At what age is it “safe” to get a HT without taking medication?

[Shesayshesay]

I am 29 and as previously mentioned in another post, I can’t take medication. I am diffusing into a NW6.

I know this can vary between person but I am sure there must be a general pattern that has been observed, is there general age for someone that has already bald to a NW 5 or 6 to safely get a HT from a dr like Dr. Zarev or Dr.Pitella to restore the top of their scalp, without medication?

 

Eg, because I am balding fast now at 29, if I am still a NW 5/6 at 38, is it a safe bet my balding is likely done, especially considering it’s happening quite rapidly at the moment?

can it be a safe bet to get a HT without medication from these surgeons?

 

Secondly, would a HT surgeon ever consider using ALL of your donor hair (over a few sessions) for the top of your scalp, as in literally leave none left and leaving a shaved scalp look? Has this been done before? One could do that and simply get SMP in the donor area to leave a more shaved stubble look?

Edited Thursday at 06:29 AM by Shesayshesay

[Al - Moderator]

Rather than trying to pick an age, which is impossible because everyone loses hair at a different rate, I would concentrate on your own situation. If you know you're headed to NW 6 and not going to take meds, then assume you will eventually be at least a full blown slick bald NW 6 and plan from there. That means if you want to get a hair transplant, go with a high hairline and don't try to dense pack. Perhaps leave the crown alone for now depending on how your crown currently looks. Take a look at your beard and chest hair. Do you have much of it? is it anywhere near matching the same type of hair that's on your head. It doesn't have to match completely (it won't), but as long as it's not a completely different type of hair (such as your head hair very straight and body hair very curly) you should be able to use it if you need to if yo have enough. These are the things you need to think about and try to evaluate.

 

[Shesayshesay]

41 minutes ago, Al - Moderator said:

Rather than trying to pick an age, which is impossible because everyone loses hair at a different rate, I would concentrate on your own situation. If you know you're headed to NW 6 and not going to take meds, then assume you will eventually be at least a full blown slick bald NW 6 and plan from there. That means if you want to get a hair transplant, go with a high hairline and don't try to dense pack. Perhaps leave the crown alone for now depending on how your crown currently looks. Take a look at your beard and chest hair. Do you have much of it? is it anywhere near matching the same type of hair that's on your head. It doesn't have to match completely (it won't), but as long as it's not a completely different type of hair (such as your head hair very straight and body hair very curly) you should be able to use it if you need to if yo have enough. These are the things you need to think about and try to evaluate.

 

Good idea! Ultimately, I will plan to look at a HT in at least 6 - 8 years which I feel I will have a good understanding on what my hairloss is doing by then.

I am a fairly late bloomer with facial hair but it is indeed growing more the more I seem to lose hair, so we shall see in 5+ years.
 

Body hair I have a lot of, does arm hair count? Because if so, consider me an unlimited donor. this would be great to know, actually.

I truly hope one of these surgeons can save me. I have a fairly small forehead so I am hoping that’s something and that I could pull off a higher hairline.

 

Edited Thursday at 07:34 AM by Shesayshesay

[Eli_Avdikian]

MPB is very unpredictble. You would never know when you'll start balding, or go completely bald. Any startegy based on such speculations would likely fail.

[Doron Harati]

There is no straightforward formula when is the optimal time, each candidate is unique with his own genetics and prerequisites.

I started to lose my hair at age 20-21, aggressively I reached NW3 at age 31 and somewhere around age 38 my hairloss more less stabilized with topical formula of Finasteride mixed with Minoxidil, while one of my closest friends started to lose hair at age 31 and became NW5 when he was 38.

[SuperC]

Best to assume it's never safe. I plan to be on Finasteride for life.

[4chanhrn]

11 hours ago, Shesayshesay said:

I am 29 and as previously mentioned in another post, I can’t take medication. I am diffusing into a NW6.

I know this can vary between person but I am sure there must be a general pattern that has been observed, is there general age for someone that has already bald to a NW 5 or 6 to safely get a HT from a dr like Dr. Zarev or Dr.Pitella to restore the top of their scalp, without medication?

 

Eg, because I am balding fast now at 29, if I am still a NW 5/6 at 38, is it a safe bet my balding is likely done, especially considering it’s happening quite rapidly at the moment?

can it be a safe bet to get a HT without medication from these surgeons?

 

Secondly, would a HT surgeon ever consider using ALL of your donor hair (over a few sessions) for the top of your scalp, as in literally leave none left and leaving a shaved scalp look? Has this been done before? One could do that and simply get SMP in the donor area to leave a more shaved stubble look?

It's hard to say, but AGA progression should slow down in 30s vs 20s, but it is hard to be sure. Progression can be non-linear. What does your family history look like? How does the most bald person in your family look like.

Is there a reason why you can't tolerate meds? I'm not a doctor, but you can consult a derm for oral minoxidil and see if it can work for you. If you can't tolerate finasteride(or even saw palmetto), it may be possible that you can tolerate dutasteride or topical dutasteride. Most studies show dutasteride is better tolerated vs finasteride. It may be also possible that you have intense sides for first few weeks/months and then they go away or you have high libido later. Sides can be scary, but they can go away as body gets used to it. Work with a derm/doc to see if you can tolerate anything at all. 

Good way to dose something like dut could be like topical 0.025% 1x/week>0.5mg 1x/10-15 days>0.5mg 1x/7 days>0.5mg 2x/week

Do blood work before starting anything.

There are also other things like saw palmetto, tretinoin, LLLT, PRP that can be used as adjunct therapy.

If you can't tolerate anything at all, then you can go conservative with FUT and do high hairline, leave crown bare.

Edited Thursday at 05:36 PM by 4chanhrn

[arthurSam]

MBP never stop. The most serious phase for me was at 46 yo.

[MC117]

16 hours ago, Shesayshesay said:

I am 29 and as previously mentioned in another post, I can’t take medication. I am diffusing into a NW6.

I know this can vary between person but I am sure there must be a general pattern that has been observed, is there general age for someone that has already bald to a NW 5 or 6 to safely get a HT from a dr like Dr. Zarev or Dr.Pitella to restore the top of their scalp, without medication?

 

Eg, because I am balding fast now at 29, if I am still a NW 5/6 at 38, is it a safe bet my balding is likely done, especially considering it’s happening quite rapidly at the moment?

can it be a safe bet to get a HT without medication from these surgeons?

 

Secondly, would a HT surgeon ever consider using ALL of your donor hair (over a few sessions) for the top of your scalp, as in literally leave none left and leaving a shaved scalp look? Has this been done before? One could do that and simply get SMP in the donor area to leave a more shaved stubble look?

You have to look at the whole area up to a NW7 to see where hair is affected with a trichoscope. Whether it's obvious by eyesight or not that's the only way to predict what is your expected stage, also the shape of your scalp helps in the prediction.  Zarev's approach is very smart in that regard as we all are different, especially if you started losing hair a long time ago relatively before checking.

After this, you'd need to assess your situation and act accordingly based on your donor and unaffected hair, family. Generally, it either strikes you suddenly later and goes fast in 5 years reaching your encoded NW, or slow since early on, or normal pace and it'd take a decade for your final pattern to be reached. No exact science, but from what I've seen (without meds usage at all or non responders).

[Gatsby]

IMHO the longer you wait to have a hair transplant the better the outcome will be. It's unrealistic to wait until you are a Norwood 6/7. However by your 40's your pattern of hair loss has pretty much stabilized (as a generalization). This is why if you are able to take medication successfully then it helps with this problem. In hindsight I had totally given up on hair transplants in this lifetime as a Norwood 7. However in doing so it was in many ways to my advantage with the advent of the use of beard hair as a donor source when used in the right hands.

[BaldDude]

Yes it's a lifelong condition unfortunately.  It may slow down but never stops.

[BaldDude]

10 hours ago, 4chanhrn said:

Most studies show dutasteride is better tolerated vs finasteride.

Source?  I read they both have the same incidence of sexual sides, at least orally.

[4chanhrn]

48 minutes ago, BaldDude said:

Source?  I read they both have the same incidence of sexual sides, at least orally.

Lots of studies like this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472914/

There are also lots of anecdotes from doctors like Kyle Gillett, Sergio Vano who found dutasteride to have less sides vs finasteride. Some people who cant even tolerate topical finasteride microdose may be fine on oral dut. Every body is different. I recommend watching Gillett health's videos about Dutasteride and Finasteride on YouTube. They suggest low dose low frequency topical dutasteride as therapy for people who want something non-hormonal.

https://youtu.be/DBl56V-ZxvY?si=yL3GXnLgGDBNpbhD

Sides can be because of lots of reasons. Increased estrogen, low level of other androgens in body, DHT isoform imbalance, fluctuation of hormones/medication etc. Increased anxiety probably doesn't help. It may also be possible you get very severe sides in the beginning for a few months but after a few months you are completely normal or even get very high libido. Working with a doctor who will do blood work and work with you to see what you can take long term is important. There is lot of unnecessary fear mongering online so working with healthcare professional who can help you is important.

If you really don't want to use drugs, HT is possible if you're conservative and do good planning. I recommend consulting Hattingen. Dr Muresanu will tell you what is possible and what is a bad idea. Often keeping high hairline and crown open could work. Or the other option is Pittella. He doesn't prescribe 5ar blockers, but that approach has risks and relies on overusing grafts to address potential future loss.

Edited Friday at 03:31 AM by 4chanhrn

[Arcticblonde]

ive read some doctors wont operate unless you are over 30

[mr_peanutbutter]

 

[BaldDude]

9 hours ago, 4chanhrn said:

Lots of studies like this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472914/

There are also lots of anecdotes from doctors like Kyle Gillett, Sergio Vano who found dutasteride to have less sides vs finasteride. Some people who cant even tolerate topical finasteride microdose may be fine on oral dut. Every body is different. I recommend watching Gillett health's videos about Dutasteride and Finasteride on YouTube. They suggest low dose low frequency topical dutasteride as therapy for people who want something non-hormonal.

https://youtu.be/DBl56V-ZxvY?si=yL3GXnLgGDBNpbhD

Sides can be because of lots of reasons. Increased estrogen, low level of other androgens in body, DHT isoform imbalance, fluctuation of hormones/medication etc. Increased anxiety probably doesn't help. It may also be possible you get very severe sides in the beginning for a few months but after a few months you are completely normal or even get very high libido. Working with a doctor who will do blood work and work with you to see what you can take long term is important. There is lot of unnecessary fear mongering online so working with healthcare professional who can help you is important.

If you really don't want to use drugs, HT is possible if you're conservative and do good planning. I recommend consulting Hattingen. Dr Muresanu will tell you what is possible and what is a bad idea. Often keeping high hairline and crown open could work. Or the other option is Pittella. He doesn't prescribe 5ar blockers, but that approach has risks and relies on overusing grafts to address potential future loss.

From the study: “There does not appear to be any clinically significant difference between the adverse event profile of dutasteride and finasteride.”