Note that the Alopecia Areata is impacting not only his scalp hair, but his beard and neck hair as well.

Don’t look to blood levels for DHT. Look for response to the lower dose of the finasteride when you drop the dose.

If I take finasteride before going to bed, I will have trouble sleeping.  I will feel agitated and restless.  This seems similar to the caffeine effect on me.  Any thoughts are appreciated.  If I take finasteride during the day, I feel no effect.

You can take finasteride any time of the day. If you prefer to take it in the morning, do so.

So I’ve always had a large forehead and and deep/high temples with baby hairs (since being a kid). Usually I take pictures from the side to track my temples. This time I took one from above with my hair pulled back. Didn’t like how it looked like that. Again, my temples have always been deep combined with baby hairs. I also took photos from the front, top and side with my hair parted. And it looked like my usual hairline again. See mentioned photos. So how come it looks so different when parted? Also, here are photos from my childhood up until now if interested. My age is 28 (29 next month). Why does the topview with pulled hair to the back look so different compared to sidepart?

PS my little sis has the exact same hairline. Very deep temples and fine hair. Looks like a men’s mature hairline.

Are you a female or male? This pattern is often a female pattern with the corner areas thinner as the hairline is evolving. When you look at layered hair, the hair often looks fuller so that is what you are seeing. Many women, like my wife who had your presentation including a high hairline, received a hair transplant to thicken up these corners. If you are a male, please write back to me at wrassman@newhair.com.

I had my fourth FUT around 11 months ago and I’ve seen zero improvement. Shock loss kicked in 3 months after the surgery and hasn’t stopped ever since. All kinds of hair (native/transplanted/vellus) are shedding. My body can’t tolerate finasteride so I bought a laser helmet which I’ve been using for 3 and a half months now. The scalp feels stiff. Will take up ketoconazole shampoo and vitamin d supplements soon. I keep cutting them shorter to get rid of the sick-ish ends with that weird wiry/coarse texture but it’s only getting worse. Visited my surgeon recently and he told me “it’s fine, you’re not bald” and dismissed me. He didn’t even examine my scalp. They rarely admit something went wrong in my experience. I am at a loss and feeling really depressed. Any help would be appreciated.

You should have, by now, developed a great relationship with your doctor after 4 hair transplant surgeries. He/she should not dismiss you. You should have developed a Personalized Master Plan for your hair loss with your surgeon when you started the hair transplants.  What it happening to you now should have been anticipated as a worst case situation. Did you create a Personalized Master Plan with your surgeon? I would be happy to take a telephone consultation with you at info@newhair.com. Sounds like you need help and advice.

I keep seeing this pop up. I am 19 right now with a NW2.5-3 and just started taking finasteride. My plan is take fin for a year then — assuming I respond to finasteride normally (just maintain hair, am not a non-responder/super responder) — get a hair transplant at 20/21ish. Why would this be such a mistake? The finasteride should roughly maintain my hair for a decade or so, right? I’ll be able to live and experience a normal young man’s experience. Once it gets bad, I can just shave it once I’m older (which is not nearly as big of a deal), or I can get another procedure. Or hell, maybe there’ll finally be a cure for this shit disease by then lol. I just don’t get why it’s considered such a big mistake. I would honestly almost rather be bald than have these shitty temples, even if my density is still solid.

It is not wise to get a hair transplant at 20 years old because you can’t make a Personalized Master Plan as your future hair loss pattern doesn’t appear for most men until 25 years of age. Without a good plan, you start the transplant, use up the donor supply (which is limited) to deal with your short term problems and then when you keep losing hair you are out of luck as there is no more donor hair left. By then you might not just be bald, but freaky looking (nobody should look freaky). I have seen too many patient who did hair transplants at 19 or 20 and ended up regretting it.

This is a nice result; however, the frontal area has a see-through look. He may have fine hair that is responsible for this or he didn’t get enough grafts or growth. A second hair transplant to double down on the fullness may be a good idea. In people with fine hair, this is common. The comb-over on the left shows how he handles the see-through look.