25 M, I suffer from annoying seb derm plus normal balding, this has been going on for a while but before my hair was you know…normal. As of 2 years or 3 I started thinning, now it has gotten worse? How bad is this? How over is it? Any options? Hairline is intact but thinning has completely ruined my once normal hair…
This is with a part but even just messy hair or a ponytail shows some gaps.
Honestly oral finasteride and oral minoxidil are the best long term and most effective
Yeah, I’ll get on that but anything else maybe? How bad are the pics, thats a norwood 2 or 3 in equivalent terms no?
Hard to apply the Norwood scale here since there is no pattern / hairline receding, however thinning is looking good and is pretty light, I wouldn’t even realise there is any thinning outside of this discussion.
Standard blood tests before considering meds include vitamin D3, Iron and B12 and testosterone primarily, and optionally biotin but it’s not done in most cases. With these you can be certain the underlying cause is not one of these common deficiencies, plus info on Test. After that treatment could be considered with a doctors prescription. Personally I did minoxidil via free Telehealth appointments covered by insurance but for finasteride they wanted me to go to a GP in person, so I went with the previous blood tests at hand so I didn’t waste more time and money and got that prescription pretty quickly with a visual assessment and consultation.
For medication the most “risk free” is topical, but for long term adherence and much better efficacy, oral is preferred. I was scared of side effects from reading shi on reddit but luckily none for me for a month now and they are pretty rare (~2% for finasteride for example), however a decision should be made at ones one discretion and doctor discussion, weighing how important this is to u vs the risks, but even with sides you can stop at any time really and it would just regress to what it would have been like at that time without any meds.
2.5mg oral minoxidil and 1mg oral finasteride is the standard, and for min at least you get most of the benefits and increasing to 5mg is only marginal and pointless if you are concerned regarding sides, however blood pressure effects are mostly above 10mg per day. With fin of course you can also do 1mg every other day or even less, with slight drops in efficacy but still some benefits, however 1mg daily is the standard to start with.
Topical formulations are significantly more expensive but have less systemic effects, but they are marginally less effective and it’s much harder to comply long term with daily applications vs just a pill. I personally used topical 5% min until I got the oral prescription but given my long hair, it’s pretty hard to go on the scalp behind the hairline so I will just use it at front until I run out, then only stay on oral. Where I live a years supply of topical Regaine 5% solution is like 450$ while 10mg generic tablets split into 4 are less than 40$ per year. So if you respond well and have no sides on orals they are definitely worth it economically and efficacy wise.
My full stack in order of importance is:
That’s really 99% of stuff with real evidence behind it after blood tests are in order, then there’s dutasteride which is only an escalation after at least a year or two of finasteride assessment, if it’s going well no point to mess with it given the higher risk and potency. Everything else is nuanced or experimental so I wouldn’t go there, mostly a waste of money if not proven at large in my opinion.
