Hair grafts for a thin crown area

[hairavatar]

I'm looking at getting hair transplants/grafts for my crown area. Its relatively thin but certainly not what any one would classify as any "bald" spot.

I have grown a lot of my hair back through finesteride. But a few years down the track there's still a bit to go which will never come back through just finesteride.

I mainly want to sort the area out as I keep getting sun burnt in there.

I have been told I'm a good candidate and should need 800 maybe 1000 grafts.

I don't know too much about the procedure but I understand that I'll probably looking at getting FUT over FUE for cost reasons.

I also don't care about the quality too much either as its just for a thin crown area. Cost is one of the main constraining factors.

I thought people may have a few good bits of advice or things to add on this forum??

Look forward to your comments.

[Tracy C]

Have you tried Rogaine on that area? You should know if Rogaine is able to fill the area in after about a year of using it. The shedding period stinks but thats temprorary. Also, are you using Nizoral or Nizoral A-D yet?

[hairavatar]

I have. I've gone through all sorts. I mainly used 7% minoxydil solution with something like 0.01% ret acid, its been a while. I didn't like it as it was annoying having to apply it all the time, plus I found it irritable. Plus its not the best for someone who likes being out in the sun and surf. I think rogaine is a bit over rated. (I used the minoxydil for around 2 years maybe).

Never heard of Nizoral is that for use in a shampoo, for temp dht blocking? I have shampoos with saw palmetto and other stuff in.

[Tracy C]

I think rogaine is a bit over rated.

I don't think so. It's proven to work and it worked for me, so I mentioned it. Nothing works for everyone though. I should say though that the only percentage of Minoxidil available legitimately here in the U.S. is 5%. There is a very good reason for that. Those formulations with higher percentages and additional "stuff" are questionable at best. You would likely have been better off using regular 5% generic Minoxidil that you can buy at your local pharmacy.

BTW, how long has the area you are concerned about been thin? How many years?

Never heard of Nizoral.

Nizoral is a shampoo. It comes in two versions, a prescription strength 2% version and a non-prescription strength 1% version. The active ingredient (Ketoconazole) is a mild anti-androgen that may be able to block DHT at the scalp. Nizoral is part of the "Big 3" and is on the list of medications useful in treating women's hair loss. You might want to give it a shot.

[hairavatar]

I paid a fair amount of money for specialist treatment and they advised against the 5% rogaine type solutions. It was a pure 7% minoxydil and 0.01% ret. acid solution. But yeah you're right different things work for different people. I didn't like having to use it all the time. I'm glad to hear it worked for you

Its been thin for a long time it got pretty bad around 7 years ago then I grew a lot back. But its still a little thin. Thin enough for me to want to look at hair transplants. Plus like I said I get a little sun burnt from there from time to time.

Thanks for the advice about Nizoral its appreciated. I use a formulated shampoo from a group called Ashley & Martin in Australia and that has Saw Palmetto in which I understand to block DHT.

(BTW my thinning is due to typical male pattern baldness).

[Tracy C]

I paid a fair amount of money for specialist treatment and they advised against the 5% rogaine type solutions. It was a pure 7% minoxydil and 0.01% ret. acid solution.

Sounds really sketchy. There were some "specialists" doing that here in the U.S.. The FDA has shut them down for the most part - and for good reason. Your "specialist" recommended against 5% Rogaine because he wanted you to use his questionale formula. The retinol in that questionable formula is what makes your thin spot more sensative to sun.

There really is no good legitimate evidence to suggest that Saw Palmetto can do anything meaningful to treat hereditary hair loss.

Its been thin for a long time it got pretty bad around 7 years ago then I grew a lot back. But its still a little thin.

Yeah I'm pretty sure that's too long. I don't think you will be able to fill it in with medications. No one is really sure how long hair follicles can remain dormant and still be resarted but for the most part I keep reading that it's probably five years.

[25 going on 65]

Just a few thoughts to add:

If you have diffuse thinning in your crown, there is a risk of shock loss from transplanting grafts into that area. I would definitely ask for a doctor's opinion on that (IAHRS-recommend surgeons may be the safest way to go).
Another thought is that the crown area can use up quite a lot of grafts, which down the line could leave you with a depleted donor supply if your loss progresses and you want work done in the frontal scalp area (which many would consider the most cosmetically important region). But I don't know how many grafts your crown would need; that's another question for the doctor.

It's possible that ketoconazole shampoo (preferably the 2&#37 combined with minoxidil might thicken up the crown, though Tracy might be right that it's perhaps been too long since the follicles shut down. Can I ask how long ago you quit minox?

[Tracy C]

Can I ask how long ago you quit minox?

Good question! Dang! I should have thought to ask that.

[hairavatar]

I was on it for about 2 years maybe more, I probably haven't used it for a few years now.
Thanks for the input on rogaine/minox but I really just didn't like using it all the time. It was just way too annoying to keep applying all the time.
As for the questionable specialist, they are certainly well respected and very well known here in Australia who would only use the best and leading techniques/methods.

Please note I'm really only concerned with advice on surgical/hair transplants.

Interesting to hear about the shock loss, I'll be sure to ask the surgeon about it.

As for further loss, its certainly something to think about. Finesteride is working well for me for now but there are certainly possibilities of it not continuing to work effectively in the future or just wanting to stop using it in the future for other reasons (and there are certainly a few reasons I would stop the use of finesteride in the future).

(I need about 800-1000 grafts).

[Tracy C]

Please note I'm really only concerned with advice on surgical/hair transplants.

Surgery should always be your last option - after all else has failed.

Yes, shock loss is a very real possibilty.

[hairavatar]

Nothing has failed. It all worked, I grew a lot back just not enough.

[Tracy C]

I grew a lot back just not enough.

That was my situation a few years ago. The medications were working and I grew a lot of hair back - but it was obvious that not enough hair was going to grow back in certain areas of my scalp. So I had hair transplant surgery to fill in the blanks. So I do understand what you are saying. You think losing your hair sucks? Imagine what it is like to be female and losing your hair.

Transplanting hair into the crown is a bigger deal than you may think it is. More grafts are required than you think you need.

I cannot see your crown but since you describe it as "thin" and not bald, you are more susceptible to shock loss from surgery. Sometimes hair that shocks out will grow back - but sometimes it doesn't. So it is possible for you to end up worse off than before having the surgery. You need to be aware of this possibility.

There are biotech company's working on a solution that may be worth waiting for. The two that interest me the most are Replicel and Histogen. I have complete coverage now but I do not have the density I want. Rather than asking my doctor for another transplant surgery to build up density, I have decided it is best that I wait for the treatments these biotech company's are working on to become available. There is a very strong possibility that the treatment Replicel is working on may immunize hair follicles from the damaging effects of DHT. If that works out to be the case, I will be able to stop taking/using meds and still gain more feminine density. So to me it is absolutely worth waiting for.

[hairavatar]

Thanks for that, that Replicel looks pretty exciting. I would have to hope for a couple of things, that it becomes affordable and available in Australia

For now FUT still seems the more realistically achievable option for me.

[Folly]

Sometimes hair that shocks out will grow back - but sometimes it doesn't.

Hi Tracy C. Do you think terminal hairs, which are healthy and in the anagen phase, can also be permanently lost from a HT ? They always say native hairs that are permanently lost from shock loss were on their way out anyway. Do you think this is true, or can you also permanently lose good terminal hairs ?

So it is possible for you to end up worse off than before having the surgery. You need to be aware of this possibility.

This happened to me. Sucks !!

Thanks.

[Tracy C]

They always say native hairs that are permanently lost from shock loss were on their way out anyway. Do you think this is true?

I am not not a doctor but I do believe that this is probably true because it makes sense.

...or can you also permanently lose good terminal hairs?

I don't know but I doubt it - unless the doctor did something wrong.