Should I cancel my scheduled HT?

[Jim1973]

I can't tell if I'm simply beginning to lose hair at a rapid pace or shedding. I started, what I thought was a shed Summer of '21 and its been continuous through 2022 and is getting worse. In my attempt to stop the hair loss progression, I started taking Dutasteride twice/week along with Finasteride the other 5 days and am using 2% Ketoconazole shampoo. In addition, along with taking DHT and probiotic pills from Nutrafol, I also began taking oral Minoxidil (1.25mg) because the topical seemed to make my head really itchy over the years. However, nothing seems to be changing for the better and more and I see more hair fall with each passing day. I have a HT scheduled for April of 2023, which I was excited for, but if I can't seem to get my existing hair to stop falling out, should I simply cancel the HT and succumb to the inevitable of going bald? I honestly don't know what else to do. Any ideas or suggestions would be appreciated. Thanks.

 

[Bigmac]

Hi Jim. It would help if you added some pictures to show the loss from last year to present day. You’re on more of a regimen than most which should be working but you could be one of the few that don’t respond much in blocking the DHT.
Without going back through your other threads, have you had bloods or your scalp checked for any underlying conditions?
Did you have an in person consultation before booking your surgery? Continued loss makes surgery a high risk. I’d be contacting the clinic to see what the doctor advises.

 

[Jim1973]

Hi Jim. It would help if you added some pictures to show the loss from last year to present day. You’re on more of a regimen than most which should be working but you could be one of the few that don’t respond much in blocking the DHT.
Without going back through your other threads, have you had bloods or your scalp checked for any underlying conditions?
Did you have an in person consultation before booking your surgery? Continued loss makes surgery a high risk. I’d be contacting the clinic to see what the doctor advises.

Hi Bigmac. I wish I had taken pics of my hair prior to this year but I had been maintaining on the typical topical MIN and oral FIN for several years so just assumed it would maintain for the long haul. I don't have any pictures prior than a couple of months ago that focus on my head. Thanks for reminding me about possible underlying conditions. I haven't had any bloodwork done to identify any underlying conditions but my scalp is itchy on/off throughout the day and has been for several years. I don't have dandruff but I definitely feel there is an underlying condition of some kind. If you have any advice on how to identify, let me know, especially if there is a particular test (either blood or scalp). My derm looked at my scalp but couldn't see anything out of the ordinary. I did my consult remotely but will be contacting them soon if I can't stop the existing hair fall.

 

[Bigmac]

Itchy scalp could be something or nothing. The only way to find out is have it checked in person by a professional. Conditions such as LPP can lay dormant or be mildly active, then the trauma of a HT can activate it fully which will cause poor growth/low graft survival. If something is found, a suitable treatment plan needs to be in place before considering surgery. There could be things like vitamin D deficiency causing it, again a check up would identify this.
Definitely contact the clinic you’re scheduled with to get their medical opinion on your situation.

 

[Jim1973]

Itchy scalp could be something or nothing. The only way to find out is have it checked in person by a professional. Conditions such as LPP can lay dormant or be mildly active, then the trauma of a HT can activate it fully which will cause poor growth/low graft survival. If something is found, a suitable treatment plan needs to be in place before considering surgery. There could be things like vitamin D deficiency causing it, again a check up would identify this.
Definitely contact the clinic you’re scheduled with to get their medical opinion on your situation.

Thank you Bigmac for the response. What is LPP?

 

[Bigmac]

Lichen Planopilaris​

This link gives you brief info about it. Searching for ir or looking for things like scarring alopecia will explain these types of scalp conditions.

Lichen Planopilaris: Causes, Symptoms and Treatment | hims

Lichen Planopilaris (LPP) is a skin disease that can lead to hair loss. Keep reading to find out more about the cause, symptoms and effective treatments.

www.forhims.com