Hi,
My answer - I definitely think so. Now read on!
The correct answer is "it all depends".
Not helpful and as with so many of the questions asked in Susan's, the best and most correct answer should be obtained from a professional. An initial assessment in person is best and a tailored treatment approach can be developed. A large warning here though - hair loss is the centre of the snake-oil salesman universe. Be careful who you rely on (obviously me included as I am not a professional, just very bald - Norwood 7 when last assessed - buggar, thought it was less!). There are sites that look at all the hair loss treatments etc and they are worthwhile reviewing to weed out the duds.
If you don't trust your local specialists or are unable to get to them, most hair transplant places that are goos will do an initial email assessment from photos. I did that a few weeks ago with Hasson & Wong in Vancouver (I am in Australia) and specifically asked as a MTF. They said they could repair me to a satisfactory male hair pattern but my loss was too great to get to a female pattern. This is because the additional coverage and density required at the hairline. A few decisions to be made there.
On the medication side (there are more accurate sources than me!!), my understanding is the the options are Minoxidil, Finasteride/Dutasteride, Nizoral shampoo, HRT.
Fin/Dut - Hits DHT, the problem at hand. Both work well a stopping the DHT poisoning. While you have T, you will need these to some extent. used Fin for 2 years. People do complain about the sides, mainly libido loss.
Minoxidil - it works but is required forever or its effects wear off. Used it until my scalp revolted big time.
Nizoral - Contains Ketoconazole. Only use once a week. Used it for a while. Not sure if it did anything.
HRT - by reducing T to a very low level, hair loss caused by DHT should go or be almost gone. There will be other effects I am sure but as the recipient of many of HRT's changes and the fact that they happen so slowly when you live them, I am not sure what I can say has actually happened. Certainly nothing to change the hair loss problem.
As male pattern baldness (Androgenic alopecia) is the result of years of DHT effect, just because your hair has thinned doesn't mean everything is dead. take away DHT and some will recover. Estimates vary from that lost over the past year to up to 7 years Not sure there is a right answer to that.
Your pic shows hair still visible at the front and thinning on the crown. Am I correct that you have vellus hairs (thin, pale fluff) all over? If so, some or many of those can recover. Your heir is very short too so as it grows, you get better visible coverage.
Try medications in whatever mix you want and then reassess in 12 months - yes, it will take that long. It has taken a long time to get here. They say that your hair loss has to approach 50% before it is very noticeable, so it has been going for some time. Min + Fin/Dut+Nizoral is your best starting option. If HRT is ever on horizon, any AA will impact positively too while continuing the others.
REDUCE DHT NOW!
All the best. Got to go and enjoy electrolysis this morning
Em
