia when there's clearly no history of prostate issues in the patient, a hefty fine can be brought down on the doctor who wrote the prescription. It's not about ignorance, it's about not wanting to risk the fine for someone else's stupid hair.

 

[socks]

Socks, the problem, at least in Canada, is that if any questions are raised as to why a young man is using Proscar vs. Propecia when there's clearly no history of prostate issues in the patient, a hefty fine can be brought down on the doctor who wrote the prescription. It's not about ignorance, it's about not wanting to risk the fine for someone else's stupid hair.

Thanks for the heads up Deaner. I did not know that about Canada.

 

[nastyman33]

Based on your guys' experience, is it possible that, by taking Propecia, I can turn into a diffuse thinner in areas where I am not currently (visibly) thinning? Can I go from simple inward temple recession to middle vertex and crown diffuse thinning from the shedding?

Also, when this summer is Merck losing its patent, making Propecia generic and driving the cost down? My derm. wouldn't give me Proscar, so I'm trying to decide if I should wait on starting my treatment til the generic comes out, or if I should start the regular Propecia and switch when the generic comes out. Any ideas where the price of the generic is going to be?

 

[socks]

Based on your guys' experience, is it possible that, by taking Propecia, I can turn into a diffuse thinner in areas where I am not currently (visibly) thinning? Can I go from simple inward temple recession to middle vertex and crown diffuse thinning from the shedding?

Finasteride will not make your hair worse. It wont make you recede more or thin where you otherwise wouldnt have. All finasteride does is lower the androgenic load on your hair follicle cells which in turn slow or stop Androgenetic Alopecia in 80% of men.

Also, when this summer is Merck losing its patent, making Propecia generic and driving the cost down? My derm. wouldn't give me Proscar, so I'm trying to decide if I should wait on starting my treatment til the generic comes out, or if I should start the regular Propecia and switch when the generic comes out. Any ideas where the price of the generic is going to be?

Sooner you start the better. Every day you do nothing is another day damage is done to your hair (of which not all is 100% repairable).

 

[nastyman33]

Just a couple follow up questions, if you guys don't mind!

I'm worried about the long term effects of Propecia. Is there any evidence that it causes long term damage? Is there any evidence that it loses it's efficacy after a certain amount of years? I'm worried that, at 23, if I start the Propecia and then it loses its efficacy, I'll only be 28 or 29 and losing my hair again.

Basically, I'm second guessing the Propecia because it's something I'll have to take for the rest of my life if I want to keep my hair, and that is not a pretty picture for me since it is an internal, hormone-changing drug, and I am only 23. As opposed to the Minoxidil, which is only a topical and not messing with the hormones.

Is it possible to take the Propecia for a couple years, then use the Minoxidil to maintain whatever regrows?

Sorry for the ramblings and incessant questions, I just don't know what to do!!!

Thanks!