Newbie Needing Advice On Male Hair Loss

[MartinMascott]

Hi folks, 39y/o white male, have always had very fine hair, but about 8yrs ago, I started getting very noticeable hair loss, predominantly at my hairline, front and center. It’s now pretty wispy at the front, and showing signs of thinning out through the middle.

About 9 weeks ago I began taking 1mg finasteride daily. About 14 days ago I began using Nizoral every 3-4 days. I know there’s more I could be doing – minoxidil, derma roller – but am finding all this a bit overwhelming, so though I would check in for some advice. I’ve taken a couple of photos which i've attached – the one from the top looks far worse than I’d imagined. I brushed my hair completely back for the pics, which is not how I normally have it, but I figured would give the best indication visually.

What Norwood do you think I am?

Should I just continue with the finasteride/nizoral for now and see how things look after 6 months, or do I need to get the minoxidil and derma rolling going asap? Or…am I too far gone…should I be looking at hair transplant surgery?

I frequently wear a baseball hat to both cover my thinning hair and protect my scalp from the sun as I live in a hot climate. Does wearing a baseball hat negatively impact my hair loss?

Thanks,

Marty

 

[MartinMascott]

ah well that's tough to read, but thanks for your honesty.

 

[Yoadrian]

I have very bad news. Looks even worse than mine. You are NW6 and finasteride isn't going to magically regrow everything as it only slows down further loss in most cases. Had you started it sooner, you would have been in a much better situation right now. Minoxidil is garbage that doesn't regrow much and loses its effectiveness in 2 years. hair transplant is not an option for you as you'll never recover your original density with it. At best hair transplant would make you NW3. If you want full head of hair at this stage you'll need a hair system and that comes with its set of pros and cons.

is that the general consensus with regards to minoxdil?

 

[Androgenic Alpaca]

Hi folks, 39y/o white male, have always had very fine hair, but about 8yrs ago, I started getting very noticeable hair loss, predominantly at my hairline, front and center. It’s now pretty wispy at the front, and showing signs of thinning out through the middle.

About 9 weeks ago I began taking 1mg finasteride daily. About 14 days ago I began using Nizoral every 3-4 days. I know there’s more I could be doing – minoxidil, derma roller – but am finding all this a bit overwhelming, so though I would check in for some advice. I’ve taken a couple of photos which i've attached – the one from the top looks far worse than I’d imagined. I brushed my hair completely back for the pics, which is not how I normally have it, but I figured would give the best indication visually.

What Norwood do you think I am?

Should I just continue with the finasteride/nizoral for now and see how things look after 6 months, or do I need to get the minoxidil and derma rolling going asap? Or…am I too far gone…should I be looking at hair transplant surgery?

I frequently wear a baseball hat to both cover my thinning hair and protect my scalp from the sun as I live in a hot climate. Does wearing a baseball hat negatively impact my hair loss?

Thanks,

Marty

I wouldn't say that you have no hope, but your balding is very advanced so you've got a low probability of recovery. If I were you, I'd stick with the finasteride and add in some minoxidil. That will probably not be enough by itself to get substantial growth, but some people seem to be super responders to those treatments, so maybe you'll get lucky and have a lot of hair regrowth. Even if you get a little bit of regrowth, it might be enough to hold on to some hair fibers so you could give yourself the appearance of a full head of hair. Or you could get enough regrowth that you could get a transplant. But partial regrowth is still a best case scenario, (and full regrowth is out of the question on just finasteride + min) so don't get your hopes too high. If you want to go down the rabbit hole, there are always stronger treatments that you can try, but that requires lots of research to figure out and you could have side effects. I do agree that your best bet is probably a hair system, though. For now, stick with finasteride + min and see where it takes you.

 

[MartinMascott]

I wouldn't say that you have no hope, but your balding is very advanced so you've got a low probability of recovery. If I were you, I'd stick with the finasteride and add in some minoxidil. That will probably not be enough by itself to get substantial growth, but some people seem to be super responders to those treatments, so maybe you'll get lucky and have a lot of hair regrowth. Even if you get a little bit of regrowth, it might be enough to hold on to some hair fibers so you could give yourself the appearance of a full head of hair. Or you could get enough regrowth that you could get a transplant. But partial regrowth is still a best case scenario, (and full regrowth is out of the question on just finasteride + min) so don't get your hopes too high. If you want to go down the rabbit hole, there are always stronger treatments that you can try, but that requires lots of research to figure out and you could have side effects. I do agree that your best bet is probably a hair system, though. For now, stick with finasteride + min and see where it takes you.

ok, so right now i'm just on finasteride (2 months) and nizoral (2 weeks) - so I should add in minoxidil right away?

 

[Androgenic Alpaca]

ok, so right now i'm just on finasteride (2 months) and nizoral (2 weeks) - so I should add in minoxidil right away?

Your choice. Some people like to use just finasteride for a few months to see how much growth is from finasteride before adding min. (Nizoral doesn't do much, but you should stick with it because it does help a little bit.) Note that there's the potential for any hair grown from minoxidil to fall out after stopping use of minoxidil, so most people suggest using minoxidil indefinitely. There's a bit of controversy in the hair loss community to what extent this hairloss will be after minoxidil stoppage, some people think that there's no point of using minoxidil (see the guy further up the thread), but I'm of the opinion that minoxidil is the one of the strongest (and safest) hair growth stimulants available and I'm skeptical that hair will be lost after stopping minoxidil - so long as the hairs are allowed to become terminal and finasteride is used as well.

On that topic, the finasteride is the most important part of your regimen. Finasteride will stop further balding from occurring by stopping the production of DHT. Finasteride usually won't lead to much regrowth since it doesn't stimulate growth, it just stops further loss. But some people seem to respond really well and will regrow a ton of hair on finasteride. Since finasteride will stop further loss, you can stick with just finasteride for a few months or even years to see what results you get before adding minoxidil. Minoxidil is a growth stimulant, it just makes your hair grow more without stopping the underlying mechanism causing balding. Which is why it works so well together with finasteride.

Anyway, the most important thing is to give things time. You say you've been on finasteride for 2 months - you probably haven't seen any change at all since it takes a long time to have improvement - if you get improvement. Stick with things for at least 6 months, but realize it may take up to 2 YEARS before the full benefit is realized.

 

[MartinMascott]

Your choice. Some people like to use just finasteride for a few months to see how much growth is from finasteride before adding min. (Nizoral doesn't do much, but you should stick with it because it does help a little bit.) Note that there's the potential for any hair grown from minoxidil to fall out after stopping use of minoxidil, so most people suggest using minoxidil indefinitely. There's a bit of controversy in the hair loss community to what extent this hairloss will be after minoxidil stoppage, some people think that there's no point of using minoxidil (see the guy further up the thread), but I'm of the opinion that minoxidil is the one of the strongest (and safest) hair growth stimulants available and I'm skeptical that hair will be lost after stopping minoxidil - so long as the hairs are allowed to become terminal and finasteride is used as well.

On that topic, the finasteride is the most important part of your regimen. Finasteride will stop further balding from occurring by stopping the production of DHT. Finasteride usually won't lead to much regrowth since it doesn't stimulate growth, it just stops further loss. But some people seem to respond really well and will regrow a ton of hair on finasteride. Since finasteride will stop further loss, you can stick with just finasteride for a few months or even years to see what results you get before adding minoxidil. Minoxidil is a growth stimulant, it just makes your hair grow more without stopping the underlying mechanism causing balding. Which is why it works so well together with finasteride.

Anyway, the most important thing is to give things time. You say you've been on finasteride for 2 months - you probably haven't seen any change at all since it takes a long time to have improvement - if you get improvement. Stick with things for at least 6 months, but realize it may take up to 2 YEARS before the full benefit is realized.

thanks for your thoughtful response and advice. I really appreciate it. My initial reluctance to start with the minoxidil right away had been from reading I would need to keep that going indefinitely. Sounds like that might not be the case though. I don't mind so much with the finasteride, as its easy and not messy to pop the pill, and I don't have side effects. Ok, I will plan to continue with the finasteride for the next few months and see how things play out, then likely add minoxidil. thanks again!
-Marty

 

[Androgenic Alpaca]

thanks for your thoughtful response and advice. I really appreciate it. My initial reluctance to start with the minoxidil right away had been from reading I would need to keep that going indefinitely. Sounds like that might not be the case though. I don't mind so much with the finasteride, as its easy and not messy to pop the pill, and I don't have side effects. Ok, I will plan to continue with the finasteride for the next few months and see how things play out, then likely add minoxidil. thanks again!
-Marty

I'm a bit of a dissenting opinion on the need for indefinite use of minoxidil. The most prominent opinion on these forums seems to be that it needs to be used indefinitely, but I think that reasoning is based on a lot of "bro science." So take my position with a grain of salt, but I think at least some of the growth from minoxidil can be retained after cessation of use (but only if finasteride is used in conjunction!). And in any case, there have been studies that show that even if there is an initial shed after cessation of minoxidil monotherapy, after a month or two hairloss will be no worse than the control group that was not given minoxidil.

Anyway, I think you've got a good strategy so far, but keep in mind that (1) it will take time to get results and (2) with your level of hairloss, I think that its almost certain that you'll need more than just finasteride to get positive results and very likely that you'll need more than just finasteride + min. Even if you will never go back to the hairline you had when you were 15, I think it'll be possible (but maybe not likely) to have a NW3 or NW4, which is still definitely a visibly balding hairline, but isn't as extreme and can be made to look better through concealers or a transplant

 

[Wolf Pack]

We normally have 60,000 hairs on top and it's hard to replicate it with surgery so you should understand that. People have about 100 grafts per cm2 naturally and 50 grafts per cm2 is enough via surgery for the illusion of full hair, especially in those with thick hair and of course you can get a second pass over these areas if needed. These luxuries are not open to you and only for those with minimal loss/thick hair, top 5% of candidates. You're too far gone with fine hair too. Transplants alone will be poor especially in your case, even Norwood 6-7 with incredible thick donor can't get it all back.

It's over most likely, but no harm in trying medication and see where it takes you in 1-2 years. You could be a super responder and recover loads which then may make you a hair transplant candidate at the very lower end of acceptability. Otherwise you will need a hair piece for full hair or just shave and accept it.Why did you leave it late, did you not mind the hair loss before? Why did you suddenly think of hair, just curious, any relationship changes? Wish you luck.

 

[MartinMascott]

We normally have 60,000 hairs on top and it's hard to replicate it with surgery so you should understand that. People have about 100 grafts per cm2 naturally and 50 grafts per cm2 is enough via surgery for the illusion of full hair, especially in those with thick hair and of course you can get a second pass over these areas if needed. These luxuries are not open to you and only for those with minimal loss/thick hair, top 5% of candidates. You're too far gone with fine hair too. Transplants alone will be poor especially in your case, even Norwood 6-7 with incredible thick donor can't get it all back.

It's over most likely, but no harm in trying medication and see where it takes you in 1-2 years. You could be a super responder and recover loads which then may make you a hair transplant candidate at the very lower end of acceptability. Otherwise you will need a hair piece for full hair or just shave and accept it.Why did you leave it late, did you not mind the hair loss before? Why did you suddenly think of hair, just curious, any relationship changes? Wish you luck.

ahh...probably denial followed by mid-life crisis? No relationship changes or anything like that...

 

[michaelle]

Thanks for the replies here. I have a similar situation, and it is pretty sad... I will still try soem Baldness Cure, who knows maybe something will improve it a little

 

[jazz1]

I would add a 1mm Derma roller every other day and 5% minoxidil + 15% minoxidil should you want better results.

Also rotate your Nizoral shampoo with Regenepure DR or BIG3 lipogaien shampoo, I prefer Regenepure DR.

 

[MartinMascott]

Hi folks - just updating where I am at. I have been continuing with the daily 1mg finasteride, and nizoral 2x per week. Over the last 2-3 weeks, I wasn't 100% sure, but thought I was seeing regrowth. Now I am sure I am. As I have fine hair to begin with, the regrowth is very very fine, and I'm a dark blonde - the regrowth is very light blonde - hence the issues I had being certain in what I was seeing. Now its gotten a bit longer its easier to see. It's encouraging, although difficult to know what overall impact it will have, as right now the hair is very fine and short.

A couple of questions:

1. What sort of time line is typical before this regrowth hair will typically thicken?
2. I still want to hold off minoxidil for now (i don't think i can stick to the regime), but am considering a derma roller - I assume there's still a benefit to using the derma roller in conjunction with finasteride?
3. What length derma roller should I use?
4. Any recommendations on decent low cost rollers?

thanks,
Marty

 

[Here For the Lulz]

Honestly man, this looks like a lost cause. It’s doubtful it will ever look better than it does right now. Once your loss reaches this stage, the amount of regrowth required make a noticeable difference is far outside of treatment capability. Not to pile on, but there’s no way finasteride has produced the regrowth you see. it takes 6-18 months to see the effects. What you’re seeing is most likely just hair that entered its Anagen phase in coincidental step with the medications.