u/0ap0

Mid 30's. NW2 with diffusion in the front, mainly around left temple. Began looking for treatment around 1 year ago with the goal to maximize hair retention while minimize potential side effects.

Around 1 year ago I began:
- Minoxidil
- Azelaic acid
- Retinoic Acid
- Alfatradiol
- Fluridil
- Ketoconazole Shampoo
- Microneedling (Relatively sporadic, averaging around once per month).

6 months ago:
- Microdose of topical finasteride (Currently about 0.0225 % of 0.55ml daily; about 0.125mg eqv)

Things I've dropped:
- Redlight therapy (I just couldn't bother with the hat, although I might give it another shot in the future)
- Topical saw palmetto

The result is that I believe I am basically thinning at the same rate as before (caveat is that my hair loss is and has always been very mild so differences are hard to tell). That's just the truth, so all the effort I put in, likely hasn't changed much. It's a relatively complicated stack and you need to apply several times per day. Most important is to let the evening application of minoxidil and finasteride dry before you apply the Fluridil. I use minoxidilmax to simplify the applications. I did experiment with other things in the past like topical saw palmetto, but I experienced some sides (most likely nocebo) and also realized that the fatty layer could block other topicals I apply, so I just dropped it. I also experienced some possible sides from finasteride when I was applying equivalent of 0.2mg/day, so I dropped back to about 0.1mg/day and I felt fine after a couple of weeks (possible nocebo again, hard to tell, might try to increase dose in the future).

I did see some new hair growth at around 4 - 6 months and my already decent hairline got just slightly better, I believe this is likely due to the minoxidil. However the diffused thinning seems to be progressing at similar rate as before (which is slow). It seems like I've had some very slow diffuse thinning essentially throughout my 20's, but I couldn't be sure it was real until early 30's. Now it seems to be thinning to a point where I might have to change hairstyle due to diffusion of an area around my left temple. Again, hairline looks fine, but it just starts to reach a point where left side diffusion is noticeable to others than me (I believe). My hair actually looks pretty great around my right temple and I doubt strangers could tell any noticeable hair loss around my right side, I can barely tell myself.

So, good news is that my hair loss seems to be mild and I probably wouldn't have much of an issue to do one or two hair transplants and maintain a good set of hair into my 40's and 50's even if I continue my conservative approach.

I feel like I really researched all alternatives out there and this is the stack I landed on. The RU-stuff, Spiro, Pyruludimite didn't seem worth it. I would love to try Clascoterone but I basically don't know where to get it. Would probably also try PP405, but I haven't really researched it and I guess you can't get it at this point anyways?

Would love to hear if I've missed anything promising or any other input!