Pleo (Diffuse Pattern Alopecia?)

pleo

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Throughout my childhood and puberty, I had a thick head of hair; I never had thin hair. Many people commented on it. At around 18 1/2 years old, I noticed a receding hairline in the area of my right temple. Not much later, the same thing started occuring on the left temple as well. It took another year until I realized I was losing hair in my frontal area as well (easily visible when I'd been wearing a cap for a while and just taken it off). The bitemporal recession stopped or at the very least hasn't progressed much in the last couple of years. I'd say it's about a Norwood 2.5.

However, I've been losing hair across my scalp in a diffuse pattern. Now, at 26 1/2, I'd still say I'm only Norwood 2-2.5 in terms of coverage; my hairline is not great but not bad at all either. My hair is low density across my complete scalp, though. The loss of densitiy seems to be the same to me everywhere. Maybe, maybe, it's a wee bit worse in the vertex area, but I'm pretty sure this has more to do with the direction of the hair growth there (no overlapping because the hair forms a circle). Based on what little I've learned about hair loss types, it seems to me I have diffuse pattern Alopecia (DPA). Even though I take care of my hair, it is very oily and I have a lot of dandruff (had this problem as a child already).

On my mother's side, my grandfather had very little hairloss even in old age. My uncle has hairloss, but not overly much; his coverage is still decent; hair densitiy is bad, though. He appears to have started losing hair not until his thirties (maybe even early forties). My father is another story: He started losing hair at an early age (around 18-20) and is now a Norwood 6-7. He doesn't remember how exactly his hair loss progressed; from the one picture I have seen it seems to me that he definitely had bitemporal recession, although not very pronounced.

I tried a few "snake oil" remedies a couple of years ago that didn't help (surprise, surprise). I also used Rogaine for a short time. I dropped it because I suffered side-effects, most notably light-headedness and ache in the heart region (this lasted the whole two, three weeks I was taking it). I never tried Propecia and have no intention of doing so. I have a history of reacting strongly and weirdly to drugs and don't want to risk anything.

Even though I'd like a full head of hair, I'm not that much bothered by my hair loss so far. Part of the reason certainly is that because of my largely intact hairline, few people notice my hair loss, especially when I buzz cut my hair; when the hair is longer, the diffusion is not that visible either (because of overlapping); it's worst when my hair is medium short. I'm not so sure
about my reaction when/if the diffusion gets so bad that I can't cover it up anymore.

I've been asking myself the following questions:
- most important to me: Is there a possiblity that I might stagnate at my present stage? If not, what Norwood might I be heading for (the diffuse thinning across my whole scalp plus my father have me somewhat worried I'll be a Norwood 6 or 7 eventually)?
- Do I really have DPA? (I'm rather certain, but not totally sure).
- How common is DPA?
- Since I'm not willing to use two (Propecia, Minoxidil) of the Big Three and reluctant to try Nizoral (as I said, because I dont' take too well to meds), do I have any serious options for combatting hair loss? (I'm not expecting the unreasonable. I am keenly aware of the fact that I'm dismissing the most effective treatment and ready to accept the consequences.)
- Are there any mild anti-dandruff shampoos?

I'd highly appreciate any input. :)



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mpbsux20

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Try minoxidil 2%....It is generally for women but since you dont seem to react all that well to meds,this could be a good option.If you are not interested in taking finasteride or min or nizoral[which are highly recommended for treating any form of hairloss] then I am afraid you would hve to let nature take its course.

If you are keen on experimenting with stuffs like Vitamins,Amino acids,saw palmetto,Aloe Vera Gel,Biotin,Zinc,Omega 3,MSM,etc then I say go for it but be aware that you would have to spend quite a lot of money and the results well they cant even hold a candlelight to that of the big 3.You might even find Revivogen quite interesting too.

As for a shampoo,try any thickening shampoo like LS&B.
 
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Perhaps these aren't the best pictures, but I don't see any loss in the temples. You might have some miniaturization in those areas, but it is impossible to tell with the short haircut.

Your vertex also looks pretty good. I don't think we can say for sure whether you're losing based on these pictures.

Regardless, I don't think you're a Norwood 2.5 yet based on these pictures. But if you are losing everywhere across the top of your head, then it is hard to tell you where your hair will be 5, 10, 15 years from now. You could either still have good, but thinning coverage, or a bald spot and temples with hair in the middle, or you could get close to a NW7.

I am in the same position as you, same age, same hair color and texture. I won't use Propecia (it gave me gyno very quickly). I have been using minoxidil for 2 years - great results for the 1st year, but it is slowly returning to baseline it seems. It is too early to tell what either of us will look like when we're 35-40. As I said, I can't even tell if you're losing.

If you really have a dandruff problem, the best shampoo is Nizoral.
 

pleo

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Thank you guys for answering. :) I'll definitely look into ru58841, spironolactone, minoxidil 2% & co.

@mpbsux20:
I thought that minoxidil alone wouldn't help with hair loss and that's the reason most use it in conjunction with finasteride. Or is that just true for some and not for others? And yeah, I'm totally aware that I risk balding if I don't get on finasteride (and minoxidil). But thanks for pointing it out.

@Tiger's Bald Spot:
I'm sorry the pics I uploaded aren't of much use. And I definitely agree that bitemporal recession isn't visible, or hardly so. I also agree that based on the pictures alone, it's very hard to tell whether I'm actually losing hair. What I can say is that my hair has thinned out a lot; it used to be much, much thicker. I guess I'm lucky that I had a good head of hair or matters would be worse.

It seems to me I've been stable for the last 1, 2 years; at least, the hair loss appears to have slowed down. But it's so hard to tell with diffuse pattern alopecia.

What are you planning to do now to fight your hair loss? I understand that finasteride isn't an option, and minoxidil alone doesn't seem to work long-time for you.
As you said, it's really hard to tell where you're headed for if you're losing hair in a diffuse pattern. Maybe we should compare our hair in a couple of years. :)


I've been thinking of seeing a a dermatologist and having a miniaturization analysis done. Are they generally good at that?


Again, thanks for sharing your knowledge. :)
pleo
 

mpbsux20

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Yep you are correct MIN cannot block DHT or any androgens from affecting your follicles but it can help you to regrow some hairs.Its your choice,you can do whatever you like.If you start with a lower dose of finasteride,you may actually not face side effects.
 
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The fact that you feel that you've been stable for 1-2 years is one encouraging sign.

I don't think that a run-of-the-mill dermatologist is going to be able to do a miniaturization study for you. I don't know everything about this, but I believe that you would generally have to go to a (good) hair loss clinic for something like that. I also know that the Dr. Rasmussen over at Balding Blog used to look at e-mailed pictures taken with a special magnifier (that you have to purchase separately on your own), and try to give you an analysis over e-mail. But I'm not sure whether he still does this.

I can't tell you whether you should use finasteride. It is entirely possible that you wouldn't get sides from it (vast majority don't). minoxidil can be very effective for some people - my dad started it in his late 30s after he got a bald spot, and his hair loss was then undetectable until he hit 50. I think it is more common, however, for it to work really well for 1-2 years and then just kind of maintain at some people near the baseline for another few years.

I am currently working on making sure that I am in killer shape, and I am planning on buzzing it in a few weeks and just letting things run their course (staying on minoxidil). Not much else to do after that.

Best of luck, man. I think your hair is still looking really good.


pleo said:
@Tiger's Bald Spot:

It seems to me I've been stable for the last 1, 2 years; at least, the hair loss appears to have slowed down. But it's so hard to tell with diffuse pattern alopecia.

What are you planning to do now to fight your hair loss? I understand that finasteride isn't an option, and minoxidil alone doesn't seem to work long-time for you.
As you said, it's really hard to tell where you're headed for if you're losing hair in a diffuse pattern. Maybe we should compare our hair in a couple of years. :)


I've been thinking of seeing a a dermatologist and having a miniaturization analysis done. Are they generally good at that?


Again, thanks for sharing your knowledge. :)
pleo
 

pleo

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Again, thank you so much for your answers. I'm really grateful you guys are being so helpful. :)

I already have wrecked adrenals (adrenal fatigue), so my hormones are out of whack right now. I've suffered from this for a year now (but getting better). My T is a third of what it used to be 5 years ago (I'm only 26). Ironically, I tested high for DHT despite that (I'm a pretty hairy guy, by the way). Despite that, I wonder if my low T might attribute for what seems to me at least a slow-down in hair loss. However, even in the time prior to my adrenal issues, I didn't detect much hair loss.

Given this situation and the fact that I have reacted strongly and sometimes in unexpected ways to drugs, I don't dare to take Propecia. Maybe my reluctance to give it a shot has beome a little more understandable. Not that I feel pressured to justify my choice, but I don't want to come off as not appreciating your advice, because I do value it.


@Tiger's Bald Spot: I already suspected that your average Joe dermatologist might not excel at analyzing miniaturization. I'll have to do some serious searching I guess.

Thanks for the compliment. :) Actually, the present state of my hair puts me in somewhat of a dilemma: My hair is too thin to look good when it grows longer (spiking it looks really bad for instance); however it's not so bad as to require constant buzzing. I don't much mind having very short hair as I think it suits me somewhat, but it makes me look more aggressive than I'd like. So I usually buzz it every 4-6 weeks and for most of the time, I'm stuck with short hair I can't really style. I'm not complaining, though. I'm thankful for what I've got left.

Your approach is actually quite similar to mine, except that I'm not currently using minoxidil. Might try it again, though.

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pleo
 
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