what would you recommend for 29 yo female with Androgenetic Alopecia

[Joan]

Thanx Joan, such a sweet prevaricator.

Yes I had a hair transplant that failed maybe due to present evidence retrograde alopecia ( self-diagnosis)?

Yes was on finasteride. for approx. 2 yr. without any discernible improvement. I should have committed longer, but at the time I was ignorant of it's potential maintenance value.

Also wore a partial hair piece/system for several years. This saved me from complete social anxiety ruin ( even though it took about 1 yr. of adjusting before the bugs were finally worked out).

Yeah so I can empathize with much of your fears anticipating your unknown future standing with hair loss.

We must try better to learn how to adapt to this intimidating disease. While we still have our faculties and commitment to our daily responsibilities, giving up what remains of our joyful sense of self must not be an option for surviving this.

In spite of any stoic impression (my brave game face) I may leave you I promise you after you saw me you would see that I'm still reeling from the aftershock.

I wish I could offer you a more practical form of comfort. -)

I had to look up prevaricator (embarrassed!), and I am being truthful with my compliments.

I'm sorry your hair transplant didn't work out. As for finasteride., you've got me wondering if my son should start taking it again. He was on it for almost 18 months but just stopped taking it about two months ago (unbeknownst to me until recently) for the same reason as you. Did you decide to stop wearing the hairpiece because it was uncomfortable?

Hair loss is, indeed, intimidating. No one knows just how much unless he/she experiences it. It has changed my way of thinking in several ways, and not for the better.

I wish I could comfort you somehow too. I hope you have loving people in your life, if only a few. That's all you need to make it through the day sometimes. (Count me as one.)

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Hey Joan,

thanks for your thoughtful and detailed response. Yes, my ferritin and vitamin D were extremely low. Ferritin was 6.7 and vitamin D was in the mid 20's. I was just wondering if you could clarify the following - you initially said you don't believe ferritin causes hair loss, then you said my hair might grow back when I increase the ferritin and vitamin D.

What concerns me is maintenance on any hair loss treatment. Doesn't Androgenetic Alopecia usually "win out" in the end? Like ID Walker said, it is thought that minoxidil stops being effective after 4-5 years. After that, do you guys think spironolactone, finestaride, and Nizoral will be enough to maintain whatever gains one has made? I can also stay on birth control pills, virtually indefinitely. Will I be able to keep my hair? Wouldn't any hair loss on this regimen be somewhat self-limiting, as androgen numbers will be drastically decreased, and stay that way?

I'm attaching some pictures. In the picture of my hair line, do you think that looks like regrowth?

The other picture is some hairs I found on my shirt today. There is a hair in the middle of the others that is about one inch and thinner. It's also got an "S" shape. Does this appear to be Androgenetic Alopecia related miniaturization, according to your knowledge and experience? I've only found a few of these so far, and the overwhelming majority of the hairs I lose are terminal, even the 3-5 inch ones. Of course, these little ones would be much easier to miss.


recedingyt,

thanks for sharing your experience. How long have you been on this combination treatment? How much hair had you lost and how much would you say you've regrown?

I said bringing up your iron might stop your shedding. I think you said your iron was low. Ferritin is how iron is stored in your tissues. They are two different things.

As for minoxidil, my dermatologist said it doesn't lose its efficacy, but I don't believe that. I think for some it will, and for some lucky ones, it won't. It might be worth a try. Nizoral never did anything for my or my son's hair loss.

I think it definitely looks like a nice amount of regrowth around your hairline. I'd be happy if I had that!

I don't know anything about "S-shape" hairs. I lose them too, but that's probably just the wave in the hair. Your hairs don't look miniaturized, but it's hard to tell from a photo.

Keep an eye on those hairs around your hairline. If you maintain them, I think you're on your way to recovery.

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I've been on spironolactone & finasteride since 1/1/15. I started estrogen 2/1/15. As for minoxidil, I started it around 12/20/14 (give or take a week or two) and continued to use it until 3/15/15. I stopped using it because I had achieved great results, going from NW5 (nearly fully bald on top) to around a NW2.5-3 and I honestly didn't think it was minoxidil that caused the success (I attributed it more to spironolactone/finasteride/estrogen at the time). I believed that since my testosterone and DHT were basically zero that even if minoxidil was the main contributor I'd keep the results I had gained. About 2 months later in May I started to notice more hair fall than usual. It got gradually worse until I was in a full blown shed that lasted until around the end of June. I was basically back to square one (NW5) at this point, so I restarted minoxidil around the start of July. By the end of July I had regrown most of the hairs I had lost. Today I sit in a better place than I did before the major shed with a pretty strong/dense NW2. I have a lot of vellus hairs on my temples that I'm waiting on right now and if they do fill in like I'm hoping they will, I'll be a NW1 (basically no easily visibly detectable hair loss).. so I think at least in my case, minoxidil is a very important part of my success.

Here's some pics to help you visualize how bad it was/how much I recovered. The June 30th picture is pretty close to how bad it was back in December before I started doing anything to treat my Androgenetic Alopecia and the August 26th picture is slightly better in terms of density and hairline than it was before the major shed occurred.

View attachment 35190

Anything is possible it seems.

Wow, that's some thick hair!

 

[recedingyt]

Recedingyt,

thank you so much for taking the time to share your experience and your photos. Your results are absolutely incredible and soo inspiring. I can't say how happy I am for you. I really hope you are out there, living and enjoying your life, as you deserve to, now that hair loss is pretty much not an issue anymore! Honestly, that's what it looks like. Just a bit of recession at the temples, but to be honest, from the perspective of a 29 year old female, I pretty much expect guys to have that going on by their mid-late 20's. It's a complete non-issue for me.

What is your spironolactone dose? I'm slowly going to increase mine to 200, and I am also taking some estradiol, as it's in my birth control, so I'm hoping that my hair gets better. I'm pretty sure I'll be adding minoxidil soon, too.

Thanks, again!

No problem, always happy to give some insight. Thanks for the kind words

I'm taking 200mg as well. Good luck with your hair. The waiting and uncertainty is the hardest part, but you seem to be doing everything you can so I'm sure you will get the results you want.

 

[I.D WALKER]

I do count you Joan,
As a matter of fact YOU are on my short list of personal favs.

Maybe your son ought to give finasteride.(+ dutasteride.) a second whirl? If he does I hope something positive can come of it. I'm thinking about dutasteride.

Yes sorry I see I left that detail out. I quit the system/piece I think mainly because of vocational opportunities. Also my seb. derm. was growing uncontrollably out of hand that shaving my head felt like the best option at the time. And thanks to a job change that was kinder to my new style this worked out for the most part.

I may try it (piece) again. I will say for me the idea of a partial is more comfortable than a full cap. I guess a lot of wig wearers feel this way? Oddly my reasons are a bit more visceral than they are really practical. Some serious denial still affecting me.

Like I previously mentioned my sides are depreciating(retrograde?), so the reality of me picking up where I left off with a piece is somewhat out of the question. A bigger piece is a bitter reminder that things are progressing as scheduled and promptly meeting my worse expectations. -)

We may not ever get over this, so we'll just have to try and get around it somehow.
I'm counting on you.

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Your determination has certainly paid off for you. Would you mind telling us (if you have not already) how long has it been since the onset of your Androgenetic Alopecia and how soon after did you first introduce effective therapy? Thanx for your response.

I've been on spironolactone & finasteride since 1/1/15. I started estrogen 2/1/15. As for minoxidil, I started it around 12/20/14 (give or take a week or two) and continued to use it until 3/15/15. I stopped using it because I had achieved great results, going from NW5 (nearly fully bald on top) to around a NW2.5-3 and I honestly didn't think it was minoxidil that caused the success (I attributed it more to spironolactone/finasteride/estrogen at the time). I believed that since my testosterone and DHT were basically zero that even if minoxidil was the main contributor I'd keep the results I had gained. About 2 months later in May I started to notice more hair fall than usual. It got gradually worse until I was in a full blown shed that lasted until around the end of June. I was basically back to square one (NW5) at this point, so I restarted minoxidil around the start of July. By the end of July I had regrown most of the hairs I had lost. Today I sit in a better place than I did before the major shed with a pretty strong/dense NW2. I have a lot of vellus hairs on my temples that I'm waiting on right now and if they do fill in like I'm hoping they will, I'll be a NW1 (basically no easily visibly detectable hair loss).. so I think at least in my case, minoxidil is a very important part of my success.

Here's some pics to help you visualize how bad it was/how much I recovered. The June 30th picture is pretty close to how bad it was back in December before I started doing anything to treat my Androgenetic Alopecia and the August 26th picture is slightly better in terms of density and hairline than it was before the major shed occurred.

View attachment 35190

Anything is possible it seems.

 

[labellavita1985]

Receding yt,

You're so welcome.

Do you mind sharing about your experience with sheds associated with minoxidil/finestaride/spironolactone?

Specifically, what was your experience when stopping and then re-starting minoxidil?

 

[recedingyt]

Your determination has certainly paid off for you. Would you mind telling us (if you have not already) how long has it been since the onset of your Androgenetic Alopecia and how soon after did you first introduce effective therapy? Thanx for your response.

I started noticing I was losing hair at around 14-15 but I didn't think much of it until I was 17 when I realized I was practically already a NW2 going on NW3. At the time I was just so incredibly... ****ed up (for lack of a better phrase, sorry :/) about my gender identity issues, drug use, abusive parents, sexual abuse, losing multiple people I cared deeply for to suicide, and so much more stuff to really care about myself or my hair so it went untreated until I was 22. That was when I started minoxidil in December 2014 and decided to finally start transitioning, a major part of which was treating my Androgenetic Alopecia.

(No need to console me on the aforementioned events! I don't want to hijack this thread and turn it into a pity party... I'm doing quite well these days since I started treating the root of my problems, my gender identity, and I wouldn't have mentioned any of it if I didn't feel it was an important turning point in my hair loss story)

Receding yt,

You're so welcome.

Do you mind sharing about your experience with sheds associated with minoxidil/finestaride/spironolactone?

Specifically, what was your experience when stopping and then re-starting minoxidil?

Sure, but some of this may sound redundant from my last post. I stopped minoxidil on 3/15/15 and all seemed well until mid-late May when the shedding started. It started out as just a few additional hairs when I was brushing my hair, in the shower, etc. but it quickly turned into a major problem. I was pulling out clumps of hair basically. I could very lightly run my fingers through my hair and 20-40 hairs would come out. I never did a hair count so I'm really not sure how many I was losing per day, but it was a LOT! By the end of June I had gone from a NW2-3 back to my starting point, which was NW5, all in the course of ~45 days. At the start of July, I restarted minoxidil and by the end of the month my hair was back to normal. I've seen some gains on my hairline since then, but it's mostly still in the form of vellus hairs so I don't want to put too much stock into them and have them never develop into full, terminal hairs.

Now I have to admit I'm not 100% sure if the shed was caused by me stopping minoxidil because for a brief time during May and June I ran out of my supply of estradiol (coinciding quite well with the onset of my shed). I was on a low dose of estradiol for the first half of May (2mg compared to the 4mg I was taking previously) and for the last half of May/first half of June I was without it entirely. I was still on spironolactone 200mg/finasteride 1.25mg during that time so my testosterone/DHT levels should still have been pretty low, but unfortunately I don't have a blood test from that time to reference my levels. In any case, I'm sure it was not good for my hair. Seeing as many postmenopausal women (whose hormonal profile would be quite similar to mine during my shed) lose their hair it seems likely it may not have been entirely related to me stopping minoxidil.

The reason I think it was more closely related to me stopping minoxidil rather than running out of estradiol is because of the speed of it all. It's not like postmenopausal women shed all their hair as soon as they enter into menopause. I also know many other MTF individuals who have had to go long periods of time without a sex hormone and they never shed their hair like I did. NW2-3 to NW5 in 45 days is crazy fast, which to me screams minoxidil shed. Especially since the timing of my shed (2 months after stopping minoxidil) is consistent with reports from other people who have used minoxidil with success and then later stopped using it. Seems that it's usually smooth sailing for about 2 months and then it all goes to crap with minoxidil sheds. I didn't see any signs of improvement until after I restarted minoxidil either. Sorry I can't be more precise, but if I had to put my money on one or the other I'd bet it was a shed of all of my minoxidil-dependent hairs.

 

[labellavita1985]

Sorry about all of the questions, but I was wondering about initial sheds when first starting hair loss treatments.

Did you experience a "dread shed?" First or second time on minoxidil?

 

[Joan]

I do count you Joan,
As a matter of fact YOU are on my short list of personal favs.

Maybe your son ought to give finasteride.(+ dutasteride.) a second whirl? If he does I hope something positive can come of it. I'm thinking about dutasteride.

Yes sorry I see I left that detail out. I quit the system/piece I think mainly because of vocational opportunities. Also my seb. derm. was growing uncontrollably out of hand that shaving my head felt like the best option at the time. And thanks to a job change that was kinder to my new style this worked out for the most part.

I may try it (piece) again. I will say for me the idea of a partial is more comfortable than a full cap. I guess a lot of wig wearers feel this way? Oddly my reasons are a bit more visceral than they are really practical. Some serious denial still affecting me.

Like I previously mentioned my sides are depreciating(retrograde?), so the reality of me picking up where I left off with a piece is somewhat out of the question. A bigger piece is a bitter reminder that things are progressing as scheduled and promptly meeting my worse expectations. -)

We may not ever get over this, so we'll just have to try and get around it somehow.
I'm counting on you.

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If you do decide to give dutasteride a go, I hope it will allow you to at least maintain your current Norwood for a long time. Regarding a partial vs. a full, I can only say, as a woman, I did try on a topper two years ago, and I've also bought two wigs for peace of mind (I'm not happy with either of them). I found the clips on the topper uncomfortable, and it felt (and looked, at least to me) like a second head. The wigs I've worn around the house a few times for a couple of hours, although itchy after a time, were still more comfortable than the clips. Truly, I can't imagine ever being comfortable in public with fake hair.

Yes, we really have no choice but to go on living and figure out how to do so as we continue to see a major part of our physical attributes diminish daily. We'll figure it out I guess--I'm counting on you too.

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Sorry about all of the questions, but I was wondering about initial sheds when first starting hair loss treatments.

Did you experience a "dread shed?" First or second time on minoxidil?

I know this question isn't directed to me, but I did not experience any additional shedding with minoxidil.

 

[labellavita1985]

Thanks for responding joan. I thought you said you've had persistent shedding on minoxidil. Do you not attribute that to your minoxidil use?

 

[I.D WALKER]

Thank you Joan always,

These following remarks probably are out of place. Forgive me OP for my brief deviation. -)

It seems with the wig/piece question the conflict revolves back to starting at the beginning. Defining perspective too has it's own limitations.

For some this can even translates downright to a matter of choosing the lesser evil.

Androgenetic Alopecia's bitter irony is yet another pill we have to chase down like the rest of our medicine. Damned if you do or don't. Toupee or not toupee? There is no right answer to it because Androgenetic Alopecia never gives you a day off.

It doesn't go into remission like some other debilitating diseases/disorders.

If/when treatment fails or loses efficacy (over time) it's back to the crossroads once more.

I feel that coping with our limited Androgenetic Alopecia options are less about acceptance more about tolerance. This may be particular true when it comes to hair pieces, toppers, wigs, etc.,.

We never get to fully close this chapter of our lives because of this constant variable(Androgenetic Alopecia), our capacity for rational tends to suffer for the worse of it.

Even to the extreme level where performing the smallest, once simpler, everyday task(s) is prepped beforehand by a self-motivational speech.

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Thanks for your thorough response. Btw your articulation skills are excellent, not to mention your kind nature clearly shows through your written exchange. Best of luck to you.

I started noticing I was losing hair at around 14-15 but I didn't think much of it until I was 17 when I realized I was practically already a NW2 going on NW3. At the time I was just so incredibly... ****ed up (for lack of a better phrase, sorry :/) about my gender identity issues, drug use, abusive parents, sexual abuse, losing multiple people I cared deeply for to suicide, and so much more stuff to really care about myself or my hair so it went untreated until I was 22. That was when I started minoxidil in December 2014 and decided to finally start transitioning, a major part of which was treating my Androgenetic Alopecia.

(No need to console me on the aforementioned events! I don't want to hijack this thread and turn it into a pity party... I'm doing quite well these days since I started treating the root of my problems, my gender identity, and I wouldn't have mentioned any of it if I didn't feel it was an important turning point in my hair loss story)



Sure, but some of this may sound redundant from my last post. I stopped minoxidil on 3/15/15 and all seemed well until mid-late May when the shedding started. It started out as just a few additional hairs when I was brushing my hair, in the shower, etc. but it quickly turned into a major problem. I was pulling out clumps of hair basically. I could very lightly run my fingers through my hair and 20-40 hairs would come out. I never did a hair count so I'm really not sure how many I was losing per day, but it was a LOT! By the end of June I had gone from a NW2-3 back to my starting point, which was NW5, all in the course of ~45 days. At the start of July, I restarted minoxidil and by the end of the month my hair was back to normal. I've seen some gains on my hairline since then, but it's mostly still in the form of vellus hairs so I don't want to put too much stock into them and have them never develop into full, terminal hairs.

Now I have to admit I'm not 100% sure if the shed was caused by me stopping minoxidil because for a brief time during May and June I ran out of my supply of estradiol (coinciding quite well with the onset of my shed). I was on a low dose of estradiol for the first half of May (2mg compared to the 4mg I was taking previously) and for the last half of May/first half of June I was without it entirely. I was still on spironolactone 200mg/finasteride 1.25mg during that time so my testosterone/DHT levels should still have been pretty low, but unfortunately I don't have a blood test from that time to reference my levels. In any case, I'm sure it was not good for my hair. Seeing as many postmenopausal women (whose hormonal profile would be quite similar to mine during my shed) lose their hair it seems likely it may not have been entirely related to me stopping minoxidil.

The reason I think it was more closely related to me stopping minoxidil rather than running out of estradiol is because of the speed of it all. It's not like postmenopausal women shed all their hair as soon as they enter into menopause. I also know many other MTF individuals who have had to go long periods of time without a sex hormone and they never shed their hair like I did. NW2-3 to NW5 in 45 days is crazy fast, which to me screams minoxidil shed. Especially since the timing of my shed (2 months after stopping minoxidil) is consistent with reports from other people who have used minoxidil with success and then later stopped using it. Seems that it's usually smooth sailing for about 2 months and then it all goes to crap with minoxidil sheds. I didn't see any signs of improvement until after I restarted minoxidil either. Sorry I can't be more precise, but if I had to put my money on one or the other I'd bet it was a shed of all of my minoxidil-dependent hairs.

 

[Joan]

Thanks for responding joan. I thought you said you've had persistent shedding on minoxidil. Do you not attribute that to your minoxidil use?

I've been shedding tons of hair every day for three years, but that amount has not increased since starting minoxidil in April 2014. I do not think minoxidil exacerbated the shedding.

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Thank you Joan always,

These following remarks probably are out of place. Forgive me OP for my brief deviation. -)

It seems with the wig/piece question the conflict revolves back to starting at the beginning. Defining perspective too has it's own limitations.

For some this can even translates downright to a matter of choosing the lesser evil.

Androgenetic Alopecia's bitter irony is yet another pill we have to chase down like the rest of our medicine. Damned if you do or don't. Toupee or not toupee? There is no right answer to it because Androgenetic Alopecia never gives you a day off.

It doesn't go into remission like some other debilitating diseases/disorders.

If/when treatment fails or loses efficacy (over time) it's back to the crossroads once more.

I feel that coping with our limited Androgenetic Alopecia options are less about acceptance more about tolerance. This may be particular true when it comes to hair pieces, toppers, wigs, etc.,.

We never get to fully close this chapter of our lives because of this constant variable(Androgenetic Alopecia), our capacity for rational tends to suffer for the worse of it.

Even to the extreme level where performing the smallest, once simpler, everyday task(s) is prepped beforehand by a self-motivational speech.

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Everything you've said is true, especially self-motivated speeches. I'll bet yours are better than mine. Maybe someday I'll be in a better place--maybe we all will. For me, hair loss and middle age (and the lack of funds to "fix" what needs fixing) have exacerbated a lifelong negative self-image. I hope in our next lives (if we do, indeed, have them), our inner beauty becomes our physical beauty. That would be fair, in my opinion, because that we can control. And you, I.D Walker, would definitely be a 10++.

 

[labellavita1985]

Is 30% by prescription only?

Thanks for all the responses.

 

[Joan]

Yes it is. But it's for completely bald areas. It won't do anything for diffuse thinning. The cream is too thick, so it won't reach all of your hair. I have to supplement it with 5%.

Why won't it do anything for diffuse thinning?

 

[labellavita1985]

I thought minoxidil was only for areas where there's still some growth ... I didn't think it could induce any growth from follicles that aren't "active" anymore.

 

[Wolf Pack]

Sometimes follicles may appear inactive but they are still producing hair. It's just that it's not visible to the naked eye so easily, but can be seen microscopically. In this situation, Minoxidil can help like all other medications. But of course the more advanced the miniaturisation is, the harder it is to turn it all around.

You have got some amazing advice from people and know a lot yourself, so basically good luck. You look pretty too so hope it works out I can't tell you have hair loss so that in itself is positive.

 

[Wolf Pack]

Why won't it do anything for diffuse thinning?

There's a theory liquid minoxidil is better due to the gravity effect, will always drip down to your follicles. Foam can sometimes get absorbed into the hair. I am not sure if k9gatton was referring to that but it's an idea.

 

[labellavita1985]

Thanks Wolf, your feedback is very much appreciated.

 

[Joan]

There's a theory liquid minoxidil is better due to the gravity effect, will always drip down to your follicles. Foam can sometimes get absorbed into the hair. I am not sure if k9gatton was referring to that but it's an idea.

I've been thinking of trying the liquid once I finish up with the foam, since it's done nothing for me. Thanks for the clarification.

 

[I.D WALKER]

Here's insight maybe some min. and/or prospective users might find helpful. Most of it is basically well known, however there's a part in article that supports anecdotal claims it may prove more effective on a dampened scalp ( freshly showered). Better absorption which makes sense due to increase in circulation of scalp by the warm- hot water.

BTW Ferudini's considered top notch in the hair transplant community.

http://hairtransplantation.feriduni...ical-therapy/minoxidil-rogainer-regainer.html

 

[labellavita1985]

Hey Joan,

if you're thinking about changing to liquid minoxidil use anyway, might I suggest trying Lipogaine? It has other active ingredients like azelaic acid to increase absorption and saw palmetto to reduce DHT levels at the hair follicle. I've read some really good reviews for it. Make sure you get the 5% men's version though, if you're already on the 5% foam.

When I finally cultivate the courage to start minoxidil, I'll be using this product.

I don't mean to sound like the president of the Lipogaine fan club, lol, its just a suggestion.

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What do you guys think the chances are of me reducing the chances and/or the extent of a dread shed by using 2% minoxidil instead of 5%?

 

[I.D WALKER]

Labellavita ,

Where are you purchasing your Lipogaine from? Thanx for sharing.