I am 20 years old and a few weeks ago I realized I have quite a big bald spot on my crown. So, 2 weeks ago I started minoxidil, finasteride, nizoral shampoo, .25 dermarolling (probably going to go ahead and buy a 1.5).  I’m probably currently NW3 or NW4. Given that I am vertex balding at the age of 20 and started the big 3 plus dermarolling, how long before I reach NW6-7 area?

Many balding patterns that become develop advanced patterns often start first with the crown area at your age. As hair is so important, you should plan on managing it properly, first by finding a doctor who understands the concept of a Personalized Master Plan for your balding. Then get a basic HAIRCHECK test ( https://baldingblog.com/haircheck-test-how-it-is-done-and-what-its-value/ ), and if appropriate, go on medications to stop or at the least slow the hair loss down. At the age of 20, treatments work well when then are managed correctly. I can even do it through telephone consultations if you can’t find a local doctor at info@newhair.com.

The authors show that the blood flow in the scalp with less hair is less than with more hair. This is because the hair requires a great deal of blood because it has a high metabolic rate. The body pumps blood to the scalp to meet the need to support the high metabolic hair organ system.  The reduced blood flow, long held as the cause of hair loss, has never been proven. This is an issue of cause and effect, less hair produces less blood supply not the other way around.

Subcutaneous blood flow in early male pattern baldness

The answer to this question is possibly, but it needs more investigation.  Read this comment published by a notable biologist

https://www.brown.edu/news/2020-04-07/androgen

Multiple injections into the scalp caused multiple abscesses and hair loss. Make sure you get to see an experienced doctor and not some unskilled doctor who is in the hair filed in it to make a buck! You may pay more heavily than with money for terrible work.

The number of grafts will depend upon (1) the final agreement of where your hairline belongs and what you want (I will assume that the V-shaped hairline is at the lowest point of your mid-line hairline as shown in the photo which should be within 1/2 inch of the highest crease of the furrowed brow), (2) the thickness of your hair (fine, medium or coarse where the finer it is, the more grafts are needed), and (3) the decision to treat the crown with medications rather than a hair transplant reflecting the number range I will give you.

Frontal reconstruction (fine-coarse hair) range would be between 2300-1600 grafts). See this hairline as an example which appears to have more hair loss than you show: https://baldingblog.com/patient-review-from-italian-vacation-photo/

Been to two different consultations now and want to decide between FUT and FUE. Both surgeons I spoke to didnt have a big preference between the two, which I was surprised by. They mentioned that with a skilled surgeon FUT scar shouldn’t be visible, as long as you care for it properly.

The cost difference is significant. For reference I have a really good donor area, NW4. If I have a thin scar in back i really don’t care, as long as it’s not huge.

Second question is that I dont want to take fin. I already have mild ED issues so I don’t want to risk it, neither does my soon to be fiance. Has anyone had success with HT and just minoxidil?

I have written extensively on my website about the differences between FUE and the strip surgery: https://newhair.com/. As the person who pioneered FUE, I am an authority on it. FUE is a great surgery if (1) you have a great surgeon doing it, (2) the surgeon who does it has good judgements on placing the distribution of the FUE excisions so that they are not clumped together and they don’t cause necrosis of the donor area and (3) they know how to handle the grafts to keep them viable for removal and until they are placed back in the head. Add to that, patient selection is critical as people with very fine hair and/or low density often make poor candidates for FUE. I believe that if you are going to develop a very advanced balding pattern, then the strip surgery is better because FUE causes donor site depletion when too many FUE grafts are removed from the donor area as shown here: https://baldingblog.com/collection-victim-photos-internet-harvested-depleted-donor-areas/

I have had 3 strip surgeries and I don’t have a scar that anyone can see. This man had about 4 strip surgeries and a few FUE surgeries and look at his donor area: https://baldingblog.com/norwood-class-7-pattern-patient-received-11000-grafts-plus-smp/. His scars were not very prominent but he had Scalp Micropigmentation just to be sure that nobody would be able to see them as the photos show.

Finasteride will prevent shock loss which is common in young men under 30.