I know I'm cooked but wouldn't mind some guidance

[Brunoistrippin]

Hi everyone,

For of all I know I missed too much time without doing anything about it. But after finding this place I would like to raise some questions.

I do not like the state of it of course, to the point of not knowning what to do and not being comfortable with it. I always had a bit longer hair than trimmed down and I don’t feel comfortable shaving if all off at all, don’t think my head shape do any good being that way, maybe with a little more body weight or lesser flapy ears would be something different.

I’m considering a derm appointment to see if there’s any chance of having results with something as I’m seeing around here but I don’t know if I already that that point.

[baldbutnotbold]

You seem to have diffuse thinned in NW5A-6 pattern and it seems to be going on for quite some time. I will be honest with you, those bald patches/spots (if they are there for longer than 3-5 years) may not even with EXTREMELY potent (eg. RU58841/Pyrulitamide^+2.5mg oral dutasteride+5mg oral minoxidil) medication yield full terminal hair as follicles there go dormant after some time due to mounting DHT pressure. Some doctors/dermatologists may also say they are “dead” but in my belief this is not true, they are dormant (which is why pp405 type of experimental medications are possible, although not on the market yet.).

Please answer these questions honestly

1)May I learn your age and for how long have you had the hair (hair on top of your scalp) you have right now?

2)Are you ready to accept the fact that you may need to buzz everything or opt for a good HT (hair transplant) if nothing else works?

3) Can you promise that you will N.O.T. in a damn million years let go of your hair once a HT happens if you choose to pursue that path or if medications (eg. oral minoxidil 5mg+oral dutasteride 2.5mg) bring your hair back without the need for an HT. If you don’t keep your promise, then the meds also won’t keep your hair, you cannot cheat nature . Keep that in mind

Yes you need to keep using finasteride/dutasteride type of 5ARI AFTER a hair transplant and yes you need to keep using these medicines if you want to keep your regrow to its original extent and keep it that way, or you will go bald as the bald eagle.

Please select a proper dermatologist, ideally a 30-40 year-old male with slight recession of hair and one who is open to learning new information, calm and clever so he will understand your situation. Avoid dermatologists who recommend you to hop on minoxidil only without a good DHT inhibitor eg. finasteride/dutasteride. provided you have no side effects.

^Disclaimer:RU58841/Pyrulitamide are not FDA approved medications for anything and as antiandrogens their topical form should ONLY be used with EXTREME caution and only if nothing else works. Personally I would NOT recommend them and I do NOT think any doctor really would. Use at your own risk, though some people report success with them. Also good against testesterone based hair loss, albeit testesterone causing hair loss is rare and maybe non-existent or vanishingly small, I do NOT exactly know whether testesterone can cause hair loss without DHT.

[Brunoistrippin]

First of all thank you for taking the time to address my post.

I’m 39 and I had a small receeding hairline late in my 20’s. Going through my 30s it started to receding more at the sides and thinning more and more and last couple years, maybe 3 or 4 it begin to annoy me how my scalp is actually showing, thinning became even more prominen, even at front and crown was affected.

Right now I need an haircut, this may be the cut I got used to it and had when having more hair. Last 8 years I begun to trim the hair way down to 4cm or less because of that.

It bothers me a bit imagining having no hair at all or only having sides showing a bit since in some sense doesn’t feel right me. I am slim, my head looks way big, my ears would be exposed in a way thst would be another thing I’m not comfortable as well. And it don’t show the personality I feel in, nor what I intend but I understand that is starting to be the way to be to not look even worse.

I’ve heard and read about finasterine and minoxidil and that is what makes me want to go to a derm, since where I live we even need recipe to finasterine but I also wanted to know if there is a chance that with those components to have some regrow. I wouldn’t mind to have a HT well but since I don’t know how many folicules I would need is hard to say if I would need 5k or 8k and that is some money to give in, I would need a plan to do so.

Also about specially finasterine or dutasterine, I understand that after an HT you should keep taking them to not loose more hair afterwards. I also read someone saying it stopped taking but I know that it can only be momentary. And I wouldn’t mind having to take it, if some of the side effects, like libido were on to impact my life.

Thanks!

[baldbutnotbold]

You are welcome, I may sound a bit alarming and harsh (I am sorry in that regard if it comes across to you like that) but I try to provide solid advices in general.

Now, your frontal regions (where receding hairline occurs) almost definitely will NOT respond to medication. Let’s be honest there.

Secondly, your parietal (or midscalp for normies) regions MAY or MAY NOT respond to medication, but in my belief they WILL respond BUT only to an extent. The reason for this limitation of a potential response is you have not diffuse thinned in a few years my man. You have diffuse thinned over several years and in general 3-5 years of constant DHT buildup after hair follicles stop producing terminal hair and instead begin producing miniaturized (vellus-like) hairs lead to follicles going dormant where the response to medication is akin to a miracle. Though follicles are still there (this is why pp405 may work if it comes out as it works differently, but that is another subject for our context.).

Thirdly, I sense that your crown was affected last of this AGA disease (as I call it that way). Crown or vertex in medical terms WILL likely respond BEST to the medications. PLEASE CORRECT ME IF I AM WRONG THAT YOUR VERTEX BEGAN THINNING LAST.

Remember this: IN AGA WHAT THINS LAST/GOES LAST IS MOST LIKELY TO RETURN!

# NOW, DOES IT MEAN THAT YOU SHOULD NOT FIGHT AGAINST THE NORWOOD REAPER EVEN IF THE ODDS ARE STACKED AGAINST YOU? OBVIOUSLY NOT!
VISIST A PROPER DERMATOLOGIST, GET YOUR BLOOD LEVELS ETC. TOO CHECKED IF POSSIBLE (AGA cannot be cured with nutrition but get that in order nevertheless) AND THEN ASK THE DERM ABOUT, NOT ASK FOR (THAT IS RUDE ), ORAL MINOXIDIL + ORAL DUTASTERIDE. SOME HAIR WILL PROBABLY RETURN BUT MANY WON’T, WITH WHAT RETURNS, YOU WILL HAVE THE GAPS. GAPS THAT DON’T FILL NO MATTER WHAT MEDICATION (VERY PROBABLY) IN THAT CASE, 1) EITHER ACCEPT IT OR 2)HAIR TRANSPLANT. You have a good donor area, if you intend to go hair transplant mate, keep that in mind. Choice is yours to make.

If you have liver-based, renal, blood-pressure related problems especially consult with an internal medicine specialist on whether to or not to take minoxidil+finasteride/dutasteride type of drugs. If you do NOT, I would still recommend that you go check in with a doctor prior to taking these medications nevertheless. Always consult a doctor, if possible an internal medicine specialist!

My recommendation will be to visit a proper dermatologist+internal medicine specialist. If not dermatologist then you definitely should visit internal medicine specialist before taking these medications, in my opinion. Also get your bloodwork done every 3-6 months for 5ARIs, blood pressure tests before and after taking (1-2hr apart usually) for oral minoxidil (if you intend to not go topical for minoxidil). Monitor for side effects, unlikely but take precautions nevertheless. For context; when I refer to medications I refer to oral minoxidil (at equal to or less than 5mg), oral finasteride/oral dutasteride (at equal to or less than 1.25mg for finasteride and at equal to or less than 2.5mg for dutasteride, I personally am AGAINST 2.5mg as this is probably unnecessary for the vast majority of folks suffering from AGA, you included.)

Dutasteride>Finasteride in potency. Minoxidil>Rosemary/Jojoba etc. in potency. PP405>All known AGA treatments (min, dut, fin etc.), if it ever comes out and turns out to be a viable med for advanced hair loss.

by the way, your diffuse thinning looks exactly how i would imagine my hair to look without medications 3-5 years into the future (i am 20 rn). coincidence, maybe

[Brunoistrippin]

Thanks again for a very detailed answer!

You’re right, last area to be affected was crown and near crown area, which with time begun to make all hair look awful and when short don’t cover the scalp well.

I do thought about hair transplant and I understand that in this cases less than 5000 folicules may not be enough. If I could find something bellow 4k for that I might as well jump into it. Maybe if sides were not worked as hard as the bridge area. But I will book an derm appointment or 2, different doctors, to see what they recommend seeing the advance state or donor area quality. I just hope they don’t say it’s too late for anything.

Medication scares me a little since side effects seems scary. I understand that it cannot happen as well but since you mention liver, I did had something in the past that makes my liver a little exposed. Nothing serious but enough to make my eyeballs a little yellowish if not a good nutricion or too much alcohol. I also understand that dutasterine might be better than finasterine? But that’s not up to me. I live in portugal and either one needs doctor recipe.

I understand that meds can also do much since sides went away long ago, actually now that I think of it front, just the tip, last 2 years became very small in folicules as well. I remember not lonn than 5 years ago I could comb my hair back after a bath to help to have so volume and now as pictures shows there is nothing there.

I really appreciate all the info and hope that either way something can be done. Have too much of a big had to go bald, I would look sick being so slim and no hair, in my perspective.