26yrs old + Balding - What to do?

[Bishop]

Hey guys,

I'm 26yrs old guy who's going been going bald for a couple years and has been reading these forums for a couple months.

I just got a short haircut the other day and really started to notice that I was losing a lot of hair (and fast) on my crown. Obviously, I've been aware of my general hair loss, but the bald-spot that I'm forming (crown) is quite large and discouraging.

My question is, what should I do? I haven't taken any medication or anything for my hair-loss yet even though I've noticed my hair thinning for about 4-5yrs now. Is there any hope? Is it worth trying Rogaine/medication or would I just be better off investing in getting a hair transplant? (FUE)

I posted some pics for you all to see. My apologies for the bad lighting. I also have a small bald-spot just behind my front hair-line due to a birthmark that I recently had removed. I think that bald-spot is the most visible in the 2nd pic. I've been trying to cover it up for my entire life and have done a pretty good job, but lately it has been getting tougher considering the fact my hair is thinning.

I've heard a few people recommending Rogaine. Not too sure how that would work, but I'm not too keen on going on other meds that have a risk of several side-effects. I've heard of the big-2 and big-3 - what do you guys recommend? Perhaps even just Rogaine + that Nizoral (sp?!?!) shampoo?

I'm quite torn on what to do, sometimes I think I should just give up and face reality that I'm losing my hair and I can't do much about it - and other times I really wish I could have a full head of hair again. I've read a bit about FUE surgeries, but I'm not sure if I would be a good candidate or approximately how much that would cost me. (I doubt I could afford it)

Anyways, any feedback would be appreciated.

Thanks.

[Tracy C]

Is there any hope? Is it worth trying Rogaine/medication or would I just be better off investing in getting a hair transplant? (FUE).

Yes there is hope. If it bugs you it is worth trying. Concerning medications or suirgery, you will need to go on medications to arrest it anyways, so you might as well talk to a dermatologist who specializes in treating hair loss and start treating it with medications.

The products that work to treat hereditary hair loss are:

Rogaine - or generic Minoxidil.

Propecia - or generic Finasteride (for men)

Anti-androgens (for women)

Low level laser therapy

These treatments above do not work for everyone. Some people will get results from one or more of these treatments, while others will not get any results from any of these treatments. If I were you, I would talk to my doctor about Propecia (or generic Finasteride). Get Rogaine foam to use in the morning and generic men's 5% liquid Minoxidil to use in the evening. Give the laser comb a try. Get Nizoral A-D shampoo and use it as directed on the bottle (twice per week - and no more).

Be kind to your hair and take very good care of the hair you still have. It's really not that much trouble. Also take very good care of your body. Eat a healthy diet, drink plenty of water, get plenty of exercise and get plenty of sleep.

[Bishop]

Thanks for replying Tracy.

Couple questions - what is the difference between Rogaine foam and Generic Men's 5% liquid Minoxidil?

Also, is this Nizoral A-D Shampoo the anti-dandruff shampoo?

[Tracy C]

what is the difference between Rogaine foam and Generic Men's 5% liquid Minoxidil?

Rogaine foam is 5% Minoxidil suspended is a mousse like foam. Generic Men's 5% liquid Minoxidil is 5% Minoxidil suspended in liquid. The medicine is the same, just the form is different. Rogaine foam is very stealthy but it is expensive. Liquid Minoxidil is not stealthy but it is inexpensive.

http://www.bernsteinmedical.com/medical-treatment/medications/rogaine-minoxidil/

http://www.bernsteinmedical.com/medical-treatment/medications/rogaine-minoxidil/tips-on-minoxidil/

is this Nizoral A-D Shampoo the anti-dandruff shampoo?

Yes. Nizoral A-D is the non-prescription, over the counter strength version of Nizoral. Many, including me, use either Nizoral or Nizoral A-D shampoo in their treatment regimen. Nizoral helps your treatment regimen in a couple of ways, maybe three. First, its helps ensure your scalp is healthy. Second, it helps take care of any possible itching or irritation associated with treating hair loss. Third, the mild anti-androgenetic properties of the active ingredient might be able to block DHT at the scalp.

[hal]

You're to young and have too much hair to consider a transplant at this point.

Your only real hope is meds-- specifically, Propecia and Rogaine.

However, please do your research-- meds are not a magic bullet and they carry their own risks in terms of side effects and other long term consequences.

Additionally, your hair loss in the short term might get much worse due to shedding, etc. This is often the case when first starting Propecia.

There are no easy answers for a young man in your situation. The best scenario is for you is that the meds stabilize your hair loss and thicken up the crown and bring your loss to a standstill for the next couple of years. All without any real side effects.

The question of course is will your own physiology permit this? Unknown. It's a gamble and you have to evaluate the risk/reward potential before moving ahead.

However, one thing is sure: IMHO, you are not a good candidate for any kind of hair transplant at this point.

Do your research, become informed, and make your decision-- and then be prepared to live and accept the consequences.

Hal

[Tracy C]

However, one thing is sure: IMHO, you are not a good candidate for any kind of hair transplant at this point.

Agreed. Even if Mr. Bishop has only minimal response to one or more of the available treatments, he will be in good shape a year from now.

[Bishop]

Rogaine foam is 5% Minoxidil suspended is a mousse like foam. Generic Men's 5% liquid Minoxidil is 5% Minoxidil suspended in liquid. The medicine is the same, just the form is different. Rogaine foam is very stealthy but it is expensive. Liquid Minoxidil is not stealthy but it is inexpensive.

http://www.bernsteinmedical.com/medical-treatment/medications/rogaine-minoxidil/

http://www.bernsteinmedical.com/medical-treatment/medications/rogaine-minoxidil/tips-on-minoxidil/

Yes. Nizoral A-D is the non-prescription, over the counter strength version of Nizoral. Many, including me, use either Nizoral or Nizoral A-D shampoo in their treatment regimen. Nizoral helps your treatment regimen in a couple of ways, maybe three. First, its helps ensure your scalp is healthy. Second, it helps take care of any possible itching or irritation associated with treating hair loss. Third, the mild anti-androgenetic properties of the active ingredient might be able to block DHT at the scalp.

Thanks for the clarification.

[Bishop]

You're to young and have too much hair to consider a transplant at this point.

Your only real hope is meds-- specifically, Propecia and Rogaine.

However, please do your research-- meds are not a magic bullet and they carry their own risks in terms of side effects and other long term consequences.

Additionally, your hair loss in the short term might get much worse due to shedding, etc. This is often the case when first starting Propecia.

There are no easy answers for a young man in your situation. The best scenario is for you is that the meds stabilize your hair loss and thicken up the crown and bring your loss to a standstill for the next couple of years. All without any real side effects.

The question of course is will your own physiology permit this? Unknown. It's a gamble and you have to evaluate the risk/reward potential before moving ahead.

However, one thing is sure: IMHO, you are not a good candidate for any kind of hair transplant at this point.

Do your research, become informed, and make your decision-- and then be prepared to live and accept the consequences.

Hal

Well, from my research - and I haven't done a great deal - I've read that there aren't too many side-effects from Rogaine. Same can't seem to be said about Propecia (especially long term) - so, I don't think I'm going to try that. Instead, I think I might just try Rogaine + Nizoral shampoo as Tracy has been saying.

One question about your post though - why would I not be a good candidate for a hair-transplant at this point? I'm just curious. Is it because I could potentially still lose quite a bit of hair?

[Bromin]

I think Age becomes a huge factor in hair transplants.

Also, getting a hair transplants will never achieve the look that you want. It's mostly for people with diffuse hair loss and balding areas.

[Tracy C]

One question about your post though - why would I not be a good candidate for a hair-transplant at this point? I'm just curious.

Mostly, it is because your stage is mild and possibly treatable without surgery. Since you are catching it this early, you might be able to recover enough hair with medications alone to be happy. Surgery should always be a last resort. If after treating it for a year or so you are still not happy, then think about surgery.

If I were in your shoes, I would stick with medications and possibly laser therapy until we know if cell based treatments get FDA approval.

Is it because I could potentially still lose quite a bit of hair?

If you do nothing to control DHT, you will likely continue to lose hair, even if you respond well to Minoxidil. Talk it over with the doctor.

[hal]

One question about your post though - why would I not be a good candidate for a hair-transplant at this point? I'm just curious. Is it because I could potentially still lose quite a bit of hair?

You're only 26 and I'm sorry to say you're probably going to loose a lot more hair.

You have a bald spot opening on the top of your head and in the next few years you're very likely to lose the central core moving forward from that area.

The hairline is very weak on either side of your front forelock. It looks like your brushing hair forward so its meeting up with the tuft up front.

More than likely you'll keep the tuft at the front of your forehead, but moving straight back will be bald. Set a baseball right behind that forelock and imagine everything in that radius being gone right back to the crown. I think that's what you're looking at.

If you get a transplant now you'll probably lose a lot of that central core due to shock loss and other factors. It may not come back if its dying as I suspect. The transplant may just be a trade off. But you'll have a scar and be out thousands of dollars and wondering where the big improvement is. You've got to save that donor area until you see where you're finally going to end up.

And even if that central core isn't really affected, you will still have to worry that it will one day thin out leaving behind the transplanted hair that may be a little thin without the native hair to blend everything in.

Sure a transplant might look good for a few years on you, but what happens 10, 15 years down the road? you end up with multiple procedures, scars, and chasing a hairline. Happens all the time with people in your situation.

And if you're thinking that you "can stay ahead of the game" by getting a transplant early, well, good luck with that one. These boards are filled with posters who have tried that particular strategy and now regret it keenly.

The reason I responded to your post is that your balding pattern resembles my own at that age. I'm 48 right now.

I just had a HT with Dr. Ron Shapiro 8 months ago. My hair right now looks a lot like your posted images save for a much stronger hairline.

The difference between us is that my hair is growing in and yours is falling out. I don't say this to be harsh, only to make you realize that you can't rush or force the process.

Meds are you best option at this point. If you can keep what you have and maybe gain some ground in the crown, you'll be doing fine.

I'd also look in to some thickeners, like Pro Thik and toppik. Those products do wonders for hair like yours.

Meds and cover products-- that's your battleground and solution for the next 5 to 10 years (barring some fantastic new treatment method).

Just one mans opinion.

Hal

[Bishop]

Thanks Hal, I appreciate you writing that out. It always helps to hear from someone like yourself who is older and has already been through what I'm going through now.

Thanks for explaining everything about HTs. After reading that I don't think I'll be getting a HT anytime soon, perhaps ever. I figured I'd want it sooner than later for the hopes of not having people notice that I even had the procedure done in the first place. I'd also consider the FUE treatment which doesn't give you a scar. Correct me if I'm wrong.

Anyways, I feel that it's more so important to me now as a younger man, but I don't see myself wanting to do anything while I'm in my 40s, besides sticking to meds like Rogaine if they continue to work by then. (Probably not).

Thus, I'm thinking about going with Rogaine foam, Nizoral + perhaps even a thickener as you recommended - if anything at all.

I appreciate all your and Tracy's help in answering my questions and taking the time to explain certain things.

[alex123]

Have you tried shaving your hair and seeing what it looks like (if it looks ok)?

Often, if you have strong hairloss genes, then all the drugs in the world won't make a difference.

[Bishop]

No, I haven't yet, but I think I won't have much of a choice but to do so soon. I'm just torn as to whether or not I should even go forward with Rogaine or anything else or just let it be. It's more or less just delaying the inevitable anyways, not to mention the expense.

[Bromin]

No, I haven't yet, but I think I won't have much of a choice but to do so soon. I'm just torn as to whether or not I should even go forward with Rogaine or anything else or just let it be. It's more or less just delaying the inevitable anyways, not to mention the expense.

It's always delaying the inevitable. It just matters in how long do you want to delay it.

If cost is an issue, there are programs out there that will help with reimbursement through loyalty programs. Also minoxidil is very cheap. Propecia's patent is about to expire next year so we can hope for true generics these coming years.

For me, it costs $18 for 3 months of monixidil (mind you it's actually a 6 month supply but I use a lot of it) and $60/per month for propecia. I am paying completely out of pocket, some people might get covered under their insurance.

Only you can make the decision of how you want to act. The results are out there and definitely worth pursuing in my strong opinion.