Dr. Rassman.

Thank you for your extremely informative and educational blog. I refer to it on a regular basis and I am extremely grateful for having this source as a reference.

I am a 36 year old male experiencing thinning in the frontal hairline primarily in the temporal area and a noticably visible thinning spot isolated to the right middle top of my head approximately one inch in diameter. I maintain very short hair (typically use a number 2 guard on the back and sides of my head, and a number 3 guard on top) with an electric trimmer. The thinning has slowly progressed over the past 5 years and appears to be more prevelant over the past year. I would attribute the frontal hair loss in the temporal area to a maturing hairline and I still have a low widows peak, albeit thinner.

My questions are:
1. What would cause the unsymmetrical thinning on the top of my head?
2. Would I likely receive any benefit from propecia in regrowing the hair in the top of my head or should I consider a localized hair transplant in that area?

Any insight you can offer would be greatly appreciated.

Best Regards

Genetic balding is often not symmetrical and it does not always follow the rules on balding patterns. Yes, hair loss does break the rules. That is why I recommend mapping the scalp for miniaturization so that you will have an idea over what is actually going on beyond what your unmagnified eye can see. You can map it yourself with the right tools (see here). Clearly, you need to know if what you see is genetic balding and the mapping will give you that information, which you can post on BaldingForum if you need help on the interpretation.

Alternatively, and a better solution, is to get to a good doctor who will tell you from proper measurements and a good thorough examination what is happening to you. If you have genetic hair loss, Propecia/finasteride is the way to go. I’d look into medication before considering surgery.