Massive Shed After 10+ Years On Big 3

[Marktwothousand]

I’m 40 and wondering if I’m just starting to lose the battle. My regimen:
- finasteride 1-1.25mg for 10-15 years (no sides luckily!)
- various rogaine formations - 5% foam for morning and minoxidil max 10% at night
- nizoral/regenpure shampoo alternating.

I am starting to get massive sheds since about 1-2 months now, pretty much anytime I touch my hair, a few strands come out. To test shedding, I do a combthru over the sink and count the hairs. One thing I can say about the hairs that do shed, is that there is no white “root” at the end of them, just a little kink where the hair would have been in the root (like, you can feel it with your fingers). I don’t know if “no root” really means anything or what, because I figure if I’m not growing as fast as I shed, then I’m losing the battle anyway right?

Last week I stopped using the minoxidil and shampooing my hair, stopped blowdrying it and stopped using all topical products to see if the shedding stopped, and while it diminished slightly, it was still 50-100 in my combthru’s over the sink. I was thinking it might just be winter dryness, but no luck.

So today I am going back on foam to regrow what hair I can and I ordered essengen-6 and spironolactone cream. I also added lasercombing again. I’ll start with the essengen-6 and see if the topical finasteride helps the shed. I’ve never used spironolactone before, am I making a big mistake? I could return it before I open it...but I read that topical spironolactone shouldn’t have any major sides.

Otherwise anyone know what this could be? Is it just the time ticking away at 40 years old and time to start looking into transplants? And if so, should I wait till I have actual bald spots for that or start ASAP?

Sorry for the long post, I know I’ve got no street cred here as a new poster, and I probably sound just as desperate as anyone else, but I don’t even know where to turn to. Even professionally I don’t know who to ask...do I see a dermatologist or should i just go to a transplant doctor at this point?

 

[shwareb]

I’m 40 and wondering if I’m just starting to lose the battle. My regimen:
- finasteride 1-1.25mg for 10-15 years (no sides luckily!)
- various rogaine formations - 5% foam for morning and minoxidil max 10% at night
- nizoral/regenpure shampoo alternating.

I am starting to get massive sheds since about 1-2 months now, pretty much anytime I touch my hair, a few strands come out. To test shedding, I do a combthru over the sink and count the hairs. One thing I can say about the hairs that do shed, is that there is no white “root” at the end of them, just a little kink where the hair would have been in the root (like, you can feel it with your fingers). I don’t know if “no root” really means anything or what, because I figure if I’m not growing as fast as I shed, then I’m losing the battle anyway right?

Last week I stopped using the minoxidil and shampooing my hair, stopped blowdrying it and stopped using all topical products to see if the shedding stopped, and while it diminished slightly, it was still 50-100 in my combthru’s over the sink. I was thinking it might just be winter dryness, but no luck.

So today I am going back on foam to regrow what hair I can and I ordered essengen-6 and spironolactone cream. I also added lasercombing again. I’ll start with the essengen-6 and see if the topical finasteride helps the shed. I’ve never used spironolactone before, am I making a big mistake? I could return it before I open it...but I read that topical spironolactone shouldn’t have any major sides.

Otherwise anyone know what this could be? Is it just the time ticking away at 40 years old and time to start looking into transplants? And if so, should I wait till I have actual bald spots for that or start ASAP?

Sorry for the long post, I know I’ve got no street cred here as a new poster, and I probably sound just as desperate as anyone else, but I don’t even know where to turn to. Even professionally I don’t know who to ask...do I see a dermatologist or should i just go to a transplant doctor at this point?

Have you considered Dutasteride?

 

[Manochoice]

You could start with a dermatologist though he/she will not have much to say other than the big 3. Would be good though to see if your scalp is inflamed or not. Maybe some blood test to see your DHT levels? So for the 10 or 15 years you had zero sides? Not even minor? Nice! Some people go the Duta way when Fina seems like it's losing ground but my understanding is that Duta hasan increased hance of sides.

 

[Hemanth IN]

i know a person (38-40 yo), he is now nw3, 3 years back, he very quickly reached nw3, at that time he had lots of hair falls, on someone's advice, he stopped shampoo and started soap and maintained nw3 from 3 years. He knows nothing about finasteride/minoxidil/keto/anything. May be some external things contributing for hairloss for you. are those hair in sink miniaturized?

 

[Marktwothousand]

Also, please see these pics. This is the first time I’ve taken pics like this so excuse me if it’s bad. I hate pics of myself, is there a better way of taking these?

Also, please bear with me as you’ll notice the area of loss is small - this is the likely result of me keeping most of it using the big 3 over the years. So I apologize if my case sounds like I’m being a diva.

You’ll notice in my first and last pic in the bald spot (that’s the area I am really concerned about) there’s still black follicles on the scalp, so I’m wondering if the hairs aren’t just breaking off?

In response to your VERY kind responses, thank you:
- no sides on finasteride! Yeah, at the VERY beginning, I think I had the “common” side effect for a few days. But naw, when I’m “ready to go”, generally no issues. Libido similar and increased when necessary. But those are the only sides I can see...who knows what it’s done to me inside? All my blood tests are well with in range, so I’m happy.

- not willing to try duta just yet - but maybe that’s something I can talk to a hair specialist about, I’d have to be really convinced that I’m losing the battle before I tried it, because duta is a much more serious drug. What about spironolactone cream and topical finasteride? That’s my next step. Anyone know what to expect?

- and no, the hair coming out in the sink are FULL LENGTH and regular colour. There are a few small hairs that come out (like 1 cm) but generally the vast majority of hairs (90%) are long and come from the root (but without the root attached). Does that mean anything? I also wonder if the sink combthrus might be exacerbating it and pulling out more than i should, is this a bad method?

Anyone know a good doctor I could consult with in Toronto about this other than my GP? Like for things like DHT testing?

Also, would I go for the strip method for transplant at this stage? I would prefer going for multi strip methods over the years, than the hole-punch method. I don’t know which is FUT or FUE or if I’m even a candidate at this point.

Back of head

Top

Back of head is on the left, front on the right toward the white door)

 

[Hemanth IN]

is it shedding all over scalp or only at hairlines? most of shedding hairs are minute or very thin compared to your normal hairs? Telogen Effluvium can trigger with male pattern baldness commonly. are you experiencing any symptom of hypo/hyper thyroid?

 

[Marktwothousand]

is it shedding all over scalp or only at hairlines? most of shedding hairs are minute or very thin compared to your normal hairs? Telogen Effluvium can trigger with male pattern baldness commonly. are you experiencing any symptom of hypo/hyper thyroid?

All over the scalp. The hairs are not small or thin - they’re regular size generally.

I have a requisition to check my TSH counts (thyroid). I am getting it checked Thursday. I am generally in good health, but did undergo weight loss in December which I heard can be a factor.

I think I am going to stop the bathroom sink comb thrus For a week and see what happens. I may be pulling out hair unnecessarily.

 

[Manochoice]

Of what I'm "hearing" (actually reading), yes! Duta is more potent. Some people do well with that also. When it cones to hair transplant I don't think anyone here would be qualified to give you good advice. For that, see a specialist, maybe a few for different opinions. The FUT (the strip one) will leave scar(s) on the back of your head so if sh*t goes south and you need to get to a point where you'll need to shave your head (due to various reasons including losing serious ground in your hair loss battle) then you'll sport a 'nice' smiley face on the back of your head. If your donor hear quality is high you'll have more options. Yes, your case does sound like being a diva!!! Ha ha ha! Kidding but in all seriousness many of us here wish we had your hair. If it worries you that much you should see a dermatologist though.

 

[Manochoice]

I don't think the combing over sink thing speeds up your shedding/losing. I think it's a myth. Hair is healthy or is not. If it's not, even a slight breeze can blow it out. Get blood check, get derma check. Derma can also keep a photo journal of your hair to track progress. Good luck on your journey man!

 

[Marktwothousand]

Of what I'm "hearing" (actually reading), yes! Duta is more potent. Some people do well with that also. When it cones to hair transplant I don't think anyone here would be qualified to give you good advice. For that, see a specialist, maybe a few for different opinions. The FUT (the strip one) will leave scar(s) on the back of your head so if sh*t goes south and you need to get to a point where you'll need to shave your head (due to various reasons including losing serious ground in your hair loss battle) then you'll sport a 'nice' smiley face on the back of your head. If your donor hear quality is high you'll have more options. Yes, your case does sound like being a diva!!! Ha ha ha! Kidding but in all seriousness many of us here wish we had your hair. If it worries you that much you should see a dermatologist though.

I know I might be being a diva, but I’ll get my hair cut this Thursday and re-post and see just how massacred irs gotten with the latest sheds.

I might also increase my ketaconazole to daily as it could be a scalp issue.

Anyway, I guess the reason I was posting now was because - well, other than being a diva - I feel like this could the beginning of true hair loss for me. And hopefully a story to all that...IF YOU STICK with the big 3 at an early age (I think I was around 23-26) you can SAVE yourself. For those that have sides, take ED drugs or just wait a few weeks and they might go away. in my opinion from what I’ve read on here, people are not giving finasteride a long enough shot before abandoning it. They have one or two incidents not being able to get a boner and they panic.

I’ve taken many kinds of medications and sometimes it takes time for the sides to go away. Anyone who is worried about finasteride, should give it a little more patience. I also thing it’s help me stave off aging and grey hairs (don’t know if that’s scientific or not,
But it seems to me that if lower DHT means less of the “getting older stuff” like hair loss, less DHT Might do other things too).

I still have to dig to find grey hairs in my beard and hair and wonder if that’s bexause of less DHT “aging” me.

Thanks so much again for the kind response as a newbie here.

 

[Hemanth IN]

All over the scalp. The hairs are not small or thin - they’re regular size generally.

I have a requisition to check my TSH counts (thyroid). I am getting it checked Thursday. I am generally in good health, but did undergo weight loss in December which I heard can be a factor.

I think I am going to stop the bathroom sink comb thrus For a week and see what happens. I may be pulling out hair unnecessarily.

Combing will just pull out telogen hair at or before exogen phase, meaning those hairs were triggered with something at 2-3 months back. if all hair are normal size hairs, you have good chances of getting all lost hairs back by next half a year if you find the reason behind it. doctors may think its Androgenetic Alopecia due to your history and hairline, but Telogen Effluvium (endocrine, nutrient, etc) also occurs along with Androgenetic Alopecia, most of doctors dont consider it. Now question is, you have stopped many things like fina, minoxidil. will it affect your hairs in future? are you experiencing something like high blood preassure before starting hair loss? this can be indirectly related, good doctor should solve it easily with plenty of tests and questions. Good luck

 

[manda]

Hey Marktwothousand,

can you please share a bit of your experience with the big 3? How advanced was your hairloss when you started treatment? Did you maintain your hair over the years or did you also see some regrowth? Did you experience any initial shed or throughout the years(except the current one)? Did you start with both fina and minoxidil at the same time?

It would be nice to hear bit of long-term users bc they rarely come here and give some insights.

And your hair is amazing for your age. You shouldn't worry too much. Even if your shedding increases it will take ages until people will notice sth. And then still you can easily fix any damage with a hair transplant. Don't worry about loosing the battle at all

Thanks and best of luck!

 

[Teeq19]

At 39, I’m in the same boat. Using both minoxidil and rogaine for 15+ years now. Was able to maintain my hair throughout with minimum side effects, the occasional ball ache was common but nothing too bad

Over the last year, my shedding has been pretty much non stop. Unlike OP, I am also shedding a ton of miniaturized hairs as well so I’m not optimistic that this is a temporary thing. Seems like a switch has been flipped and I’m not sure there is much I can do to stop it

 

[Marktwothousand]

Hey Marktwothousand,
can you please share a bit of your experience with the big 3? How advanced was your hairloss when you started treatment? Did you maintain your hair over the years or did you also see some regrowth? Did you experience any initial shed or throughout the years(except the current one)? Did you start with both fina and minoxidil at the same time?

Thanks and best of luck!

My hairloss was minor when I started - mostly a receding hairline and in the top front corners. I started finasteride off-label and minoxidil out of the bottle (eyedropper) af the same time. Foam wasn’t invented yet Went with just the 5% twice a day until I learned about Dr. Lee 15%. I used Nioxin Shampoo until I learned about Revita a few years ago. That is now gone, so I switched to regenepure.

My only advice as a long term user would be what I’ve alresdy said... stick with the finasteride, try to get over the sides. Take ED drugs if it bothers you that much, but really, they should go away for the vast majority of guys. My “uneducated” opinion about the libido side effect is: if the patient was experiencing it on finasteride, they’re likely prone to experiencing it off finasteride too. Be consistent with all your treatments...twice a day rogaine/minoxidil, Twice a day! Don’t be a diva over how “sticky” or messy the solution can be, find workarounds.

And also, of course...START EARLY!!! I think most young guys in their 20s don’t know things like propecia exist. And if they do, my advice would be: Don’t just read about these regimens...DO IT.

I wouldn’t say I noticed a huge amount of regrowth, sometimes yes, but it would come in cycles. My family commented my hair sometimes looked pretty thick. I would say that then emphasis for me was not so much that the regimens gave me a ton of hair back...I was just able to arrest the balding before it started.

Until now

 

[Marktwothousand]

At 39, I’m in the same boat. Using both minoxidil and rogaine for 15+ years now. Was able to maintain my hair throughout with minimum side effects, the occasional ball ache was common but nothing too bad

Over the last year, my shedding has been pretty much non stop. Unlike OP, I am also shedding a ton of miniaturized hairs as well so I’m not optimistic that this is a temporary thing. Seems like a switch has been flipped and I’m not sure there is much I can do to stop it

sorry to hear that. What a similar case we have. Tell me about your shedding and has it caused a noticeable change in how your hair looks? A year is a long time to shed. What is your regimen exactly?

I too, got an occasional “ache” but I can’t be sure it was related to the finasteride or not, but no lumps detected and the aches never lasted long, so it was never bothersome. the ache might be able to be relieved by busting. (Sorry to be vulgar but it’s true)

 

[Teeq19]

sorry to hear that. What a similar case we have. Tell me about your shedding and has it caused a noticeable change in how your hair looks? A year is a long time to shed. What is your regimen exactly?

I too, got an occasional “ache” but I can’t be sure it was related to the finasteride or not, but no lumps detected and the aches never lasted long, so it was never bothersome. the ache might be able to be relieved by busting. (Sorry to be vulgar but it’s true)

My regimen has always been minoxidil in the AM and PM and Finasteride PM. I’ve played with the finasteride dosages a bit, 1mg daily and the occasional 2.5 mg dose (I have a proscar 5mg script and one for generic 1mg Finasteride)

I noticed some very thin spots in the middle of my scalp in April ‘18 while applying minoxidil. Didn’t think much of it but I believe seeing that made me start paying more attention to how much hair I would lose in the shower. Sometimes it was just what I would consider a normal amount and other times I would panic by how much hair would be on my hands

Fast forward to today, my density has taken a huge hit and I see so many more miniaturized hairs now. When I blow dry and style my hair in the AM, you cant really tell I have lost so much hair but by the end of the day when my scalp is oilier it is very noticeable.

I also had a bout with seborrheic dermatitis over the last 4 months which I believe exacerbated things.

 

[Teeq19]

My advice as a long time big 3 user
1 - stay consistent with rogaine application AM and PM. Actually, just stay consistent period. Changing up routines constantly is rarely beneficial. Pick a regimen and give a reasonable amount of time to evaluate it
2 - if you have scalp conditions, ie seborrheic dermatitis, be aggressive in treating it because I strongly feel that scalp inflammation contributes to male pattern baldness
3 - stressing about hair loss is normal but It can quickly consume you. If your hair loss begins to take over your life then seek help! Talk to a friend or professional . I do not think it is a coincidence that my worst shedding months occurred when I was stressing about hair loss the most

 

[Marktwothousand]

3 - stressing about hair loss is normal but It can quickly consume you. If your hair loss begins to take over your life then seek help! Talk to a friend or professional . I do not think it is a coincidence that my worst shedding months occurred when I was stressing about hair loss the most

i agree with everything this guy said but especially this. Since I have been doing my “bathroom sink shed combthrus” and really focusing on how much hair has come out, I’ve gotten really stressed about it and my heart starts pounding with anxiety when I see all the hair, and my mind runs agog with visions of expensive transplant bills let alone scary surgery. And the anxiety causes whatever stress hormones to trigger and surge, which causes more loss and so on.. so yeah! Good advice

 

[FBaldy]

Just had to say to mark ts, your hair looks excellent. I went on big 3 @ 30 but stopped after 5 years it really was too late imo. Now in my early 40s I can see more decrease at the back and front hair line sucked either way, but I think ill go shaved head soon.

The key to the big 3 imo was you have to start it almost before the hair loss starts !

If I ever get good money I may look into hair transplant and then restart the big 3, I can see the big 3 does work but more if you have the hair on the head in the first place, keep it up imo especially if you don't get the sides.

I can also 'testify' 5 years coming off the big 3 the side effects did go away Id say after 6 months, my heart beats are more regular and less palpitation type, erections are night and day and last longer and sex drive is night and day too. I also don't miss the smell and oily sticky hair, its nice to have clean hair even if there isn't much !

 

[Manochoice]

So many people here tend to realize they had some sides while treating hair loss and they only realize after quitting.