All Information There Is: Need Help

[Walt White]

This is my first post here. So go a little easy on me, okay? After doing a lot of research online, I reached the conclusion that DHT is the major cause of androgenic alopecia. I guess there are no debates there. As far as I know, genetically predisposed hair follicles in the (mostly) frontal region of the scalp react badly to DHT and become miniaturized. I think it's some kind of an allergic reaction but I'm not really sure. These miniaturized follicles later fall off, leaving the bare scalp. Hence, the only way to prevent that is to stop DHT from reaching the hair follicles in the scalp. There are mainly 3 chemicals used to do this:

1) Finasteride - Usually sold under the brand name Propecia.This compound inhibits 5-alpha-reductase and prevents testosterone from converting into DHT, reducing DHT levels in the bloodstream. Less DHT in the bloodstream means only a small amount of it reaches the scalp and hence miniaturization is reduced. Dosage - 1 mg daily
2) Ketoconazole - Usually sold under the brand name Nizoral, this compound is a powerful antifungal agent, I believe. And for reasons not completely understood, it lowers scalp DHT, preventing miniaturization. Available for use in 1% and 2% solutions. Topical use hasn't been linked to any significant ill-effects.
3) Minoxidil - This compound doesn't prevent hair loss but increases hair density. Effectively useless without using the previous two compounds. From what I've been able to figure out, it's a powerful vasodilator i.e it dilates blood vessels and increases blood flow. And apparently the anatomy of the scalp is such that the frontal region receives very little blood flow. For some reason, this leads to a buildup of sebum in the region. Unfortunately for us, this sebum contains high levels of DHT, which leads to miniaturization. Minoxidil prevents that by increasing blood flow, reducing the sebum and hence the DHT, to a degree. Usually available in 5% solution.

That's all the information I have. What I need help with is the following:

I've been using finasteride (1 mg daily) and ketoconazole 2% twice a week for almost a year now. And the results have been good. I think I'm about a 5a on the Norwood scale. I'm 22 BTW. But the affected area isn't completely hairless. There are lots of miniaturized hair follicles there. I haven't been using minoxidil. My hairline has stopped receding and I think my thinning has stopped too. Now, what can I do to reverse the miniaturization on my scalp? I guess one option is to wait for the miniaturized follicles to fall off and get replaced by healthy ones but that might take a very long time. I thought maybe I could wax it off to accelerate the process. But I'm scared that if I do that, the follicles may never come back and I'll become completely bald. What should I do? Any suggestions and/or information would be highly appreciated.

 

[Roberto_72]

If you are Norwood 5a it is going to be difficult to see the miniaturized hair grow back to the "terminal" (fully fledged) size.

For that I am afraid you can only hope in a hair transplant.

Another option could be local anti androgens but they do not work miracles I am afraid.

Waxing your vellus hair will lead to nothing interesting.

 

[Walt White]

Thank you for the reply. That is quite disheartening to know. But I can't give up just yet. I'll just keep on looking.

 

[SmoothSailing]

Pictures would help us determine how likely it is to get regrowth. If you're 5a I think transplant is necessary.

I'd add minoxidil to your routine. Any reasons you haven't? If you respond it's the best thing for regrowth, with your DHT under control it will likely push those miniaturized hairs into becoming thicker and healthier.

 

[rafiles]

This is my first post here. So go a little easy on me, okay? After doing a lot of research online, I reached the conclusion that DHT is the major cause of androgenic alopecia. I guess there are no debates there. As far as I know, genetically predisposed hair follicles in the (mostly) frontal region of the scalp react badly to DHT and become miniaturized. I think it's some kind of an allergic reaction but I'm not really sure. These miniaturized follicles later fall off, leaving the bare scalp. Hence, the only way to prevent that is to stop DHT from reaching the hair follicles in the scalp. There are mainly 3 chemicals used to do this:

1) Finasteride - Usually sold under the brand name Propecia.This compound inhibits 5-alpha-reductase and prevents testosterone from converting into DHT, reducing DHT levels in the bloodstream. Less DHT in the bloodstream means only a small amount of it reaches the scalp and hence miniaturization is reduced. Dosage - 1 mg daily
2) Ketoconazole - Usually sold under the brand name Nizoral, this compound is a powerful antifungal agent, I believe. And for reasons not completely understood, it lowers scalp DHT, preventing miniaturization. Available for use in 1% and 2% solutions. Topical use hasn't been linked to any significant ill-effects.
3) Minoxidil - This compound doesn't prevent hair loss but increases hair density. Effectively useless without using the previous two compounds. From what I've been able to figure out, it's a powerful vasodilator i.e it dilates blood vessels and increases blood flow. And apparently the anatomy of the scalp is such that the frontal region receives very little blood flow. For some reason, this leads to a buildup of sebum in the region. Unfortunately for us, this sebum contains high levels of DHT, which leads to miniaturization. Minoxidil prevents that by increasing blood flow, reducing the sebum and hence the DHT, to a degree. Usually available in 5% solution.

That's all the information I have. What I need help with is the following:

I've been using finasteride (1 mg daily) and ketoconazole 2% twice a week for almost a year now. And the results have been good. I think I'm about a 5a on the Norwood scale. I'm 22 BTW. But the affected area isn't completely hairless. There are lots of miniaturized hair follicles there. I haven't been using minoxidil. My hairline has stopped receding and I think my thinning has stopped too. Now, what can I do to reverse the miniaturization on my scalp? I guess one option is to wait for the miniaturized follicles to fall off and get replaced by healthy ones but that might take a very long time. I thought maybe I could wax it off to accelerate the process. But I'm scared that if I do that, the follicles may never come back and I'll become completely bald. What should I do? Any suggestions and/or information would be highly appreciated.

Hello, you are still young. When did you first notice a balding area. You can try minoxidil, because you have nothing much to loose and it`s also not that expensive and one time application (daily) should be enough.

 

[Fullhead1day]

Post pictures.. I would add Minoxidil to your regimen, especially since you said you still have miniaturized hair up there. Minoxidil should thicken those up.
I would also start wounding with a 1.5 mm dermapen or derminator. Dont get a dermaroller as it is really shitty.

 

[Walt White]

Pictures would help us determine how likely it is to get regrowth. If you're 5a I think transplant is necessary.

I'd add minoxidil to your routine. Any reasons you haven't? If you respond it's the best thing for regrowth, with your DHT under control it will likely push those miniaturized hairs into becoming thicker and healthier.

I thought perhaps minoxidil wasn't necessary. Since what it does is essentially increase the blood flow, I figured I could do it myself by massaging my scalp.

 

[Walt White]

Hello, you are still young. When did you first notice a balding area. You can try minoxidil, because you have nothing much to loose and it`s also not that expensive and one time application (daily) should be enough.

One time application of minoxidil should be enough? That's not what I heard. I heard you need to apply it definitely to keep the hair there.

 

[SmoothSailing]

I thought perhaps minoxidil wasn't necessary. Since what it does is essentially increase the blood flow, I figured I could do it myself by massaging my scalp.

We don't currently know exactly how minoxidil works, there are only theories, one being increased blood flow.

I'm fairly certain I wouldn't have got the results I've gotten from minoxidil just from massaging.

 

[Walt White]

Post pictures.. I would add Minoxidil to your regimen, especially since you said you still have miniaturized hair up there. Minoxidil should thicken those up.
I would also start wounding with a 1.5 mm dermapen or derminator. Dont get a dermaroller as it is really shitty.

Here are some pictures of my scalp. Btw I have no idea what a dermapen/derminator is. Could you explain it to me?

 

[Walt White]

We don't currently know exactly how minoxidil works, there are only theories, one being increased blood flow.

I'm fairly certain I wouldn't have got the results I've gotten from minoxidil just from massaging.

Oh okay. I'll try it then. How should I apply it? 5% solution twice a day?

 

[SmoothSailing]

Oh okay. I'll try it then. How should I apply it? 5% solution twice a day?

That's what I do. I apply slightly less than what they say on the packet as I got dry puffy eyes from the stated dose. So maybe start a bit less than the stated dose.

 

[Fullhead1day]

Here are some pictures of my scalp. Btw I have no idea what a dermapen/derminator is. Could you explain it to me?

Yeah, minoxidil should definitely thicken that up. Not the temples though, seems like you are completely bald at the temples. However, remember to be absolutely disciplined with it. Missing applications can cause severe damage and take away all your gains. Furthermore, your hair will become dependent on it, so it requires lifelong commitment.

Look it up. Dermastamp is just a stamp with 1.5 mm needles. You literally push down as hard as possible, all over your head, and make yourself a bloody mess. Derminator is basically an electronic dermastamp that is much more expensive, but worth the price as it is less painful and more comfortable to use.

Study was done on wounding. They call this process wounding, and I know it sounds crazy, but the idea is to wound your scalp, which will then signal for growth factors. These growth factors are obviously beneficial for hair. Here is the study done on wounding. You can replicate the study, as they used Minoxidil 24 hours post needling.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/

 

[Walt White]

Yeah, minoxidil should definitely thicken that up. Not the temples though, seems like you are completely bald at the temples. However, remember to be absolutely disciplined with it. Missing applications can cause severe damage and take away all your gains. Furthermore, your hair will become dependent on it, so it requires lifelong commitment.

Look it up. Dermastamp is just a stamp with 1.5 mm needles. You literally push down as hard as possible, all over your head, and make yourself a bloody mess. Derminator is basically an electronic dermastamp that is much more expensive, but worth the price as it is less painful and more comfortable to use.

Study was done on wounding. They call this process wounding, and I know it sounds crazy, but the idea is to wound your scalp, which will then signal for growth factors. These growth factors are obviously beneficial for hair. Here is the study done on wounding. You can replicate the study, as they used Minoxidil 24 hours post needling.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/

Thank you for the suggestion but I thought we're not supposed to put minoxidil on open wounds. So I guess it's not compatible with a dermastamp? And actually I haven't lost any hair on my temples.

 

[Walt White]

That's what I do. I apply slightly less than what they say on the packet as I got dry puffy eyes from the stated dose. So maybe start a bit less than the stated dose.

Thank you for your suggestion. I'll take it under consideration.

 

[Walt White]

Pictures would help us determine how likely it is to get regrowth. If you're 5a I think transplant is necessary.

I'd add minoxidil to your routine. Any reasons you haven't? If you respond it's the best thing for regrowth, with your DHT under control it will likely push those miniaturized hairs into becoming thicker and healthier.

Btw finasteride and minoxidil need to be taken indefinitely to retain the hair. Wouldn't it be more economic to get a hair transplant? Since the transplant would be permanent, I think.

 

[hlt4678]

I would say that you have two advantages here. One, you are young and younger people tend to respond better when starting a regimen, in my opinion. Two, you have diffuse hairloss. It just seems to me that diffuse hair loss sufferers seem to enjoy better results.

You really do need a growth stimulant like minoxidil to make this work. Do a bit of research on the side affects to look out for and if you see it happening then dump it and try something else. Stemoxydine is another option. That could be plan B. You could potentially grow 4% of your hair back on Stemoxydine. That doesn't seem like much but all told it works out at about 1700 new scalp hairs. People would pay decent money to get a FUE to achieve that kind of result. Also, because you have diffuse, short hair your gonna have a much easier time than most of us trying apply that sh*t.

Good luck!

 

[Walt White]

I would say that you have two advantages here. One, you are young and younger people tend to respond better when starting a regimen, in my opinion. Two, you have diffuse hairloss. It just seems to me that diffuse hair loss sufferers seem to enjoy better results.

You really do need a growth stimulant like minoxidil to make this work. Do a bit of research on the side affects to look out for and if you see it happening then dump it and try something else. Stemoxydine is another option. That could be plan B. You could potentially grow 4% of your hair back on Stemoxydine. That doesn't seem like much but all told it works out at about 1700 new scalp hairs. People would pay decent money to get a FUE to achieve that kind of result. Also, because you have diffuse, short hair your gonna have a much easier time than most of us trying apply that sh*t.

Good luck!

Wow. Thank you for the suggestion. What's the difference between diffuse and non-diffuse hair loss? If I may ask.