Is it time to take action? What should I do?

[camel_flame]

Hi All,

I'm about to turn 25. I've been lurking around this forum for the last 2-3 weeks. I've decided to try and become a bit more proactive about what I perceive to be my receding hairline. I went on a dumb anorexic crash diet last year and lost about 40 lbs in 4 months (I started eating healthy again around November). A few months later I started shedding a lot and I went to see the dermatologist at the beginning of April - he looked through my hair and did a pull test, declared that I didn't seem to be balding and then I probably had telogen effluvium. My shedding seems to be slowing down now. However, my hairline does seem to have receded some over the last year. I've heard Telogen Effluvium doesn't usually impact the hairline? In any case, here are a few pics of me, I was wondering if you guys could suggest to me where I stand in terms of my hairline and whether it would be worthwile to try rogaine? (I'm scared of propecia and I've already started doing nizoral twice a week...). I'm scared that if I start rogaine the initial shed will further damage my hairline...

Thanks in advance for any responses. Here's some pics I took today after getting a haircut. (I have asked several hair stylists if they think I am thinning or balding and they all say no, I'm just being paranoid, but maybe they are just being nice to me?)

(Edit: Also I should note that there you can't see them in the photograph, but there are a decent number of isolated hairs just at the fringe of my hairline that I've only noticed in the last 4-5 months. I'm somewhat confused as to whether the Telogen Effluvium might have anything to do with that? My hair everywhere on my entire head looks a bit thinner compared to about 8 months ago, and when I first noticed the shed the hair had the characteristics an anorexic person's hair would have (at 800 calories a day), but now the quality has gotten a good bit better since I've realized the stupidity of my diet)

 

[Dark Link]

Uh.. maybe it's me but I don't see any loss. Maybe some temple recession but that could be a mature hair line. How do you plan to get in rogaine to your scalp with that thick head of hair!

 

[anxious1]

yeh better take action before u turn into an ape u hairy bastard. most of us would kill for that hair. its funny how ppl with hair dont even comprehend how lucky they are, with hair u can be a rock star, an actor, a superhero. without hair u can be the same things, but just a bald one with less confidence, that gets less money, less girls, less everything.

your lucky man, u dont have male pattern baldness.

 

[Notcoolanymore]

I really can't tell whether you are losing any hair. If you know you are and you want to do something about it there are two things that work: minoxidil and finasteride. Finasteride is the most effective thing you can use to put a stop to your loss.

 

[camel_flame]

Where do you guys think I would fall on the Norwood scale? The problem is that while I know my hair isn't the same as it was 6 months to a year ago, I can't tell if it's from the possible Telogen Effluvium or male pattern baldness or just normal aging? My thinking was to go and have a dermatologist check me out and then consider waiting till the end of the summer to see if my hair improves any due to post-Telogen Effluvium regrowth (if it doesn't then it's probably a good idea to start up rogaine?). I'm scared of finasteride because of the side effects (my dad started taking it when he was like 35 but he reported no side effects... idk if side effect occurence may be genetic?).

 

[Dark Link]

Norwood 2

Maybe even Norwood 1.75

 

[camel_flame]

Norwood 2

Maybe even Norwood 1.75

Hmmm... ok, that's sorta the sense I got from looking at my own pics. Given that my temple area hasn't really changed over the last 8 months, I'm going to assume I'm not going to recede to a Norwood 3 overnight (and hopefully not in the next 2-3 years?)... so I will wait things out over the next three months and see if my hair quality improves in general... if it doesn't, then I will consider using Rogaine.

Sorry if I come off as overly anxious, I know that my situation isn't too bad (my dad has almost no hair left and I have watched him progress from a full head of hair...!) but after lurking on many hair loss forums for the last month I've gotten the sense that it's good to try and catch this phenomenon early. Unfortunately the last derm I went too wasn't too friendly, told me that rogaine barely works at all and finasteride sorta works (not sure I fully trust him given how many people talk about rogaine success online...). I'm also worried that a rogaine shed could leave me worse off than I am now?

 

[Dark Link]

Do you know what age your Dad went bald? How aggressive was it? How about your Mom's side? You are right, you do want to catch it early. If you are comfortable with it I would take finasteride as the first line of defense. Taking minoxidil is effective in like 40% of the population. But for whatever reason if its taken with finasteride it does some good in a greater percentage of people using it.

I would only take it if you were 99% sure you are going to bald further....

 

[camel_flame]

Do you know what age your Dad went bald? How aggressive was it? How about your Mom's side? You are right, you do want to catch it early. If you are comfortable with it I would take finasteride as the first line of defense. Taking minoxidil is effective in like 40% of the population. But for whatever reason if its taken with finasteride it does some good in a greater percentage of people using it.

I would only take it if you were 99% sure you are going to bald further....

On my mothers side nobody went bald in any generation. (They all got full white hairs though) On my dad's side he and one of his brothers went bald but his other brother still has a full head of hair. My dad started noticibly receding in his early to mid 30's and the Doctor put him on finasteride. Then it very slowly kept going until around 45 when he said he quickly lost all of his hair on top.

I don't actually care very much if I lose my hair in my mid 30's, I just want my hair for a few more years so I can keep dating and find the right girl. The way I see it, once I've reproduced I have won "the game" and it doesn't really matter what I look like...

 

[I.D WALKER]

Thanx for sharing Camel, One question for you; Have you actually had your M.P.B. concern properly diagnosed by a well qualified and respected physician? This would be mh first recommendation if you have not already done so.

 

[camel_flame]

Thanx for sharing Camel, One question for you; Have you actually had your M.P.B. concern properly diagnosed by a well qualified and respected physician? This would be mh first recommendation if you have not already done so.

Hi I.D WALKER - Yes I visited the same dermatologist who my father has been seeing for the last 10+ years for his male pattern baldness. He looked through my hair and said he didn't think I was balding because it usually follows a pattern. I then claimed that my hair still seemed dead compared to before my crash diet and that I saw keratin bulbs, etc etc and so he said it very well could be Telogen Effluvium if there is anything even happening or it could be very early male pattern baldness. So he gave me no real/firm diagnosis... I didn't know what to think of it as he could just be saying that to cover himself on the off chance. I also talked to my hair cutter (well actually 6 different ones) and they thought I wasn't balding/thinning either). So maybe it's just in my head?

Btw, thanks everyone for being very understanding. It has eased a lot of my stress just to have a place where I can express this concern to others (I keep this to myself in my day to day life as I doubt anyone wants to talk about this subject with me).​

 

[Cincinnati Kid]

On my mothers side nobody went bald in any generation. (They all got full white hairs though) On my dad's side he and one of his brothers went bald but his other brother still has a full head of hair. My dad started noticibly receding in his early to mid 30's and the Doctor put him on finasteride. Then it very slowly kept going until around 45 when he said he quickly lost all of his hair on top.

I don't actually care very much if I lose my hair in my mid 30's, I just want my hair for a few more years so I can keep dating and find the right girl. The way I see it, once I've reproduced I have won "the game" and it doesn't really matter what I look like...

If only, sir. Trust me, even if you "win" the game, your confidence will likely go in the crapper as it does for most men once their hair loss comes to the point where the only option is to just shave it all off. I let myself believe that for a while, but I was only fooling myself. Being bald at any age sucks. Thankfully we live in an era where there is at least SOME ways to treat it, albeit not cure it. That being said, judging by the pics from your OP, if I saw you in person I would want to slap the **** out of you just like all fellow young dudes I see that are NW1 or 2 with nice thick hair while I have baby fine hair -- been that way since I was a kid -- so I don't get much scalp coverage even when grown out. Your hair looks to be pretty solid, dude.

 

[stop dht]

Dude maybe for armenian or kurdish standarts , u r balding but for normal humankind u better care about your hairs but not in your scalp

 

[camel_flame]

Uh.. maybe it's me but I don't see any loss. Maybe some temple recession but that could be a mature hair line. How do you plan to get in rogaine to your scalp with that thick head of hair!

Hey Dark Link,

Looking at my hair again today, I have to say there is definitely something going on with the left temple. However looking at a few pics of myself from Oct - Feb it seems like it was the same then as it is now? Going to see if I can meet a dermatologist this week who is known for hair treatment.

My thinking is that if my temple recession isn't too aggressive, perhaps I can wait a few months to see if I'm recovering from the hypothetical Telogen Effluvium (Telogen Effluvium). I was diagnosed with anorexia nervosa for four months last year (May - August) in which I lost about 40 lbs mainly through not eating enough... I know, really stupid and especially if I had known I would lose/thin-out my hair I would have never done something like that... I'm assuming that would trigger the Telogen Effluvium symptoms I noticed?

My hair all over my scalp just seems a bit thinner than it was a year ago, but the hair quality has improved dramatically in the last 4 months and I'm hoping that some hairs will now grow back (I've read that people with Telogen Effluvium recover their hair slowly once the triggers have disappeared). My worry is that given how thin I feel my hair is just now (it's not noticeable to anyone except me when I look at it under the bathroom lights and part my hair), if I have to go through a finasteride/rogaine shed then it will potentially become noticeable to others - so if I wait a few months before trying either of those two then maybe my hair will be a little thicker as I recover from Telogen Effluvium?

One question regarding Telogen Effluvium that perhaps some of you may know the answer to - the type of hair I have been shedding and the amount has changed over the last 6 months:

- Around Jan/Feb I would have a lot of full size hairs fall out, but all my hairs would look thin, dead, crinkly and with keratin bulbs. I compared them to the hairs of some of my family members and mine just looked sickly.
- Around March I had these small, tapered hairs (usually like .5 to 1 inch) fall out, they looked very thin, still with keratin bulbs, though the bulbs looked sometimes quite small, with the amount of shedding being less than before. The hair seemed to be healthier texture wise. I was told I also had a bad case of dandruff so I started using Nizoral and a moisturizing shampoo.
- Then over April/May I had a mix of 1-1.5 inch tapered hairs with keratin bulbs and normal length hairs w/o tapered ends (also often having a tiny black bulb at the end), but the shedding rate seemed to decreased a good bit (I am tempted to say that now the shedding has tapered down and recovery might start?). The texture is almost always healthy looking and the hairs seem to be getting thicker (in diameter) and having better pigmentation. Dandruff seems to have mostly dissappeared though I've now been told by hair cutter that my scalp is kinda dry. Very few of the tiny baby hairs that I was observing in Feb/March...

My question is, does this pattern of hair-shedding/texture-changes sound like it could be coming from male pattern baldness or from Telogen Effluvium?

 

[Dark Link]

Hey Dark Link,

My question is, does this pattern of hair-shedding/texture-changes sound like it could be coming from male pattern baldness or from Telogen Effluvium?

The bulbs on the end of your hair mean you are shedding hairs. This is not as a result of malnutrition where your hair breaks off without the bulb. The dermatologist is going to see your thick head of hair and probably say wait it out.

The shedding your experiencing is likely 1 of 2 scenarios.
Scenarios 1: You are developing a mature hair line.

Johnny Depp is by no means bald. But his hair receded back a bit. This is an adult mature hairline. Is it losing hair?? Yes. Is it male pattern baldness.. No.

Scenario 2: You have the start of male pattern baldness. No way to know unless it progresses past the mature hairline. The thing is finasteride and minoxidil doesn't seem to work very well at stopping your mature hair line losses. So you might as well just wait it out a bit.

 

[camel_flame]

The bulbs on the end of your hair mean you are shedding hairs. This is not as a result of malnutrition where your hair breaks off without the bulb. The dermatologist is going to see your thick head of hair and probably say wait it out.

The shedding your experiencing is likely 1 of 2 scenarios.
Scenarios 1: You are developing a mature hair line.

(pic of johnny depp)

Johnny Depp is by no means bald. But his hair receded back a bit. This is an adult mature hairline. Is it losing hair?? Yes. Is it male pattern baldness.. No.

Scenario 2: You have the start of male pattern baldness. No way to know unless it progresses past the mature hairline. The thing is finasteride and minoxidil doesn't seem to work very well at stopping your mature hair line losses. So you might as well just wait it out a bit.

Hi Dark Link,

Thanks for the response. Two questions though:

(a) You say that malnutrition would lead to hairs breaking. However there is quite a bit of literature on the internet about how people who suffer a bout of anorexia will often get Telogen Effluvium and that a sign of this is the keratin bulbs at the end of the hairs being shed. It would seem that if the Telogen Effluvium is triggered by anorexia (in my case, 4 months of usually eating 600-800 calories a day, leading to ~40lbs weight loss) then even after one begins eating healthy the onset and later subsiding of excessive shedding would lag behind when the body stabilized nutrition wise. Do you think malnutrition can trigger Telogen Effluvium or is the only hair loss you'd expect to see through actual breakage?

(b) How would you explain the change in the length and vitality of the hairs that I have observed over the last 4 months or so? It seems like the average length of the hairs I observe coming out are is increasing (much fewer baby hairs), less of the shed hairs appear to have tapered ends (which means they were hairs that grew long enough to be cut by a barber). My hair also on the whole feels healthier as I've been careful about eating enough this year... I'm somewhat assuming that all the hairs on my head will have to go through a cycle or two before they grow back normal (or at least I'd hope).

Sorry if I sound a bit desperate. I'm smack in the middle of my 20's now (half way in a week) and while I notice mature hairlines on many of my male friends (so that seems to just be a part of being this age and I think I can live with it), potential overall thinning of my hair bothers me as at least in my mind I see thick volumous hair to be a sign of vitality. I mentioned my concerns that I'm thinning to a few of my friends and they looked over my hair and said it seemed fine, so it may be more of a body-image issue (hmmm, that's probably why I was anorexic last year?). Any thoughts on the psychological aspect of all this?

Again, thanks a lot for your responses!