Be honest, is it time to accept defeat?

[A_4_Archan]

As a few others have pointed out, why not try shaving your head first and see if you like the look? You could even throw in some SMP to create an illusion of density.

Keep taking your meds but just make sure the doc’s keeping an eye on things. If your donor area improves significantly, then maybe down the road, consider a hair transplant with a combo of scalp and body hair.

But if you can rock the shaved or buzz cut look, you might just want to say "screw it" to the meds and surgeries. You'll feel like a weight's been lifted. Believe me you will be a relieved man

Occasionally, stepping back can propel you forward. This is not about winning or loosing, this is all about taking smart steps which can improve the situation safely.

Best of luck brother.

Edited August 27 by A_4_Archan

[londonbased]

I’d also recommend micro-needling. I use derma-roller 0.5mm twice weekly. Can likely do a bit deeper 3x per week. Doing this with topical minoxidil gives you the best chance. 

[coaster358]

8 hours ago, A_4_Archan said:

As a few others have pointed out, why not try shaving your head first and see if you like the look? You could even throw in some SMP to create an illusion of density.

Keep taking your meds but just make sure the doc’s keeping an eye on things. If your donor area improves significantly, then maybe down the road, consider a hair transplant with a combo of scalp and body hair.

But if you can rock the shaved or buzz cut look, you might just want to say "screw it" to the meds and surgeries. You'll feel like a weight's been lifted. Believe me you will be a relieved man

Occasionally, stepping back can propel you forward. This is not about winning or loosing, this is all about taking smart steps which can improve the situation safely.

Best of luck brother.

Thank you,

part of me wants to “give up” and drop everything,

I don’t think I’ve had any side effects but who knows without meds I might feel 5x better

i think the only thing keeping me holding on is that I’m quite young and if the next 5-10yrs there are better alternatives I would regret losing it all now 

[Melvin- Admin]

Given the weak donor. I think it would be wise to either shave or continue with medical treatment. I would advise against a hair transplant. 

[Fox243]

23 hours ago, NARMAK said:

Can you back up your claim with scientific literature, because the 10 year Japanese study on Finasteride showed that results continued to improve year on year for those patients that saw positive results even from year one. They even have images showing the difference between various years if you want to go look it up.

That's why I think it's incorrect to say to OP just give up. We also don't know if he's on Dutasteride everyday until he replies and if he is, then he's maxed that part out unless he willingly chooses to go for a higher dosage which personally I wouldn't recommend but is available.

His Minoxidil even if it is everyday 2x right now could still get an added boost with Microneedling put into the mix once a week at 1mm to 1.5mm over the next few years.

MPB isn't straight forwards and I don't agree OP should just give up. He looks like he's made up tremendous ground in the before and after comparison from what I can see and another 2 solid years of treatment might get him to a pretty solid place from where he was.

However this is a forum and everybody is free to disagree but if I was in OPs shoes, I wouldn't quit after all the improvements. I would however continue to keep the hair short and buzz like to help minimise the balding look as much as possible but keep the hair just long enough to see progress month to month in density etc.

His DUPA is probably the biggest concern towards any meaningful transplant and that's why I would rather see him get to a much better place via medication and Microneedling.

So I don't have literature atm to provide to you. What I will do is point out major limitations of a study like that on our participant. Those are males taken from a random sample in the population that is Asian (which has shown to respond better to meds). Our participant is a guy in his 20s with DUPA. There's simply almost no way to predict how he will fare in the next 5-10 years because of the limited sample size regarding DUPA, let alone such severe DUPA in his 20s. We can hope to extrapolate that since he was a good responder, like the Japanese study, he will continue to be a good responder. But honestly, given "the abnormal" population that better represents him (i.e. this community), which tends to need to require multiple HTs, despite being on meds, I would not be optimistic once he goes the HT route. I think it's better he just stick to his treatments until something better comes out, if he is comfortable being on treatments long term.

Edited August 27 by Fox243

[NARMAK]

29 minutes ago, Fox243 said:

So I don't have literature atm to provide to you. What I will do is point out major limitations of a study like that on our participant. Those are males taken from a random sample in the population that is Asian (which has shown to respond better to meds). Our participant is a guy in his 20s with DUPA. There's simply almost no way to predict how he will fare in the next 5-10 years because of the limited sample size regarding DUPA, let alone such severe DUPA in his 20s. We can hope to extrapolate that since he was a good responder, like the Japanese study, he will continue to be a good responder. But honestly, given "the abnormal" population that better represents him (i.e. this community), which tends to need to require multiple HTs, despite being on meds, I would not be optimistic once he goes the HT route. I think it's better he just stick to his treatments until something better comes out, if he is comfortable being on treatments long term.

I agree OP should stick to his treatments for a few years and then look into a hair transplant if he shows improvement and has saved enough for the right Doctor, but given he is a responder, I'm much more likely to encourage OP to keep fighting on because he's clearly benefited from the medication and can probably enhance his results even more with Microneedling 1x a week at 1mm to 1.5mm.

The answer you basically told OP originally was to give up and then you have by your own post I'm replying to told him to carry on with medication. So obviously you can even see now it's worth keeping on with treatment to see where he gets to.

I don't agree that there's a massive difference between Caucasian, Afro and Asian men etc. when it comes to the study showing positive outcomes for men that respond over a 10 year period. There's another study which is a European one out of Italy I believe which also said there was positive outcomes but the Japanese study had a much larger participant pool and also pictures to compare for patients. 

Given OP looks to have responded pretty damn well imo, I think it's definitely worth trying to stay on and as far as I'm aware, there isn't any proper DUPA study out there so even if it's just one example, maybe OP Microneedling into his donor areas alongside the Minoxidil use might be able to show us if it is effective in helping improve the donor areas affected by DUPA.

[Fox243]

Just now, NARMAK said:

I agree OP should stick to his treatments for a few years and then look into a hair transplant if he shows improvement and has saved enough for the right Doctor, but given he is a responder, I'm much more likely to encourage OP to keep fighting on because he's clearly benefited from the medication and can probably enhance his results even more with Microneedling 1x a week at 1mm to 1.5mm.

The answer you basically told OP originally was to give up and then you have by your own post I'm replying to told him to carry on with medication. So obviously you can even see now it's worth keeping on with treatment to see where he gets to.

I don't agree that there's a massive difference between Caucasian, Afro and Asian men etc. when it comes to the study showing positive outcomes for men that respond over a 10 year period. There's another study which is a European one out of Italy I believe which also said there was positive outcomes but the Japanese study had a much larger participant pool and also pictures to compare for patients. 

Given OP looks to have responded pretty damn well imo, I think it's definitely worth trying to stay on and as far as I'm aware, there isn't any proper DUPA study out there so even if it's just one example, maybe OP Microneedling into his donor areas alongside the Minoxidil use might be able to show us if it is effective in helping improve the donor areas affected by DUPA.

Sorry, perhaps my intentions didn't come across properly in a previous message. I don't think he should stop meds, but I don't think he should expect signfiicant improvement from here nor should he get a HT, at least until we get "scarless" HTs. I only think he can carry on meds in hopes that future treatments would help him, not that I expect him to regrow another norwood from current meds.

[Shesayshesay]

Contact Dr.Zarev or Dr.Pittella

 

body hair and beard hair is an option in combination with your donor hair

[LeveledUp]

Add dermarolling.