# Men's Hair Loss > Introduce Yourself & Share Your Story >  40 and developing a bald spot

## Samson

Hello,

I'm a 39, turning 40 in a month and have decided to do something about my hair.  

Most people would say that I have a full head of hair.  However, every time I went to my stylist, she would tell me it's thinning.  I had no idea what she was talking about since my hair still felt thick and my hairline has been the same since I started growing hair as a baby.  When asking friends and my ex g.f, they all said that I was worrying over nothing.  However, a few months ago, I took a bunch of pictures of my dome,,,,,,,, yikes,,,,,,, panic!!!!!!  I've always had a swirl on the back part of my head.  That swirl has now gotten bigger and I can  see a lot of scalp.  

I know that male pattern balding has maternal inheritance, so I'm supposed to look at my grandfather on my moms side, right?  Well my grandfather was pretty bald in his old age but I actually didn't meet him until he was in his late 50's, early 60's (we lived on different continents), so I don't know when he started thinning.  My mom has pretty thin hair, but my uncles ( in their 60's) all have plenty of hair.  My brother just turned 41 and has a thinning dome on top.  So it certainly seems it's in my genes.

I've used rogaine for a while now but it doesn't seem to work and it makes me itchy and flaky.  Besides., I have an aversion to drugs unless absolutely necessary. I've therefore decided to go in for a consultation with a hair transplant doctor.  I've searched a bit online but am unsure of who the good doctors are.  Can anyone recommend good reputable doctors in Los Angeles?  How much can I expect to pay and are the results really for life?  I've heard that these days, the doctor will only pluck a few select follicle cells and clone them in bulk.  Has it really advanced to that point or do they still pluck and plant it, one by one on the bald spot?  I'm very prone to scarring and wonder if it'll leave marks where they extract and insert the graft.  Any information would be much appreciated.

Best,

Samson    

P.S This what I'm talking about.

P.P.S  For anyone that's undergone hair transplants, how many grafts would I need to replenish my dome and how much would it cost?

P.P.P.S  In order to transplant grafts, is it necessary to shave the afflicted area?

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## Winston

No reputable hair transplant surgeon will touch you at this stage of hair loss so be careful. The most reputable surgeons are in the IAHRS. There's a list on this forum or go to www.iahrs.org
You should either see one of them or a good dermatologist to check out your hair and where you stand with your hair loss. If its male pattern baldness and it probably is, then they will most likely start you on Propecia.
Its way to early to be thinking about a transplant.

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## Samson

Winston,

Thanks for your reply.  I thought being proactive would be better than waiting until it's all gone.  Does propecia work better than minoxidil?  Is rogaine better than generic with equal concentration?

TIA

-Samson

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## mkamph

if you used propecia or dutasteride for a while and at least stopped the thinning, then you could think about a transplant.  you have a lot of hair, so you should be able to make your dome look whole again with drugs and a transplant.  you just have to be committed to ongoing drug treatment.  otherwise, a reputable surgeon wouldn't work on you.

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## CIT_Girl

Doctors are not capable of cloning hair follicles which is the main reason why any reputable doctor would be extremely hesitant to work on you at this point.  There is only a finite amount of donor hair available and if you were to harvest it, trying to achieve coverage in your crown, there might not be enough left if you hair loss progressed later in life.  You would be better of waiting to see if you will need coverage in the frontal area as your hair loss progresses.

Also, you do not necessarily want to transplant hair into an area that is only thinning slightly, as you risk damaging existing hair.  Having too many grafts placed in this area might exacerbate shock loss which could even leave you with a net loss of hair if more fell out than was transplanted.

Your best bet right now would be to start on Propecia for at least 6 to 12 months to see if your hair loss stabilizes.  In the meantime, hair loss in the crown is easier to hide than recession in the front.  You could try using a product such as Toppik Hair Building Fibers, which can fill in thinning or bald areas.

Also, regarding the genetics of hair loss: it can actually come from your maternal _or paternal_ side, so you should also look to your father and any male relatives on his side for an indication  of the sort of hair loss pattern you might follow.

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## Samson

> Also, regarding the genetics of hair loss: it can actually come from your maternal _or paternal_ side,


 The male pattern balding gene resides on the x chromosome, which guys get from their mothers.  It would be impossible to genetically inherit the male pattern balding gene from the fathers side since he contributes the y chromosome to his sons.  How does hair loss come from the paternal side?

Thanks for your reply CIT girl.  You've talked me out of pursuing implants.  I was going in for a consultation but I think I'll be wasting mine as well as the doctors time.  I'm going to try propecia and see how I do with it.

Besides, when taking pictures with dry hair and no oily rogaine in it, my hair doesn't look quite as bad.

P.S My apologies for looking naked.  I'm actually wearing shorts. =/

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## Samson

If I go on propecia, are there any benefits or synergistic effects to take rogaine concurrently?  Are there any side effects to taking both at the same time?
Are there any natural/ organic alternatives to taking propecia and/or rogaine?
I've been told that black beans are good for your hair follicles.  Any truth to that?

TIA

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## CIT_Girl

My understanding is that conventional wisdom has dictated that men inherit their hair loss from their mothers' sides of the family but more recently, experts believe it can be inherited from either side.  The actual mechanism by which is is inherited isn't understood but it appears that the genes responsible are actually autosomal, meaning that they reside neither on the X or Y chromosome, which is why it can be passed on from either side.  I suppose once we can officially pinpoint the gene responsible, we'll be able to say for sure.

I think trying Propecia is a smart idea.  In 6 to 12 months, you can reassess your situation and possibly consider further interventions.  However, you seem to have a great head of hair and, as you mentioned, the bald spot is hardly noticeable with dry hair.

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## Samson

CIT girl,

Again, thanks for your reply.  My knowledge of genetics is very limited and my B.S biol is from 94 and I'm no longer in the field.  Thanks for explaining the science behind it.

Does propecia only prevent further hair loss or can it regrow hair?

TIA

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## mlao

I am not a doctor but I know from family experience you can inherit genes for hair from your mother or father, slightly more from your mothers side. I once read the ratio was 52% vs 48%.
Propecia works well at maintaining hair and some people even get re-growth.
A good place to read about medications is Dr. Robert Bernstein's website. He is a pioneer in hair restoration. http://www.bernsteinmedical.com/
I hope this helps.

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## CIT_Girl

Propecia has been shown to regrow hair in some men.  Merck & Co. claims that it regrew hair in 48% of those treated during a 5-year study, however, most other sources say it's not nearly that high.  Propecia is typically more effective in the crown than in the front- which is promising for your particular case. 

Propecia and Rogaine work differently and probably synergically.  Dr. Cole has told me that, usually when he sees a really outstanding result from drug therapy, it's someone using both in combination.  The side effects shouldn't be compounded by taking both but it's possible you could suffer the individual side effects associated with each.  

As far as effective natural treatments, the main one I've heard of is Saw Palmetto.  It is supposed to reduce the amount of DHT your body produces and thus may reduce hair loss.  It has also been shown to regrow hair in a very small percentage of individuals.  I know there are many natural/organic therapies other forum members have heard of/tried; you could try doing a search or start a new topic specific to that subject to get some more feedback.

I had not heard that about black beans but it sounds interesting- maybe something to do with the antioxidants?

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## Winston

> The male pattern balding gene resides on the x chromosome, which guys get from their mothers.  It would be impossible to genetically inherit the male pattern balding gene from the fathers side since he contributes the y chromosome to his sons.  How does hair loss come from the paternal side?
> 
> Thanks for your reply CIT girl.  You've talked me out of pursuing implants.  I was going in for a consultation but I think I'll be wasting mine as well as the doctors time.  I'm going to try propecia and see how I do with it.
> 
> Besides, when taking pictures with dry hair and no oily rogaine in it, my hair doesn't look quite as bad.
> 
> P.S My apologies for looking naked.  I'm actually wearing shorts. =/


 They haven't found one particular gene that triggers male pattern baldness. Its believed to be several different genes involved  and only one gene remotely related to MPB has been discovered and it was published this week http://www.thebaldtruth.com/articles...air-loss-gene/

You basically have a full head of hair with the very beginnings of thinning. I believe most reputable doctors will suggest you begin Propecia, and there are no natural alternatives that actually work. One thing to note is that if you are not actively shedding and you dont notice your hair getting worse, you could consider just going to a doctor and having your scalp checked for hair miniaturization. If theres not much miniaturization you can take a wait and see approach before you take the drug. Some people experience shedding when they first begin and this could be stressful.

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## Samson

Winston, mlao,and CIT girl,

Thank you for your replys.  Much appreciated.

 :Smile:

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## Red20

> Hello,
> 
> I'm a 39, turning 40 in a month and have decided to do something about my hair.  
> 
> Most people would say that I have a full head of hair.  However, every time I went to my stylist, she would tell me it's thinning.  I had no idea what she was talking about since my hair still felt thick and my hairline has been the same since I started growing hair as a baby.  When asking friends and my ex g.f, they all said that I was worrying over nothing.  However, a few months ago, I took a bunch of pictures of my dome,,,,,,,, yikes,,,,,,, panic!!!!!!  I've always had a swirl on the back part of my head.  That swirl has now gotten bigger and I can  see a lot of scalp.  
> 
> I know that male pattern balding has maternal inheritance, so I'm supposed to look at my grandfather on my moms side, right?  Well my grandfather was pretty bald in his old age but I actually didn't meet him until he was in his late 50's, early 60's (we lived on different continents), so I don't know when he started thinning.  My mom has pretty thin hair, but my uncles ( in their 60's) all have plenty of hair.  My brother just turned 41 and has a thinning dome on top.  So it certainly seems it's in my genes.
> 
> I've used rogaine for a while now but it doesn't seem to work and it makes me itchy and flaky.  Besides., I have an aversion to drugs unless absolutely necessary. I've therefore decided to go in for a consultation with a hair transplant doctor.  I've searched a bit online but am unsure of who the good doctors are.  Can anyone recommend good reputable doctors in Los Angeles?  How much can I expect to pay and are the results really for life?  I've heard that these days, the doctor will only pluck a few select follicle cells and clone them in bulk.  Has it really advanced to that point or do they still pluck and plant it, one by one on the bald spot?  I'm very prone to scarring and wonder if it'll leave marks where they extract and insert the graft.  Any information would be much appreciated.
> ...


 You don't need a hair transplant.

You need to get on Propecia.


I hate Minoxidil, also.  I switched to Fluridil and I love it!  It doesn't leave a greasy feeling or make my head itch.

I started using Advodart and I had a terrible shed.  Once I started using Fluridil my shedding completely stopped.

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## KeepTheHair

My hair look about the same as yours when dry and when wet and so on.

When i apply a lot of rogaine...it looks really really thin. But once it dries well within 1-3 hours it looks the same as before, just slightly different in color and texture. Maybe even sliightly thicker since SOMETHING is in my hair.

Your lucky  :Smile:  you had twice the time I had. Your hairline is probably better than mine. I am only 20! lol


I am only on rogaine for about 10 days now or so, I have noticed some shedding. Will continue for a few months and see what happens.

Good luck let

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