Was the dermatologist wrong?

[Norcaljake]

Hello all,

I am new to the forum and am hoping I am posting in the right place. I need some serious help.

I am a 21 year old male that is currently not on a regimen. My mothers father is completely bald but my fathers side has no history of hair loss.

About a year ago I cut my hair short, since then I have noticed my hair thinning a little bit in the very front. I specifically noticed my scalp was a little more visible. Since then I went and visited a dermatologist who told me "your hairline on your temples are not terribly receded and you show signs of new growth" this being said it had put my anxiety to rest for a few months.

Recently however I have noticed that I have a ton of baby hairs or velha hairs on my hairline when I style my hair up. Is this the new growth? Or was she wrong? Is this really a receding hairline.

I was hoping for some insight on how I can tell if these baby hairs are coming in or going out. Any advice is much appreciated!

Thank you!
http://i1054.photobucket.com/albums/s500/norcaljake92/securedownload_zpse57efe3d.jpeg

 

[zzzzz]

If you can pull out your hairs effortlessly in the supposedly thinning area than it is almost certainly male pattern baldness. It must be extremely early though if the derm wouldn't diagnose it as male pattern baldness yet. Just wait and see if it gets worse before hopping on finasteride

 

[Norcaljake]

If you can pull out your hairs effortlessly in the supposedly thinning area than it is almost certainly male pattern baldness. It must be extremely early though if the derm wouldn't diagnose it as male pattern baldness yet. Just wait and see if it gets worse before hopping on finasteride

They don't come out very easy, but they are very noticeable when I put my hair up. I think waiting is a good idea, I just hope I don't hope on the finasteride regiment too late. I also tried nizoral for a little bit and had a very bad allergic reaction so I stopped that.

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I just uploaded a picture in my initial post.

 

[zzzzz]

looks like male pattern baldness to me

 

[Agahi]

Looks like it to me also. The problem with derms is that they do not specialize in male pattern baldness, so they can rarely diagnose it in my experience(especially if they dont have male pattern baldness.

I'd get on treatment if I was you. You noticing it is the #1 reason I think you are losing hair. You will notice a small change in appearance before anyone else.

 

[aj218]

Your hairline seems receded. Having alot of vellus hairs where there were terminal hairs, especially on the temples is a sign of male pattern baldness.

 

[Norcaljake]

Looks like it to me also. The problem with derms is that they do not specialize in male pattern baldness, so they can rarely diagnose it in my experience(especially if they dont have male pattern baldness.

I'd get on treatment if I was you. You noticing it is the #1 reason I think you are losing hair. You will notice a small change in appearance before anyone else.

It seems unanimous then. Is there any chance that the derm was right by saying this was new growth?
I have been under an exceptional amount of stress lately between caring for someone on hospice and college.

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Your hairline seems receded. Having alot of vellus hairs where there were terminal hairs, especially on the temples is a sign of male pattern baldness.

I have always had "baby" hairs on my hairline I have just noticed more of them lately. The derm said she saw new growth. So what is the difference between new growth and vellus hairs that are slowly shrinking?

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Since I am allergic to Nizoral and my Derm wont agree that I have a receeding hairline, does everyone agree I should try finasteride?

 

[Agahi]

Id say yes finasteride and minoxidil. with these two your hair should be fine for pretty much the long run. The mini hairs on the hairline usually indicate regrowth only if you are on treatment. In the absence of treatment they are very likely to be miniaturized.

You also confirmed for me my thought that the derm would be wrong. A female derm would know even less about male pattern baldness than a male imo.

(yes I realize females can get it to, please no one say im not addressing that. It is simply very rare. My female derm didn't think men where balding until they where what we know is nw4)

 

[zzzzz]

1mg or 1.25mg of finasteride daily, nothing else needed

 

[Norcaljake]

Id say yes finasteride and minoxidil. with these two your hair should be fine for pretty much the long run. The mini hairs on the hairline usually indicate regrowth only if you are on treatment. In the absence of treatment they are very likely to be miniaturized.

You also confirmed for me my thought that the derm would be wrong. A female derm would know even less about male pattern baldness than a male imo.

(yes I realize females can get it to, please no one say im not addressing that. It is simply very rare. My female derm didn't think men where balding until they where what we know is nw4)

Alright so I'm going to start minoxidil ASAP. My derm obviously won't prescribe finasteride at this stage. Do you think this will be enough to stop the recession?

I am okay with having signs of hair loss down the line but as I am only 21 I would like to put up a fight.

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Have you had any negative side effects with either minoxidil or finasteride? I was extremely allergic to nizoral so that definitely won't be an option.

How much mane time do you think ill have left?

Thank you for all of your help btw!

 

[Agahi]

No side effects. The occurrence of actual side effects is very low.

Ask your derm for a perscription and if denied ask for a referral to another or suggest you are considering to use an online pharmacy(this should convince the doctor to give you one. If they still wont, use an online pharmacy (I use inhouse).

As far as time left with hair... I went from a nw1ish to almost a nw3 within 2 years of only using minoxidil when i was 21ish. I am afraid to think where i'd be if I hadn't started finasteride (im 27 now). (my dad is nw7 since 30ish)

 

[Norcaljake]

No side effects. The occurrence of actual side effects is very low.

Ask your derm for a perscription and if denied ask for a referral to another or suggest you are considering to use an online pharmacy(this should convince the doctor to give you one. If they still wont, use an online pharmacy (I use inhouse).

As far as time left with hair... I went from a nw1ish to almost a nw3 within 2 years of only using minoxidil when i was 21ish. I am afraid to think where i'd be if I hadn't started finasteride (im 27 now). (my dad is nw7 since 30ish)

Hmm should I even waste my time with minoxidil then? Or should I just hop on a finasteride regiment as soon as I can?

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No side effects. The occurrence of actual side effects is very low.

Ask your derm for a perscription and if denied ask for a referral to another or suggest you are considering to use an online pharmacy(this should convince the doctor to give you one. If they still wont, use an online pharmacy (I use inhouse).

As far as time left with hair... I went from a nw1ish to almost a nw3 within 2 years of only using minoxidil when i was 21ish. I am afraid to think where i'd be if I hadn't started finasteride (im 27 now). (my dad is nw7 since 30ish)

I have also noticed that if this is male pattern baldness that I don't have the common M shaped pattern of recession. My temples are slightly receded just not in a pointy fashion like I see most commonly. Mainly having thinness in the front and noticeable baby hairs. How does this (my type of male pattern baldness) typically progress?

 

[Agahi]

I have M shaped hairloss, so Im not 100% on how yours will progress. Someone else may be able to help. You could also check with sucess stories to find a similar loss patter (this is what I do)

The minoxidil thing I go back and forth on. finasteride alone should maintain fine, but Ive seen charts that show that even for simple maintaining the two together are much better. A personal choice I think. I use both and nizoral for maintaining.

 

[Norcaljake]

I have M shaped hairloss, so Im not 100% on how yours will progress. Someone else may be able to help. You could also check with sucess stories to find a similar loss patter (this is what I do)

The minoxidil thing I go back and forth on. finasteride alone should maintain fine, but Ive seen charts that show that even for simple maintaining the two together are much better. A personal choice I think. I use both and nizoral for maintaining.

So based on all of your info I have been looking on inhouse at finasteride options. I did not realize how expensive propecia was. Has anyone had any luck with alternatives such as Finax? I am quite nervous about taking a random drug, but propecia is very expensive.

 

[Agahi]

fincar on there

 

[BlackSheep]

Looks like it to me also. The problem with derms is that they do not specialize in male pattern baldness, so they can rarely diagnose it in my experience(especially if they dont have male pattern baldness.

I'd get on treatment if I was you. You noticing it is the #1 reason I think you are losing hair. You will notice a small change in appearance before anyone else.

The heck? Dermatologists are trained to cover - surprise surprise - dermatological conditions. Androgenetic alopecia is one of them. In fact, given how common it is, they arguably have a far greater level of experience with it compared to other doctors.

Addressing the OP's question, just looks like you have a maturing hairline to me. A definitive way of telling, if you're bothered to do this, is to cut your hair uniformly with a single setting (e.g. 2) and see if there are any density changes across your scalp.

 

[Agahi]

The heck? Dermatologists are trained to cover - surprise surprise - dermatological conditions. Androgenetic alopecia is one of them. In fact, given how common it is, they arguably have a far greater level of experience with it compared to other doctors.

Addressing the OP's question, just looks like you have a maturing hairline to me. A definitive way of telling, if you're bothered to do this, is to cut your hair uniformly with a single setting (e.g. 2) and see if there are any density changes across your scalp.

Ive been to around 5 derms. Not a single one would diagnose me with male pattern baldness which I obviously have. 4 of them had never heard of finasteride. Just because you are trained in something does not make you know everything about it. In fact because they have such broad training in all skin issues they have likely very little training in male pattern baldness unless they specialize in it. I m a trained US navy sailor, but I could not tell you more than 10% about any particular navy job aside from what Im trained in specifically.

 

[BlackSheep]

Ive been to around 5 derms. Not a single one would diagnose me with male pattern baldness which I obviously have. 4 of them had never heard of finasteride. Just because you are trained in something does not make you know everything about it. In fact because they have such broad training in all skin issues they have likely very little training in male pattern baldness unless they specialize in it. I m a trained US navy sailor, but I could not tell you more than 10% about any particular navy job aside from what Im trained in specifically.

A quick disclaimer: whatever I'm about to post isn't an attempt to sound a***-retentive on this topic or dismissal of your experience, rather, to give the laypersons on this site another perspective from the all-too-common dismissal of expert advice in favour of community intervention and/or alternative solutions. Also note I'm a medical student strictly for the purpose of reinforcing this viewpoint only.

You've been to around five dermatologists, all of whom missed your diagnosis and the majority hadn't heard of one of the most common prescription drugs in use in the West (Finasteride). It's so commonly used for this issue (Androgenetic Alopecia), Patient.co.uk has an entire comprehensive page on it.

Those dermatologists you saw, for whatever reason, are rubbish. I regret reading you run into a succession of such "inept" doctors. However, that experience is an anecdote and can't be used as an objective assessment regarding the diagnostic prowess of a dermatologist. In fact, your experience directly contradicts my own - It was the one dermatologist I saw who dismissed the proposition I had male pattern baldness with laughter when I knew I never had it all along, despite my main GP insisting I had it. Lo and behold, I'm regrowing hair on just antihistamines and betnovate alone.

When a person graduates from med school and enter their first batch of rotations, they're constantly accumulating experience and knowledge on relevant conditions. Some doctors go the extra mile for their patients, others do enough just to get by.

However, as qualified dermatologists, they ARE supposed to know about Androgenetic Alopecia inside-out, from the epidemiology to the prognosis and mechanism of action of all relevant drugs. Exceptional derms would then know about ongoing research, the outcome of recent clinical trials and even literature concerning some of these common hair loss/"good for scalp" alternative remedies.

My central point here is that it most definitely is a part of the average dermatologist's toolkit to know about male pattern baldness/Androgenetic Alopecia and the most common drugs used to affect disease course. Hell, as a med student, all I'd need is one physical look at your scalp to see if it was male pattern baldness (non-scarring, occasional vellous hairs, receding hairline/crown hair loss, +- family history)*.

These derms you saw must've been exceptionally incompetent*. Please take my word on that. I hope you're now seeing someone who's actually qualified to treat you.

* Unless there's something about your presentation that was seriously amiss?

 

[Agahi]

Fun fact. The med student of Derm #1 actually knew a **** ton about it, but couldn't convince the Doctor to give me a prescription for finasteride at the time.

You are assumeing I am thinking all derms are incompetent, all I am saying is that the OP knows far more if his hair is receding than anyone else, no matter know much training they have. Things besides male pattern baldness causing loss is fairly rare so if a derm doesn't give a realistic alternate diagnosis(something like your issue, not simply something like stress or "nothing can be done"), I say feel free to disregard their opinion.

Ill agree that most derms know their ****, but the OP needs to realize that many do not. You call the last in his class at med school Dr. remember.