My difficult situation (New Member/First Thread Post)

[Raccooner]

You’re 42, atleast thats what your bio says. If so, density loss is to be expected at that age. I would agree with @DoctorHouse and just go for a transplant. If you want your hair through your 60s hop on finasteride as well. A transplant is going to give you the biggest bang for your buck and if there ever was a time in your life to get it, now is it, at 42 your long-term plan isn’t very long like most 20 year olds on here.

I think PRP and nanofat transfer is the first step. Wait the 18 months to see the result. If there isn't much or any progress from this then more PRP should be administered. If that fails then a transplant is probably it. I really don't like the idea of transplanting though. It's painful, scars, not all grafts survive. Often the transplant result is less than ideal. To hold out for hair multiplication would be a better idea assuming it ever comes. Yep I'm 42, sad to become an old fart. Wish I could start life again, it didn't work out well for me unfortunately. Too much bad luck.

 

[WaccWaccWacc]

I think PRP and nanofat transfer is the first step. Wait the 18 months to see the result. If there isn't much or any progress from this then more PRP should be administered. If that fails then a transplant is probably it. I really don't like the idea of transplanting though. It's painful, scars, not all grafts survive. Often the transplant result is less than ideal. To hold out for hair multiplication would be a better idea assuming it ever comes. Yep I'm 42, sad to become an old fart. Wish I could start life again, it didn't work out well for me unfortunately. Too much bad luck.

Its all perspective. 42 better than 52 and 62. Transplant is forsure a process but unlike all the other one’s concerning hair it’s a lot more guaranteed. I think you bypassing PRP and nanofat will save you money and more importantly time. We’re all going to be old, that’s why we shouldn’t waste time dwindling at what could have been with some luck. If you want it, put your foot down. Good luck and efforts.

 

[Diffused_confidence]

You’re 42, atleast thats what your bio says. If so, density loss is to be expected at that age. I would agree with @DoctorHouse and just go for a transplant. If you want your hair through your 60s hop on finasteride as well. A transplant is going to give you the biggest bang for your buck and if there ever was a time in your life to get it, now is it, at 42 your long-term plan isn’t very long like most 20 year olds on here.

Maybe try finasteride for 1 year first then consider hair transplant. He may recover some from medication and reduce the graft count.

 

[DoctorHouse]

I think PRP and nanofat transfer is the first step. Wait the 18 months to see the result. If there isn't much or any progress from this then more PRP should be administered. If that fails then a transplant is probably it. I really don't like the idea of transplanting though. It's painful, scars, not all grafts survive. Often the transplant result is less than ideal. To hold out for hair multiplication would be a better idea assuming it ever comes. Yep I'm 42, sad to become an old fart. Wish I could start life again, it didn't work out well for me unfortunately. Too much bad luck.

If you don't want to keep making bad choices which you refer to as bad luck, don't waste your money on PRP. No one has achieved super great results at the hairline with it. If you go to a very reputable hair transplant doctor you will have a higher chance of a better outcome and with your hair caliber, you should get a nice result. I would rather put close to 8 grand towards a very reputable doctor unless 8 grand is a drop in the bucket for you. I guess if you have millions, then go for it.

 

[hairhelp777]

I contacted my trichologist a couple of days ago by email.

Dear _______,

I've been doing research on what I may have. I know you told me the condition I have is male pattern hair loss (this is true in the receded temples) however there are symptoms I might have forgotten to discuss. I was getting plenty of itching, pruritis, burning sensations, redness, pustules and bleeding on the scalp last winter. Given the location of the area of concern in the right vertex, which is thin (I think you recall), I might have folliculitis decalvans. If you believe I am misguided in my analysis, could you explain to me why I do not have this condition? Thank you for your time.

Sincerely,
_____________


Hi _________,

Here is an image of the top of your head where the classic symptoms of Androgenic alopecia is very present. The only topical treatment that has been FDA approved and is the less harmful of all treatments for AA is Minoxidil 5%

In my professional opinion your scalp does not show any symptoms of any other scalp problems. You do not have foliculitis decalvans. Your Androgenic Alopecia has progressed a great deal due to the fact it has been untreated for many years.

As a Trichologist I take my profession very seriously and I work with all dermatologists. Hair loss is very traumatizing, I want to make sure you are getting the very best treatment.

I have done the very best for you. I have made my professional opinions, yet you still want more answers. This is your right, and this is why Im suggesting your next step is a dermatologist.

My suggestion is for you to see a dermatologist and ask for a scalp biopsy if you feel that the right side area near your crown is burning and itching.


Wishing you all the very best.

If you are having itching, puritis ,burning sensations - these are not normal 'MBP' symptoms..

Re: the biopsy -it biopsy will be hardly noticeable/maybe completely undetectable
in the long run, especially with the loss you already have. They take a very small area - usually from an area that is inflammed -and may be lost anyway soon

If you are going to fork out for expensive procedures, it's worth knowing what you have beforehand.

I started finasteride before I realised I had LPP - it caused horrible flare ups/burning sensation. There are some people on the LPP forums who have also reported this reaction - even though it's a treatment for people with FFA.

 

[hairhelp777]

I contacted my trichologist a couple of days ago by email.

Dear _______,

I've been doing research on what I may have. I know you told me the condition I have is male pattern hair loss (this is true in the receded temples) however there are symptoms I might have forgotten to discuss. I was getting plenty of itching, pruritis, burning sensations, redness, pustules and bleeding on the scalp last winter. Given the location of the area of concern in the right vertex, which is thin (I think you recall), I might have folliculitis decalvans. If you believe I am misguided in my analysis, could you explain to me why I do not have this condition? Thank you for your time.

Sincerely,
_____________


Hi _________,

Here is an image of the top of your head where the classic symptoms of Androgenic alopecia is very present. The only topical treatment that has been FDA approved and is the less harmful of all treatments for AA is Minoxidil 5%

In my professional opinion your scalp does not show any symptoms of any other scalp problems. You do not have foliculitis decalvans. Your Androgenic Alopecia has progressed a great deal due to the fact it has been untreated for many years.

As a Trichologist I take my profession very seriously and I work with all dermatologists. Hair loss is very traumatizing, I want to make sure you are getting the very best treatment.

I have done the very best for you. I have made my professional opinions, yet you still want more answers. This is your right, and this is why Im suggesting your next step is a dermatologist.

My suggestion is for you to see a dermatologist and ask for a scalp biopsy if you feel that the right side area near your crown is burning and itching.


Wishing you all the very best.

If you are having itching, puritis,burning sensations - these are not normal 'MBP' symptoms...a biopsy will be hardly noticeable in the long run. This doesn't mean you definitely have a scarring alopecia - but if I were you I'd be a a lot more suspicious as what you've described are the main symptoms.. I wish I'd realised earlier (I was diagnosed with LPP in Feb after lots of loss and pain/puritis). I didn't research enough beforehand and thought it was normal MBP. Mine felt like something was crawling under my head/heavy tingling sensations which sometimes flared up horribly - like when I started finasteride. You might also have both male pattern baldness and LPP like me - even though neither are exterme cases.

If you are going to fork out for expensive procedures, it's worth knowing what you have beforehand. And also get treated so you can hopefully get rid of the symptoms like burning etc. and maybe halt the loss.

And if it's MBP the recommended treatment options will be different generally.

 

[Raccooner]

If you are having itching, puritis ,burning sensations - these are not normal 'MBP' symptoms..

Re: the biopsy -it biopsy will be hardly noticeable/maybe completely undetectable
in the long run, especially with the loss you already have. They take a very small area - usually from an area that is inflammed -and may be lost anyway soon

If you are going to fork out for expensive procedures, it's worth knowing what you have beforehand.

I started finasteride before I realised I had LPP - it caused horrible flare ups/burning sensation. There are some people on the LPP forums who have also reported this reaction - even though it's a treatment for people with FFA.

Thank you for the heads up. The good thing I can report is the scalp trichodynia/scalp dysesthesia (redness, burning and itching) isn't a normal or chronic occurrence any longer. It stopped being a daily issue around April. If I do get a breakout it's minor and only stress related. I am taking meds to deal with my anxiety and depression to keep these problems at bay. I noticed too that when I was taking Finasteride I had bad headaches, itching and flares but it took at least a couple of weeks to get these symptoms. I think it's likely if I had linchen planopilaris that flare burned out by now. What do you think it was that caused or triggered your outbreaks of pruritus associated with lichen planopilaris? The problem with a biopsy is if none of the scalp is enflamed, results may not show the culprit condition. Perhaps it will read inconclusive or pseudopelade of brocq? They're not 100% accurate either and a lot depends on the talent of the interpreter. The frustrating thing is I've had so many people look at the scalp (expert professionals) and tell me there's no scarring present. I wanted to revisit one I had seen recently to be sure certain problem areas were accounted for and was told not to waste my time or money. I looked at the problem area today and the thinning for sure exists but scarring it's really not an easy call to make. The main diagnostic in scarring alopecia is loss of follicular ostia (follicular openings in any given place). Also it is normal to get scalp problems when feeling stressed (which I was). I know what you're saying that getting a procedure could further aggravate the condition if it's still active. I've read this. How can I be sure the condition is not active any longer? I tried to join the "Let's Put Out The Fire forum for LPP" but was refused since I couldn't prove I had a diagnosis of lichen planopilaris. I think there's more of an argument that I had a neutrophilic condition like folliculitis decalvans since my bloodwork showed a high out of range reading of 83.80. The thing is I don't have the tufted (doll like) hairs like what is commonly found in folliculitis decalvans. It amazes me how there is no non-invasive way to determine conditions of hair loss. We live in such a high tech age but in many ways the medical tests used are crude and barbaric as if we're still living in caveman days. My opinion is better technology would exist if greed and agendas weren't diverting funds and censoring individuals who make ground breaking advances in medical science. I wouldn't be shocked if I had both male pattern baldness and a scarring alopecia condition. What I do know is I have male pattern baldness but when it comes to the scarring issue the doctors strongly dismiss this as a possibility. I guess they've seen enough people to know from their clinical experience. Normally one biopsies when doctors aren't sure or have a strong suspicion and it is they who suggest it, in my case the doctors were very confident in their diagnosis despite my questioning. Should I not trust the experts? What percentage of the time do you believe the experts get it wrong?

 

[hairhelp777]

If you get flares, that is pretty commmon in the autoimmune conditions like LPP, FFA I think.

No one really knows what causes LPP - I have no idea what caused mine - although I noticed a major flare when I started finasteride - I eventually stopped it after a year. I take ceterizine (antihistamine) now - but there are lots of other treatments people e.g. Hydrochloroquine, Otezla et.c

You might want to check out Dr. Donovan's posts/blogs - he is a scarring alopecia expert.

If i you didn't have any symptoms other than hair loss - I'd be cofident that the drs you saw were right. It's just with the pain/burning when stressed - this sounds like an autoimmune thing - this happens to me - at least it did before I started treatment. I suppose it could just be seb derm - or even another nerve issue or other medical issue causing burning -but this is why they recommend biopsies in many cases. A lot of people end up getting misdiagnosed by many doctors on the boards like I've said as scarring alopecias are pretty rare....and/or underdiagnosed and lots of general dermatologists don't have a clue about them or how to treat them.

 

[Raccooner]

If you get flares, that is pretty commmon in the autoimmune conditions like LPP, FFA I think.

No one really knows what causes LPP - I have no idea what caused mine - although I noticed a major flare when I started finasteride - I eventually stopped it after a year. I take ceterizine (antihistamine) now - but there are lots of other treatments people e.g. Hydrochloroquine, Otezla et.c

You might want to check out Dr. Donovan's posts/blogs - he is a scarring alopecia expert.

If i you didn't have any symptoms other than hair loss - I'd be cofident that the drs you saw were right. It's just with the pain/burning when stressed - this sounds like an autoimmune thing - this happens to me - at least it did before I started treatment. I suppose it could just be seb derm - or even another nerve issue or other medical issue causing burning -but this is why they recommend biopsies in many cases. A lot of people end up getting misdiagnosed by many doctors on the boards like I've said as scarring alopecias are pretty rare....and/or underdiagnosed and lots of general dermatologists don't have a clue about them or how to treat them.

I saw a dermatologist who had a webpage about hair conditions, even mentioning a number of scarring alopecia types but in terms of me she didn't notice anything. Her web site didn't mention pseudopelade of brocq. I hope she knows how to recognize that. She thought I had hair loss from androgenetic alopecia and telogen effluvium, which I am convinced is 100% correct. She also thought my hair loss was even on both sides, which it wasn't. I had two other trichologists confirm this. Then the latest dermatologist I saw for my stem cell and platelet injections; I mentioned the idea of scarring alopecia to her and she dismissed that I had this. I wonder how the doctors have so much confidence when making a diagnosis? She never asked me if I had itching, burning, blood, blisters, trichodynia before but I volunteered it in sending her messages. She did look over my scalp somewhat. I'm not even certain she got all my lab work, probably didn't. What it comes down to is are these professionals even doing their jobs? It seems obvious things they need to look for and ask aren't being done. I would like to go to a scarring alopecia specialist. I know of one but based on his questioning he will likely ask me to get a biopsy done. The thing is there's confocal microscopy and multiphoton microscopy, which can usually determine the situation going on below the surface and identify most likely if there's scarring or what the hair condition is. If this is the case, why aren't the dermatologists using this tool instead? Most people refuse biopsies as no one wants to lose some hairs, be in pain and cut up. Has anyone here used multiphoton microscopy or confocal microscopy to assess their hair loss conditions? The sad thing is I think none of the dermatologists I went to even had a dermatoscope! Seems to me like they're bumming off but don't mind charging a hefty fee. Looking my scalp over I think there's a good chance I have focal atrichia. It's spots about the size of a pencil eraser tip where little to no hair is present and is often found in androgenetic alopecia. The unfortunate thing is what I read online about it that hair won't regrow in these spots unless it's transplanted.

https://donovanmedical.com/hair-blog/focal-atrichia-Androgenetic Alopecia​

 

[WaccWaccWacc]

I have the same problem and I am very scared. I don't want to be bald.

lmao… welcome

 

[Here For the Lulz]

This is 100% male pattern baldness. What you’re experiencing right now is the denial. The sooner you get out of that the better.

 

[JaneyElizabeth]

This is 100% male pattern baldness. What you’re experiencing right now is the denial. The sooner you get out of that the better.

Leave now until you come on at 3 am to verify bald men from around the world in the HairLossTalk.com classic game: Guess if I am going bald from two pics in bad lighting plus I might have Telogen Effluvium or DUPA or be in menopause or maturing my hair lines cause I have never even seen bald guys ever in my neighborhood but my derm appointment isn't until after the end of Russian Xmas or Jane 7, I think or is it January, lol. Nobody tells you not to bully the small guys who will keep their hair and now make jokes at every reunion you show up to until the last one where they show up with your X wife who used to be fat but now is hot and sells like 40 Firebirds weekly at the car lot so yes, leave now before you become me, a tranny with great hair who instead, just loves her wig regardless. I only need beautiful hair of my own so I can take off my wig and dance on tables and tell bald guys to just try it on. You will like it.<Janey winks>

Best,
Will

 

[Raccooner]

This is 100% male pattern baldness. What you’re experiencing right now is the denial. The sooner you get out of that the better.

So just that I understand, your comment is relating to my particularly hair situation shown in the photographs I posted?

 

[esoteric716]

I started finasteride before I realised I had LPP - it caused horrible flare ups/burning sensation. There are some people on the LPP forums who have also reported this reaction - even though it's a treatment for people with FFA.

Wondering about this myself...

I've been diagnosed with folliculitis decalvans through a biopsy, though the weird little patches of hair loss (and FD itself) resembles LPP. I wanted to get on finasteride to stop the hair loss that seems to be occurring, while cutting gluten out of my diet and reducing dairy, plus getting on a probiotic. I wonder if you or @Raccooner have updates to your conditions at all?

 

[Raccooner]

Wondering about this myself...

I've been diagnosed with folliculitis decalvans through a biopsy, though the weird little patches of hair loss (and FD itself) resembles LPP. I wanted to get on finasteride to stop the hair loss that seems to be occurring, while cutting gluten out of my diet and reducing dairy, plus getting on a probiotic. I wonder if you or @Raccooner have updates to your conditions at all?

My condition seems unchanged. Gone to many dermatologists, trichologists and a transplant surgeon. 0% consensus of scarring alopecia, 100% consensus of androgenetic alopecia. However I didn't go to a hair loss only dermatologist specialist. I never did a biopsy because I don't want to be left with (additional) scarring. It's unlikely though I will be told anything different if I went to Jerry Shapiro. Given the thinness of patches of hair I have and then being linear I'm thinking its scarring alopecia. What's frustrating is when the experts tell me what I am assuming is not the case. I've gone to some people repeatedly and they tell me you don't have scarring alopecia. One doesn't even want to see me again because she's so sure. I can see the argument it could be androgenetic alopecia. I see yellow/brown dots but thin or no hair emerge. This is a sign of androgenetic alopecia. Regrowing it, that is what I wish I could figure out. Even more annoying is it concentrated in the right side of my vertex. I also have receded temples. Life's a bummer. We have control of nothing, not even our bodies.

 

[hairhelp777]

Wondering about this myself...

I've been diagnosed with folliculitis decalvans through a biopsy, though the weird little patches of hair loss (and FD itself) resembles LPP. I wanted to get on finasteride to stop the hair loss that seems to be occurring, while cutting gluten out of my diet and reducing dairy, plus getting on a probiotic. I wonder if you or @Raccooner have updates to your conditions at all?

A lot of people report success with AIP diet on the LPP forum - I'm trying to avoid hot chili. I can't really tell how much it helps. There is sometimes overlap with LPP and FD. Not suggesting you necessarily have this though.

Dr Donovan discusses it here: https://donovanmedical.com/hair-blo...d-overlap-syndrome-lpp-fd-phenotypic-spectrum

My hair loss has slowed considerably or the past couple of years - since I started topical steroids and other treatments.

Were you diagnosed with FD by biopsy? Are you on any treatments

 

[esoteric716]

A lot of people report success with AIP diet on the LPP forum - I'm trying to avoid hot chili. I can't really tell how much it helps. There is sometimes overlap with LPP and FD. Not suggesting you necessarily have this though.

Dr Donovan discusses it here: https://donovanmedical.com/hair-blo...d-overlap-syndrome-lpp-fd-phenotypic-spectrum

My hair loss has slowed considerably or the past couple of years - since I started topical steroids and other treatments.

Were you diagnosed with FD by biopsy? Are you on any treatments

Yea, so the first biopsy said FD. Second one last week says FD also, but some things resemble LPP so they can't be sure... Derm thinks that the pathology points to FD though. I got some steroidal injections done on Thursday for it.

And yea, I'm on no gluten (ok, I cheat just a little bit occasionally, but usually very good about it), very little sugar (basically just whats in fruit), and limited dairy (2 cups of milk per day but nothing else). I'm also taking Vit D, 2 tbsps of pumpkin seed oil, and a good 15 strain probiotic. Also on clindamycin and rifampin, 2x day

 

[MannyG]

Yea, so the first biopsy said FD. Second one last week says FD also, but some things resemble LPP so they can't be sure... Derm thinks that the pathology points to FD though. I got some steroidal injections done on Thursday for it.

And yea, I'm on no gluten (ok, I cheat just a little bit occasionally, but usually very good about it), very little sugar (basically just whats in fruit), and limited dairy (2 cups of milk per day but nothing else). I'm also taking Vit D, 2 tbsps of pumpkin seed oil, and a good 15 strain probiotic. Also on clindamycin and rifampin, 2x day

Hi new to this forum. I have been suffering from DF for over 15 years and still have no relief I have been on Rifampicin /Clindamycin Humira injections, nothing cures it My scalp is inflamed dolls tufting of the hair follicles and scabbing scalp.

I did read where a few people did get good results by using Tea tree oil, magnesium oil, and probiotic shampoo. They also take Probiotic Kefir to help with good gut bacteria and they went Gluten free. I have started trying this myself and will hopefully wean off the antibiotics.

hope you find a solution

 

[Here For the Lulz]

So just that I understand, your comment is relating to my particularly hair situation shown in the photographs I posted?

Sorry took so long to see this reply, but yes. Specifically, the one of your hairline. Understand I’m not trying to be a Dick, I just don’t want to blow smoke up your butt and cost you time. Literally everyone here on treatment says the same thing...they wish they had started sooner.

If I didn’t give you my honest thoughts then there would be no point in responding at all. I would rather be blunt and truthful than glaze over what I say because I’m worried about feelings because that is what I would want.