Dr. Thomas Dawson wrote a good description of Dandruff in the Hair Transplant Forum May/June 2017 issue as follows:

This is Diffuse Unpatterned alopecia (DUPA) which shows only 5 normal thickness hairs which are labeled in the photo (1-5) and the rest are miniaturized. This comes from the donor area which almost certainly is see-through. Note that this is best seen when the hairs are cut short because they can be easily counted as you can see on the long hairs on the left of the photo. Anything over 20% miniaturization is DUPA if it is the donor area.

 

I had 4500 grafts in Turkey almost one year ago, I see holes in my transplant pattern.

Yes, I see what you are talking about. A session of 4,500 grafts requires a great deal of skill in handling the grafts. Grafts that are out of the body exposed to air for 10 seconds will die before they are put into the recipient area. Quality control therefore is very important. I suspect that the quality control may not be tight. I too would have expected to see much more density present. What is unfortunate, is that your donor area has been depleted by over half and another FUE in the donor area could cause you donor site depletion and a see-through donor area that looks like it is balding. My recommendation is to see a doctor with years of experience who knows how to manage your problem and won’t make you look worse in the donor area.

This is the result of using microneedling along. This shows that this technique can reverse hair loss as a result of wound healing and the production of healing molecules in the wounds.

Nice response in a 23 year old with minoxidil and finasteride use for 4 months

I have developed bleeding and many pimples in my recipient area 3 months after my hair transplant.

You might have an infection or cysts from the surgery. Go back and have your surgeon examine you, culture the drain these cysts.  Lance pimples that are large and then commence treatment if needed.

I recently noticed my hair thinning and it has put me in a state of sadness. There are times during the day where I can’t bring myself to do anything because of how upset I am about my hair loss. I am a 23 year-old Asian male with what I suspect to be diffuse thinning. However, I have not seen any hair fall out on my pillow and just a few fall out when I shower. Would it be possible for you to look at some pictures of me to give me a confirmation? I want to take Finasteride but I am scared to death of the sides.

I don’t think that you are balding. Asians often have lower than average hair density and with your black hair and light skin, the see-through of low density reflects the high contrasts between skin and hair color.  To find out if you are balding, you need to see a doctor who has an instrument called HAIRCHECK which will tell you if you lost hair bulk in any part of your scalp. In men, this is caused by genetic hair loss. I suspect that if you get this test, it will show that you do not have hair loss but to be sure get the test. Even if you are not balding but your hair appearance is not satisfactory, you can get Scalp MicroPigmentation and reduce the contrast between your scalp and your hair. See https://scalpmicropigmentation.com