Misdiagnosed for 10+ years... until now.
Summary
TLDRAlesandro's decade-long struggle with hair loss involved misdiagnoses and unsuccessful treatments, including minoxidil and finasteride. After a hair transplant, his condition worsened, leading to a breakthrough when a nurse practitioner diagnosed him with alopecia areata incognita, not androgenic alopecia as previously believed. The correct diagnosis and treatment with corticosteroids finally sparked regrowth, highlighting the importance of accurate diagnosis and patient advocacy in hair loss treatment.
Takeaways
- đ Alesandro's struggle with hair loss began at a young age and was misdiagnosed multiple times by different physicians, including a transplant surgeon.
- đ Despite trying treatments like minoxidil and finasteride, Alesandro did not see improvement and eventually underwent a hair transplant, which initially provided good results but later thinned out.
- đ The script emphasizes the importance of a thorough and accurate diagnosis, suggesting that many dermatologists may not provide the necessary care for hair loss patients.
- đ Alesandro's situation improved when he connected with a community that provided data-driven approaches and eventually received a correct diagnosis of alopeica areata incognita from a specialist.
- 𧏠The story serves as a cautionary tale about the underwhelming care that many hair loss patients receive and the need for patients to advocate for themselves.
- đŹ Clinical studies show that minoxidil, a common treatment for hair loss, only works for about 40-60% of people due to challenges in penetration and activation.
- đ Alesandro's experience with finasteride was not unusual; many users do not see significant results, and the script suggests that higher doses or different drugs might be more effective.
- đ± After a decade of treatment failures, Alesandro finally saw regrowth by combining topical finasteride, minoxidil, retinoic acid, and micro-needling, which enhanced the effects of his treatments.
- đ The script outlines a five-step framework for tackling hair loss: identifying hair loss types, aligning on goals, building a regimen, tracking results, and adjusting the plan based on data.
- đ Alesandro's story underscores the value of educational resources and community support in helping individuals navigate the complexities of hair loss treatments and find effective solutions.
Q & A
What was the initial diagnosis given to Alessandro by five different physicians?
-Alessandro was diagnosed with androgenic alopecia on five separate occasions by five different physicians, including a transplant surgeon.
What treatment did Alessandro try before joining the hair loss community site?
-Alessandro tried minoxidil, finasteride, and a hair transplant before joining the community site.
Why did Alessandro's minoxidil treatment not work as expected?
-Alessandro's minoxidil treatment did not work as expected because topical minoxidil has difficulty penetrating deeper layers of the scalp skin, and many people lack enough activity of the enzyme sulfotransferase in their scalp for minoxidil to be effective.
What is the typical timeframe for seeing results from finasteride treatment?
-Clinical studies show that it can take 6 to 10 months to see slight cosmetic improvements from finasteride, with the biggest hair gains coming between months 12 and 24.
Why did Alessandro's hair transplant start thinning after a year?
-Alessandro's hair transplant started thinning after a year because he quit taking finasteride, which is necessary to stabilize hair loss and protect the investment of a hair transplant.
What was the turning point in Alessandro's hair loss journey?
-The turning point was when Alessandro was correctly diagnosed with alopecia areata incognita by a nurse practitioner trained under Dr. Alfredo Rossi, after being misdiagnosed for over a decade.
What treatment led to Alessandro finally seeing regrowth?
-Alessandro started seeing regrowth after incorporating a topical corticosteroid treatment into his routine, as prescribed by the nurse practitioner under Dr. Alfredo Rossi's guidance.
What role did the hair loss community play in Alessandro's journey?
-The hair loss community provided Alessandro with resources, support, and a framework to reassess his situation, which ultimately led him to the correct diagnosis and treatment.
What advice does Alessandro have for others struggling with hair loss?
-Alessandro advises others to be patient, stay vigilant, and be their own patient advocate, using the resources and community support available to them.
What is the importance of a thorough scalp examination in diagnosing hair loss?
-A thorough scalp examination, using a device like a dermatoscope, is crucial for diagnosing hair loss accurately, as it allows clinicians to identify specific markers that can differentiate between various types of hair loss conditions.
Outlines
đ Hair Loss Struggles and Misdiagnosis
The paragraph introduces Alessandro's decade-long battle with hair loss, which was misdiagnosed multiple times as androgenic alopecia. Despite treatments like minoxidil and a hair transplant, his condition worsened. The speaker expresses frustration with the lack of clear communication and incorrect diagnoses from medical professionals, highlighting the emotional toll and financial costs of these failures.
đŹ The Science Behind Hair Loss Treatments
This section delves into the science behind minoxidil, a topical treatment for hair loss, and its limitations due to penetration issues and enzyme activation requirements. It discusses how combining minoxidil with retinoic acid and micro-needling can enhance its effectiveness. Alessandro's experience with minoxidil was unsuccessful, and the paragraph also covers his transition to finasteride, an oral medication, and the typical timeline for its effects.
đ± Hair Transplant Journey and Its Aftermath
Alessandro's decision to undergo a hair transplant is detailed, including his choice of a renowned surgeon in Turkey. The paragraph outlines the transplant process, the surgeon's strategy, and the immediate positive results. However, it also describes the subsequent thinning of the transplanted hair and Alessandro's emotional struggle when he stopped finasteride, leading to increased hair loss.
đ Revisiting Treatments and Seeking New Solutions
After experiencing setbacks, Alessandro reconnects with his surgeon who recommends returning to finasteride. The paragraph discusses the importance of continued treatment post-transplant and the emotional impact of hair loss on Alessandro. It also touches on the desperation and common pitfalls people encounter when exploring various hair growth products without a scientific basis.
đ Education and Community Support
Alessandro discovers the speaker's website and community, which offers data-driven approaches and personal support for hair loss. The paragraph explains the community's framework for tackling hair loss, including identifying hair loss types, setting goals, building a regimen, tracking results, and adjusting treatments. Alessandro's decision to join the community and his first interactions are highlighted.
đ ïž Implementing a New Treatment Plan
The paragraph outlines Alessandro's new treatment plan, which includes topical finasteride, minoxidil with retinoic acid, and micro-needling. It discusses the importance of adherence to the treatment and the use of progress tracking tools. Despite following the plan, Alessandro does not see immediate results, leading to further investigation into potential reasons for his lack of response to treatments.
đ„ Reevaluating the Diagnosis
As Alessandro's hair loss continues, the paragraph discusses the reevaluation of his diagnosis. It covers the possibility of other hair loss types, such as autoimmune conditions, that might be contributing to his lack of response to standard treatments. The importance of blood tests and the role of DHT levels in assessing treatment effectiveness are also explored.
đ The Impact of a Correct Diagnosis
Alessandro finally receives a correct diagnosis of alopeica areata incognita from a specialist, which explains his poor response to previous treatments. The paragraph details the diagnostic process, the identification of specific signs of alopeica areata, and the immediate treatment with corticosteroids. It also reflects on the simplicity of the diagnosis and the emotional relief it brings after years of struggle.
đ Reflections on the Journey and a Renewed Outlook
In the final paragraph, Alessandro shares his gratitude for the correct diagnosis and treatment, and the positive impact it has had on his life. He emphasizes the importance of education, community, and perseverance in the face of hair loss. The speaker calls for higher standards in hair loss care and offers resources to help viewers advocate for themselves in medical settings.
Mindmap
Keywords
đĄAndrogenic Alopecia
đĄMiniaturizing
đĄFinasteride
đĄMinoxidil
đĄHair Transplant
đĄAutoimmune Hair Loss Disorders
đĄCorticosteroids
đĄMicroneedling
đĄRetinoic Acid
đĄDifferential Diagnosis
Highlights
Alesandro's hair loss journey began at a young age, causing significant distress.
Despite multiple diagnoses of androgenic alopecia, treatments like minoxidil and finasteride failed to stop his hair loss.
A hair transplant initially showed promise but began to thin after a year, leading to further despair.
Alesandro's story underscores the common issue of misdiagnosis and inadequate care in hair loss treatment.
The importance of a thorough scalp examination and clear diagnosis before treatment was emphasized.
Alesandro's experience with minoxidil was not unusual, as many users discontinue use due to perceived ineffectiveness.
Combining minoxidil with retinoic acid and micro-needling can enhance its effectiveness.
Finasteride's full effects can take up to two years to manifest, which many patients and clinicians may not realize.
Alesandro's decision to stop finasteride cold turkey led to a rapid resurgence of hair loss.
The psychological impact of hair loss on Alesandro was profound, affecting his self-esteem and mental health.
Alesandro's encounter with a nurse practitioner under Dr. Alfredo Rossi led to a correct diagnosis of alopeica areata incognita.
The correct diagnosis of alopeica areata incognita alongside androgenic alopecia explained Alesandro's treatment resistance.
Alesandro began treatment with a topical corticosteroid, which led to noticeable regrowth.
The video provides a framework and checklist for individuals to advocate for themselves during dermatology appointments.
Alesandro's story concludes with a message of hope and the importance of perseverance in the face of hair loss.
The video calls for a higher standard of care in the diagnosis and treatment of hair loss.
Transcripts
look here your hair is still
miniaturizing Finance rate is not
working with you I hit rock bottom you
know in my mind I wasn't thinking you
may have something else there is another
maybe kind of loss that is taking place
so I was 5 seconds away from an answer
for 10 years and it was clear to her and
it wasn't clear to them did they know
and not told me it's something that I
keep asking myself
imagine getting diagnosed with patternn
hair loss hopping on fastrite hopping on
minoxidil but over the next decade your
hair loss just gets worse imagine paying
thousands of dollars for a hair
transplant only for one year later that
transplant to start
thinning this is the story of alesandro
he's a member of our community with a
10year history of treatment failures
prior to joining our site today he's
finally seeing regrowth and in this
video we're going to detail exactly how
he got
there here's what I find Crazy
allesandro was diagnosed with androgenic
alipa on five separate occasions by five
different Physicians including a
transplant surgeon the diagnosis was
wrong his story is as much a cautionary
tale as it is a reflection of the
underwhelming care that too many
dermatologist provide to hair loss
patients I hope you can use the
takeaways from this interview so that
you never have to go through the same
experience we'll cover alesandro's story
and the datadriven approach that we
applied while working with him you'll
learn about his treatment mistakes his
successes the strategies for tackling
endogenic alopecia you might be
interested in strategies for autoimmune
hair loss disorders and most importantly
how to dominate your next dermatology
appointment and force your clinician to
give you a proper scalp exam and a clear
diagnosis we even have a video and a PDF
for that which you can download below
but for now let's get into alesandro's
story As Told by him and we'll make this
as educational and impactful as
possible my hair loss started when I was
really really young so I was like not
even 14 I was a child I went to the
barber and he told me he was a friend of
my father's and he told me I see some I
wouldn't say bold spots but you know
some lack of density here on the top of
of my sculp my type of hair loss was I I
started like to have a reeding hairline
basically to lose some density in the in
the in the center so from here backwards
yeah that was terrifying I was like in
high school so it was really really you
know tough on me as a as a kid and so he
told my father he told me and I was like
quite shocked we we met uh this
dermatologist and he told me I mean yeah
you suffer from alishia like your father
it's genetic there's nothing you can do
after a year or two years my situation
was getting worse slowly but surely
worse so that's when we swap doct we
change the doctor another dermatologist
told me maybe you should give minoxidil
a try so I went to a pharmacy here in
Italy I don't know if in the US as well
but we have pharmacies that prepare the
minox themselves so I went for for it
and uh I started doing this say therapy
so uh 2 milliliters uh twice a day for
those who don't know topical minoxidil
is a drug used to treat pattern hair
loss also known as androgenic alopecia
it helps improve micro circulation it
might reduce inflammatory substances
called prostaglandins and clinical
studies show a strong enough safety
profile for the FDA to approve minoxidil
as an over-the-counter medication for
androgenic Alopecia now safe is one
thing effective is another we're going
to get to that in a second but for now
just know that many pattern hair loss
patients who are younger than 18 they'll
generally only be recommended minoxidil
partly because it might help but also
because some of the more powerful drugs
used to treat pattern hair loss things
like faside they can POS developmental
risks for those who are still in
adolescence so how did alesandro's
experience with Minoxidil go I quit
minoxidil after one year when I was 15
16 I quit minoxidil nothing really
worked but I kept applying it blindly
I'd say I was really young so I didn't
even know really what to do and how to
do it this isn't surprising despite
being FDA approved alesandro's poor
experience with Minoxidil is not the
exception it's the rule in this clinical
study researchers found that 95% of
minoxidil users quit within one year and
2third of those users said that they
stopped because the drug had no effect
so is there any truth to corroborate
that well yes a deeper look into the
clinical data shows that topical
minoxidil actually only works for about
40 to 60% of people the reason why is
twofold first topical minoxidil has a
hard time penetrating into deeper layers
of the scalp skin where our hair
follicles reside and second topical
minoxidil is delivered inactively it
needs to come into contact with an
enzyme called sulot transferase in order
to sulfate or activate and then it can
attach to our hair follicles and have an
effect no sulfo transferase no way for
minoxidil to work and a lot of people
don't have enough activity of this
enzyme in their scalp for minoxidil to
get the job done fortunately studies
also show that these are fixable
problems if you combine topical
minoxidil with retinoic acid and Micron
needling you can enhance its penetration
and its activation potentially seeing up
to fourfold better results it's that
simple and if clinicians did a better
job educating patients about these
options my guess is that a lot more
people would be sticking with Minoxidil
a lot fewer people would be saying it
doesn't work alesandro did not have that
information so let's see where he goes
next when I wasn't like 17 18 I talked
to the doctor again to the first
dermatologist and he told me now you're
old enough to try the Finas
ride and I was I I wouldn't say I was
desperate I said yeah yeah let's let's
right I mean you are a doctor you're
telling me this and it's I I guess one
of the best or most uh famous treatments
for hell loss so I said yeah why not and
he he told me ah you're going to improve
a lot with this you're
like everything will be fine everything
is going to be all right so I I was
super happy that was almost 11 years ago
this makes sense alesandro is now 18
years old he's eligible for five Alpha
reductase Inhibitors like oral faside
these medications they lower levels of
dihydrotestosterone also known as DHT
which is the hormone causely linked to
the balding process and in doing so they
can help regrow hair for what it's worth
faside is considered the gold standard
drug for treating androgenic alopecia in
men dozens of studies show good hair
growth outcomes decent safety profiles
and sustained hair regrowth 1 2 5 even
10 years into the future this all sounds
great so what happened when allesandro
started taking finasteride what was his
response like so I started to to to do
with the to take the FAS ride and I was
I was thinking if I remember correctly
one milligram so I did this for a few
years and my hair loss was slow year by
year I couldn't tell if I was getting
really really worse or not so I thought
maybe it's working maybe it's not
obviously I didn't gain like new hair
I'm not improving but I'm not even like
getting worse so I was really confused
you know here's another thing most
clinicians will not educate their
patients on how long it takes for hair
growth drugs to actually work for finast
ride the clinical studies show that it
can take 6 to 10 months just to see
slight cosmetic improvements but the
biggest hair gains those actually come
between months 12 and months 24 all too
often our team sees people quitting
finast at month three month four saying
they tried it and it didn't work they
have no idea that it takes a full two
years to achieve its effects and if
clinicians let people know about this
while prescribing I think a lot more of
their patients would have better
adherence and thereby better outcomes
another thing is that most clinicians
don't tell their patients what it means
to respond to finasteride some patients
Envision full hair regrowth in reality
response means something different it
means any slowing stopping or partial
reversal of hair loss versus a placebo
technically you can still be benefiting
from finast but still losing hair just
at a slower rate than how you would if
you weren't using the medication we talk
about this in our video series about
finasteride non-responders so keep this
in mind a slowing of hair loss is still
technically a response now let's go back
to alesandro and what he decided to do
next when I was 23 24 I said okay that's
enough uh nothing is working with me the
only solution I thought was the hair
transplant so I started looking for
surgeons and I found a top one a really
famous one which is in Turkey uh not to
be confused with those guys that you
know they they sell you hair transplants
for
$2,000 it's not one of them he's a great
guy and he's like really really famous
so I went to talk to him in
turkey and he told me yeah what we have
to do here is do five 5,000 grafts which
is the maximum they can take from the
side and the back of your head and put
it in the top so he said let's not lower
the hairline let stay there and let's
work our way from here to the back so my
my hair transplant reached let's say
here so I didn't touch the vertex the
vertex wasn't involved he told me you
can you could be a great patient uh your
transplant is going to turn uh really
great uh let's do it so I did it I was
24 so six years ago the clinic was
awesome uh it was treated like a king
everything went well uh the day of the
operation the surgery after the surgery
they told me your crafts so the hair
they plucked from the sides and the back
survived really good they were healthy
everything went well uh so I went back
home I waited a few months obviously I
wasn't sleeping at night you know I was
like oh my God I'm gonna have new hair
it's gonna be awesome and I must say the
hair transplant worked really well the
hairline was great was so natural the
results were was amazing to me so I was
really happy um they told me one year
before the the transplant they told me
keep keep taking Finas ride don't don't
quit the Finas ride because the finess
ride will help you also after the
transplant so that's what I did I kept
taking Finas ride uh what's funny is
that when I went to the clinic to meet
the surgeon he put He put my scalp under
a microscope and he told me look here
and he he pointed at my hair you're
still your hair is
miniaturizing so fin R is not working
with you and I was like I was struck I
was like what I mean crazy and he told
me yeah but you know maybe maybe it's
because the you're taking the one
prepared by the pharmacy so maybe it's
not that strong uh use the proser which
is a famous one you can find anywhere so
yeah I said yeah maybe maybe it's uh
that's why maybe that's why for
reference there are a number of dosing
studies on faside with participants
testing anywhere from2 mg up to 5 mg
daily for regrowth these doses they all
roughly reduce the same amount of serum
and scalp DHT however most of the
studies still show directionally better
results for people on higher doses of
finasteride Alexandre was prescribed 1
milligram daily procar is the 5
milligram version of finasteride so I
understand why his surgeon made this
recommendation there's a little upside
with a higher dose however the key word
here is little The increased hair gains
going from 1 to 5 migs of finasteride
it's very marginal which means this is a
low leverage recommendation with a not
so big payout what would have been more
impactful well perhaps maybe switching
from finasteride to dutasteride as
dutasteride can reduce more DHT and lead
to significantly better hair growth
outcomes versus finasteride and yet
dutasteride in many domains will share a
similar safety profile so if you find
yourself in this situation keep in mind
that there are High leverage regrowth
options at your disposal now back to
alesandro so after one year of the
transplant my results were complete
let's say I was happy I was still taking
a Finas ride but at that point I said
okay now I have like a good situation
I'm happy I don't want to take Finas
ride anymore I don't want to be on drugs
uh I don't want to be taking any any any
medication any drug so I made a huge
mistake I guess maybe I quit to cold
turkey only after a few months so after
a year and six months after my
transplant I started to see some loss of
density in my in my scalp so I panicked
and I said oh my God it's not possible
it's not possible that my situation is
getting worse again just after a year
and a few months after my transplant so
that was really really when I hit a
really rock bottom you know it was like
mentally was super tough because I had
the impression the idea that
I I was able to overcome my problem and
after just one year and a and a half I
was back at I wouldn't say square one
because I still kept some hair but it
was noticeable for people in alesandro's
position this sentiment is incredibly
common a transplant can dramatically
boost the appearance of your hair to the
point where you can feel so good so
confident that you forget that hair loss
in the surrounding areas can still
progress if you want to protect that
investment that hair transplant you
generally need to make sure that your
hair loss is completely stabilized and
the most studied and reliable way to do
this for men is with finasteride so what
happens when somebody quits that drug
well here's a chart showing that within
3 months hair shedding starts to
increase and within 12 months you're
usually back to where you would have
been prior to using the drug in the
first place the bottom line you should
be aware of these risks be aware of the
withdrawal effects even if you're
feeling good about your hair that was
really really when i h really rock
bottom you know it was like mentally was
super tough because I had the impression
the idea that I I was able to overcome
my problem and after just one year and a
and a half I was back at I wouldn't say
square one because I still kept some
hair and uh it wasn't like day by day
but it was noticeable let's say that's
when I talked to the surgeon again and
he told me yeah you quit Finas ride you
shouldn't have let's I want you to go
back on Finas ride and let's see what
happened so a few a few more uh months
have passed and then the pandemic hit
and was really tough yeah what happened
was I I didn't
have any solution at that point I was
stuck this is not unfamiliar territory
for hair loss sufferers when people
experience setbacks when they experience
treatment failures desperation can set
in it's as if every hair growth ad
starts to find you and you fall into
this habit of maybe buying pills topical
supplements shampoos devices without any
trial and error process in place and
without knowing if these marketing
claims that you're seeing even align
with scientific reality most of the time
they don't and in researching one
product allesandro had bought that's
actually how he stumbled across our site
so one day uh I was reading an article
uh on R mushroom because I was always
looking for you know new information or
some something new I just bought a 40 âŹ
40 uh
lotion from a you know a really
well-known
brand where some R mushroom was in it
when I started reading the article I was
so so angry man because I thought maybe
this RI mushroom is can you know can
work it's a solution but then I and I I
was mad at the the guy who wrote the
article because I said ah this guy is's
lying no it's working it will work for
me and but in the end I must admit the
article was really really well done and
I started to say who's this guy I mean
who's this website and it's it's so
interesting I reached out it was
obviously was your your website your
community I reached out and uh just
after a few days I I read all the
literature on the website I read all the
you know all the guides you you wrote
and I was super hopeful I said this guy
is going to help me I know we can find a
solution together I know we can work
together and uh yeah that's that's when
we we met the first time alesandro ended
up joining our membership Community this
is where we offer educational resources
and personal support for people fighting
hair loss prior to joining most members
find themselves in a position where
they're not seeing success they're tired
of earning cash they're over the
marketing gimmicks and they're ready to
have a clear path forward one that will
respect their treatment preferences and
also come with support from people
people who only care about getting them
a good outcome not selling them into
some hair care brand cuz they affiliate
with them allesandro had also opted for
our coaching package which means that he
and I would have the chance to connect
every week during a 1 to two hour group
call I like this format because it
creates multiple touch points it helps
with accountability and those things for
people who have complicated cases really
help to go for the best outcomes on our
first call together allesandro detailed
all of his treatment attempts all of his
failures the transplant everything then
after getting that information we began
to implement a framework that we use
with everybody inside of our site one
identify your hair loss types two align
on goals three build a regimen four
track for results and five adjust
accordingly Based on data not emotion so
let's apply this framework using what we
know about alesandro so far first he's
got a familiar history of androgenic
alopecia he also described hairloss and
regions associated with androgenic
alopecia the temples in the frontal for
loock of his scalp he says his hair loss
has been gradual over a series of years
and he's had four or five dermatologists
and a transplant surgeon all align on
the same diagnosis androgenic alopecia
nothing else this makes for a very
strong case that allesandro is dealing
with androgenic alipa so we'll call that
step closed for now second alisandra let
us know that he wanted new hair growth
but he also was getting side effects
from oral finasteride and he wanted to
find a way to quit the medication this
allowed us to Define clear goals first
get alesandro hair regrowth and second
eliminate his side effects from fastr
for step three we have to take in
account alesandro's treatment history he
didn't see hair regrowth from faside
however he noticed a big shed when he
quit the drug that suggests that maybe
faside was working he just fell into
that category where it was slowing
things down not necessarily reversing
the loss moreover allesandro quit
topical minoxidil after one year but he
didn't know about all these adant
therapies the retinoic acid the Micron
needling that might have helped him turn
into a responder given the alignments of
his diagnosis the past treatment
attempts the strong data supporting the
things that we just talked about in
helping androgenic alpia patients we
decided to show him this data and we
also showed Alexandre the results
Horizons for these treatments that's the
time that it would take for them to
start producing cosmetic results after
reflecting on all of this alesandro
settled on the following plan topical
finasteride which some studies show
should allow him to Leverage The Power
of oral finasteride but with a lower
risk of side effects 5% minoxidil
combined with retinoic acid and finally
micr needling which along with the
retinoic acid should help to enhance the
effects of minoxidil alesandro also oped
to try some other stimulation-based
interventions like the scalp massages
because he felt that his scalp perimeter
muscles appeared to be really tight and
he found the exercise to be very
relaxing so this was his new plan
allesandro intended to try these things
for at least four to 6 months which is
the short end of when we might expect
cosmetic improvements and he also chose
to track his progress through self
assessments and subjective measurements
of his own hair shedding now those
metrics they're certainly not perfect
usually we want people to be tracking
with our progress logs tool where you
upload your regimen your photos you tag
the dates you tag the scalp regions of
the photos and then this Autos sorts to
give you a fully private fully
standardized log that is super easy to
navigate super easy to update and
examine your progress in any specific
scalp region and if you choose you can
also share that log with our community
so our team and others can provide
feedback and support but for people who
have been fighting hair loss for a long
time they often have the self-awareness
to know if something is or isn't working
alesandro had that and so these
measurement tools that he settled on
were going to be what worked for him
personally I had high hopes for
alesandro's protocol I mean the clinical
data strongly suggests that this new
regimen if followed properly should
achieve some significant results and
while adherence can be a problem for
some people which is why we built our
treatments calendar which sends you push
reminders via your phone for when you
need to micro needle or apply topicals
or use a shampoo with ketoconazol any of
that alesandro happened to be a person
who was highly motivated and as our
group calls continued it became more and
more apparent that he just had no issues
on the adherence front so fast forward a
few months allisandro is adhering to the
plan he's showing up to the calls he's
engaging our team he's even reported
that his side effects from finast ride
have subsided this is great news one of
our goals is already accomplished but
how was his hair doing I was spending
like quite some time you know every day
working on my sculp I did everything I
could and uh I made sure I did it
correctly so I was like asking you
thousand questions to make sure I was
using the micro needling I bought a pen
so it was like also an economic you know
um investment I was doing all these
things and I was applying the uh at this
point I switched from oral to topical
Finas I was applying it after after the
minoxidil every night and it was leaving
my hair horrible in the morning and
after a few a few months I was hoping
that the massages would be working in a
way but I didn't see any growth the
micro needling as well wasn't even you
know I wasn't getting the results other
people were getting this was hard to
hear despite the new protocol allesandro
had seen effectively no changes to his
rate of hairfall no changes in the
progression of his hair loss no signals
that what he was doing was doing
anything now keep in mind that while
that experience feels discouraging we
have to remember our fifth pillar using
data to make adjustments responding to
these treatments would have been
wonderful but not responding to them
that's still great data because that
data even if it's negative helps to
provide insights that we can start to
use to troubleshoot maybe ask better
questions and adjusting the plan so what
might be going on here well possibility
number one is that maybe allesandro
needs more time for results
after all we've only just reached that
minimum viable point for results
Horizons especially with faside the best
results aren't even realized until year
two of the medication now In fairness to
alesandro he had been using finast on
and off for the better part of a decade
so while this was still a possibility it
might not necessarily be a plausibility
even still this is an easy thing to test
all Alexandre needs to do is just keep
trying his treatment protocol and we can
evaluate in the coming months Poss Poss
ility number two is that something else
is going on either allesandro has
something preventing him from seeing
hairy growth from androgenic alopecia
treatments or he might have another type
of hair loss that needs to be treated
differently preventing him from getting
results so let's start with that first
category these blockers to hair regrowth
from androgenic alopecia according to
the clinical data people with igf-1 or
growth hormone deficiencies they tend to
see really poor responses to hair growth
drugs like minoxidil and finasteride
again this is easy enough to test just
get a serum test for igf-1 if it's low
medical professionals can help you
identify why that's low and in many
cases get you treatment and get those
levels back to Optimal moreover many of
our members who consider themselves
non-responders to finasteride will later
do blood tests for DHT and a huge
portion of them have found that their
serum DHT levels they're not depressed
they're actually within normal to high
ranges the implication here is that for
these members maybe those DHT reduced
drugs might not be having much of a DHT
reducing effect again this is easy to
test for just get a serum DHT test if
it's low great if it's normal or high
consider upping your dose of finasteride
switching to dutasteride switching to
topical dutasteride these things have
helped many of the members in this
category move from that non-responder to
responder class for 5 Alpha reductase
Inhibitors so on this front what were
the results for allesandro well he got
blood work his IG F1 levels looked
totally normal great that's another
piece of data so what about his serum
DHT levels well allesandro had actually
gotten a number of DHT tests while still
taking oral finasteride an oral
finasteride at 1 milligram to 5 mg is
supposed to reduce blood levels of DHT
by about 70% he told us his results his
DHT was always in the normal range
sometimes it was even high unfortunately
allesandro was a bit stuck on what he
could do about this because keep in mind
that he already got side effects from
oral finasteride which is why he made
the switch to the topical if he UPS his
topical dose more of that drug might Le
into the bloodstream and start causing
the same side effects as the oral
medication now he could try to lower his
scalp DHT through other means like
Androgen receptor antagonists this might
include experimental options you might
have heard of some of these topical
spirolactone topical flil topical cb31
ru58841 topical pomide and others but
but all of these options they lack
long-term safety and efficacy data on
men so understandably alesandro wasn't
really interested at this stage in
exploring them so what about the
possibility of other hair loss types
maybe masking as androgenic alopecia or
preventing a response from alesandro's
current treatments well we have some
tools to evaluate this here you can
evaluate your health history and then
cross reference any unusual symptoms you
have with conditions that are linked to
hair shedding dis disorders such as
telen of fluvium then you can go about
systematically tackling each of those
suspected causes so say you've got a
thyroid disorder or a vitamin deficiency
or anything if it's having an impact on
your hair then if you address those
causes it should also help to improve
your hair for anyone interested in help
on this we have a regrowth road map
Health assessment survey inside of our
site that can help you out with that
process but alesandro did lab testing
here too based on his symptoms and the
results didn't really tell us too much
we checked my testosterone levels dedr
testosterone levels so we we I did
plenty of exams I did really everything
and uh I would say results came back
pretty normal except my bil Rubin so as
you said before maybe um I had elevated
Billy Rubin which is correlated to uh
the Gilbert Syndrome which is just a
condition I I it doesn't have any impact
on on your life but it gives me some uh
yellowish let's say in my in my eyes but
as you as you rightly said before always
thinking about the let's say standard
androgenic alopa not not you know not
outside of those of that box the good
news was that alesandro's lab tests
helped him rule out some of the
potential secondary causes of hair loss
the bad news was that it didn't
definitively answer why he remained such
a poor responder to such a strong hair
growth stack and as another month or two
passed he started to go deeper into
those results Horizon Windows yet his
situation was not changing no slowing
down of hair loss no decrease in hair
shedding nothing at all could something
else be going on given all the data so
far we felt it was important to start
operating under the assumption that the
answer might be yes so we started to
revisit one of the big initial
assumptions about allesandro that he was
actually dealing with androgenic alipa
and I know that that sounds crazy to
consider given that he has a family
history his patterning of loss the five
medical professionals on five separate
occasions converging on the same exact
diagnosis and nothing else even still
there were some Oddities around
alesandro's case for instance alesandro
had some mild symptoms associated with
autoimmunity we won't list them here but
if somebody has an autoimmune condition
their likelihood of having a second
autoimmune condition increases keep in
mind that there are some autoimmune
conditions that cause hair loss and that
these conditions they have different
causes than androgenic alopecia so they
require different treatments secondly
when we asked Alesandra to describe the
hairs that he was shedding while combing
through his hair or taking a shower he'd
routinely mention that all of the hairs
that fell out were the exact same hair
diameter he never noticed a mixture of
thin hairs and thick hairs now this
isn't unheard of but for men with
androgenic alopecia you would typically
expect a mixture of both thick hairs and
thin hairs to shed as this indicates the
presence of hair follicle
miniaturization which is a defining
characteristic of male pattern hair loss
yet allesandro wasn't experiencing this
even over months and months of tracking
his hairfall so let's do a quick recap
allisandro isn't seeing a robust
response to FDA approved hair loss drugs
he has symptoms of autoimmunity
unrelated to his hair his hair shedding
is uniform in diameter his hair
transplant continues to thin and that
started within a year after his surgery
these are all signals that perhaps this
androgenic alopecia diagnosis is maybe
wrong maybe it's incomplete in my mind
uh I wasn't thinking like you you may
have something else there is another
maybe kind of loss that is taking place
there is something aimmune I didn't
think about it I mean I was so focused
on you know trying all these approaches
that I was thinking one will work and or
maybe will take more time but something
will move the needle but nothing nothing
really did I I was really starting to
you know to lose hope and to think that
maybe it's just the way I am you know so
it was yeah as I said it was really
really tough mentally so if we lean into
the framework that we outlined and we
start reassessing all of this data what
are the possibilities well in all of our
calls together allesandro indicated that
he had no history of scalp pain scalp
redness significant scalp discomfort or
massive bouts of hair shedding following
scalp pain this indicated that a
scarring Alopecia masking as androgenic
alopecia something like diffuse Lyin
planopilaris was probably less likely
that's because these hair loss types are
often but not always accompanied by
bouts of scalp pain and bouts of hair
shedding that left us us with another
possibility diffuse alipa Arata or alipa
Arata incognita this is a type of hair
loss that can look in some cases exactly
like androgenic alopecia it can even
present alongside androgenic alopecia
but it comes from completely different
sets of causes and thereby requires
completely different sets of treatments
some studies also report that shedding
an alpia Arata it can be uniform and
present without hair diameter diversity
that sort of sounds like Alesandra which
means that this might be a reasonable
hypothesis worth exploring so we brought
all of this data up to allisandro we
sent him our guides on alipa Arata that
feature photos of people with alipa
Arata Incognito we also asked him to
find a dermatologist specializing in
this type of hair loss and in his
location preferably one connected to a
university and who publishes research
this was a big ask for alesandro and he
didn't necessarily know where to start I
mean he was based in Italy and he'd
already seen a lot of dermatologists in
his area and was understandably
disenfranchised with the level of care
that they were giving him but by
complete chance another member of ours
Carlo also happened to be from Italy
Carlo had seen significant hair recovery
from a rare hair loss disorder known as
Lyin plop Polaris and he happened to be
very familiar with the university-based
dermatologists in alesandro's area you
told me why don't you talk to Carlo I
think I think he really like his his um
his uh profile uh overlaps with yours
and and you can you can talk to him like
talk to him I said yeah sure I'll I'll
talk to him so I connected with Carlo
which is a fellow Italian and uh we we
talked a lot and he was uh so so kind
and he he told me I'm I'm living here in
Italy in Rome right now and he he's
living there in in California I guess
and he told me there is a guy there's a
doctor which is a really good one and he
lives in Rome he he visits patients in
Rome and that was a quite a coincidence
right and he told me why don't you call
this doctor and and uh and talk to him
through Carlo alesandro was able to
connect with somebody called Dr Alfredo
Rossi he is a world-renowned clinician a
professor at the University of Rome a
co-author of over 80 peer-reviewed
papers and a specialist in the
identification and treatment of rare
hair loss disorders and this doctor
showed some really you know good
insights some good ideas on how to
tackle his kind of hair loss let's say
autoimmune hair loss with an approach
that was that wasn't really used by
someone else so it was like a Trail
Blazer in a way right so ones that you
know open New Roads and I was really
interested in this guy so I talked to
him and uh he also knew your website
when I talked to the guy uh I called the
the to to book an appointment with him
and the the assistant told me he's not
available for five months when I when I
went on to Google to search for this guy
I I suddenly I I I realized he was super
famous here in Italy and uh he was all
only in in those blogs that talk about
hair loss he was everywhere it took
months to get an appointment and when
allesandro finally did he walked into
the clinic met with one of Dr rossy's
staff members and this is where the
story gets crazy just listen to what
alesandro says so I waited and firstly I
took an appointment with his let's say
his a he wasn't there I talked to
another person but they assured me was
like the same so I went there I sat down
she saw me and she said yeah let's let's
take a look so she took like a magnifier
I don't know what to call a microscope I
she put my my my
scalp under and after a few seconds she
took some pictures and she said you have
Al alopa I mean you you have androgenic
alopa but you also have Alisha
incognita and I was what I mean really
what what's that for those who are
wondering alipa Arata is an autoimmune
disorder it's where your hair follicles
lose immune privil and the body starts
to attack them the estimated risk of
developing alipa Arata is about 2% over
your lifetime so it's rarer but it's
common enough that clinicians and
dermatologists see it on a regular basis
it usually presents in patches like this
or like this but not always it can also
present diffusely and evenly across
somebody's scalp and when this happens
it's particularly harder to diagnose
especially in cases where androgenic
alopecia
is also present even still a good
dermatologist should be able to make
what's called a differential diagnosis
why because there are very clear markers
for a differential diagnosis that all
dermatologists should know about so she
said ah look look here you can see some
small really really tiny white hair
that's some indication of Alish cogn and
she also said something that I I kept
thinking about she said you have some
empty
follicles and the standard let's say
traditional androgenic Alisha doesn't
get you there so it's when with with
alopa and you you you you can tell it
far better than I I'm doing right now
but with alopa under genic Alisha you
have a smaller hair every cycle let's
say in a rough way you don't have a
empty empty follicles that's what she
told me I don't know if that's correct
but she said that's why I could I could
you know tell you it's alapa right away
it was so evident to me this is
important both androgenic alopecia and
diffuse alpia Arata can present with
hair follicle miniaturization the
patterning of loss even the disease
progression can look very similar but
with diffuse alipa Arata or alipa Arata
incognita you'll also often see yellow
dots surrounding the follicles you can
see the presence of white unpigmented
hairs you might see distopic or
exclamation Mark hairs while shedding
and if a clinician doesn't know how to
look for these things they cannot make
that differential diagnosis yeah that
was that was really interesting you know
after all these years it was so easy for
her to diagnose this and I was obviously
was quite shocking to me it didn't you
know take I don't know months or
multiple exams to get there it was
obvious to her and also to the to the
Doctor Who visited me like a few months
after this is what blows my mind
apparently five doctors along with a
transplant surgeon didn't know how to do
this the nurse practitioner trained
under Dr Rossy did she spotted it within
5 Seconds what was really interesting
was that as soon as I as I sat down the
Doctor Who was like trying to examine my
my scalp it took like two seconds five
seconds and she said this is Alish inog
like five seconds so it was five seconds
away from an answer for a year let's say
or for 10 years and no one told me and
and and at that point my mind was you
know going everywhere like was crazy
because what my first thought was If
Only They you know the surgeon would
would have told me the the day before
the transplant when you apply for a
transplant you go there the first thing
they do is they examine your scalp I
don't remember now the the the the
what's the reason the main reason but
they do and they also take some blood
you know they they they do some exams
and it was clear to her and it wasn't
clear to them to an E of people you know
that it's just doing this every day to
multiple people I mean did they know uh
and not told me or they didn't even know
I don't know what's worse you know I
don't know if it's the uh not knowing or
not not even paying attention I I don't
know but that was something that you
know I it's something that I keep asking
myself in my eyes this new diagnosis for
alesandro was sort of like the aam's
razor moment it's the simplest
explanation for why all of his past
treatments had failed yes he still has
androgenic alopecia but now he also
knows he has this other hair loss
disorder alipa Arata incognit and that
might have been preventing him from
achieving results I said Rob you can
believe this I mean she she said this so
it's an outo a immune condition and we
were both happy about it I mean we were
both like also excited about it right so
she explained what kind of you know uh
thing that was and she just really you
know it didn't take much for her to give
me this
corticosteroid it's this this like foam
alipa Arata isn't treated with Minoxidil
it's not treated with finast it's
treated with corticosteroids and maybe
by incorporating corticosteroids into
his routine
perhaps he'll finally turn a corner so
that's exactly what he started to do he
added in a topical corticosteroid once
per week olux or cetol to his scalp and
she said apply this foam once a week
which was weird as a you know once a
week I mean it's isn't that too little
like once a week what's that gonna do I
mean nothing is working with my hair and
she said yeah just apply this and keep
on applying minoxidil and keep on
applying uh topical n right every day so
I was doing once a week one let's say
handful like like this of the
corticosteroid called Olu once once a
day I was using the uh minoxidil so one
ml a day and one mill of topical faside
so I was doing that I started applying
this and she was right I mean they were
right the doctor was was there as well
the say the main guy was there as well
and they told me yeah you improveed so
we we we comp paired pictures together
and uh that was a there was a bit of
disappointing right there because I
remember telling you about it by email
and the pictures were the quality of the
picture was not good and there this was
January so four months in and the
picture they took me the they took the
second picture uh say of the second
visit where blurred in a way they were
kind of dark uh and the first pictures
were bright so they was like yeah is
that improving or is it just what you're
telling me so you had I had these doubts
and how could you blame me I mean after
10 years of suffering you're you kind of
you know you lose your mind a bit so you
lose also some you know trust in people
understandably allesandro was a bit
skeptical at first I mean he hadn't yet
noticed any regrowth for himself and he
had a very frustrating treatment history
with other dermatologists but then he
had a follow-up appointment booked
months later so perhaps he'd start to
notice things by then and that's
actually exactly what happened it was
March and was I went back there so he
said yeah come on over let's take a look
and at that point that was my happy day
because when I went back two more months
were uh passed at the time was like six
months in and uh I I really noticed the
difference and he he told me you you do
not see because you you you're not you
know you're you're not a doctor but I I
can see it like from here and I'll show
you right now and I really did see a
difference the difference was mainly
with the size of the hair the diameter
the scalp overall looked healthier and
the the way he took the picture was he
split my hair here and part them like
this and I could clearly see the
difference between the first time I went
there and that time so there you go
finally a decade into fighting hair loss
allesandro is no longer seeing this
progressively worsen for the first time
he is seeing hair regrowth and it's
continuing to regrow and it's all
because he got into the hands of a nurse
practitioner and a doctor who actually
knew what they were talking about and
because he was willing to evaluate and
re-evaluate that initial assumption
about his case in the face of new data
first I want to say that your website is
golden is amazing because when when I
when I got there was like oh my God this
is how it should be done this is how
people should tackle this because you
offer in a really clear concise and and
really really well organized way it's
it's an opportunity you know to for
people to to Really you know it's a deep
dive you know they you you just go there
and you see all these resources and all
this data and I think it's uh it's
really well done and it it really
changed my life uh because it's losing
hair and or suffering from hair loss is
not just about the hair itself we all
know it's about you know you're the way
you you see yourself the way you appear
the way if you're really young like I
was you felt like old and it's like it's
it's it's really hard you know I'm a
sensitive type of guy so it's it's it
was really tough on me you really offer
some clarity and you really you really
you know earn the trust of of people
there because it's uh I felt I felt at
home you know it's it's weird to say
because we just met on here on on Zoom
or we did we made calls on but also the
community itself is amazing and people
are really helping each other and it's a
small community but it's really valuable
allesandro today is continuing to see
regrowth and he finally has relief in
knowing that this problem is no longer
getting worse for him he also wanted to
share some words with anybody who
decides to watch this video two things
are really important for people who
maybe will watch this for me to to to
know and one thing is that if they're
looking for a really a a way uh to to
cure their uh hair loss or to improve
their situation your website is the
place to start because it's uh again
it's so well done and well organized
yeah and this world is so full of you
know the industry itself is full of
interests so every everybody's pulling
you from another a direction right so
you're like in the middle and you're
confused and you don't know where to go
so that's why it's really valuable what
you do and uh I'm so happy we we met
because otherwise I wouldn't be I
wouldn't be here today I wouldn't be as
happy as I am today and don't lose hope
and this thing take time and uh you you
said it in the website as well it's a
marathon it's not a Sprint so just you
know be patient and keep working on it
and uh maybe you'll find some solution
and some some light at the end of the
tunnel so again I'm so I'm so happy with
it this and uh I'm really open for
everybody who wants to maybe talk to me
or connect with me and uh please share
with everybody my my I don't know my
number my email address because I'm I'm
really happy to help not just them but
also what you do I feel I I I really
think is uh super valuable when I
reflect on alesandro's story on the one
hand I am Overjoyed I mean he had spent
so much time so much energy and the
sheer relief that it must feel to
finally know that this problem is no
longer getting worse it's finally
improving I find that to be beautiful
and moving I wish that for everybody
facing this and yet I also find myself
devastated that he had to go through
this in the first place I mean why was
he misdiagnosed by five different
clinicians five separate times why
didn't any of his doctors know how to
make that differential diagnosis why
didn't they rule this out before giving
him a trans plan why was it that our
team who has no diagnostic capabilities
or access to micro zoomed photos of
alesandro scalp why were we the first to
even suspect this why weren't his
clinicians tracking his treatment
responses over the decade and revising
recommendations accordingly why was
allesandro left for 10 years to figure
this out all on his own that's the kind
of stuff that really bothers me because
if alesandro's Case were just a one-off
that would be one thing it's not it's
this lacking standard of care that is
far too prevalent and far too common for
hair loss sufferers and it's time that
things change I wish everybody who's
fighting hair loss had access to an
alfredo Rossi or a Jeffrey Donovan or a
top hair loss clinician I wish these top
tiered dermatologists didn't have months
to years long waiting lists I wish
bottom feeder dermatologists would stop
selling their hair loss patients into
PRP or PRP plus a cell or stem cells or
exosomes or any other poorly supported
autologus therapy many of which have
shown no benefit over mic needling
despite costing 1,000 times more money I
wish popular hair growth Brands would
stop manipulating the setup of their
clinical trials to include participants
who will get results from a nutritional
supplement but who won't reflect the
average consumer of the product that
that company is selling and I wish
dermatologists would stop recommending
those products to fill their pockets and
at the expense of your hair so to
allesandro I thank you for your
perseverance and your commitment to
Carlo I thank you for your your
incredible support to our community and
to everybody else I remain hopeful for a
better future for now you need to stay
vigilant you need to stay educated you
need to be your own patient advocate and
to help you where we can we've put
together a new video and a PDF checklist
about how to dominate your next
Dermatology visit so if you have been to
a dermatologist and felt that they
barely looked at your hair or dismissed
your health symptoms or didn't really
evaluate your hair loss with scrutiny
this is never going to happen again we
have a framework and a list of questions
in this video in PDF that you can bring
to your dermatology appointment and they
cannot answer those questions unless
they actually examine your scalp
thoroughly with a micro zoomed device
like a dermatoscope or a photo triog so
use that video use that framework use
that PDF checklist and hopefully you
won't ever need to wait 5 years for a
5-second answer that could change
everything again most people watching
are not going to face allesandro
situation most people watching this will
not have alipa Arata or alipa Arata
Incognito for the few that do I hope
this changes things for you and for
those who don't please still use this
framework the lessons this video this
checklist to level up on your hair gains
thank you for watching and I will see
you next time
Voir Plus de Vidéos Connexes
#1 Overlooked Factor When Fighting Hair Loss
Bald Man Burns Scalp, Accidentally Regrows ALL His Hair
ESPECIALISTA revela A VERDADE sobre o MINOXIDIL
How to stop worrying about finasteride's side effects and avoid the nocebo effect
TOPICAL DUTASTERIDE UPDATE AFTER 1.5 YEARS...
Why minoxidil stops hair loss forever
5.0 / 5 (0 votes)