https://www.thecut.com/article/med-spa-hair-loss-treatments-balding-men-botox.html

The article calls out Ozympic as producing hair loss; however, I suspect that when people lose weight rapidly, hair loss is often a known side effect of a “negative nitrogen balance”, essentially losing your body proteins and fat.  The body is intrinsically smart, so it knows that when you are losing weight, it has to sacrifice functions that are not critical to living, and hair growth is one of those dispensable functions.  This is especially true in men with genetic hair loss, as weight loss can trigger genetic hair loss or accelerate what is already going on. 

Both corners of my hairline were the same before I started my routine of 5% minoxidil, finasteride and microneedling with a 0.75mm needle. 

Congrats! This is an awesome response. Nothing like persistence and follow-through. The value of microneedling is, I believe, the key to your success, but it is clearly only part of the solution.

I have seen a few patients who have responded better to finasteride at a higher dose, suggesting that that particular individual just needed a higher dose. If you understand Bell Curves, the 1mg dose determined as the ideal dose by Merck in their original studies used a Bell Curve to make that determination. We can sit on either side of that Bell Curve as we find the ideal dose of finasteride for us. 

[If you have any questions, you can reach me at williamrassman33@gmail.com] 

That makes no sense to me, as adding topical finasteride while you are taking oral finasteride at the 1mg dose, will add blood levels of finasteride.  With topical finasteride, the drug will come across the scalp and go into your body. There is therefore no reason to add topical finasteride once you are on the proper dose of oral finasteride.

In evaluating this spot, a knowledgable surgeon will know or want to find out:

1- This location is not typical for Triangular alopecia as it is  too far back from the temple peak.

2- What does the trichoscopy show as there are hairs within the bald spot that might shed light on the diagnosis (will rule in or out alopecia areata)

3- Most likely that this is not genetic patterned balding as it is not located in the patterns for such balding

4- This is a clean scar sitting inside normal hair, likely a form of alopecia that has a clear “cut” border

It turns out that this lesion was biopsied, and the diagnosis was definitive for Citrical Alpecia (scarring alopecia). This man had this for many years, and it was stable, suggesting that the disease had already done its damage and could be, therefore, transplanted as was done with good immediate results. The problem with such diseases is that:

1- It could return at the site and kill all of the transplanted hair

2- it could appear at another site and do the same damage

3- if the disease was active during the transplant, it would either immediately kill the new hairs as they started to grow or slowly kill off the new hairs over time.

 

Many articles have discussed the attractiveness of hairy men over balding men.  The most notable was a Mens Fittness article many years ago that stated that to be president of the United States (after Ike), you must have had hair.  Hair makes men appear more trustworthy, according to that article.