26 years old, male, diffuse hair loss. No hope to restore hair? HT is not possible ? (Photo)

A doctor usually needs to exam a patient, diagnose a problem (of WHY you are losing your hair), then needs to understand the goals and expectations of a patient before giving them options or treatment plan.  If you don't have good donor hair, then surgery may not be an option. These are things you need to discuss with a doctor in person.Scalp MicroPigmentation may also be an option but that is also something you need to discuss with your doctor in person.

When a patient with hair loss comes to my practice, I first ask the age
of onset or how old they were when they started losing hair. I also ask how
quickly this is progressing and if there are other male family members who have
similar patterns or hair loss. Assuming that you have male pattern hair loss,
you are experiencing is progressive miniaturizing of hair. Hair normally grows
in a cycle and at the end of every cycle, it sheds. When the new hairs come in,
they come back thinner. I would typically assess the top of your scalp with a
microscope to identify the amount of hairs that are thinning relative to the
amount of hairs that are still thick.



There are two medical options to treat hair loss. One is finasteride which
is a drug that inhibits an enzyme called 5-alpha reductase that is responsible
for the conversion of testosterone to dihydrotestosterone (DHT). Hairs that are
sensitive to dihydrotestosterone will progressively thin until they disappear.
When someone has that type of hair loss takes finasteride, it slows that
progression and can allow them to have thicker hair for a long period of time.
Unfortunately, medical studies t has shown long-term sexual side effects of finasteride.
In addition, literature does not provide enough information about all the
factors that cause hair thinning because dihydrotestosterone is not the whole
story. Many men will take finasteride and still progressively lose hair. The
other drug is minoxidil which is applied topically and appears to keep hair
around longer so that it appears that the scalp has more coverage, but it does
not reverse hair thinning.



For a patient like you, we don’t go for the hair transplant first. This
is a significant change in the paradigm of how to treat hair loss. The standard
approach in the past is to do a hair transplant. However, the patient
continuously loses hair after a transplant. Many patients will opt to do
another hair transplant and another one every few years until they reach the
end of the donor area. Unfortunately, there’s a mismatch between the amount of
hair that you have in donor and the amount of scalp you need covered.
Eventually, people will have plugs on their scalp which is an obvious hair
transplant.



In our practice, we have developed a non-surgical treatment called Hair
Regeneration. A material for wound healing called extracellular matrix that is
used to help regenerate tissue and skin by recruiting the adult stem cells to
make this wound-healing mechanism. When this material is injected in a
formulation combined with platelet-rich plasma (PRP), it is remarkable in how
effectively it can reverse hair thinning. We have hundreds of patients who come
from all over the world and every week, we see more and more patients for this
treatment as we continue to prove its benefit. It appears to have a minimum 3
years of benefit and maximum of 5 years. The younger the patient is and the more
coarse the hair is, it appears that they get remarkably more volume and
correction, which has a lot to do with early intervention. So when someone
notices hair loss, the earlier they come, the better it is. I would actually
say that in most patients who have existing hair, it far exceeds the benefits
of any hair transplants. I hope that was helpful, I wish you the best of luck,
and thank you for your question.



This personalized
video answer to your question is posted on RealSelf and on YouTube. To provide
you with a personal and expert response, we use the image(s) you submitted on
RealSelf in the video, but with respect to your privacy, we only show the body
feature in question so you are not personally identifiable. If you prefer not
to have your video question visible on YouTube, please contact us.

You should be evaluated by a knowledgeable physician who can diagnose your shedding. It is unusual to have rapid hair shedding in androgenic alopecia. A hair pull test and a scalp biopsy are usefull to determine etiology.Without a firm diagnosis, treatment should be postponed.