It seems that you are losing the entire frontal hairline and if you look carefully, you will see a ‘U’ shaped frontal hairline. We classify this as a Class 3A pattern of balding. Gene Hackman (actor) developed this type of hairline which you can see in his movies, a ‘U’ shaped frontal hairline. When he got older, the leading edge became thinner. He looked good anyway. See him here so you know what I mean: http://abcnews.go.com/Entertainment/gene-hackman-alive-rep/story?id=28554729. You can also try the drug finasteride and you have a chance at reversing it (see: https://baldingblog.com/2017/04/24/2-years-finasteride-young-man-early-20s/) or you can do a hair transplant like some of the guys in this video and get your hair back: https://www.youtube.com/watch?v=sisfX3XBmOw

The good news is that genetic balding does not impact the sides in 99% of men. All of the patterns for genetic hair loss have the horseshoe of hair around the sides and the back of the head appearing normal in thickness.  Don’t what if yourself into believing what will not be.

The patient in the top view is 4 days after ~1850 graft FUE procedure. Clearly the transplants are barely detectable at this time. Even immediately after the surgery, there was no pink color to his scalp even just one day after the surgery because his skin was ruddy in color.  The second patient (C) is 18 hours following a 1600 graft FUE procedure with us. His skin is fair and very sensitive so that a bright pink color appeared immediately after the surgery. This is rare and present only in small number of people, particularly those who have very sensitive, fair skin.  As this patient is from out-of-town and went home after his hair wash, I will not be able to demonstrate the appearance of his recipient area in the 4th day, but most people like him usually retain a mild pinkish color for up to a week after the transplant. His surgery caused an increased blood supply to the skin surface. This a particular type of skin which is easily hyperemic when traumatized with a surgery. If this happens to you and you know you have this type of skin, you should consider wearing a hat for the week or until the pink color goes away. To find out if you have this type of skin, I suggested a simple scratch test by running your fingernail slightly dug into your forehead for a distance of about 2 inches (don’t break the skin just scratch it). If you have this type of skin, this scratch will appear bright pink and it will stay for hours, possibly the rest of the day. If the red scratch disappears in less than an hour, you will not have to worry that you will be unusually pink after the surgery.

Now, compare the woman on the middle (D) on the right whose skin was more ruddy and one day after the surgery there was only a little pink color to it. Within 3 days, all of the pink color was gone. The patient on the third row was a lady with fair skin who was also pink the day after the surgery, but the picture shown below at 6 days, does not show any pinkness as it disappeared as I would expect. The last two pictures (row 4 and 5) are patients one day after surgery and two days after surgery.  Please note that there is no redness present and in the bottom patient 2 days after surgery, even I could not find where the grafts were placed. This is what normally happens.

Also note that there is no crusting with any of the patients because we are very fastidious about our washing procedures after surgery.

I have to say, this has been a real education for me, as a woman, reading how devastated young men get get when they experience hair loss. One thing I am certain about…there are JUST as many physical pressures on men as there are on women. For what it’s worth, I have been privy to a lot of private female conversations and I have never once heard a woman criticize a man for hair or say she’s lost her attraction to him. My question for you guys is, what can we do to help the men in our lives feel sexy and supported if they’re having this issue? What would you like to hear from the women in your lives?

I always tell men that it is not what is on their head but what is in their head when it comes to hair loss. As a woman, you look in the mirror and either like what you see or don’t. Some men are ok with balding while others are not. Feeling sexy is really your sense of yourself and your ability to be yourself without hindrances. Take it to the extreme and look at some of our Vets, who have had facial deformities from war. Women may comment about them more than balding men, so looks do count.

Yes, there is the use of systemic minoxidil which can grow the hair. The side effects are typical minoxidil side effects like low blood pressure.  You need to find a doctor willing to prescribe this.  I generally recommend that you first try the finasteride and as 90+% of people tolerate it well, there is no need to go to an alternative; however, if you are the 4% that has sexual side effects, then I would prescribe the oral minoxidil. This drug was used in its oral form in India and other poor countries that could not get finasteride with great reported results I have heard at medical meetings. Some doctors in the US are also reporting good results with the oral form of minoxidil.

I had a hair transplant and the hairline I was given is too low. The doctor said he would FUE out the hairline grafts.

Putting a hairline too low is a real bad problem. Just trying to do FUE to the grafts in the hairline does not work well. The laser hair removal systems can kill the grafts but leave you with marks in the frontal hairline.  Best to send me photos and let me see the extent of the problem.

Finasteride not only decreases the conversion of testosterone into DHT but also nearly a dozen reactions as you can see here:

https://en.wikipedia.org/wiki/5%CE%B1-Reductase#List_of_conversions

This study looked at PFS patients and determined that compared to healthy controls, they have altered levels of chemicals in the brain that are known to be affected by finasteride (dihydroprogesterone, DHT, allopregnanolone etc.)

As this blog posts seems to suggest, it is hypothetically possible that something else caused these “changes in the brain”, but it would be a very big coincidence that these PFS patients have abnormalities in the the exact chemicals that are already known to be affected by finasteride.

Taken note.  Every drug you take has effects that go beyond what it is designed for. The FDA requires drug companies to identify as many of these side effects as can be identified. Clearly, the system is very far from perfect with the FDA and the drug companies and how they interact.

I have been loosing my hair evenly for about four years. I quit smoking for about 6 months and noticed my hair had stopped falling out and was definitely filling in. I started smoking again about two weeks ago and the whole process started again . Needless to say I’m convinced that smoking is the cause of my hair loss and I’ve quit again for two days . I will not be smoking again as I love the hair. It’s may take a month or two to see a difference in the hair loss don’t get discouraged

Thanks for the information. People always ask me about the connection between hair loss and smoking. You seem to have nailed it.

I am so thankful I found this site, as many have already expressed. I had my 8th back surgery on 2-28-2017. Things went wrong, and I hàd severe leg pain from nerves. They put me on this drug and I just started to notice a ton of hair falling out. I have such thick hair, and everyone has always been amazed at it. At this rate I’ll be buying a wig! 

See a doctor who specializes in hair loss, like us for example. The stress you have defined in your problem to me plus possibly the drugs you are on, in combination can cause hair loss. You should see an expert doctor who can assess your hair loss.

I am 18. I had very thick and dense hair. I was facing slight hairloss. I started using Hair and shoulders. And I started loosing crazy amounts of hair and started going bald in front region. Now I am quitting head and shoulders. lets hope for the best.

At 18, you may be experiencing accelerated genetic hair loss. Maybe it is not the Head and Shoulder’s shampoo.  See a good doctor.