When you have genetic balding, the genetically impacted hairs respond to DHT, is a byproduct of testosterone metabolism. Even a low Testosterone will still be converted by the liver into systemic DHT and working in combination with your genetics, you get the hair loss effect.
How do I go about finding out if I am a candidate?
You will likely develop into a full Class 7 pattern of balding which I see is almost there now. These sides will become lower, either quickly after the hair transplant or sometime in the near future. Finasteride may slow that process down. Good doctors routinely perform trichoscopy to rule out diseases in the donor area and establish the metrics that I am about to discuss. It would be best to have your lifetime donor supply of grafts ascertained, including (1) donor density and (2) hair shaft thickness of the donor hairs. This will tell the surgeon what you will look like after the hair transplant, which should be shared with you. Not all grafts are equal; for example, coarse hair has 10 times the value of very fine hair (cosmetic-wise). Hair transplant science is well-established today. See the following patients: https://baldingblog.com/difference-between-norwood-class-7-patients-with-photos/
[If you have any questions, you can reach me at williamrassman33@gmail.com]
I’m 22. I recently went to turkey to complete a FUE hair transplant, where basically it was just to fix my hairline and make it more straight and filled out a bit more and not a full scalp job. I also got my beard filled out as there was little area of no growth, everything was going fine and my transplanted hairs have fell out and i can see some hairs pushing through(please note i wasnt using any medication but have went back on topical minoxidil and started prp treatments). I am currently at the 10 weeks stage but as time has went on through the transplant process at around the 6-8 weeks stage i started to notice extreme hair shedding of my natural hair i had before, big clumps of aleastt 5 hairs each time a brush my hands through my hair, please not my hair is quite fine as it is so its started to really impact my density. My question is will all these hairs grow back when they want to, i went to my local clinic back home and had a hair check where they put a camera into my scalp but there was no baby hairs pushing through for my original shedded hair, will they start to push through later in the cycle? Or is this permanent shedding? Its really stressing me out as my hair density is probs around 70% of what i had originally and its still falling, this is really starting to effect my life and i just want to know that everything will be alright.
Men who are 22 and actively balding will have miniaturized hairs well beyond the visible area to the naked eye. If your doctor had used a hand microscope, he/she would have probably seen significant miniaturization of the hair behind your frontal balding area in your case. These miniaturized hairs will get shocked out from the hair transplant, unless you were put on finasteride. In my experience, shocked-out hairs rarely return. This could have been prevented had someone evaluated you properly and detected these miniaturized hairs. Finasteride can prevent shock loss in most men, but at 22, you are unusually vulnerable to shock loss. I hope that your estimate that 70% of your native hairs remain because that number may sustain your look. You may have another problem if the Turkish clinic has taken out too many grafts (often the case in Turkey). The average Caucasian only has about 6-8000 grafts for hair transplantation in their lifetime. Still, that number depends upon various factors, including (1) remaining hair in the donor area, (2) your final hair loss pattern that should appear by the time you are 30 or less. You have tp get a detailed Master Plan for your future balding (inevitable). Did someone measure your donor supply and give you an estimate as to your total usable donor supply and what your future looks like? Do you know your final hair loss pattern? When you finish your shedding and are growing out your transplants, write to me, and I can discuss this over the phone. My email address is Williamrassman33@gmail.com
I know that theres a small chance that your grafts don’t shed at all, but thats not what I am talking about. I had my surgery done 2 months ago, most of my transplanted grafts shed until the 1 month mark, since then i have kept around 30-40% of the others and they grew like my other hair. Is this normal that not all shed, or should i expect them to also fall out in the next weeks?
It is common to lose all or some of the transplanted grafts between weeks 2-5. Many of the grafts that stick around will grow, similar to your native hair. I transplanted my cousin, and in just 4 months, he had a full head of hair. He told me that he never shed any grafts. Then I did another transplant on him to thicken up the previous transplant because his hair was “fine”. He didn’t shed grafts the second time either. I find that one in 30-50 patients, will not shed their grafts.
I am 39 years old. I have not taken any medication for my hair loss.
I have written about this before on Reddit. Medical treatment is important, but at 39, it is unlikely that you will get a good response to it. It is worth trying anyway. I am concerned about the pattern of balding you are showing. I want to ascertain that this is genetic, not a form of autoimmune disease, as your pattern is not classic for genetic balding. Good doctors routinely perform trichoscopy to rule out diseases of the recipient and donor areas. I would look at the nature of the hair and the skin in and around the balding area. If I am concerned, then I would biopsy the areas of concern because autoimmune diseases of the scalp kill hair transplants. Assuming you have no autoimmune scalp disease, I would establish your lifetime donor supply of grafts, including (1) donor density and (2) hair shaft thickness of the donor’s hairs. This will tell the surgeon what you will look like after the hair transplant, which should be shared with you. Not all grafts are equal; for example, coarse hair has 10 times the value of very fine hair (cosmetic-wise). Hair transplant science is well-established today.
[If you have any questions, you can reach me at williamrassman33@gmail.com]
These men clearly are using some medication to get those hairlines. Do you agree?
Half of the male population is not balding and some of them have hairlines like these men without medications. Just great genetics!
This is a wonderful result and shows the power of microneeding at maximizing the results of medication and cause such good growth. A microneedling maintenance program should be continued at least once a month and if you see hair loss, then increase the frequency of the microneedling. Stay on the finasteride and the minoxidil.
[If you have any questions, you can reach me at williamrassman33@gmail.com]
From this single photo, I don’t think that you are balding. Your hairline is a V-shape, typical of a mature male hairline. The fact that you have a widow’s peak indicates the location of your juvenile hairline at the tip of the widow’s peak. What you have drawn is a female-shaped hairline. Get an expert to do the hairline for you. If you are planning a hair transplant, then you will have to live with this hairline for the rest of your life. Really want to do this?
[If you have any questions, you can reach me at williamrassman33@gmail.com]
This is a patient I treated with a single surgery last year with 3,300 grafts. The after photo is on the left. He was thrilled with the results, and now he doesn’t think about his hair much of the time, which is the takeaway here.
[If you have any questions, you can reach me at williamrassman33@gmail.com]
I know it isn’t a super bad case of MPB yet but I really don’t like these temporal recessions. They make me look old and I want them to go away. I’ve traced where my hairline used to be and I’m wondering: can it be restored with just fin + min or will I need to buy a hair transplant at some point?
I am not 100% sure that this is balding. To be sure, I need to see a frontal view with your eyebrows lifted high so that you forehead creases. That will tell me exactly where your hairline belongs, if it is receded, and by how much.
This may be an early Class 3 pattern of balding. If you are under 22, it will likely respond to minoxidil and finasteride. If you are over 26, if it doesn’t respond to the above medications, then try microneedling for 6 months, which should regrow your hair. If not, you can get a hair transplant if you have tried it all and are over 25, which will work well if this is balding. The design of your hairline you sent to me is clearly feminine. You need a good doctor to design it properly if you get a hair transplant, and it should be a mature MALE hairline.
Will this impact the hair transplant growth?
Wounds like this could leave a scar, which could be minimized if stitched with very small sutures. The stem cells for the grafts are still there, and I expect them to grow.
[If you have any questions, you can reach me at williamrassman33@gmail.com]
Is shock loss after HT worse if you’re on fin and min than if wouldn’t be taking any medication? And how long does it last approximately? I’ve lost a lot of native hairs as well.
Finasteride takes time in some men. Give it a full year before drawing conclusions. I have found that in close to 100% of men, the drug will slow, stop, or reverse the hair loss. Slowing it down is common and sometimes hard to detect unless the drug is stopped, when hair loss will immediately accelerate. Stopping hair loss is less common, and reversing it is even less common (more common in men under 23). Finasteride is very effective at preventing hair loss
There is some good teaching in your photos. This is an outstanding regrowth of hair from microneedling and minoxidil. I want to call your attention to the corner area which received microneeding beyond (below) the natural adult mature hairline, which did not bring back the hair to the full extent of the microneddling. It is important to note that microneeding in areas where your juvenile hairline is lost, microneedling this area will not bring your juvenile hairline back. For those who are microneedling, please limit it to the mature hairline you want to return to.
[If you have any questions, you can reach me at williamrassman33@gmail.com]
I found this graph showing the various racial origins for various hair densities.
Reference: Interesting graph!Diversity in human hair growth, diameter, colour and shape. An in vivo study on young adults from 24 different ethnic groups observed in the five continents. Geneviève LOUSSOUARN, Isabelle LOZANO, Ségolène PANHARD, Catherine COLLAUDIN, Charles EL RAWADI. , Gilles GENAIN, L’OREAL Research and Innovation,
11-13 rue Dora Maar 93400 Saint-Ouen,,France, Eur J Dermatol 2016; 26(2): 144-54
Diversity in human hair growth, diameter, colour and shape. An in vivo study on young adults from 24 different ethnic groups observed in the five continents
Background: Based on previous findings, from a worldwide study, classified the shapes of human hair into 8 major types, from straight to highly curly. This clearly extended the usual classification of hair into African, Asian or Caucasian types. However, determinations of hair growth parameters and hair density were excluded from such studies. Objectives: To measure and compare the hair growth profiles of young adults without alopecia living in the five continents. Materials & Methods: 2249 young adults (18-35 years, females and males) without alopecia, originating from 24 various human ethnic groups were includedin the study. Total hair density, telogen percentage and growth rate on three different scalp areas were measured, using non-invasive validated techniques. Natural hair colour level, curliness and hair diameter were additionally recorded, when practically possible. Results: Diversity in hair growth parameters among the entire cohort was a key finding, with differences linked to scalp area, gender and geographic origin. Statistical approaches depicted African hair as having lower density and a slower growth rate. Asian hair showed a thicker diameter, with faster growth. Caucasian hair showed a high total hair density. Conclusion: On the one hand, this inter-continental study of hair growth parameters provides initial valuable base-line data on hair in young adults without alopecia, and on the other hand, further extends our knowledge of this unique human appendage.
Click to enlarge for details
[If you have any questions, you can reach me at williamrassman33@gmail.com]
After overcoming my initial fears about fin and now being on it, my worries have shifted to the possibility of it not working. Just asking about stopping loss not about regaining ground.
Finasteride takes time in some men. Give it a full year before drawing conclusions. I have found that in close to 100% of men, the drug will slow, stop or reverse the hair loss. Slowing it down is common, stopping it is less common, and reversing it is even less common (more common in men under the age of 23).