Diffuse Thinner Too Late for HT? Retrograde Alopecia at sides

[late-bit]

The photos begin with my wet hair, and then there are the dry ones after.

More background information about myself:

I have started taking 0.5 mg of Finasteride every other day since last month (May 2024). I think I'm shedding because the upper right area on the back side of my head has worsened quite fast and I see hairs falling out in the sink. I also microneedle my scalp and sides at 1.5mm once a week starting around the same time as Fin.

I noticed thinning (had a small bald spot) beginning in the crown area since at least the age of 15-16. I am now 28 and it has progressed to what you see in the images. It's awful I know, especially with the long hair. I was always in denial about my hair loss, chalked it up to just having naturally thinner hair and ignored it until one day I saw a video of myself and was absolutely shocked about how bad it really was.

The mid to lower portion on the back of my head is still quite thick, but the sides of my head have thinned a lot, it looks like I may have retrograde alopecia. That worries me a lot as I've learned the sides of your head are supposed to be donors for hair transplants too. Can HT surgeons restore the sides of your hair too? Maybe there wouldn't be enough grafts since I have advanced loss on the mid scalp and crown area and density is low to begin with.

I considered topical Minoxidil, but I heard it's lethal to cats if even a drop gets on them and they lick it. I work from home and I'm around my cat all day, so it's not an option for me. As for Oral minoxidil, I've heard it's not as safe or recommended, the possible side effects worry me for the long term and I've had a history of random chest pains before, so overall I feel like I just want to stick with finasteride.

Right now I believe it's too early for a HT since I've just started taking finasteride to hopefully prevent further loss and get some regrowth. But, assuming I stabilize with what you currently see and with no regrowth, would I not be a candidate for a hair transplant at all? Maybe I could get FUT to cover my mid scalp and vertex, and get a fade haircut on the sides? What do you all think?

There's also a surgeon I was interested in, Dr. Luis Nader as he seems to be conservative with his grafts and have read good things about him.

[Al - Moderator]

Hello @late-bit. Welcome to the forums. I would place you between a NW 5 and NW 6. The shedding you mentioned, did that start happening shortly after you started  using Finasteride? If so then that could be a good sign. A lot of people get shedding first before the new growth comes in.

 

[late-bit]

39 minutes ago, Al - Moderator said:

Hello @late-bit. Welcome to the forums. I would place you between a NW 5 and NW 6. The shedding you mentioned, did that start happening shortly after you started  using Finasteride? If so then that could be a good sign. A lot of people get shedding first before the new growth comes in.

 

Thank you Al! I'm hoping it is shedding from Finasteride, it did seem to get worse quite quickly. To me, it looks like I'm at least seeing a shed from the upper right area of the crown

April 9th - Pre-Finasteride

May 30th - Post-Finasteride

June 18th - Post-Finasteride

 

[mr_peanutbutter]

you need to go to doctors who are specialised on high norwoods such as dr.pittella, eugenix, zarev and maybe cyprus

 

id also strongly consider starting oral minoxidil which will also boost your bodyhair which you will definitely need to get transplanted too to get an acceptable rate of coverage

 

without bodyhair that would be the maximum that is possible

 

 

Edited Monday at 07:35 AM by mr_peanutbutter

[late-bit]

4 hours ago, mr_peanutbutter said:

you need to go to doctors who are specialised on high norwoods such as dr.pittella, eugenix, zarev and maybe cyprus

 

id also strongly consider starting oral minoxidil which will also boost your bodyhair which you will definitely need to get transplanted too to get an acceptable rate of coverage

 

without bodyhair that would be the maximum that is possible

 

 

I appreciate you sharing that information!  Do you mean that with my donor alone from the back hair, I would have a similar result as this older gentleman that was worked on by Dr. Pathomvanich? For oral minoxidil, I have concerns including the possible side effects long term, things like chest pain and the increase of resting heart rate. It's also a drug that I can't stop taking or any hair that was regrown with it will fall out quite quickly if I wanted to stop taking it after a transplant right?

If I wanted to stop oral minoxidil, I'd be afraid of what that could do to my hair even with a transplant to be honest.

[SeanT1]

Looks like finasteride is working its magic, hopefully you'll see thickening soon. 
It can take many months before the benefits are seen.

I think you're a candidate for a hair transplant, specially with doctors who specialise in your kind of case.  And SMP will work wonders to improve density illusion for you combined.

 

SMP before and after;

Edited Monday at 03:08 PM by SeanT1

[late-bit]

Thank you Sean, that's really encouraging to hear. I've been keeping my expectations very low with finasteride when it comes to regrowth since it's apparently not as common, but your comment gives me hope   That would be a great bonus.

I was looking at Dr. Pitella's post about a NW7 he restored, which is quite amazing. Gives me a lot of hope I can come back too

[SeanT1]

1 hour ago, late-bit said:

Thank you Sean, that's really encouraging to hear. I've been keeping my expectations very low with finasteride when it comes to regrowth since it's apparently not as common, but your comment gives me hope   That would be a great bonus.

I was looking at Dr. Pitella's post about a NW7 he restored, which is quite amazing. Gives me a lot of hope I can come back too

You should check Eugenix also, they've worked magic on many NW6/7.

Happy to help, your fight is not over yet. 

[late-bit]

That's awesome I'll check Eugenix out too. I'll probably be lurking here a lot and checking out posts from the doctors. If I see any regrowth I'll post updates here too. I might give it one year or two before deciding to get a hair transplant to see how well I do with Finasteride.

Other than that though, I've been hearing word of Verteporfin as a potential "cure" for regrowing extracted donors which is very interesting. It makes me wonder if I should wait to see how that goes, but not too sure.

Edited Monday at 06:37 PM by late-bit

[SeanT1]

3 hours ago, late-bit said:

That's awesome I'll check Eugenix out too. I'll probably be lurking here a lot and checking out posts from the doctors. If I see any regrowth I'll post updates here too. I might give it one year or two before deciding to get a hair transplant to see how well I do with Finasteride.

Other than that though, I've been hearing word of Verteporfin as a potential "cure" for regrowing extracted donors which is very interesting. It makes me wonder if I should wait to see how that goes, but not too sure.

I'm not sure, there has always been the "next cure for hairloss" over the past decades, but nothing seems true or solid.