Second part: November 12, 2018
It's been about a month since I wrote about my hair falling out and I've learned a lot! Both about my own situation and about hair loss in general. Here is an update since my last post on the subject.
Where do I start?
Well here it goes. So in the last episode of WTF is happening to my hair I summarized that my hair had gone from quite thick (this wasn't actually as true as I thought), to thinning quickly (this is mostly true). What I found out was that I had likely be going through invisible hair loss + telogen effluvium = panic time!
Invisible hair loss
Some people lose hair very quickly starting in their late teens or early 20s. It can start right after puberty ends because most hair loss is due to a hormone called DHT. The summary of DHT is that it is produced due to a breakdown of testosterone and can cause havoc to your hair. When you're young your hair follicles and body can handle DHT more easily. As you age and if you have DHT-sensitive follicles you will start to lose hair as DHT blocks the follicles ability to product good hair and as your body loses its ability to deal with getting rid of it. First the hair gets finer (miniaturization), then eventually stops growing all together. This article does a good job to explain it and this company that wrote it sells the typical products to slow, and hopefully stop or reverse it.
For me I likely had been losing hair thickness and density for some time. It's hard to tell, but I went back into my photos and it seems like from my high school photo to now I've lost a good chuck of hair volume and thickness. For invisible loss which happened to me its less noticeable because your hair line doesn't recede and you don't show bald spots or scalp until it gets too thin (50% loss or so). This happened to me. Interestingly I've seen 10-year old photos of myself where my scalp is showing and I never noticed. Then some from a few years ago show no scalp - so I may have had some loss and regrowth before but just never knew. It's tough to tell too at times since lighting, hair length and how its styled can have a great affect on if you seem to have fuller hair or thinner hair at any given time.
Anyway - I had likely been going through some thinning for many years and then a big stress period earlier in 2018 caused extra thinning and shedding to occur which I noticed as hair fall, which alerted me to a potential issue which made me more sensitive to examining my hair which led me to the following set of doctors, and appointments which led me to take action!
I would estimate my hair coverage (on the top of my head) to be 50% of what I had in my early 20s and most of the issue seems to be in a section from the crown moving forward along my vertex.
So what action did I take?
1) Hair clinic in London - prescribed scalp care shampoos as my scalp was apparently a mess and minoxidil + DHT killing cream applied daily to scalp - they diagnosed Telogen Effluvium.
2) Dermatologist in Toronto - who diagnosed Telogen Effluvium, ordered a bunch of tests to rule out prostate cancer, thyroid issues, lupus and other problems you only wish upon your worst enemy which he anticipated would come back clean - and he was right
3) Hair clinic in Toronto - diagnosed hair thinning along vertex mostly and put my scalp under a microscope camera which we looked at on a TV. This is not a fun thing to see overall but at least you can clearly see the thick hairs vs the fine hair and really start to understand the difference in healthy vs non-healthy hairs.
4) Walk-in clinic - doctor diagnosed Telogen Effluvium, I eventually got finasteride prescribed from him
Results & Actions
1) Blood test negative - i.e. no reason my hair is falling out from the test and no health issues raised from the results in general
2) Got the only two FDA approved drugs for hair loss - minoxidil and finasteride
3) Using much higher quality and medical based shampoos and conditioners
4) Eating as healthy as reasonable
5) Reducing stress as much as possible as stress releases more cortisol which is especially bad if released on a sustained basis and can cause general cell damage + accelerate hair loss by helping to increase DHT production
What did I learn?
1) Watch your damn hair thickness even if you don't see a receding hairline or bald spots forming as it sneaks up on you - first signs could be less manageable or voluminous hair meaning your individual hair are less thick and maybe some thinning has occurred. Take some photos each 3-6 months in comparable lights, angles, etc... The sooner to address the issue the better the chance you have at helping it!
2) Minoxidil - "The mechanism by which minoxidil promotes hair growth is not fully understood"... but it's thought to work by increasing blood flow to the follicles. Side effects are minimal from my understanding. I can't get great stats but apparently it helps the majority of people to some extent. Originally developed to treat ulcers - it was found to help hair instead. Yeah win!
3) Finasteride - The big boy - side effect can be to libido and other sexual function either temporary or all the time you use it, or as some have claimed even afterwards. Also some other crappy side effects you can read about. The side effects seem to affect fewer than 2-3% of users, but everyone has to make their own decision. The pros though are that something like 90% see hair loss reduction or stopping or reversal. Originally used to combat enlarged prostate.
4) Dutasteride - a more effective DHT blocking drug vs Finasteride - interesting article here on the comparison. By the comparison article you can see it quotes Dutasteride being much more effective at blocking DHT - both from a percent blocked and consistency doing it. It was also a prostate drug originally (and still is). It is not yet approved by the FDA for use as a hair loss medication. It also has similar side effects (and I think even more) than Finasteride.
5) Clean your damn scalp and if you have dandruff or other bad scalp shit - fix it! This can lead to less productive follicles.
6) Use qualify products early on .. an once of prevention equals a pound of cure - or whatever it is that they say.
7) All of this stuff costs money but if you regularly drink booze, smoke, eat out, buy useless consumer crap then you can easily afford this stuff if you want to try to keep your hair longer.
8) Better products/treatments (including easier more reliable transplants) are being developed and will be developed - and the future generations will benefit - and maybe our generation (born in the 70/80s) too with these developments. Minoxidil, Finasteride & Dutasteride may look like bloodletting techniques to people 100 years from now.
9) No FDA approved - or proven clinically technique, drug, etc.. is effective at stopping or slowing down grey hair - it seems the best bet there is hope you don't have the premature grey hair gene and take care of your health early on (i.e. eat healthy food and avoid all smoking and overdoing sugar, booze, fast food, processed food, etc..), as poor health, especially smoking has been associated with accelerated grey hair.
So for me, what is the story? Well my hair loss has continued to some extent but it seems to have slowed a bit. I'm hoping with the better hair care, lower stress and medical help it will turn around and I'll even grow some back that I lost in the last 6 months.
Only time will tell but I'm doing what I can at this point.
Best of luck - to you and me!
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