23 just had a consult, was told I'm too young for finasteride, not sure what to think

[Fortunate Son]

Yesterday I was finally able to go for a consult at a hair clinic (Hair Plus MC in the Netherlands. Since I'm not looking for a transplant I just went to the closest one). Basically, I told the nurse about all my symptoms:

- Hairline that is still receding (pics)
- History of hairloss (maternal grandfather had MPB + my 36yo half-brother does, same mother different father. Should mention his father has MPB, but mine has no hair loss at 60). My temples have receded slightly further than my dad's since about a year.
- Losing a lot of hairs on top of head, not at sides/back. Hairs coming out are often thin and light, all with bulb at the end
- Counting at least 50+ every time I wash my hair, but it's hard to count so might be closer to a 100 sometimes (but I usually wash it once every two days)
- Noticing some of those short thin hairs around hairline, even some peach fuzz on my right temple/corner where it has most recently receded. (tried to take pic but I don't think iPhone5 is good enough for this)
- Hair in general feels and looks thinner to me on top than in the back. Even running my hands lightly through my hair I often notice 5+ hairs coming out. Nothing comes out of the back no matter how hard I pull.
- Scalp itch, but no dandruff, or scalp issues
- Had blood tested for hyperthyroidism and iron deficiency (since I'm also underweight) but no issues there.

So what she told me is that she thought I was too young for propecia, and she advised me to use ketoconazole shampoo for the itch start using minoxidil to hold on to my hair and then come back if it gets worse.

I guess there's nothing wrong with that advice, it's just that I'm worried my hair will get worse a lot faster now since I've only noticed increased hair loss for about 6 months and it already feels noticable thinner to me. I feel like now is the moment to use propecia if ever, because now is when I have the most hair to hold on to. It seems clear to me that I have MPB on account of my symptoms.

The reason she wouldn't give me a prescription is that she doesn't like the idea of someone being on that drug for 15+ years until a cure comes out because of the way it affects your hormones. It's not that I disagree, but I'm afraid minoxidil will not maintain my hair the way that propecia can, and now while my hair loss is still minimal and hard to notice after styling my hair, and there are some great new treatments on the horizon (replicel, histogen, etc.), it would be the most beneficial time to use propecia.

It seems to me that so many guys here my age and younger are on propecia. Maybe it's a Dutch thing to be apprehensive about preventive medication, but I can't help but feel like propecia might not be such a bad idea for me. I just don't like that advice 'come back when it's worse'

Does anyone have similar experiences with doctors not subscribing propecia? Do you think I should get a second opinion at another clinic? Would it help to contact and IAHRS-listed clinic (Going to Belgium is a slight hassle but certainly doable)? Should I just go for minoxidil+keto shampoo and forget about propecia?

Thanks

[jxlegend]

I've only ever heard of <18 being too young for Finasteride... maybe a different doctor will help you out?

[WHTC Clinic]

You may not be experiencing MPB, but the shedding may be caused by a skin condition. Has the itching stopped since ketoconazole? No two individuals are the same when it comes to hair loss. Your goals are key to finding the most beneficial hair loss treatments.

[Fortunate Son]

You may not be experiencing MPB, but the shedding may be caused by a skin condition. Has the itching stopped since ketoconazole? No two individuals are the same when it comes to hair loss. Your goals are key to finding the most beneficial hair loss treatments.

I've only used the keto shampoo (I bought Regenepure DR) once two days ago and I don't really feel like it changed much yet. I have to say the scalp itch is very minor, it's not constantly present but it comes and goes a few times a day. Sometimes I feel like there is a tiny bump where the itch is, but that's uncommon. Both my GP and the nurse at the hair clinic looked at my hair and my scalp and didn't say anything about my scalp looking irritated or something.

I really do feel like I'm seeing minitiurization take place. A lot of the hairs I lose tend to be thin and lacking colour. They're only coming from the top of my head. I mean, with a history of hair loss in the family, what else could it realistically be?

[bmoreno515]

Hey is your scalp itch on your hair line and temples?

[Fortunate Son]

Hey is your scalp itch on your hair line and temples?

No, it's mostly on the centre top of the scalp, more often on the right side of that area than the mid/left (right side of my head also has more temple recession)

[bmoreno515]

That's how my hair loss is, I have more thinning on the right side and my hair is receded more on that side. I also get the itch on the right side and not so much the left.

[Fortunate Son]

That's how my hair loss is, I have more thinning on the right side and my hair is receded more on that side. I also get the itch on the right side and not so much the left.

How old are you? Is your hair loss similar to mine? Are you treating it?

[bmoreno515]

Its some what similar, I have a thread that has my temples but its hard to tell with mine but I am not treating it with finasteride or minoxidil only because I am nervous about side with fin and possibly making my hair worse but that shouldn't stop you from making a better choice then me, if anything yoh would probably be making a wise choice. I do however take vitamins to try to slow some of it down but it is not as effective as proven treatments. What do you feel like you should do?

[bmoreno515]

How is your crown area?

[Fortunate Son]

How is your crown area?

I really don't know. I feel like I'm thinning all over on my scalp. The thing is that my brother's hair loss is not so extremely aggressive as it gets, so his crown bald spot didn't become too visible until he was about 30. So it's not like my hair loss is super noticeable at 23, but my hair line has that classic receding M shape, asymmetric recession, it has already receded past the hairline that my mum and dad have, and now I feel like the top is slowly getting thinner. Is this not enough cause for concern?

I'm really at a loss what to do because everyone is telling me I still have hair so I don't need to treat it yet, but I thought the treatment is supposed to be about prevention. I just don't want to wait until it becomes noticably thinner. It already feels thinner than sides and back when I run my hands through it. I want to try finasteride but both my GP and the nurse told me to come back when I start seeing bald spots. If maintaining what you have is the game right now I don't want to wait until I have a bald spot. What kind of advice is this? The hairline recession looks bad enough as it is, and my fringe is getting worse at hiding it.

I really want someone with experience to weigh in on this. I'm afraid if I just wait that I will regret it later. Odds of it getting progressively worse seem stacked against my favour. I really just want to visit some more clinics and get their opinion. Are there any experts/experienced readers out there willing to way in on my case? I'm at such a loss what to do... I ordered Kirkland moam online but I have no idea when it will be delivered. I just want to do the absolute best job I can at keeping what I have and from what I've read finasteride is the only way to do that.

The fact that time is ticking on this and that I have no idea how far it will go if I do nothing is making me feel nervous. I just want to get on top of this thing, have someone really look at my scalp. Isn't mapping for minitiurization/scalp biopsy/etc a thing? Where can I do that? I just want to get the best possible look at my scalp. It's not like money is an issue for me. My GP wouldn't even refer me to a dermatologist. Wtf is that about? I go to these things with an open mind, I'm not asking them to prescribe me anything directly, but all people will do is look at me and say: 'you haven't lost that much hair yet'. So helpful.

[Fortunate Son]

I know that 'my hair feels thinner' is vague and subjective, but if I try to rationalize my symptoms as mentioned (especially the receding hairline) and the fact that my own brother is an NW3/4 vertex and getting worse, and so was my maternal grandfather at that age, how can I just wait this out? I don't want to wait until I'm an NW3
Vertex. The hair loss and itch is aggrevating enough, and not being able to hide my receding temples anymore, if this is already weighing me down so much now, how much more emotional will the whole thing get when I'm an NW3 and people can see through my crown?

I know I'm just venting now, but all I want to do is find the best course of minimizing any further loss so one day when I'm hopefully not too old there will be a cure or at least some kind of safer treatment with good efficacy and if/when that day comes I will have as much as I can to work with. I want to fight this any way I can but I need help. I need to know where to go and who to see who will take me seriously and understand how it feels to have so much to lose and see it all slipping through my fingers, and not tell to stand by and watch as it gets worse. I just want someone to read this and tell me who to see, what kind of method to diagnose this. I just want a good treatment plan that involves close attention and monitoring and not just waiting until it gets noticeable. Where do I go here? Anyone?

[bmoreno515]

Sorry I took so long to reply and don't feel like your venting, these forums are for reasons like this so we can express how were feeling and ik my advice isn't the best but if you can find a dermatologist who can prescribe finasteride then id do it if I were you, if you can see a significant change in your hair that only you are able to tell then make the jump on finasteride, you can save what you have and possibly get some growth if you apply minoxidil at the temples but growing the temple area is very hard. You can get a blood test and see where your testosterone levels are.

[PatientlyWaiting]

Too young for fin at 23 is ridiculous. I never listen to primary physicians when it comes to hair loss, only dermatologists/hair specialists. Did you see a dermatologist? Regular doctors, from my experience, are not very helpful when it comes to MPB.

[Fortunate Son]

Too young for fin at 23 is ridiculous. I never listen to primary physicians when it comes to hair loss, only dermatologists/hair specialists. Did you see a dermatologist? Regular doctors, from my experience, are not very helpful when it comes to MPB.

My GP wouldn't even refer me to a dermatologist, so I went for a free consult at a local hair clinic and the nurse said she doesn't think I should take propecia because I am 23 and my hair loss is not very advanced yet, she said the long-term effects of the drug are not very well known so she wouldn't prescribe it until I am older or my hair loss suddenly gets worse. She said she doesn't like the idea of someone being on the drug for 10-15+ years.

I'm not sure how to find a dermatologist. I looked on the website of my local hospital which lists the dermatology teams there but no one seems to really specialize in cosmetic dermatology/hair loss so I feel like that would just be a waste of time.