25 yo, 7 years of hair loss - Advice needed

[Hair87]

I have been reading through these forums since very long time, now decided to join.
Hair (Here) is my story:-
1. Baldness runs through my family. (My father is NW 5V)
2. Started losing hair at 18 (Triggered early due to extreme stress and poor health)
3. At 21, concerned with continued hair loss, went to a clinic specializing in hair loss treatments.
Medication i am taking since then:-

• Saw palmetto capsule (Powder 100mg+Extract 250mg) - Twice a day first year, once a day afterwards
• Hair oil with Saw Palmetto (every alternate night)
• Shampoo with Saw Palmetto (next day of applying oil)
• Multivitamin with 10mg biotin (Once a day)
• R89 Homeopathic medicine
• Laser therapy - on and off (like one session a month)

Result:-Was able to maintain my hair for 4 years, lived a healthy and stress free life.
Side Effects:-Almost Nil

Situation Now:-
Got a job six months ago. Stress returned and so did my hair fall.
Diffuse thinning all over. Scalp is very much visible. New hair that are coming are very thin and week. Hairline has receded around half an inch or so. Major thinning has happened around the crown area.

Advice needed:-
I still think i can do some more to help maintain my existing hair.

Options i have:

• Finasteride
• Minoxidil
• PRP
• Nizoral Shampoo
• LL Laser Therapy (Have tried this before but was not regular)

What options would you suggest? What changes shall i make to my current regime?

[8868alex]

Hi 87

The first question you need to ask yourself is how serious are you about stemming the flow of the follicular tide. For me and many others, it was (and is) a necessary act. If you are the same, then the bottom line is this:

At this point in time (particularly for someone your age and your position), the only way to successfully treat MPB is Finasteride. To clarify what I mean by this, Finasteride has been proven to lower DHT and thusly attack the root cause. The key decision is whether or not you want to begin this medication. It's a personal decision that only you can make. Personally, I've been on it for over 4 years and never looked back. I mention this for the purposes of transparency. I also believe that my situation is reflective of the vast majority of users in my opinion.

Are there risks of side effects?... yes (I imagine you have looked into this)

Do I think that those affected fall into an unfortunate minority?.. yes

Now to the other therapies -

You could consider PRP (look up Dr Joseph Greco for instance). Jury is still out but there may be something to this.

Minoxidil is a solid adjunct therapy but on it's own will only buy you time at best. I speak from personal experience here (for what it's worth). Go with the foam!

Laser therapy - (deep breath). I also think this is worth considering as an adjunct therapy but once a month won't help much. Again, this is from personal experience and I stress the word adjunct. I think Tracy C has some fairly solid insight into this particular modality, but again this is just her opinion. Backlashers please temper your responses AFTER reading what I wrote. To be clear I'm not advocating LLLT on it's own at all.

Nizoral Shampoo may possibly help in lessening the impact of DHT on the scalp. Using it alone won't be enough though. I use it myself once a week as directed.

The majority of what you were (are) taking will not make a great impact in all honesty. If you are serious about stopping or slowing the loss, you must consider the above first. Even these are are not certain to address the problem but at least you are then taking it seriously.

There are those who praise RU and perhaps this may lead to something in the future. However, the fact remains that this is very much an experimental option that does not have a great deal of confirmed data regarding safety or effectiveness at this time. Up to you, but tread with caution.

We are all looking to the future (Aderans, Histogen, Replicel, etc) with baited breath but it's important to focus on what is actually available now. My advice to anyone in your position is to weigh up the pro's and cons of Finasteride. I am trying to choose my words carefeully as not to offend those who are genuine in their valid opposition to it, but it remains the gold standard at this time.


Hope this was of some use!

[WarLord]

Minoxidil is a solid adjunct therapy but on it's own will only buy you time at best. I speak from personal experience here (for what it's worth).

Incorrect. And I really don't know, where does this opinion come from? Early long-term studies from late 80's indicated that an average minoxidil user (on 3% minoxidil!) would reach baseline after ca. 15 years. This is in accordance with anecdotal pieces of experience, because some men have been keeping their hair on this drug since it entered the market in 1987.

My personal experience agrees with these findings as well, because I have kept my NW 1.5 hairline on 2% minoxidil from 1997 to 2008, and only then I switched to 5% minoxidil. In summary, I have been on minoxidil for 16,5 years, and only last year I added 5-AR blockers, because I wanted to be 100% safe that I won't lose my hair until the end of my life (which is quite a realistic expectation).

The 5% minoxidil version is considerably weaker than 5-AR blockers, sure, which can explain the higher incidence of failure, but my experience tells me that too many guys, who whine about the loss of efficiacy on internet forums are simply slackers, who often interrupt the treatment for many days or even weeks, and they subsequently wonder that their hair was not kept in place by some magic.

[8868alex]

Incorrect. And I really don't know, where does this opinion come from? Early long-term studies from late 80's indicated that an average minoxidil user (on 3% minoxidil!) would reach baseline after ca. 15 years. This is in accordance with anecdotal pieces of experience, because some men have been keeping their hair on this drug since it entered the market in 1987.

My personal experience agrees with these findings as well, because I have kept my NW 1.5 hairline on 2% minoxidil from 1997 to 2008, and only then I switched to 5% minoxidil. In summary, I have been on minoxidil for 16,5 years, and only last year I added 5-AR blockers, because I wanted to be 100% safe that I won't lose my hair until the end of my life (which is quite a realistic expectation).

The 5% minoxidil version is considerably weaker than 5-AR blockers, sure, which can explain the higher incidence of failure, but my experience tells me that too many guys, who whine about the loss of efficiacy on internet forums are simply slackers, who often interrupt the treatment for many days or even weeks, and they subsequently wonder that their hair was not kept in place by some magic.

Right, just take it easy for one second...

If you have done as well on Minoxidil as you suggest, then that is great. I have no reason to disbelieve your comments.However, is it reasonable to assume that since you were a very low Norwood to begin with, then perhaps your loss was not particularly aggressive? in turn, a more moderate medical intervention may have done the trick for you. Like I said, good for you. In addition, you do reference supportive anecdotal information which is arguably subjective. For the record, I still use Minoxidil and have done so since 1999. I supplemented this with other therapies from about 2008 onwards. I would discount myself from the "slacker" subset in light of this. Try to remember that the intention is to help each other here so please contribute and not attack.

When you say you added 5-AR blockers, I am curious as to what you actually mean? (Propecia, Saw Palmetto, etc) In terms of advising others, this attention to detail is quite pertinent.

Some interesting points nevertheless and I wish you the best with your continued regime!

[WarLord]

Right, just take it easy for one second...

If you have done as well on Minoxidil as you suggest, then that is great. I have no reason to disbelieve your comments.However, is it reasonable to assume that since you were a very low Norwood to begin with, then perhaps your loss was not particularly aggressive? in turn, a more moderate medical intervention may have done the trick for you. Like I said, good for you. In addition, you do reference supportive anecdotal information which is arguably subjective.

And you think that the picture that we get on this and other forums is objective? What is the exact percentage of successful users? Based on the posts, you would have to deduce that finasteride loses its efficiacy in most users after 5-10 years. Yet the Rossi et al.'s 10-years' study shows that only 4% men experienced a reversal of the positive trend. How can you deduce anything far-reaching from internet posts?

http://www.hairlosshelp.com/forums/messageview.cfm?catid=10&threadid=105275

"Been on minox since it first came out in 1989. I bet a lot of you guys were just born. On it for 23 yrs had good gains. Now almost 50 yrs old. It did what it suppose to do. Buy you time for something new to help treat MB. Back than they said we are about 5 yrs away for better treatment. Like I said over 23 yrs and still not much new treatment to grow hair. I never touch oral drugs. Topical was only way I would go. After all these years. My gains are slowly going away."

In other words, this guy is still above baseline after 23 years. So much to the "limited success on minoxidil". I think that what many guys mean by "limited success" is actually "limited regrowth". But I don't talk about people, who idly wait until they are NW4 and only then they are looking for help. If minoxidil keeps your hair in the NW 1.5-2 stage, you can live even without regrowth.

[8868alex]

And you think that the picture that we get on this and other forums is objective? What is the exact percentage of successful users? Based on the posts, you would have to deduce that finasteride loses its efficiacy in most users after 5-10 years. Yet the Rossi et al.'s 10-years' study shows that only 4% men experienced a reversal of the positive trend. How can you deduce anything far-reaching from internet posts?

http://www.hairlosshelp.com/forums/messageview.cfm?catid=10&threadid=105275

"Been on minox since it first came out in 1989. I bet a lot of you guys were just born. On it for 23 yrs had good gains. Now almost 50 yrs old. It did what it suppose to do. Buy you time for something new to help treat MB. Back than they said we are about 5 yrs away for better treatment. Like I said over 23 yrs and still not much new treatment to grow hair. I never touch oral drugs. Topical was only way I would go. After all these years. My gains are slowly going away."

In other words, this guy is still above baseline after 23 years. So much to the "limited success on minoxidil". I think that what many guys mean by "limited success" is actually "limited regrowth". But I don't talk about people, who idly wait until they are NW4 and only then they are looking for help. If minoxidil keeps your hair in the NW 1.5-2 stage, you can live even without regrowth.

Last round of diplomacy...

My information comes from my personal experience and from a variety of resources that are too inumerous to mention. Not from the forums, they are merely a platform for conversation.

Take a breath for a second and you'll see that I'm not actually disagreeing with you. It appears that you have a pro Minoxidil arguement and are somewhat sceptical of Propecia - entirely acceptable (though some advice for our friend who started the thread may be more constructive).

Leave it there!

[hellouser]

Incorrect. And I really don't know, where does this opinion come from? Early long-term studies from late 80's indicated that an average minoxidil user (on 3% minoxidil!) would reach baseline after ca. 15 years. This is in accordance with anecdotal pieces of experience, because some men have been keeping their hair on this drug since it entered the market in 1987.

My personal experience agrees with these findings as well, because I have kept my NW 1.5 hairline on 2% minoxidil from 1997 to 2008, and only then I switched to 5% minoxidil. In summary, I have been on minoxidil for 16,5 years, and only last year I added 5-AR blockers, because I wanted to be 100% safe that I won't lose my hair until the end of my life (which is quite a realistic expectation).

The 5% minoxidil version is considerably weaker than 5-AR blockers, sure, which can explain the higher incidence of failure, but my experience tells me that too many guys, who whine about the loss of efficiacy on internet forums are simply slackers, who often interrupt the treatment for many days or even weeks, and they subsequently wonder that their hair was not kept in place by some magic.

Minox doesnt stop AGA, its only a growth stimulant. Its more likely that your MPB wasnt/isnt progressive.

[WarLord]

Minox doesnt stop AGA, its only a growth stimulant. Its more likely that your MPB wasnt/isnt progressive.

For Goodness sake!!!

You really want to trump all the geniuses before you?!

[WarLord]

Please, look at your post, read it once more, and realize, what a nonsense you have written. Thank you.

[8868alex]

For Goodness sake!!!

You really want to trump all the geniuses before you?!

Lol, no idea why you would react like this. Nothing wrong with healthy debate but jeez, take it easy!

[Shan]

Use the Big 3
Fin
Min
Nizoral

[8868alex]

Use the Big 3
Fin
Min
Nizoral

Yep, thats fairly solid info.

[hellouser]

Lol, no idea why you would react like this. Nothing wrong with healthy debate but jeez, take it easy!

Nobody likes being wrong in the Internet. Especially on BTT since you can't edit your posts when you've made an error

[Hair87]

Thanks 8868alex for your advice. I really appreciate the time and effort you have put in to write such a detailed reply.
Thanks WarLord/others for your comments as well.

Well, I have made my decision and I will be taking up Finasteride 1mg, Rogaine 5% foam and Nizoral 1% shampoo. Infact, already purchased the medications and started my new regine today. I just hope i don't fall into unfortunate minority of those who suffer from Fin side effects..

Will be going for LLLT from next weekend onwards.

Also today, i buzzed off my hair to the minimum so i do not have to go through that horror of seeing my hair going down the sink again whenever i shower/comb. It will help in applying rogaine nicely as well.

Hopefully, i will have thicker and fuller head of hair six months from now..My last few months have been miserable because my my hair loss..

I have one query, should i take saw palmetto along with Fin? as i don't want to over do this.

Thanks

[Shan]

No need to take Saw P when on Fin.
I also buzz down when I shed but might keep it like this
Good luck with results and I'm pretty positive you ain't gonna get no sides just awesome hair