rate of loss -- how fast?

[SteveDT123]

Hello,

I noticed some thinning in the crown area when I was ~21 or 22. At 23 I started Propecia for 6 mos then stopped then started again a few months later. Since then I have been using propecia daily. I am now 27 and I think the crown has gotten slightly worse-- but not bald yet. My hair line receeded a bit on both sides-- but my hair is still fairly thick on the top of my head everywhere else. I'm thinking Im a Norwood 2 probably?

(1) So Im curious does it sound like the propecia is working? Or should I have experienced zero loss between when I started taking it and now?

(2) what are the specific tests that I see people refer to that examine the genetics and hormone levels? Where can I get one?

(3) In general what is everyones rate of loss between first noticing and going completely bald. Im hoping that the propecia is slowing it down enough to get out of my 20s and into my 30s, but I cant really gauge it.

Thanks!
Steve

[mattj]

Hi Steve,

1, The Propecia might have helped slow down the rate of loss. You will never know for sure, but without using this treatment your hairloss might have become far more advanced during the same space of time. Propecia doesn't always completely halt hairloss.

2, I'm not aware of any tests that can provide genuinely useful information for predicting hairloss or otherwise assisting in fighting it. Some guys get hormone levels checked. Perhaps someone else will chime in here...

3, Male pattern balding is far too unpredictable to give any sort of concrete answer here. Everyone is different. Some guys lose a lot of hair very quickly, others gradually lose hair over decades. Sometimes, for no apparent reason, hairloss can suddenly accelerate. Your started losing your hair quite young, but it doesn't sound like it's that aggressive. That's a good sign. Maybe the Propecia is responsible or maybe it's just the luck of the genetic draw.
You don't indicate that you've noticed any recent increased hairloss so you might make it into your thirties with little or no further loss.

[Dr. Glenn Charles]

Propecia works better for some patients than others. However, from the story you described it sounds like it is working for you to some degree. Many patients do not realize that the Propecia was slowing down or stopping the hair loss process until they stop using it.

[SteveDT123]

Thank you both so much for your responses! I guess I will keep an eye on it-- I wish there were a more scientific way I could go about checking my progress.

With regards to future options- I read some of the horror stories of transplants, but I am still confused: (1) lets say Im a norwood 2 now and I stay that way for some time. If I get transplants to restore the hair line nothing changes about the slow thinning on top right? I would still continue something like propecia to prevent that from thinning? (2) What about the transplanted follicles? would they in turn thin as well requiring more transplants? (3) do all transplants require that large scar as some have shown? Are there no other techniques? I dont know what makes up good candidate hair, but my hair on my sides and back is very thick.

Thanks again!
Steve

[Carlos]

I think that doing a transplant would be the worst solution for the problem. Take it from someone who knows. I did the surgery and I was still balding but this time with a 5 inch scare in the back of my head. If you ever decide to shave off your hair that scare will be there. I did the surgery when I was 27 years old. Now I am 35 years old and still thinning but with a huge scare in the back of my head this time. My opinion and thoughts would be not to ever do surgery because it will not help. If the product you are using seems to be helping maintain because using other products could help increase the balding. If worse comes to worse a system will be the best way to go. But you have to know how to cutt and style it yourself. Make it your own. Through time it will be part of you.

[Carlos]

(1)lets say Im a norwood 2 now and I stay that way for some time. If I get transplants to restore the hair line nothing changes about the slow thinning on top right? You are right. If you get the transplant the rest of the hair on top will still be thinning. You will still be balding. You have millions of follicles and they will only place a few hundred to thousands. That is not enough to cover your head. I would still continue something like propecia to prevent that from thinning? If Propecia seems to be working then continue using it. If you start other products that are misrepresenting themselves, you may lose your hair faster.

(2) What about the transplanted follicles? would they in turn thin as well requiring more transplants? The replacement of the follicles tends to help a little bit because the hair does grow from it. Each follicle can hold up one to more hair strands. The follicles that were transferred on me some had three some had one. They seem to be the same as to when I first did the surgery so they are not thinning yet. However, As long as you are thinning and balding you are going to need more follicles that will grow hair. You will need more transplants to try to cover some of the thinning areas. In turn, you will have more scares in the back of your head and you will still need more transplants. It will be an ever ending transplanting because they are placing only but so many and you need millions.

(3) do all transplants require that large scar as some have shown? There is no other way to remove the follicles without surgery. Are there no other techniques? I don’t know what makes up good candidate hair, but my hair on my sides and back is very thick. Anyone with thick hair on the sides and back is a great candidate

I know that you stated that you are not very thin now but you have to look at long term.
Really consider what goes with it meaning a little more hair in the front or top of your head that eventually won’t really matter because you are still thin and with a scare(s) that will be there for life.

[SteveDT123]

Thanks Carlos-- I appreciate your comments. One point of clarification: you said at worst do a system but you'll have to style and cut your hair yourself. What does this mean "system"? Like hair club for men? Is this different from a toupe?

Steve

[mattj]

A system is basically a hairpiece.

A hair transplant does not stop the progression of hairloss. You would need to continue taking propecia long term.
Transplanted follicles are extracted from the 'safe zone' at the back of the head. By some quirk of nature, the hair in this region doesn't suffer the same fate as the hair at the front/top/crown often does, and really it is because of this that transplants are possible.

There are two ways in which a surgeon removes hair from a patient for transplant. The strip method is where a strip of scalp is taken from the donor region and each follicle is individually dissected under powerful microscopes for planting in tiny incisions at the balding area. The wound from the removal of the strip is closed in such a way that hair grows through the scar, helping to disguise it.
These days, in the right hands, the scar is usually very fine and discreet, but will be noticeable with very short hair.

The second method of extraction is Follicular Unit Extraction (FUE). With FUE, a hand-held punch is used to remove each chosen follicle from the scalp, and the wounds created are very small and quick to heal. Most patients will see little in the way of scarring even with a shaved head.
Grafts are implanted into the recipient area in the same way as with strip.

Strip is still the standard when it comes to transplants for a variety of reasons and that is unlikely to change, but FUE is much less invasive and if you couldn't tolerate having strip surgery then it's an option you could look into.

[SteveDT123]

mattj thanks again for your response-- another follow up if you dont mind: what are some of the reasons that FUE is not used more often? more expensive? more risk? less follicles? It just seems like that would be preferable to a scar, so Im curious for more info.

[mattj]

FUE requires increased dexterity on the part of the surgeon and the whole process takes longer. These things add up to greater cost.
The punches used are very small to minimize scarring, but this means that they cut very close to the follicle. This means that there is increased chance of damage to the follicles upon extraction which can lead to less of them growing. Opinions differ on just how many grafts are effected on average, but individual surgeon skill will make a big difference.

With strip you get every visible follicle from within that strip, while with FUE the surgeon has to take follicles from a wider area. If too many are removed it's possible for the donor region to start looking thinned out. A lot of grafts can be taken but for larger sessions strip is still recommended.

[Carlos]

Hello Steve. Sorry for not being more specific however, a "System" is a fancy word for toupe or hairpiece. Alittle more of a modern name.

[fileextension]

my grandfather is bald and so is my father. i am in my mid twenty and would like to know how to avoid it? or can it be avoided?

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