Before you read this, please read part one as it deals with the psychological impact of hair loss on young men. In this piece, I’ll review a brief history of my hair loss and discuss the most effective treatments and options for those struggling with Androgenic Alopecia. I wrote this to help younger men avoid my fate and to help them become confident in who they are.
My Brief Hair Loss History
When I was 12, I went swimming with the pretty girl across the street. She constantly flipped her wet hair behind her head like Ariel from the Little Mermaid. I thought it would be funny to imitate her because there is no better way to endear a girl than to make her laugh and feel insecure about herself. I tilted my head back under the water and shot it upward with my nose in the air. I screwed up my impression of Ariel and all I did was slick my hair back revealing my hairline. She commented on how scary it looked and asked me to never do it again. Being a young lad, I continued to do it for years to freak out my friends.
What I wouldn’t realize until later is that this experience was the beginning of my hair loss story. By the time I reached my senior year of high school, I knew something was up(or literally going back). God blessed me with a “fivehead” and a high hairline. Additionally, I’m short, inflexible and chunky. Yahtzee.
When my alopecia developed in high school, I began to look funny wearing my hair down to cover my forehead. The recession at my temples created an “M” effect. To fight nature, I spiked my hair up instead. It didn’t look bad and a lot of people (I still had my detractors) liked it. However, once my hair went up I began to intensely focus on the state of my hairline. I was 17.
When I was 20, I met one of my best friends during a breakdancing contest. Afterward, I told him my age and he was shocked. He later told me he thought I was 35. When I first entered the professional world, people assumed I was in my thirties. Girls never told me they avoided dating me because of my hairline, but I certainly heard their friends make fun of them for dating me. Don’t let anyone fool you. Some women won’t care and even find a bald man sexy, but most prefer a full head of hair.
At 25, the mental effects of my hair loss culminated after a break up with a beautiful, six-foot tall, red-head. My hair loss continued to worsen, but at 26 a new experience occurred. When they shaved my head at OCS, I noticed thinning on the mid-anterior and vertex of my head. My vertex actually had a small bald spot. At 29, my hair is getting to the point where I can barely hide the thinning with dry hair and the recession continues to creep back. It’s really depressing because I’m two months into taking Avodart and it’s my last hope before I shave my head for good.
In retrospect, my hairline receded faster than nearly all of my peers, but it was still slow enough where I did not notice the gradual recession. My hairline was already very high so a few more inches really didn’t change anyone’s perception about me. When I was 17, I visited a dermatologist who told me my only option was a hair transplant and nothing else would work. 12 years later, I could kick this guy’s ass for giving me such horrible advice. The truth is I could have maintained my hair had he directed me towards Propecia, which was available at the time.
My experience motivated me to make sure that men suffering from hair loss in their twenties and teen years receive the correct information that I never did. Hair loss is no longer a completely hopeless or untreatable problem. This post is about directing young men suffering from hair loss to the correct medical information.
Hair Loss
The main culprit doctors attribute to male pattern hair loss to is a chemical known as DHT. The body produces DHT to assist during puberty and hand to help sexual development in men. At some point in a male’s life, the DHT attacks hair follicles on the front, top, and the crown of his head. DHT attacks hair follicles like they are foreign invaders. Hair grows in a cycle that takes anywhere from 3-9 months and without a DHT inhibitor like Propecia or Avodart, DHT continually attacks the hair follicles and hair strands progressively grow back thinner and shorter each cycle until they can no longer survive on their own. For an unknown reason, the sides and back of the head are not affected by DHT creating the infamous horseshoe pattern for bald men. This is also why transferring hair from the back of the head to other areas can lead to successful and permanent hair transplants.
How Do I Assess My Hair loss?
Hair loss can be difficult to assess. Even when an individual suffers from rapid recession like myself, it’s difficult to determine if a hairline is losing a quarter to a half-inch every year. It’s generally when a person sees a picture of himself that he realizes his hairline is different. Furthermore, it’s difficult to keep track of hair loss through photography. A slight change in the angle of the photograph, the lighting, or the use of a flash can drastically change the appearance or severity of hair loss. In fact, many dishonest companies and doctors use these photographic tricks to create stunning before and after pictures in their advertisements.
The best way to assess your hair loss is to visit a dermatologist, family doctor, or doctor who specializes in hair treatment. In all honesty, I would avoid the former two and visit a well-respected hair loss surgeon for an assessment. Many family practitioners and dermatologist will not share sympathy for your condition which could lead to horrible advice like I received when I was 17. I also dealt with a doctor who was reluctant to prescribe me Propecia when I was 28. Despite the excellent results of treatments like Propecia, many doctors seem hesitant to prescribe hair loss medication for good candidates. This is probably due to all the horrible treatments, false miracle cures, and the over-reported complaints of sexual dysfunction of drugs like Propecia.
If you are nervous about visiting a doctor, you could wet your hair and have a friend inspect your head. This is especially useful for those who are unsure if they are thinning on the top or crown of their heads. With a wet head, any waning spots in your hair are easily identified. Many hair loss surgeons direct their patients to wet their heads and send in pictures for more accurate online consultations. Nevertheless, your best option is to visit a well-respected hair loss specialist.
Non-Surgical Treatments
An ounce of prevention is worth a pound of cure. In fact, a few ounces of prevention may be worth 20,000 dollars ( Cost of Wayne Rooney‘s hair transplant) of cure. It is far easier, cost-effective, and less stressful to maintain your existing hair. As of right now, there are two FDA approved treatments for hair loss. The best is known as Propecia (Finasteride).
Propecia is the same as Proscar which was designed to treat enlarged prostate in men. Proscar is 5 mg and Propecia is 1 mg. Propecia works by limiting or reducing the amount of DHT which either slows, stops, or in some cases reverses hair loss. According to studies, Propecia produced positive results for 80% of all participants during its clinical trials. Most reviews from doctors and testimonials from patients online also indicate that Propecia (Finasteride) is more effective when administered at a younger age. I will provide a few links at the bottom as there are many questions on the use and the side effects of Propecia.
I believe this medication is the best defense against hair loss and it should enable many young men to preserve their hair. I didn’t like my hairline five years ago, but I would love to have that hairline right now! I would also recommend having your doctor prescribe Proscar as it is cheaper, covered by insurance, and can be cut into smaller pieces and taken just like Propecia. The small differences in your cuts do not make a difference on the potency of the medication.
Avodart is another DHT prohibitor or primarily used for the treatment of benign prostatic hyperplasia. I am one of the few non-responders to Propecia(the rare 20 percent) so I have been taking Avodart for three months. Avodart is not FDA approved for hair loss and the long-term effects for this medication are unknown. However, clinical trials have shown Avodart to be more successful at regrowing hair than Propecia either due to blocking both types of DHT or because it restricts more DHT. Nonetheless, there is no reason to take Avodart unless a year or more taking Propecia has proven ineffective. Propecia works for most men, it appears to have fewer side effects, and it has a much shorter half-life than Avodart making it a far safer option. Only switch to Avodart if approved by a physician. Many physicians will not recommend Avodart because it is not FDA approved for hair loss.
The second FDA approved treatment for hair loss is Minoxidil or more popularly known as the brand Rogaine. I recommend picking up the generic 5% minoxidil (over the counter) from a local drugstore as you will save a lot of money. Minoxidil is a liquid application that you must apply to the affected areas twice a day. It is still unclear why Minoxidil increases hair growth. Experts generally believe Minoxidil increases blood flow to the hair follicles and lengthens the growing phase of hair. Minoxidil is generally advertised to work on the crown of the head, but numerous users on the internet claim it works on all areas. Clinical trials only measured results on the crown and mid-anterior regions of the head.
Without surgery, the best combination for those suffering from hair loss is utilizing both Finasteride and Minoxidil. They work differently but appear to have a cumulative effect. From my research online, this is the most effective hair cocktail on the market that provides actual results.
Most leading hair restoration surgeons prescribe these medications to their patients before and ever after hair transplants. While many people claim miraculous results from these two drugs, most results I’ve seen appear to occur on the mid-anterior (top of the head) and the crown(upper back of the head). It is also more likely that these medications will prevent further hair loss than restoring your hair to its former glory.
Hair Transplant
Hair transplants have become very effective and safe methods for hair restoration. If someone suffers from severe hair loss, a hair transplant is the only permanent solution. A skilled surgeon will harvest either a strip of follicles or individual hair follicles from the back of the head(They are DHT resistant) and artistically place them on the crown, top, and front of the head. The days of hair plugs are long gone and a respectable hair transplant should be virtually unknown to anyone inspecting your hair. The danger of hair transplants stems from choosing the wrong surgeon(There are a lot of them out there…beware of low prices). A good physician should perform an operation that leaves minimal scarring on the back of the head and creates a natural hairline in the front. Generally, more than 90 percent of the hairs will remain after a hair transplant. An individual should spend a considerable amount of time researching, asking questions, and reviewing (even contacting) results of former patients. You should never be pressured or rushed into making a decision. Furthermore, doctors should set realistic expectations such as the reality of further hair loss(the continued loss of non-transplanted hairs) and the possible need for additional operations to increase hair density. I have provided a link for trusted hair restoration surgeons at the bottom of the page. If a hair surgeon is not listed in this association, I would not risk my head along with 5,000-20,000 dollars with the possibility of being butchered. Again, I believe hair restorations are very safe and successful operations, but only in the hands of a qualified and experienced hair restoration specialists.
I have already contacted a doctor on this list and it is only a matter of time before I have a procedure done. I’m only waiting to see if Avodart will help slow my hair loss. If not, I’ll need to plan a more aggressive surgery. I’ll also have to settle for a more conservative hairline since donor hairs from the back of my head are limited and my natural hair loss will continue. Also, these are expensive operations.
Other Treatments
Everything else on the market is snake oil. Don’t waste your time! Don’t believe you need 15% Minoxidil or things like Palmetto Oil.
The Confidence Cure
If treatment is not your thing, I do have some practical advice. I actually like receding hairlines on guys. Ever since I saw Vegeta from DragonBallz, I thought the look was kind of cool. Granted, I don’t like how receded my hairline has become but I think most men in their 20’s have natural and masculine looking hairlines. Having Justin Bieber hair at 29 would look kind of stupid. I didn’t write this for the sensitive guys with some minor recession or slight thinning on their crown, this is for the young men suffering from serious and early hair loss. Here are some tips to help you keep up with the hairful guys.
1) Some recession looks good!- Get on Propecia to maintain what you got and be a man. Rock that recession with pride!
2) Get your ass in the gym!- Listen, some girls will never accept a bald head. That’s life. But I promise you if you have a decent body in your 20’s and 30’s many women won’t care. After all, does a nice body on a woman still make your head turn? Why would you think women are any different?
2) Style- Attraction is so much more about how you present what you got than what you actually got. If you can layer a nice shirt with a jacket, wear pants that fit, and choose a nice pair of shoes with a few unique accessories, then a smile and a confident hello will get you places. Also, don’t be scared to rock some cool hats. I bought a straw hat when I was in the Philippines and 20 minutes later I was taking modeling pictures with a very nice girl in a bikini. I wasn’t in bad shape, but I wouldn’t say I was in great shape. Look nice and choose to be confident. She didn’t even notice my hair loss until she read my blog.
3. Keep the hairstyle short!- Either shave it off or wear the hair short. A short look minimizes the contrast of a receding hairline while a shaved head actually looks like a fashion statement.
4. Don’t Worry- I struggle with this myself. However, it looks like fate has chided me with hair loss. If I can’t change it, I should refocus my attention on my career, education, body, or something useful. It’s much healthier to focus on something that you have control over! Your confidence as a man is seldom changed by women. However, what you accomplish in your life will make you a more interesting and confident person.
Final Thoughts
Do more research!!! This is nothing more than a brief overview of treatments. For any medication or treatment, please talk to your doctor. There is a lot of good and bad information out there and the links I provided below will get you started on the right direction. Good luck and remember, it’s just hair!!
Links
The Sly Bald Guys– This is by far the happiest and healthiest hair loss community on the web. They believe in shaving the dome and practicing radical self-acceptance. I don’t agree with their complete abhorrence of Propecia, hair transplants, or SMP, but they’ve realized that the best way to be attractive has nothing to do with your hair and everything to do with confidence and becoming the best bad-ass you can be. I love these guys!
The Scalp Guru– I believe in treating hair loss from least invasive to invasive. In other words, 1: Get on Propecia and rock the recession or shave the head and be confident asf. (2) Get an SMP. (3) Get a hair transplant from a well-researched doctor.
For the SMP world, there may not be a better consumer advocate than Damien Porter at Scalp Guru. He spends a lot of his time seeking the best SMP artists in the industry. I’ve had quite a few conversations with Damien and find him trustworthy and honest, despite some bullshit people like to say about him online. BTW, every great SMP transplant surgeon or SMP practitioner will have some negative feedback — it’s impossible to keep everyone happy.
The Bald Truth– This is Spencer Kobren’s talk show and website dedicated to hair loss. The forum is loaded with information. There is some criticism that this website and show is just a marketing machine for a group of hair loss surgeons, but I have a very hard time believing there is not a substantial amount of genuine content on the site.
International Alliance of Hair Loss Restoration Surgeons – The only surgeons you should consider for a hair transplant. This is the only group that is recommended by the American Hair Loss Association and the only organization that requires members to show consistent and quality transplants as opposed to only requiring membership fees.
Hair Transplant Network – Another strong community for those of us who suffer from hair loss. Create a profile and post pictures and receive advice and suggestions from members. Several prominent hair loss surgeons are part of this community and also dispel free advice. The best part is you can track others’ results from medications or follow their results and progress after a hair transplant surgery.
Dude, Where's My Hair 