Rate of balding vs response to meds?

[Knendell]

Do you think there is a correlation of how rapidly the baldness progresses and how the person responds to treatments. For instance: I have been balding since 20yrs old and I am 30 now at a diffuse NW3. I can still pull off the look of having decent hair as long as it is clean and I have the right haircut. Because of the slow progression do you think it will take longer for me to respond to the medications?

 

[bubka]

there are a lot of opinions on this...

I would say that the best responders to finasteride / dutasteride are those with moderate to aggressive hairloss

again, no real data or science to back that up

 

[hair today gone tomorrow]

there are a lot of opinions on this...

I would say that the best responders to finasteride / dutasteride are those with moderate to aggressive hairloss

again, no real data or science to back that up

iim just curious why do you feel this way? just based on your observations?

 

[bubka]

my own personal anecdotal evidence

aggressive MBP is usually in younger males, and we do know that younger males do respond better than older males who have had male pattern baldness for some time

Spencer Cobrin of The Bald Truth has mentioned it a few times as well

 

[cal]

We probably need to point out a distinction between the loss rate as opposed to the loss severity in total.

The young & major-losing male pattern baldness guys probably see the most reduction in LOSS RATE with medications, but their cases may still render them worse than average in the severity of the total loss they've got.




Also, the lesser-losing guys who start medications when they are older are probably gonna have a harder time regrowing as much because their lost hair has been gone longer:

A 45yo Norwood#3 has probably not been a Norwood#2 for at least 10-15 years. Those Norwood#2 hairs have been fully "dead" for a long time and the meds will have a hell of a hard time reviving them.

Whereas a 25yo Norwood#3 was probably still a Norwood#2 only 2-4 years ago. So even though his overall male pattern baldness condition and his loss rate was much worse, he'll probably have an easier time regrowing the Norwood#2 than the older guy will. His medications only have to reverse 2-4 years of hair loss to get a whole Norwood level back.

 

[masculineyourheart]

Yeah, but unfortunately growing that 2-4 years of hairloss back is not as simple as jumping on Meds and watching it grow. People with hairloss at a younger age tend to have it very aggressively and as such is much more difficult to halt in it's tracks.

I reckon a young person losing their hair would have a much better chance of regrowth with a heavy regimen whereas an older person would realistically only be able to go for maintenance but could do so on a much lighter regimen than their younger counterpart.

 

[pproctor]

Do you think there is a correlation of how rapidly the baldness progresses and how the person responds to treatments. For instance: I have been balding since 20yrs old and I am 30 now at a diffuse NW3. I can still pull off the look of having decent hair as long as it is clean and I have the right haircut. Because of the slow progression do you think it will take longer for me to respond to the medications?

Rules of thumb: (With many exceptions)

1) Medical treatment is better at coarsening what you have than replacing what you have lost. I.e., the more fine hair you have, the better you are likely to respond. Further, hair that has been fine for decades often coarsens well, though it may take a while to respond.

2) In contrast, regrowth of hairs from follicles that do not already have a hair (even if vellous) in them tends to be limited to hairs lost less than 4-5 years ago.

3) While any fine hair in the area may coarsen, regrowth of "new" hair from shiney bald areas is chancy-- perhaps no more than 10-15% of the time. It makes a nice bonus, but should not be a primary goal of treatment.

4) Correlary: Medical treatment generally does not bring hairlines foreward unless the loss is very recent and the area is not yet shiney.

Peter H. Proctor, PhD,MD

 

[DoctorHouse]

Dr Proctor , with medical intervention such as using Proxiphen, how long does it normally take for a fine hair to coarsen to a thick hair that would be the same thickness as a non-affected thick hair? And would this happen regardless of how old a person is? Another words, if a person has an area of diffuse thinning hairs, how long would it take to get that area of hairs back to their original thickness and if it is age related diffuse thinning can it still happen?

 

[A_DHT_Driveby]

i think this topic is a great question to discuss. i am an aggressive diffuse hair loss sufferer. My hairloss started abruptly in November of 2006. i was told by more then one doctor at that time it was most likely telogen effluvium brought on by seb. derm., so i tried to wait it out. After 8 months, i started finasteride, after 12, i started on Min., i'm now on both. My hairloss is still diffuse although not as bad as before. Long story short, i don't subscribe to the theory that the more recent and rapid the hairloss, the easier it is to reverse or control. i was very aggressive in my treatment and i am still losing hair.

 

[DoctorHouse]

Bump for Dr Proctor

 

[casperz]

I started receding around 25, front was gone by 35 and now at 43 my crown was shiny. I was
researching hair transplants and came across this site. I tried minoxidil alone around age 35 with
no results after six months. I had a consult with a hair transplant surgeon and he suggested I should try
finasteride/minoxidil even though I had already tried it. After the results I've gotten I don't think I
will get a hair transplant, just wait for HM.

About 90 days ago I started an aggressive regime based on what I had read here and gotten
results that I cannot believe :woot: , here is the thread:

viewtopic.php?f=12&t=44478

So I don't think it's how long you've been bald it's the meds or the combo of them that makes
the diff. I doubt that I'll ever get the front back but there are a ton of small hairs about 1/8" all
over the frontal scalp so maybe the combo I'm taking will kick in. If not the hair transplant or HM should
take care of it.

 

[pproctor]

Do you think there is a correlation of how rapidly the baldness progresses and how the person responds to treatments. For instance: I have been balding since 20yrs old and I am 30 now at a diffuse NW3. I can still pull off the look of having decent hair as long as it is clean and I have the right haircut. Because of the slow progression do you think it will take longer for me to respond to the medications?

Often enough, just the opposite. Persons whose baldness is rapidly progressing may take a while to start responding to medical treatment. But, while regrowth of lost hair tends to be limited to what has disappeared over the last 4-5 years (if it grows back at all) reversal of coarsening may occur even after years.

Peter H. Proctor, phD,MD

Rules of thumb: (With many exceptions)

1) Medical treatment is better at coarsening what you have than replacing what you have lost. I.e., the more fine hair you have, the better you are likely to respond. Further, hair that has been fine for decades often coarsens well, though it may take a while to respond.

2) In contrast, regrowth of hairs from follicles that do not already have a hair (even if vellous) in them tends to be limited to hairs lost less than 4-5 years ago.

3) While any fine hair in the area may coarsen, regrowth of "new" hair from shiney bald areas is chancy-- perhaps no more than 10-15% of the time. It makes a nice bonus, but should not be a primary goal of treatment.

4) Correlary: Medical treatment generally does not bring hairlines foreward unless the loss is very recent and the area is not yet shiney.

Peter H. Proctor, PhD,MD

 

[pproctor]

More info:

(BTW, I've been at the 2008 international Stroke Conference, so haven't had a chance to get back here. I'll explain the relationship between "neuroprotectant" antistroke agents and agents for the treatment of pattern hair loss some time-- Suffice it to say that both diseases seem to share common mechanisms and common agents. Interestingly, up to and including low-energy laser light.)

Anyway, while regrowth tends to be limited to recent (last few years) loss, coarsening may occur after a very long time indeed. I have clients in their 70's with really long term thinning who tell me than have significantly coarsened up really long term miniaturized hair.

BTW, the same is only rarely true of regrowth. One client tells me he regrew hair that had been lost for 30 years. But this is very rare. Also, microscopic examination shows that about half of hair follicles that appear superficially appear to be dead and fibrosed ("scarred-up") still have a microscopic hair in them. So it may be that what we think is regrowth is really an extreme case of coarsening.

Anyway, hair tends to come back in the reverse of how you lost it, recent loss first. An reasonable rule of thumb is 3-6 months for every year it has been lost, with first result showing at about 3-6 months of treatment. Vellus hair tends to show first. This sheds within a few monst and tends to be progressively replaced by coarser hair. A jump from an empty follicle to a full-blown terminal hair happens, but growth and loss of progressively coarser hair is more typical.

Peter H. Proctor, PhD,MD