I will try to address both your questions and the situation you describe. As to fees and specific treatment reccomendations could you please e mail me directly with some photos at
drtrue@hairlossdoctors.com.
The most important thing to talk about is: should you be doing transplants right now? Unfortunately, your hair loss started very early in life, in your teens. Because of this you are at risk to have the most aggressive and progressive form of male pattern baldness. While there may be exceptions, most men who start to lose their hair in their late teens go on to Class 6 or even 7 by the the time they hit thirty. Most of us who have a lot of experience are very cautious about jumping into transplants as a first step with a man of your age. We only want to do treatment if we can be assured that not only will we produce a result that looks good now, but that we will be able to sustain a restoration that will look good and natural for the rest of your life. You definately have to beware of transplanting the crown or committing to a low hairline in you situation as these present the highest risk to cause problems down the line if you balding becomes truly extensive.
You have already taken the most important step for you now in ordering the finasteride. You should start it soon. Do not take the full 5 mg per day as taking a larger dose has no proven additional benfit and carries a much greater risk that you will experience side effects. Buy a pill splitter at the chemist and cut the pills into quarters. Cut up a month's supply at a time and mix up the pieces in the bottle. This will inclease the odds of getting a relatively steady daily dose. You could experience more regrowth if you also use Minoxidil 5% solution to the scalp twice daily for the first four months and one to two times daily afterward (once you have started the minoxidil do not stop it without consulting a hair loss specialist, as abrupt stopping can put you into a period of increased hair loss). I do not advise using dutesteride unless finasteride fails. The odds are very good that this regimine will help you.
In your case you should use the finasteride for several months before having a transplant. It is very important that we see how effective it will be for you and whether you will experience any side effects with it that will prevent you being able to continue with it, before you embark on transplants. Usually it will take three months for the rate of hair loss to decrease; by six months the quality of hair in the balding pattern should be improving, and by 12 months you may actually have some recovery particularly in the crown o recently lost hair. Once we reach this stage we will have a better idea how to approach transplantation for you.
I do understand that I am asking you to be patient about fixing a problem that you would like yo have fixed yesterday. But, believe me, this approach will serve you well over the long run.
Meanwhile, you can continue to learn about transplants and slect the best doctor for you. I will be happy to correspond with you and keep in touch to answer questions as you go along. Amd, we can correspond privately to determine if ultimately I can be of service to you for transplants. You may also want to start using alopecia masking cosmetics such as Dermblend or Toppik. They can be very helpful stopgap measures to hide your thinnning hair until further measures can be taken.
I appreciate you presenting your situation in this open forum as our discussion is relevent to many others and hopefully they will benefit as well.
I look forward to hearing from you further.
Sincere regards,
Dr. True
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Robert H True MD MPH
American Board of Hair Restoration Surgery
True & Dorin Medical Group
New York City
