27 y.o. Male on Triple Therapy hoping to stabilise

[dothestrand]

I am 27 hoping to stabilise my hair loss for a potential future transplant.

I have been on finasteride for 3 years (pre-picture below), Minoxidil for 1 month (some shedding evident on right side below), and ketoconazole for 1 month.

My interpretation is that I am between a Norwood 3V and a NW4. Probably closer to NW4.

I have more advanced hair loss on my right side at the temple and crown compared to my left. Half way through a mild shed currently for Minoxidil.

I have lived with hair loss since I was approximately 20-21. It went through an initial increase when I lost quite a bit of weight at 21. It then increased considerably approx 21-22 (when I was taking Maximuscle protein shakes and going to the gym frequently).

I have further noticed more hair loss during exam periods (I have regular exams due to my career and will continue this through my life).

I can tell when I am losing hair as the scalp is warmer to touch than the surrounding areas and there is an itching sensation.

This past month since on triple therapy rather than just Finasteride have noticed only mild warmth in hair loss areas and no itch.

Aim:

Conservative hair transplant with good future reserve.

Plan:

Review triple therapy results in 6 months with hair transplant surgeon.

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Any help, advice, or suggestions for future treatment would be really appreciated.

Do you feel my hair loss is stable enough for a transplant?
Do you feel I am a good candidate for a transplant?

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Additional information:

Family history: Father Norwood 2/3 at 67 / Mother’s brothers all Norwood 6/7 in mid 40s and 50s.

Diet: Historically poor. Have improved past month with more fruit and vegetables in diet and taking vitamin supplements. No smoking. Drink alcohol socially.

Photos (attached):

1. Wet Hair April 2015 (at start of Finasteride monotherapy)
2. Dry Hair May 2018 (1 month post triple therapy hence slight shed)
3. Birds eye view with crown May 2018 (2.5 months into Minoxidil at crown so anticipate this should improve in 1-2 months)

Apologies the first picture is with wet hair - it’s the only picture I have at the time.