Jamie McCollum, MD

It’s impossible to tell from a photo. You’ll need to examined by a hair specialist to see if you are actually thinning.  And other causes will need to be ruled out. 

The answer is...maybe.   Your age, past medical history and medications will help your doctor determine what (if any) pre-op testing is needed.  

If you’re young healthy and on no medications, those tests aren’t necessary.  But, they also aren’t unreasonable.  

Given the investment that you are making in time and expense for your hair transplant, I would not let one doctor ‘s requirement for lab work weigh heavily in your decision of choosing your surgeon. Especially if he can provide you the convenience of drawing those labs in his own office. 

First, I’d Like to thank you for including the pictures with your question. 

I often see young men, with varying degrees of hair loss, who are seeking a transplant.  For the vast majority of these young men, my advice is to start with oral and topical medications, and consider LLLT, PRP if indicated. And as we see their pattern develop, response to the medications, and their changing goals and expectations over time, we can then plan for a transplant at some point in the future.  

But, not every case is the same.  My advice is to find a reputable hair transplant surgeon that you trust and have that conversation with him/her.  Consult with 2 or 3 if needed until you are satisfied.  

First, let me say that’s it’s great that you have been proactive, seen a doctor and started finasteride. So many young men , and even teenagers, are sharing your situation.  Finasteride is the perfect start and you should plan to take it long term. Next step, you should find a great hair restoration doctor. It can be someone who does, or even doesn’t perform transplants. But, make sure that a good portion of their practice is dedicated to hair loss. They can offer you other options like laser cap, PRP, nutraceuticals, and will likely recommend minoxidil. 

I haven’t seen shock loss in any of my PRP patients, but it is a known potential complication and I make my patients aware of its’ possibility before their PRP treatment.   You should certainly return to the Doctor that performed your PRP and let him perform an examination and any investigation that he/she feels warranted.  If it is, in fact, shock loss causing your hair loss, continuing your routine therapies (minoxidil, laser cap, finasteride) will help to limit the loss and help your hair to recover.   

Go for it.  Won't be a problem this far out.  You may want to refrain from alcohol 2-3 days before your next treatment.

As with any daily medication, plan to take it at about the same general time of day. Such as morning, midday, evening, or before bed. Extreme precision isn’t necessary. Though I applaud your commitment!

It’s difficult, but any results for hair take time, and you shouldn’t give up at the 6 month mark.  I would also urge you to add topical minoxidil to your regimen. And consider using a laser cap.  Be sure to compare photos from just before you started treatment as you may underestimate your incremental improvements.

Great question. As long as your associated arrhythmia is well controlled, it should be no problem. Your Hair Transplant Surgeon may want you to visit your cardiologist in preparation for the transplant.  The prolapse may also influence your surgeon’s choice of antibiotics. However, with a mild prolapse, as you described, that isn’t really necessary. 

Most of your growth should be in by now.  But, you may still see more as far out as 14 months.