MODERATE DIFFUSE THINNING: Am I a candidate for hair transplant?

[drphilmustache]

Hello, 19M balding since I was 15. I have been on 2.5mg min for ~2 years, 1mg finasteride for 1 year before recently transitioning to 0.5mg dutasteride since this February. I recently started RU58841 5% 2 weeks ago, and also have been taking 4mg KLOW daily for around 2 months.

Judging from photos, my density hasn’t really improved all that much over the past 2 years and I really don’t want to start college with a really obvious bald spot. I’m wondering if a hair transplant will be suitable for me since I heard diffuse thinners can’t get one because healthy native hairs situated right next to where the new follicles are transplanted, causing them to die. Which is why transplants are usually done to slick bald areas. However, I’ve also seen stories on reddit of people getting diffuse thinning transplants and it working out very nicely.

Now I’m wondering: should I continue on my current regimen and hope for regrowth, or just get the transplant? Any insight is appreciated.

vvv first photo from today. 2nd one is from 2023.

 

[Yar]

Hello, 19M balding since I was 15. I have been on 2.5mg min for ~2 years, 1mg finasteride for 1 year before recently transitioning to 0.5mg dutasteride since this February. I recently started RU58841 5% 2 weeks ago, and also have been taking 4mg KLOW daily for around 2 months.

Judging from photos, my density hasn’t really improved all that much over the past 2 years and I really don’t want to start college with a really obvious bald spot. I’m wondering if a hair transplant will be suitable for me since I heard diffuse thinners can’t get one because healthy native hairs situated right next to where the new follicles are transplanted, causing them to die. Which is why transplants are usually done to slick bald areas. However, I’ve also seen stories on reddit of people getting diffuse thinning transplants and it working out very nicely.

Now I’m wondering: should I continue on my current regimen and hope for regrowth, or just get the transplant? Any insight is appreciated.

vvv first photo from today. 2nd one is from 2023.

Simply take 1 mg of estradiol; it will increase hair density and fill in the crown with new hair.

 

[drphilmustache]

Simply take 1 mg of estradiol; it will increase hair density and fill in the crown with new hair.

Will topical alfatradiol work too? I dont wanna hop on hrt and get gyno and lose my gains

 

[Yar]

Will topical alfatradiol work too? I dont wanna hop on hrt and get gyno and lose my gains

Yes, using it topically will help; you shouldn't lose the results you've achieved with alpha-estradiol. Only estradiol promotes hair growth on the scalp.

 

[drphilmustache]

Yes, using it topically will help; you shouldn't lose the results you've achieved with alpha-estradiol. Only estradiol promotes hair growth on the scalp.

Right the problem is alpha estradiol only works by blocking the androgen receptor right so its functionally identical to RU58841 which I’m already using. Would a topical beta estradiol work instead like estradiol cream?

 

[Yar]

Right the problem is alpha estradiol only works by blocking the androgen receptor right so its functionally identical to RU58841 which I’m already using. Would a topical beta estradiol work instead like estradiol cream?

Substituting RU with estradiol is not equivalent, as these substances differ in their pharmacological activity, mechanisms of action, and side-effect profiles.

 

[drphilmustache]

Substituting RU with estradiol is not equivalent, as these substances differ in their pharmacological activity, mechanisms of action, and side-effect profiles.

Yes I’m just gonna get estriol cream and apply it topically. Not sure if this is your area of expertise but would supplementing this with something like a sarm e.g. ostarine work to avoid the decrease in muscle mass caused by the estrogen?

 

[baba_yaga]

you can increase oral min to 5mg daily, increase duta to 2.5 mg daily. May get some regrowth, but unlikely.

 

[Yar]

Yes I’m just gonna get estriol cream and apply it topically. Not sure if this is your area of expertise but would supplementing this with something like a sarm e.g. ostarine work to avoid the decrease in muscle mass caused by the estrogen?

you can increase oral min to 5mg daily, increase duta to 2.5 mg daily. May get some regrowth, but unlikely.

Scalp hair grows only in the presence of estradiol. Unfortunately, if you are taking finasteride or dutasteride and your testosterone levels skyrocket without a corresponding increase in the aromatization of testosterone into estradiol—and hair loss does not stop—then the hair loss will worsen. There must be an increase in blood estradiol levels resulting from the aromatization of testosterone via the aromatase enzyme.

 

[Jakejr]

There must be a better way

 

[baba_yaga]

As Yar said, you need higher levels of estrogen in your blood. In addition you need systemic anti-androgens. In other words, low potency HRT may give you regrowth, other than that you hair transplant. No other interventions give you a high chance of regrowth.

 

[RXShopMD_Team]

Balding since 15 and on a strong regimen at 19 is tough, and it is understandable to want to fix it before college. A few honest points:

• Transplant at 19 is risky for a simple reason: your final pattern is not known yet. Most reputable surgeons are cautious under about 25, especially with early aggressive loss, because hair placed now may end up as an island if loss continues behind it, and donor supply is limited for life.
• Diffuse or crown-dominant thinning is often a poorer surgical target than a clear frontal recession, since grafts spread over a thinning area add less visible density.
• On medication: dutasteride since February is still early. Many people need 12 months on a new DHT blocker to judge it. Stacking several new things at once (RU58841, peptide blends like KLOW, which are research products without human safety data) makes it impossible to tell what is helping or causing side effects.

Short term, concealers like fibres and a shorter haircut can make a big visual difference for college. Medium term, a consultation with a hair-loss dermatologist and a conservative surgeon who will give a long-term master plan, including whether you are a candidate at all, is the safest route.
Disclosure: I work on the editorial team of an online pharmacy, general information only, not medical advice.