Hair Loss Misdiagnosis

I am a 25 year old male with dark and curly hair. Some family background: My father has no hair loss, but has a high hairline. Possibly NW2/NW2A. My paternal and maternal grandfathers both experienced Male Pattern Hairloss around the age of 60. My maternal uncle is an NW2 but has no other hairloss. My younger brother (age 23) however while having a higher hairline than mine has definitely experienced noticeable frontal hairline recession in the last year. Around October of this year I became concerned with my hairline after getting a shorter than normal haircut. I usually wear my hair medium length and longer in the front which completely covers any visibility of my hairline. I expressed concern to my parents and a few close friends at the time and all of them said I had no noticeable hair loss, and if anything maybe had receded a tiny bit at the hairline. I did make an appointment with my PCP to check it out but ended up being scheduled to see another doctor at the last minute. I had never seen this physician before and she said that she could not give me an answer about hair loss because she had never met me before nor had she seen my hair. She ordered blood tests which all came bak normal. I went on with my life. During the months of December and January I experienced extreme emotional stress and more sleep deprivation than normal as a result of the new job I started around Christmas time. Around February I got another haircut, and shortly afterward felt extreme itching and burning at the back of my head right where the occipital bone meets the top of the neck. My rommate had a look and said that it looked very red and inflammed. I made an appointment with my PCP and met with him a few days later. I described my symptoms and my thoughts about possible hair loss. He had a look all over my head and asked if I had a history of thin hair or anything while also noting redness on below my occipital bone where I had experienced the itching. I said no because people have always told me I have had thick looking hair. His diagnosis was that I had “Age related hair loss” on my hairline and “possible” thinning on my vertex crown. He said he could not be sure. I asked if this meant I had a mature hairline or was undergoing male pattern baldness. According to him there was no way to tell either way until it gets worse/if it gets worse. He spoke to me about minoxidil and finasteride which I was already familiar with after extensive research online. However he said in my case it was much to early to start on either of these treatments. I left the office not feeling entirely convinced of his diagnosis. Later after going online and seeing examples on forums of men who were thinning at the crown and hairline I became very stressed and thought that if I possibly had thinning this may be a sign of mpb and should begin treatment immediately. I emailed my physician and asked him if it were possible to get a referral to a dermatologist for a second opinion. He said of course but that either way the treatment for hairloss would be finasteride/minoxidil and didn’t see the benefit of seeing a dermatologist. In fact he prescribed me Proscar and said I could begin using Minoxidil if I wanted to. This was a bit over a month ago and since that time I have been using both medications. However, since that time I have continued to have itching, bumps, and pain all over my scalp (even down my neck) and ears along with what seems to be a rash on my ears. Also, in speaking with my mother and others it came to my attention that I had apparently always had a cowlick near my crown and that it looked exactly the same as always which may have been what the doctor was talking about when he discussed my “possibly” thinning crown. That said I apparently do have a more noticeable line of thinning hair behind my head in between the vertex crown and my neck which the physician apparently didn’t notice. However after looking up pictures online I don’t really see any examples that look similar to the thinning pattern I have behind my head. I am going to continue using the medications advised my my pcp until my dermatologist appointment which is scheduled a little bit less than a month from now however I can’t help but feel a little wary in regards to the medical treatment/advice I’ve received up to this point.

My questions are:
Would Finasteride/Minoxidil have an effect on my hair if I didn’t in fact have MPB? I now find 1 or 2 hair strands when running my hands through my hair for a time. Sometimes more. However, I know that Minoxidil is said to cause an increase of shedding 1-3 months after initial usage.

2. How often do you find cases where patients where misdiagnosed in regards to their hairloss?

3. Is a line of thinning below the rim of the crown along with itching/pain in the scalp, ears, and eyebrows something you see in patients with genetic hairloss?

4. Do dermatologists often do miniaturization studies or hair bulk measurements? I know from reading many of your answers to questions that this is the most crucial part of measuring possible hairloss, and am worried my dermatologist will either not have the equipment to do those measurements or not know how to do them period. I live in Seattle and there are not a great deal of hair loss specialists nearby, and none of the HT surgeons I’ve looked up seem to be highly recommended.

The simple fact is I cannot diagnose your condition. If you think you were wrongly diagnosed, see another doctor. Genetic Male Pattern Balding is not a difficult diagnosis to make. Having a small microscope to look at your scalp helps for a miniaturization study but this is not always necessary. Propecia does not work for non balding patients and Norwood 2 is generally not considered balding as it more reflects the impact of a maturing hairline than genetic balding in most men.