S
silo
member
Hi all, apologies if I’m posting this in the wrong place (or if it’s something that’s been posted loads of times before), and sorry for the long post, but I would really appreciate any advice or tips. FYI I’m 32 and located in the UK.
Long story short, I’ve had recurrent episodes of diffuse hair shedding since 2020, with the remission periods between them becoming shorter and shorter. I’ve been applying minoxidil consistently for the past six months and have used ketoconazole shampoo for a good few years, way before the shedding started. Blood tests have come back clear, apart from low vitamin D and borderline underactive thyroid, but these have been followed up with normal results. Two specialists have said that it’s likely chronic telogen effluvium, with no known cause. I agree with this because the shedding has also at times been from the back and sides of my head, as well as my facial hair.
But the most worrying part for me is they said chronic TE can accelerate androgenetic alopecia, if you were always genetically predisposed to it, which I think is what is now happening to me. My hair has gradually become thinner (which I think is to be expected with chronic TE), but the main issue is that I’m noticing a lot of the hairs that are falling out now are short and thin, which I understand is miniaturisation and representative of permanent hair loss. Also the first cm of my hairline suddenly looks really thin and see-through (there are some tiny hairs coming through, but I predict they’re going to fall out like the other new growth has).
In terms of the chronic TE, I’m not sure there’s a lot more I can do. But what I do want to try and do is not permanently lose any of the hair I’m shedding through AGA, which is why I’m considering topical finasteride. I appreciate even if it works, I could continue shedding that hair because of the TE, but at least I’d be keeping the follicle ‘alive’ for the periods of remission, as well as for if/when the condition might stop.
I’m going down the topical route as I, like many others, am worried about the potential side effects. I realise there can be some systemic absorption over time, even with topical application.
I was going to order a 60ml bottle of topical 0.05% finasteride + 5% minoxidil (without alcohol) from Hims, which they recommend applying twice a day. From my understanding, this can be excessive, so my plan is to mix this with a 60ml bottle of 5% minoxidil (again without alcohol) to make a 120ml bottle of 0.025% finasteride + 5% minoxidil (please someone let me know if it doesn’t work like that!).
What I’m unsure of is how often to apply it – I’ve read that the half-life is three days, so would it be best to start with one application every three days and see how that goes? Or two applications (on the same day) every three days? It’s so hard to judge, because I want to minimise the risk of side effects, but I also don’t want to waste time continuing to lose hair because the dosage is too low. I was also thinking I could initially prioritise application at my hairline, rather than the entire top of my scalp, as this is where the main loss seems to be at the moment, and see how that goes first?
I’m also planning to get blood tests done before I start any treatment, and to monitor this semi-regularly (pricey, but I’d rather be safe than sorry). The clinic I’ve found offers blood tests for: DHT, androstenedione, LH, oestradiol, testosterone, FSH, prolactin, free androgen index, and free testosterone (calc.). Do you think that covers most bases?
Again, sorry for this being so long, but I’d be grateful for any help. Needless to say, it’s been a really stressful experience…
I’m be happy to share progress and updates on here if that would be useful.
Long story short, I’ve had recurrent episodes of diffuse hair shedding since 2020, with the remission periods between them becoming shorter and shorter. I’ve been applying minoxidil consistently for the past six months and have used ketoconazole shampoo for a good few years, way before the shedding started. Blood tests have come back clear, apart from low vitamin D and borderline underactive thyroid, but these have been followed up with normal results. Two specialists have said that it’s likely chronic telogen effluvium, with no known cause. I agree with this because the shedding has also at times been from the back and sides of my head, as well as my facial hair.
But the most worrying part for me is they said chronic TE can accelerate androgenetic alopecia, if you were always genetically predisposed to it, which I think is what is now happening to me. My hair has gradually become thinner (which I think is to be expected with chronic TE), but the main issue is that I’m noticing a lot of the hairs that are falling out now are short and thin, which I understand is miniaturisation and representative of permanent hair loss. Also the first cm of my hairline suddenly looks really thin and see-through (there are some tiny hairs coming through, but I predict they’re going to fall out like the other new growth has).
In terms of the chronic TE, I’m not sure there’s a lot more I can do. But what I do want to try and do is not permanently lose any of the hair I’m shedding through AGA, which is why I’m considering topical finasteride. I appreciate even if it works, I could continue shedding that hair because of the TE, but at least I’d be keeping the follicle ‘alive’ for the periods of remission, as well as for if/when the condition might stop.
I’m going down the topical route as I, like many others, am worried about the potential side effects. I realise there can be some systemic absorption over time, even with topical application.
I was going to order a 60ml bottle of topical 0.05% finasteride + 5% minoxidil (without alcohol) from Hims, which they recommend applying twice a day. From my understanding, this can be excessive, so my plan is to mix this with a 60ml bottle of 5% minoxidil (again without alcohol) to make a 120ml bottle of 0.025% finasteride + 5% minoxidil (please someone let me know if it doesn’t work like that!).
What I’m unsure of is how often to apply it – I’ve read that the half-life is three days, so would it be best to start with one application every three days and see how that goes? Or two applications (on the same day) every three days? It’s so hard to judge, because I want to minimise the risk of side effects, but I also don’t want to waste time continuing to lose hair because the dosage is too low. I was also thinking I could initially prioritise application at my hairline, rather than the entire top of my scalp, as this is where the main loss seems to be at the moment, and see how that goes first?
I’m also planning to get blood tests done before I start any treatment, and to monitor this semi-regularly (pricey, but I’d rather be safe than sorry). The clinic I’ve found offers blood tests for: DHT, androstenedione, LH, oestradiol, testosterone, FSH, prolactin, free androgen index, and free testosterone (calc.). Do you think that covers most bases?
Again, sorry for this being so long, but I’d be grateful for any help. Needless to say, it’s been a really stressful experience…
I’m be happy to share progress and updates on here if that would be useful.
