So I went to the dermatologist after my barber noticed a bald spot on my crown. He didn’t seem to really care (as he was bald) but he wrote me a prescription for finasteride and minoxidil. However, my wife and I are about to have our first child and we want to have another one. She’s taking a strong stance on me not starting finasteride until we have our second kid. She’s worried about fertility. Is it worth starting on minoxidil then getting on finasteride in a couple years? I’m worried I won’t stick to minoxidil twice a day since I work shifts so it makes it really tough to apply.

You can use minoxidil once a day at night after a hot shower and leave it on until morning. That works and it is less of a headache.

You have a classic movement to a maturing hairline. This movement is in process. You can see bits of your juvenile hairline still present which were originally a rounded hairline look. A mature hairline is V-shaped. The picture on the right shows what is a disappearing rounding to the hairline.

I had a patient who I brought to the International hair meetings where there were about 400 doctors present. He had alopecia totalis, not a single hair on his body anywhere. He had SMP done by us, and when the doctors met him, none of them could tell he had SMP even though they knew. A well done SMP should be undetectable. The hair can be shaved or long, nothing in-between works as well.

People with SMP, can you tell its SMP from really close? from tressless

No, your donor area is depleted. I don’t believe that 99% of people who get 5000 FUE grafts can support that number without getting a see-through donor area. Your residual donor density is probably too low for reasonable coverage. Scalp Micropigmentation works well for managing the APPEARANCE of this problem (See: https://scalpmicropigmentation.com/)

It is rounded and there are no temple peaks because they are incorporated into the rounded hairline. This is the same hairline that she had when she was a child at 5 year of age.

No! If you pick off these crusts, you will also remove the grafts. I wrote a paper on this, and because this is a problem, I always advise the patient to wash immediately the day after surgery so crusts don’t form. I have developed a special washing technique for this.

See here: https://baldingblog.com/wp-content/uploads/pdf/mp-2006-graft-anchoring.pdf

You need to develop a Master Plan with a good doctor to determine your lifetime hair supply and how much has been used so far. You must know this for future planning. Your residual donor density can be measured by your surgeon to establish what the future possibilities are.