Laser Comb and Transplants

Hi there. I am a 25 year old UK doctor (straight black hair/olive skin). I first noticed hair loss about 4 years ago. It has progressed at a slow rate. I have not receeded at all but am a diffuse thinner – the main areas are at the front-top of my head (about 1.5 cms behind my adequately thick frontal hairline) and also at the crown.

My hair looks quite thin in these areas when wet (with very visible scalp) but if I blow dry my hair and wear it choppy/spiky/drawn towards the middle, it still looks good and my friends/family don’t think I look bald. I started propecia (with full compliance) 2 years ago with a good result – pretty much halted hair loss and possibly even grew back a little hair in the thinning areas.

However, over the last couple of months I have started to thin a bit further in these areas. I am considering buying a laser comb. (Not keen for topicals).

My questions to you are:
1. I know the laser comb currently has no FDA approval for hair loss but does have good(ish) reviews – do you think it is the most logical next step or should I go for minoxidil?

2. Transplants – (which I realise would be a bad decision at my current level of hair loss): It sounds like for a successful transplant I will have to endure a period of going almost entirely bald first in order to assess what needs filling in and to avoid just losing original hair around the transplants over the following years – is this true or can you transplant around thinning hair?

Thanks

From your writing, it appears to me that you are experiencing male genetic hair loss which has responded to Propecia. I am glad to hear that you have been compliant on Propecia for 2 years, but as you know, Propecia may not solve the problem completely. The science is out on the various laser treatments including the laser comb/brush. As for the minoxidil, you can try it, but I would not recommended stopping the Propecia.

In terms of the hair transplant, there is a delicate balance of timing here. People do not have to go bald to get hair transplants, but preventive hair transplants are not indicated unless the thinning has moved past a particular point (something that a good, honest doctor who specializes in this field should be able to tell you). Patience is a virtue, but failure to make a timely decision is a liability. Quite a balancing act! You need to have your scalp hair mapped out to find out how far back the miniaturization is going, so that you can develop a Master Plan before attempting any surgery.