Help! Can I be saved? (28 years old)

[basiafak]

Hi guys. I was hoping to get your views about getting a hair transplant. I am a 28 year old male. I have been losing my hair, initially in a NW3 pattern, but lately throughout the top of my head, for about 6 years. I have been on minoxidil for 4 years and on propecia for the last few months. The loss has become more pronounced in the last year or so. I think it's time to to decide between a hair transplant and just giving up.

- Am I a good candidate for a transplant now or does it look like I will never be able to get decent coverage throughout the top of my head?
- Is it likely that the thinning/balding area expands further on the sides and crown?

 

[Bigmac]

I would hold off getting a hair transplant. You’ve only been on Finasteride for a couple of months, it needs time to work. Usually, between 6 - 12 months to see if you’re responding to it. You could look into oral minoxidil too, some people are reporting positive growth.
Once your hair is stabilised, you’ll be in a better position to decide how to proceed. You may even regrow enough hair to hold off on surgery.
While you’re waiting to see what results you get from the meds, you can use this time to research clinics.

 

[bullitnut]

I agree with the advice from Bm…..give the meds a chance to save your hair… Stop the loss from progressing further and grow back miniaturised hairs… Hair transplant is the last option.

 

[Raphael84]

@basiafak

I would agree with the advice above from Bigmac and supported by bullitnut.

Despite having retained native hair on top, the larger and progressive pattern of loss can be seen with what would appear to be a NW5 pattern. At only 28 years of age and considering that we lose hair well into our older years, beginning finasteride was a sensible decision in an effort to retain and strengthen as much as possible.

With your current pattern, surgery would likely not be in your own best interests at current when considering the long term. Waiting to see how you may respond to and tolerate finasteride over a longer period of time will be important, because if your are unable to commit to it, loss may accelerate and in many cases, topical minoxidil alone is not sufficient to maintain current hair.

As you have also detailed that the rate of loss has increased over the last 12 months, it is important to stabilise this loss before considering any surgery as placing amongst unstable native hair may present a higher risk of shock loss which you would want to avoid.

Your photos dont clearly show your donor area, but at current I would continue to use medication and monitor your hair over the next 12+ months to better understand how effectively medication may be working. As Bigmac has said, perhaps look into oral minoxidil as a replacement for topical and then reassess.

I wish you the best

 

[Kevboy]

Medications are the way to go for sure.

 

[Cosmedica Clinic]

Give the Finasteride a full 12 months to see how you respond to it.

 

[Philw]

Please dont rush into a hair transplant
Holding onto ur hair is key so try the meds for 12 months u need to be in a situation where u have stabilized ur hair

 

[John Cole MD]

You want to begin regenerative medicine as soon as possible. The sooner you begin improves your chance of responding. You have a much better chance to respond in the top, crown, and frontal tuft. You are less likely to respond on the lateral hairline or peaks. You've let that become more advanced, but you could still respond here, as well. You will see improvement in 3 to 6 months if you are a respondent. Not everyone is. If you are responding, you can expect to see more improvement at the 9-month mark. Not everyone wants a pharmaceutical solution especially when they will need to continue this for many years. If not, you should seek cell-based therapy. These are usually not as good at growing lots of hair, but they are excellent at preserving hair and increasing density. Good luck. Hold off on surgery for now.

Dr. John Cole