I just turned 17, and I have a family history of balding in most members of my family, both my mother’s and my father’s side.  What should I do?

I assume you have genetics in the family, and you are concerned that you MIGHT follow the family pattern somehow. Just keep an eye on your hair by looking for unusual hair shedding, thinning in the front or crown, or recession of the hairline. If you should start developing these symptoms, see a good hair expert and build a complete Personalized Master Plan that you can follow over time as your hair situation changes. A good doctor will care about you, and that is important, in my opinion.

Are hair from the back of your head actually immune to dht or is this a myth?

Yes, Dr. Norman Oreintrich reported this in 1959, telling us that the band of hair reflecting the remaining hair of a Class 7 pattern is resistant to the effects of balding and DHT. That is why hair transplants work so well, as they last the lifetime of the patient.

I was surfing the internet on topics related to hair loss and came across your balding blog which is a super helpful resource. I saw you posted on there a math formula on how to estimate the amount of grafts available in the donor area.  When I looked closely with the ultra close up/ zoom option on my phone at a section of my donor and calculated the math, I average about 2.55 hairs per follicular unit which based on your formula would put me at having roughly 7,598 grafts that I can transplant. The only thing is, from what I read the diameter of you hair follicles also factors in. I don’t have a tool to measure but I’m guessing it’s more on the fine side like 45-50 microns. At 2.55 hairs per FU with the hair being more on the fine side, can you tell me how that would skew the available donor and what that would roughly bring my number to?

And, does that formula matter if it is FUE o FUT you plan to do?

This young man found that the finasteride restored his forelock but not his hairline.  The forelock is independently genetically from the surrounding hair, including the lateral hairline

The younger you are, the more likely there will be regrowth, especially in the frontal hairline. The crown is easier to regrow at most ages with drugs like finasteride. Microneedling may change the game on regrowth, worth a try at the least.

I saw in one of your posts on your blog where you said somebody who is 35 years old with a Norwood 3A pattern has a worst case scenario of reaching a Norwood 5A. How do you know that? I thought the extent of hair loss can’t be predicted and in all of your posts you say that hair loss is progressive.  Also, if you live long enough, will a Norwood Class 3 become a Norwood CLass 7 pattern?

Everyone with balding genetics has a hair loss pattern that will evolve in their lifetime at an age determined by the genetic clock in each hair follicle. That pattern depends upon your inheritance and the progressive nature of hair loss reflects the movement to this “Unknown” pattern that you have. I developed general rules of thumb over 32 years in this business that give me insights into the statistics of patterned hair loss as it reflects the age and circumstances of each patient I examine.  Some balding men, for example, with a Class 3A pattern of balding, may never progress further, so a Class, 6 or 7 pattern for that person, may not be a genuine concern for me with some probability predictions made by me. Every person I examine is different.  For the ‘victim’ of balding, they worry about developing a Class 6 pr 7 pattern, which may be familial, so they rightfully worry. 

About your second question:  No.  If you don’t have the genes for a Class 7 pattern, you will not develop one even if you live to 100.  The problem is that there is no way to tell what genetics you inherited and how that genetics is expressed in your body.  That is why a doctor with great experience, like me, brings some value but still can’t predict the pattern 100%. My grandfather lived to 102 and retained his juvenile hairline and a full head of hair. This proved to me that hair loss is not inevitable for men. My Grandmother lived to 114, and she retained her juvenile female hairline throughout her life.

This astute 23-year-old male examined his donor area through a hand microscope purchased from Amazon after reading some advice I gave on Reddit.  He was suspicious about having DUPA based on his view of his donor area, so he sent them on to me for an opinion.  Both Dr. Bernstein and I believe that this is a case of DUPA.  Note that the dark thick hairs are normal terminal hairs, while most of the other hairs have a smaller diameter, some are even thinner than the rest, and those hairs don’t have much color to them.  These thin hairs are miniaturized.  I can’t say how long they will survive in the donor area, but I suspect his progression will be slow. If he were to use it for a hair transplant by a doctor who is ignorant on what DUPA looks like, his hair transplant likely will fail, and the shock to the donor area could accelerate the disappearance of hair there (I am speculating).  CLICK TO ENLARGE