23M Considering Hair Transplant After Aggressive Hair Loss, Current Treatments Ineffective

General
1

Hi everyone,

I’m a 23-year-old male dealing with fairly aggressive hair loss and I’d really appreciate some advice from people who’ve been through something similar.

I started minoxidil about 4 years ago. Initially I was on 5% topical minoxidil, but I continued shedding. About a year later I switched doctors. He moved me to 5% foam minoxidil plus multivitamins, but unfortunately that didn’t help much either and the hair loss kept worsening.

After that I switched doctors again. This one took me off topical minoxidil because I had a lot of itching and irritation. Instead, he prescribed oral minoxidil 2.5 mg, multivitamins, and monthly PRP treatments (5 sessions).

Around the 3-year mark, I moved to a bigger city with better dermatologists and consulted another doctor who seemed far more knowledgeable. He explained that 2.5 mg oral minoxidil alone is usually too low, and that I also needed a DHT blocker to address the root cause.

So my treatment was changed to:

  • 10% topical minoxidil

  • 5 mg oral minoxidil

  • 0.5 mg dutasteride daily

  • PRP every other month (4 sessions)

His PRP technique was also different. He used a double-spin method, injected only the platelet-rich portion, and applied the remaining plasma using a dermapen. My previous doctor hadn’t used double spin.

By this point I had already lost around 60% of the hair I originally had when I started treatment, but I did notice some improvement during the PRP sessions.

After finishing those treatments, he told me to continue the medications for a year and then return for maintenance PRP, but I was moving abroad for a year so I couldn’t continue the sessions.

Now that I’m back, it feels like most of the gains from PRP have disappeared, and the medications seem to be doing more maintenance/slowing than regrowth.

Recently I consulted another doctor who suggested that 10% topical minoxidil was overkill and advised me to stop topical minoxidil entirely. I followed that advice but within 2 months I experienced heavy shedding, which freaked me out, so I restarted 5% topical minoxidil.

My current stack is:

  • 5 mg oral minoxidil daily

  • 0.5 mg dutasteride daily

  • 5% topical minoxidil

Genetically, my hair loss is very aggressive. My dad’s entire side of the family is bald and my dad lost most of his hair by 25.

At this point I honestly don’t want to keep chasing temporary treatments like PRP that require constant maintenance. I’m currently somewhere between Norwood 3 and 4, and I’m considering going ahead with a hair transplant.

My current thinking is:

  • Get a hairline transplant

  • Possibly add some grafts to the crown

  • Continue medication

  • If I lose more ground later, do a second transplant in the future

I’d really appreciate advice from people who have experience with early transplants, aggressive hair loss, or similar situations.

Is this a reasonable approach, or should I wait longer?

Thanks in advance.

2

Sounds like you’re dealing with aggressive AGA. If you’re considering a hair transplant, it’s crucial to continue medications to maintain results. Oral min and topical dut are good choices alongside a transplant. Keep in mind, a transplant isn’t a cure; it’s part of an ongoing treatment plan. For stability, you might see consistent results over several months with your current regimen. Choosing a transplant now or waiting depends on personal preference and how much hair loss stabilization you see. Dive into some transplant stories on the board to gauge others’ experiences.