Thinning at age 20

[Organman1013]

Hello everyone,
First let me thank you all for the paragraphs of great advice and words of support on this forum. I'm sure I am not alone when I say I lurk the hell out of these forums looking for ways to keep my hair. We all will make it!
I'm 20 years old, and about a year ago I noticed some very minor thinning at the top of my head around the crown. That's on the areas you don't really get to see in the mirror, but someone pointed it out to me and after taking some pictures I was convinced I was going bald. Stupidly, I decided to try to not think about it, and I attributed it to stress or a bad diet.
Fast forward one year, the thinning increased, not drastically but noticeably. A little background on my family, my father is 67 with a full head of hair, with minor thinning at the crown. Both of my grandfathers were Norwood 2 when they passed away. The only baldness I see in my family are two cousins, a few years older than me whose hairlines have visibly receded along with their vertex's being bald. However, both of their fathers (not related to me by blood) are bald.
Although being in denial for a bit, and having the reassurance of my family that I was imagining it, I decided to go to my doctor and he agreed that I was indeed going thin. He sent me to a dermatologist, who I just saw today. She immediately asked me if I wanted to go on propecia, then she offered the option of some sort of injection into my scalp (no idea what this was) but I refused. I agreed to go on propecia, and I just took my first pill a while ago. I also added nizoral 1% to my regimen. Perhaps one day I will go on rogaine, but the doctor didn't recommend it.
I will be sure to update this thread with pictures, but here is what I look like now.

Any advice/reassurance would be appreciated. People with hair who pull the whole "shave it off" speech really have no idea how detrimental this is to our psychological well being.
Godspeed.

 

[PhillyCarter]

Well it seems like you are having some thinning but it may still be hereditary. The balding "gene" actually comes from the maternal or mother's side so if you mother's father was blading chances are this was passed down to you. A one percent ketoconazole shampoo is a great regimen to start with as well as a thickening conditioner. Nizoral does contain 1% ketoconazole however they contain harmful ingredients including sulfates and parabens. These can cause more damage to your hair then good. It's safer to look for a ketoconazole shampoo without sulfates and parabens that way you are on a healthy plan to reversing your hair loss. As for propecia it has some scary side effects, I would stay away from that especially at your age.

 

[GoldenMane]

At 20 years old you're plenty old enough for finasteride. Without it, your chances of keeping your hair into your 30s is pretty slim. With it, your chances are more like 80%. Your chances of getting side effects are less than 5%, and these are temporary, they will subside within a few months of quitting finasteride. If hair is important to you, then you need to at least try finasteride, it's very effective and most people have no adverse side effects.

Get on the big 3. If you do get sides (and they're not psychsomatic...), then try spironolacetone. Hair loss is caused by conversion of testosterone into DHT, and then the DHT binding with androgen recepto sites on your hair follicles. In order to prevent hair loss, you need to either prevent DHT formation (finasteride) or block the androgen receptor sites so that DHT can't bind with the fllicles (spironolactone). Finasteride is by far the more effective of the two since it's systemic, but if you're among the minority of people who get side effects then spironolactone is your best backup