First time on a hair loss forum, help very appreciated!

[zpt]

Boy. I’ve managed a bit over a year now avoiding actually getting an account on a forum like this one, but today I had a google moment, read around a few threads here, and noticed you seem like an intelligent and supportive bunch. So, if you don’t mind indulging me, I want to give a full, no-picture picture (ha) of where I’m at, in the hopes that you guys can point out all the holes in my mental insulation as it currently stands. (Warning: this will be a novel…)

Let’s set the scene: mid to late 20s, always a big hair kinda guy, lots of compliments for it, crucial part of my artsy identity, etc. Father’s in his 60s with a full head, but on mother’s side it’s pretty bleak. Kind of hard to know since everyone on that side seems to have both a mother and father with awful hair, but from my research it seems like my fate is nonetheless sealed.

I first started noticing my issue overnight about a year ago. One morning in the shower, there was suddenly a dozen or so hairs between my two hands after one shampoo application, and that was just the beginning. There was a period when for about a month or two I was down to almost zero discernible hair loss, but now it’s back up again. I’d say I lose around 200-300 hairs on a good day, 300-500 on a bad one (typically when I’ve shampooed). I’ve noticed virtually no difference in my dry hairline or volume over this year period, though (hairline is not receded but maybe less consistent, although some follicles are clearly still replacing hairs and it seems a bit early to call it), and I think it’s very possible that I am losing at least some of these same hairs, from the same follicles, over and over — at least maybe for now. (Granted, that’s once dried: when wet, it DOES look like I’m a bit thin overall, especially in certain spots, and even once dried depending on the lighting and angle I can sometimes see through to little bits of my scalp until I muss up my hair in the way I know gives total apparent coverage. However, I’ve simply never paid even a tenth as much attention to my hair before, and it’s very possible that it’s never looked all that much better wet than it does now. Maybe I’m just still in that irrational hope phase. =P)

When I first saw a derm a year back, he said I definitely had telogen effluvium, and that recovery (or at least cessation) was very possible. Though he worked for a very respectable hospital, I got the “salesman doc” vibe from him (he’d try to prescribe super experimental stuff without any word about potential side effects or even general caution), and he was grossly expensive ($250 per appointment, which came out to around ten minutes of his time, no insurance taken), so I ditched him and sought more guidance from my internist and another derm or two. I’d like to believe it, but given I’ve found NO testimony on forums that actually make it sound like recoverable telogen effluvium in men is anything more than a wishful myth, I’m not so sure. I’m definitely losing hair rapidly all over my scalp, though, not at the typical speed and pattern of MPB (yet?).

I’ve been on 5% rogaine (the liquid dropper kind) for a year now. Maybe because I still have quite thick hair, the stuff seems to get trapped in there, and flakes a good amount throughout the day. It’s gross and tedious, and my every-other-day shampoo regimen (though I rinse it at least once a day, in cold water) isn’t enough to stop it. I’ve heard the foam version is better in this regard (true?), though I’ve never gotten it simply because I don’t understand how it would work. If I have a still quite full-ish head of hair, is the liquid kind my only bet? And if not, how would I work the foam in?

I’ve not gone the fin route, despite the glowing testimony of a friend, since unfortunately for the past few years I’ve been having trouble getting it up as it is (ladies and gentlemen: my life). Though I had some great sex in teens/early twenties, that was mostly with one partner I really trusted and I very unfortunately need a ton of time before I can get to that place with someone. Very serious emotional issues/anxiety, I think. Now I’ve had a couple recent bad experiences with women (understandably) not being all too patient with me in bed, and that certainly can’t help. But maybe there’s a physical component to this issue, as well. I’ve done all the tests and haven’t identified a biological culprit, but I’m a bit worried about taking a drug that has some awful side effects which despite their rarity I may be particularly susceptible to (the quack-y derm and my great internist say fin is probably nothing to worry about, but my more sober derm and my psychologist both tell me to stay the heck away; the latter even had a patient for whom fin shrank his nuts, but he had such bad body dysmorphic disorder he kept taking it anyway). Propecia is a temptation, but one I imagine (hope) I’ll never feel bold/desperate enough to gratify.

Mentally, I’ve tried preparing myself for the worst. I’m a tall, thin, generally attractive guy who’s had lots of great opportunities with beautiful women over the years (though again, because of largely emotional issues, I’ve only ever managed to act on a few of them; regret city, on my way!), but I’m very pale, have sharp features, that kind of “beauty mark” (ugh)-prone European skin, sunken dark eyes, etc., and to top it off, I’m certain I have a bad scalp beneath it all: got a big head, was dropped as a child, skin’s prone to scarring, and I just know that in order to remain decently attractive I need that coverage. So I’m fretting big time about what lies beneath.

But at the same time, the idea of being one of those half-hair guys just to cling to what’s left is really not my thing. (No offense intended to present company, since I think generally speaking trying to work with what you’ve got is sensible; I’m just an OCD lunatic.) I’ve held to the conviction that, despite the inevitable shittiness of my scalp, as soon as my hair gets to that “obviously thinning” stage when strangers on the subway notice (or, rather, don’t notice you at all), I’m just gonna shave the whole damn plot and be done with it. (There’s also a practical interest there: I’m sick of buying rogaine, dealing with the minox flakes, styling my hair with gel to keep the frizzy telogen phase hairs looking as orderly as possible, etc. If it’s not gonna look good alright even with all that bullshit, it would be a bit of a relief to just pull the plug.) Though given I’ll never be a Willis or Statham in terms of face structure/body type, I’m telling myself (without knowing anything of the logistics…) that I’ll just get a full-blown wig every few months, or wear really nice hats, etc. Basically, above all, I just want to remain a visually striking person, even if I risk winding up looking rather ugly or even a bit nutty. I know that a half-there head of hair is just going to look sad on me, and given a choice between sad and odd I’d choose the latter. (Odd is at least possible to make sort of cool-looking, at least to/for some people.)

I guess the question I have, after the previous two paragraphs, is how easy is it to get a good-looking, not-totally-obvious full-head wig? Like I said, I understand this can’t be cheap: I just want to know if wearing a full-header is super uncomfortable, or if they just don’t make good ones, etc. Side effects, anything like that?

I suppose in a sense that a transplant of some kind is also hypothetically possible, but if I wind up having the same exact hair situation as my grandfather or uncle (or where my elder cousin seems to be heading), I would be the type that at a certain point would run out of donor hair. And if I need to have a big misshapen bare dome at some point or another, it’s probably best not to add a network of scars to it. Right?

Thanks to anyone who might care to reply to even just a tiny bit of this mess. It felt kind of nice to write, anyway.


P.S. I haven’t had an ounce of caffeine in a year, figuring that it probably only adds to body stress, and that getting back to a cup a day of joe might only make matters worse. Is that dumb?

[beetee]

From my understanding, telogen effluvium is quite distinct from male pattern baldness. If you read up on MPB, the loss of a large amount of hair at one time is not typical of the way it progresses. I believe that there is typically a medical reason for telogen effluvium, such as a deficiency, a hormone imbalance, a thyroid problem, etc. I don't think it would be treated in the same way as MPB, such as finasteride, minoxidil (which would be good news for you, as my personal belief is that they don't really work for most people). Have you had some comprehensive blood testing done? If not, I would really recommend it, along with seeing a good dermatologist or general practitioner (make sure you stress to them that your loss is taking the form of large amounts falling out in a short time period and is not following the traditional pattern of male pattern baldness). There might be a good possibility that whatever the underlying cause is could be treated and the hair loss should stop and/or reverse (again, presuming that your loss is telogen effluvium and not male pattern baldness).

[zpt]

Thanks for wading through all that and replying -- I really appreciate it.

Fortunately, I did have a blood test done, once a year ago and once about a month ago. At first I had a heavy vitamin D deficiency, but after lots of liquid supplement that seems to have balanced out. Otherwise, my thyroid was a bit high once but nothing to the extent that you might suspect TE to ensue.

Anyway, yeah, hoping that somehow that's nevertheless what it is (a derm or two has told me that sometimes the cause can simply never be identified), but it could just be a weird onset/manifestation of MPB. Mother's side definitely makes that a strong possibility, if not now then probably eventually.