Is it true? Diffuse thinning

[baldnotbeautiful]

So I am a diffuse thinner. I still have pretty good coverage, however, I still have lost a lot of density throughout my 'horseshoe' area. I now have a inch sized bald spot on my crown, which is still coverable with a bit of a comb over/toppik combo, but otherwise not much is 'slick bald'. I do have some temple reduction though, NW 1.5 at most. I would love being able to get a HT and increase my density, but from what I've read, diffuse thinners are not good candidates. Is this still true? Or have things possibly changed at all? I've just read trying to fill in diffuse areas can cause shock loss to the area that hairs remain and end up with a net loss of hair. Any info is appreciated.

[Tracy C]

...but from what I've read, diffuse thinners are not good candidates. Is this still true?

Yes that is usually true. Take the time to book and appointment with a dermatologist who specializes in treating hair loss. There are medications available that may help you.

[baldnotbeautiful]

I've tried propecia and did nothing but shed for the 6months I was on it....hair went from being pretty good to noticeably thinning. I had some of the sexual sides effects as well. I've been off of it for 2mths and have thickened back up some, but not back to baseline, and my side effects have gone away. Minoxidil on my crown has been what has caused my inch sized bald spot. I used to have decent coverage, but since I've tried to thicken it up with minox, I now have a bald spot where I've used it. Seems like a HT is my last option.

[Tracy C]

It takes a long time to treat hereditary hair loss. It can take 12 to 18 months before you can see cosmetically significant improvement - and shedding is part of the process. Some people shed more than others but almost everybody grows the hair that shed out back - if they stick with treatment. Sometimes it truly does get worse before it gets better. Your best chances of getting back to baseline and improving was to stick with treatment. Many people have been through this same thing before you, including me. I stuck with treatment and I grew a lot of hair back. Stopping treatment due to shedding is usually the worse thing you can do.

Only a doctor can determine if a hair transplant is an option for you. If you are not a good candidate, an ethical doctor will tell you so. Make sure you go to an ethical doctor.

[baldnotbeautiful]

well after stopping propecia and realizing what it feels like to not be on this drug, I can't see myself getting back on it, unfortunately. I guess I could try it at like a 1/4th of my past dosage(1mg).

anyways, thanks for your replies, I will probably just see how things go, in the next 6mths-1yr i might be just about completely bald anyways so being diffuse won't even matter

[Tracy C]

...in the next 6mths-1yr i might be just about completely bald anyways...

It is very rare for anyone to go that bald that quickly. So unless you have some other underlying disease or condition that way cause such a thing to happen, it is just not very likely to happen.

[gillenator]

Do you have any pics that you could put up?

The more caliber that you have to your diffused hair, the better chances that it will grow back from shockloss. It's the more debilitated hair that usually does not come back. It sounds like you have a larger thinning zone so you may want to wait on HT surgery and get as much bang out of your exisitng coverage as you can.

Eventually, most diffused thinners will begin to also recede and that is a good time to start surgery because there is little visual coverage left when the degree of caliber minimizes to that point. So if the shockloss is more permanent at that point in time, you won't feel like you have lost as much.

And you may want to consider talking to your doctor about pulling back your dosage of finasteride. I agree that it is not uncommon for the shedding to manifest once a new hairloss drug is started like finasteride or minoxidil.

And some patients do begin to notice visual gains once the shedding subsides.

It's getting through these phases that can be challenging for sure.

[baldnotbeautiful]

heres a few I took real quick with an iphone, so sorry for quality. pics are under fairly harsh light...

1st pic is hair right after shower, rest are just different angles.

http://imageshack.us/photo/my-images/407/img1693k.jpg

I live about 4hrs from Dr. Cooley, I am somewhat interested in a Acell/PRP injection. Anyone have any info on this or know if it would be a good solution for someone with my type of hairloss?

[gillenator]

bnb,

Thanks for sharing your pics, they were helpful.

Without question, you are a diffused thinner IMHO. And it also appears that you are on the threshold of receding (losing) where the diffused hair is the weakest.

You can contact Dr. Cooley direct regarding your questions about using a non-surgical approach in your next step however at this point is where many guys start surgery to fill in those areas where the hair is so diffused that even if it shocks out, the new transplants should produce a much visual improvement.

If it were me, I would try to get back on finasteride at a lower dose and/or frequency to stabilize your crown as much as possible, and potentially start in the frontal zone to enhance your frontal third with grafts.

[win200]

Yes that is usually true. Take the time to book and appointment with a dermatologist who specializes in treating hair loss. There are medications available that may help you.

To add: diffuse thinners aren't always bad candidates. If you have DPA--diffuse patterned alopecia--there's a good chance you could be transplanted, because your donor region will remain stable. If you have DUPA--diffuse UNPATTERNED alopecia--then you will almost certainly not be a candidate, because the transplanted hair would be susceptible to DHT, and the donor region would eventually thin and reveal a scar (if you used FUT). From your pictures, it's hard to tell if there are signs of DUPA, as we can't see the "permanent" region. That's a question that you'd have to raise with a surgeon. Because you're a diffuse thinner, you should be scrutinized extremely closely for any sign of DUPA. Getting a transplant when you have DUPA is generally considered a disaster.

[baldnotbeautiful]

thanks for the responses guys. I will probably contact dr cooley next week at some point.

From what I can tell, my donor region seems fine, so I believe I would be a DPA, but obviously I am not an expert.

I am a little hesitant to get back on finasteride because of how much better I've felt(sexually) while being off of it...but maybe a lower dosage every other day or something would help. I will talk to the doc about that as well. I am using minox for the past 6weeks or so on my crown which I think has caused a bit of a shed, as my crown definitely looks worse than it did 2 months ago.

[Tracy C]

I am using minox for the past 6weeks or so on my crown which I think has caused a bit of a shed, as my crown definitely looks worse than it did 2 months ago.

Stick with it for at least a full year. Also judging from your pictures you could benefit a lot from a good quality concealer such as Dermmatch. Using a good concealer could help you feel better about yourself while you are treating it.

If you haven't already done so, replace your regular shampoo and conditioner with sulfate free shampoo and conditioner. Since your hair is short you can get away with using a sulfate free 2-n-1 instead of a separate shampoo and conditioner. Ask your doctor for a prescription for Nizoral shampoo and use it once a week in place of your regular shampoo.

[baldnotbeautiful]

I use toppik on my crown and it helps a lot, and I use nizoral 1% about once a week.

[gillenator]

To add: diffuse thinners aren't always bad candidates. If you have DPA--diffuse patterned alopecia--there's a good chance you could be transplanted, because your donor region will remain stable. If you have DUPA--diffuse UNPATTERNED alopecia--then you will almost certainly not be a candidate, because the transplanted hair would be susceptible to DHT, and the donor region would eventually thin and reveal a scar (if you used FUT). From your pictures, it's hard to tell if there are signs of DUPA, as we can't see the "permanent" region. That's a question that you'd have to raise with a surgeon. Because you're a diffuse thinner, you should be scrutinized extremely closely for any sign of DUPA. Getting a transplant when you have DUPA is generally considered a disaster.

Good post win200 and I could not agree more with your comments! This is where a microscopic evaluation of the entire scalp is crucial to distinguish between DPA and DUPA.

[win200]

Good post win200 and I could not agree more with your comments! This is where a microscopic evaluation of the entire scalp is crucial to distinguish between DPA and DUPA.

Thanks! I think we can't collectively over-emphasize the need to go to a surgeon that will do an exhaustive consultation by microscope of THE ENTIRE SCALP. I actually consulted with a surgeon who sort of rummaged through my hair by hand and never took any sort of magnifying instrument to my scalp. If I had DUPA but still looked like I had good density, he could have missed miniaturization entirely and done a transplant that could have been a disaster. You want a surgeon who will be THOROUGH, and make absolutely certain that you're an ideal candidate. While Bill Rassman is no longer an IAHRS member, he did the field a real service by adamantly insisting upon the need to map the entire scalp for density and miniaturization in order to detect patterns of thinning as well as establish a baseline. The bottom line is that you shouldn't let anyone cut you until they've exhaustively inspected your scalp to know that they're dealing with. And while I can't tell anyone what to do re: having a transplant, I think it's prudent, if there's any odd thinning or shedding, to wait and see how it develops over time--ESPECIALLY if you're in your twenties. The younger you are, the harder it is to predict how your loss will advance.