24M seeking help for aggressive androgenetic alopecia - "nuke" stack?

[bigwill2]

Hey hairloss community,

Thanks for keeping this subreddit so informative

I’m a 24M with aggressive Androgenetic Alopecia (Dad & maternal grandad went bald in early 20s). I live a healthy lifestyle - lift weights 2-3x/week, eat well, sleep well, rarely drink, and don’t smoke.

My Situation & Questions​

I’ve been on 1mg finasteride daily for about 2-3 weeks with minimal side effects (maybe slightly less semen volume, but nothing major). However, I feel like my hair is already looking thinner and shedding more, though I didn’t take proper before pics to compare (big mistake, I know). I understand shedding can be normal early on, but it’s definitely making me anxious.

I also get that finasteride takes at least a year to show real results, but since I’m still early in the process, I want to make sure I’m on the most effective possible protocol and not wasting time with something that might not work.

I want to be as aggressive as possible with my treatment (without, you know, cutting my balls off). My goal is to find the most effective stack that balances efficacy vs. potential side effects - essentially, what gives me the best shot at regrowth while keeping risks reasonable?

Here’s the stack I’m considering:

1. Combined daily oral: 0.5mg Dutasteride + 2.5mg Minoxidil
2. Ketoconazole shampoo (2%) – twice a week
3. Alpecin caffeine shampoo – as my daily option
4. RU58841

Questions:​

• Is 2.5mg oral Minoxidil safe for long-term use? What side effects should I watch out for?
• Is 0.5mg Dutasteride actually more effective than 1mg Finasteride, or does it not make a major difference?
• Does RU58841 actually work, and is it worth adding to my regimen? Should I be using topical finasteride + Oral dutasteride instead

Main question - Would you tweak anything in my approach?

I’d love to hear about your experiences and recommendations. Appreciate any advice you guys can give!

 

[losingbattle88]

Bro. I overdosed on dutasteride and oral min and hair got destroyed. Be careful. My hair got nuked after 1.5 years.

 

[bigwill2]

Bro. I overdosed on dutasteride and oral min and hair got destroyed. Be careful. My hair got nuked after 1.5 years.

What do you mean bro, are you able to explain? I didn't know overdosing on these drugs would cause adverse effects to the hair

 

[Renovation]

Hey hairloss community,

Thanks for keeping this subreddit so informative

I’m a 24M with aggressive Androgenetic Alopecia (Dad & maternal grandad went bald in early 20s). I live a healthy lifestyle - lift weights 2-3x/week, eat well, sleep well, rarely drink, and don’t smoke.

My Situation & Questions​

I’ve been on 1mg finasteride daily for about 2-3 weeks with minimal side effects (maybe slightly less semen volume, but nothing major). However, I feel like my hair is already looking thinner and shedding more, though I didn’t take proper before pics to compare (big mistake, I know). I understand shedding can be normal early on, but it’s definitely making me anxious.

I also get that finasteride takes at least a year to show real results, but since I’m still early in the process, I want to make sure I’m on the most effective possible protocol and not wasting time with something that might not work.

I want to be as aggressive as possible with my treatment (without, you know, cutting my balls off). My goal is to find the most effective stack that balances efficacy vs. potential side effects - essentially, what gives me the best shot at regrowth while keeping risks reasonable?

Here’s the stack I’m considering:

1. Combined daily oral: 0.5mg Dutasteride + 2.5mg Minoxidil
2. Ketoconazole shampoo (2%) – twice a week
3. Alpecin caffeine shampoo – as my daily option
4. RU58841

Questions:​

• Is 2.5mg oral Minoxidil safe for long-term use? What side effects should I watch out for?
• Is 0.5mg Dutasteride actually more effective than 1mg Finasteride, or does it not make a major difference?
• Does RU58841 actually work, and is it worth adding to my regimen? Should I be using topical finasteride + Oral dutasteride instead

Main question - Would you tweak anything in my approach?

I’d love to hear about your experiences and recommendations. Appreciate any advice you guys can give!

I'd also recommend reading through the long craniofacial thread (ignore most of OP recent pictures etc as it goes off topic) but understand that scalp tension is a real thing and increases DHT. We cant change the shape of our skull but we can decrease downward pressure caused by chronically tight temporalis and frontalis muscles. Basically try to 'loosen' galea stretch.

I rarely post as the usual crooks destroy the thread, but noticed you have deep forehead lines, especially at a young age. stop raising eyebrows if this is a common thing (this activates frontalis muscle and instantly tightens galea, try it and see, squeeze scalp with one hand then raise eyebrows feel the galea tighten?). Focus on anything that reduces this scalp tension and DHT ie posture, massage sides of head (not scalp), breathing through nose not mouth, not overdoing the weight lifting etc.

Continue whatever meds as I doubt it will hurt. But also doubt it will make a real difference considering your situation unfortunately, you also need to address the fact your scalp is tightening, calcifying and developing fibrosis.

If you do meds alone it's like pissing against the wind.

 

[losingbattle88]

I'd also recommend reading through the long craniofacial thread (ignore most of OP recent pictures etc as it goes off topic) but understand that scalp tension is a real thing and increases DHT. We cant change the shape of our skull but we can decrease downward pressure caused by chronically tight temporalis and frontalis muscles. Basically try to 'loosen' galea stretch.

I rarely post as the usual crooks destroy the thread, but noticed you have deep forehead lines, especially at a young age. stop raising eyebrows if this is a common thing (this activates frontalis muscle and instantly tightens galea, try it and see, squeeze scalp with one hand then raise eyebrows feel the galea tighten?). Focus on anything that reduces this scalp tension and DHT ie posture, massage sides of head (not scalp), breathing through nose not mouth, not overdoing the weight lifting etc.

Continue whatever meds as I doubt it will hurt. But also doubt it will make a real difference considering your situation unfortunately, you also need to address the fact your scalp is tightening, calcifying and developing fibrosis.

If you do meds alone it's like pissing against the wind.

Just cut off your balls and u be free of hairloss.

 

[Renovation]

Just cut off your balls and u be free of hairloss.

I'm doing fine on current regime, maybe you could try something new and eventually change your username?

 

[Mr. Slap Head]

Just stick with finasteride and oral min. Other stuff you can try along with those, but those 2 are by far the most effective.

 

[losingbattle88]

I'm doing fine on current regime, maybe you could try something new and eventually change your username?

U werent even balding bro.

 

[Renovation]

U werent even balding bro.

I had a hair transplant at about 25 yo, and top up about 29 yo. That helped until about 34 yo but lost more native hair and the transplanted hair started to minaturise. So was absolutely balding, some recession but also diffuse thinning.

 

[losingbattle88]

I had a hair transplant at about 25 yo, and top up about 29 yo. That helped until about 34 yo but lost more native hair and the transplanted hair started to minaturise. So was absolutely balding, some recession but also diffuse thinning.

If u believe magnesium and msm cures hairloss think again.

 

[Renovation]

If u believe magnesium and msm cures hairloss think again dumbass.

I've added what I said above only last 2 years, and seen improvements on top of everything else. Minimal magnesium and occasional MSM, it's mainly in muscle tension frontalis occipital and temporalis.

Keep coping but why you bother responding to people here I don't know, just fills up the thread with your same crap replies

 

[Mr. Slap Head]

Stick with finasteride and OM 2.5mg for about 4 months and reassess.

 

[losingbattle88]

I've added what I said above only last 2 years, and seen improvements on top of everything else. Minimal magnesium and occasional MSM, it's mainly in muscle tension frontalis occipital and temporalis.

Keep coping but why you bother responding to people here I don't know, just fills up the thread with your same crap replies

Muscle tension BTW xD

 

[SnortingFin]

I've added what I said above only last 2 years, and seen improvements on top of everything else. Minimal magnesium and occasional MSM, it's mainly in muscle tension frontalis occipital and temporalis.

Keep coping but why you bother responding to people here I don't know, just fills up the thread with your same crap replies

Muscle tension BTW xD

Believe it or not, idc. But what Renovation is saying is true and applicable in my case.

One day I slept furrowing, I woke up with debilitating nerve pain like symptoms.

I've had tensed my eyebrows & frontalis.

That's what have triggered my Androgenetic Alopecia.

 

[losingbattle88]

Believe it or not, idc. But what Renovation is saying is true and applicable in my case.

One day I slept furrowing, I woke up with debilitating nerve pain like symptoms.

I've had tensed my eyebrows & frontalis.

That's what have triggered my Androgenetic Alopecia.

I dont have any tension buddy nor pain or itch or inflammation. and still got male pattern baldness. I dont know what ur smoking but I want some.

 

[bigwill2]

Stick with finasteride and OM 2.5mg for about 4 months and reassess.

Not currently on OM 2.5mg. Should I go straight in or start with topical?

 

[abovedagame]

I had a hair transplant at about 25 yo, and top up about 29 yo. That helped until about 34 yo but lost more native hair and the transplanted hair started to minaturise. So was absolutely balding, some recession but also diffuse thinning.

Were you on finasteride after your hair transplants?

 

[Mr. Slap Head]

Not currently on OM 2.5mg. Should I go straight in or start with topical?

I’ll be honest. As thin as your hair is I’d jump straight into it. Time is of the essence.

 

[Mr. Slap Head]

I mean there’s nothing wrong with trying topical min. Especially if you never used it before, you never know you could be a rare hyper responder.

Could try topical min plus finasteride for 3-4 months. Reassess. If you aren’t moving the needle enough could then add in oral.

 

[SnortingFin]

I dont have any tension buddy nor pain or itch or inflammation. and still got male pattern baldness. I dont know what ur smoking but I want some.

Read again but slowly and have your magnifier at your disposal, I said in my case f*****