When It's Time to Call It Quits.
As you are already aware, my channel is dedicated for those who are dealing with hair loss and for those who are looking for solutions to getting back their hair, whether through hair transplants, hair loss medications, or by other means. I am a strong advocate of those who are suffering from hair loss to do whatever it takes to get your hair back. But, there also comes a time when you have to draw the line between continuing your fight against hair loss and finally throwing in the towel and calling it quits. I just wanted to give you guys my personal thoughts on exactly where I would draw that line so that those who are contemplating either calling it quits or are not too sure on whether to continue to fight the good fight can get a view of my own thoughts and go from there.
Currently, we have several hair loss medications that work in various mechanisms of action to treat hair loss. We have finasteride and dutasteride (off label but more effective), both which inhibit DHT and are effective in most people taking them, and minoxidil. If you are 100% unwilling to take hair loss medication, whether due to side effects or because of other personal reasons, I think those who are suffering from hair loss early on should consider calling it quits, only because statistically, there is a high percentage you will continue to lose hair. Obviously, if you are suffering from mild hair loss and at an age where hair loss has been stabilized, it wouldn’t make sense to give up unless you just didn’t care anymore, but that’s the hard part in determining how fast or slow you are or will bald in the future. Currently, the only FDA approved hair loss medication is minoxidil and finasteride (and in some other countries – dutasteride), and as I stated, without taking hair loss medication, it is highly likely that you will continue to recede and lose hair. There really isn’t a point in getting a hair transplant, which is the best preferred method in rectifying androgenetic alopecia, at least on an aesthetic level, if you are going to continue to lose hair because you’ll end up having to play a game of catch-up and will continue to deplete your donor hair and waste money at the same time as you get more and more hair transplants. Sure, we have things like microneedling and lasers and other things that can be beneficial for hair growth, but as you know, one of the major causes of genetic hair loss is our sensitivity to androgens, particularly DHT. IF you want to slow down and possibly reverse hair loss, you need to, first of all, target the main cause and then synergistically as a secondary complement, use other known means to treat hair loss which includes lasers, microneedling and minoxidil, good hair loss shampoos and vitamin supplements. Without inhibiting DHT first, hair loss will resume and over the years, you will continue to lose more hair and miniaturize.
Now if you do decide to go with a hair transplant and decide not to take hair loss medication, you have to realize that the areas not treated with hair transplantation is still prone to balding. For example, I got 1700 grafts into my frontal hairline and if I were to stop taking hair loss meds for an extended amount of time, the areas behind it is most likely to continue to recede and thin out over time, and to me personally, that would defeat the purpose of getting another hair transplant, unless you are okay with just having that one particular region treated with hair transplantation and the likelihood of the rest prone to further balding.
In terms of the Norwood scale, and this is assuming you are still taking hair loss medication, if you are anywhere between a NW-2 to a NW-5, I’d personally continue fighting hair loss. I personally feel that at this level of hair loss and even at a NW5, you have a very good chance of getting a good head of hair back, especially if you work with a proficient hair transplant doctor who can create a good natural looking hairline with added density in the mid scalp and crown. Most people up to a NW-5 should be able to get a good illusion of a full head of hair, assuming they have at least average hair density, decent hair follicle characteristics, such as graft size and donor availability. There are a lot of variables in this including the onset of hair loss, family history, etc., but assuming hair loss has stabilized to a certain extent and you are at least of age where hair loss seems to be somewhat controlled (meaning you’re not already at a NW5 at age 20 or have extensive hair loss at a younger age), I personally would continue pushing forward. Now it becomes a bit more difficult, at least in my opinion, if someone who is a NW-6 or a NW-7 tries to fight hair loss only because that person has already lost so much hair. Imagine trying to have Dr Phil with a good head of hair, given the limited donor area he has. The best candidates are those who treat hair loss early in the game, when they see the first signs of miniaturization or temple recession. For me, if I were a NW-6 or NW-7, I would call it quits. I would call it quits because even with a hair transplant, most people will not have enough donor supply to get good coverage with good density. Most people have to sacrifice between having a defined hairline with not much coverage behind the hairline, or having full coverage with poor density. Obviously with advanced hair loss, you can also incorporate body hair to add in density, but most of the results I have seen on people with body hair transplants on the scalp doesn’t look natural, the hair characteristics are not the same as far as thickness and length, and the hair cycle doesn’t completely match to that of the scalp hair. This is why most people who are in the upper NW chart resort to hair pieces only because they realize a hair transplant wouldn’t do much, and even with a hair transplant, they most likely would not be content with the results. Or they simply shaved their heads and embrace it or you can also do SMP (scalp micro-pigmentation). This isn’t to say that those with a NW-6 or NW-7 can’t have successful outcomes. I’ve seen some people as a NW-6 or NW-7 who were content with the outcome of their hair transplants but with anything, results are always subjective and while it may look good to one person, someone else might not think the same.
All in all, I’m not trying to discourage anyone from stopping their fight against hair loss, especially if you are already at an advanced level of hair loss, but rather to give you guys my insight and my personal opinion based on current treatments and what I have experienced and seen in the hair loss and hair transplant industry. But the good news is that there are better treatments in the pipelines in regards to stem cell research and hair replication, for example Dr. Tsuji and Replicel/Shiseido’s RCH-01 on derma sheath cup cell injections, we have Follica, Stemson Therapeutics, Dr Christiano, Histogen, etc., so hopefully we get some good updates in the near future. And it’s true that it’s easier said than done, especially with so many people who are afflicted with hair loss and wanting to find a solution to fix it, and I probably won’t truly even know myself as far as what I would do until, God forbid, I’m in a position where I really have to decide if I need to really stop the good fight or push on and continue forward.