This patient with straight, medium fine hair had presented a Norwood class 3A pattern when I first met with him years back. His first hair transplant surgery was 1927 grafts, and while it gave him a hairline that he had been missing for years, he decided to have another procedure (of 2222 grafts) a year later to fill it out a bit more. No further procedures are planned.
Click the photos to enlarge.
After (4149 grafts total over 2 procedures):
Before:
Some claim that finasteride has, overtime, worsened and accelerated their receding hairlines. Is this medically possible? Or is what they’re seeing just a result of aggressive MPB that hasn’t responded to the drug?
Thanks!
I do not know why finasteride would worsen hair loss. It is a drug treatment that slows down hair loss. Finasteride does not work well on frontal hairlines, but this does not mean it makes it worse. Perhaps in the process of slowing down the top/crown area drastically with not much effect on the front hairline, the overall perception may seem as if the front is worsening faster. I really do not know, though. This is just my speculation.
Dr. Rassmann:
My corners appear to be receding, but I don’t seem to have hair loss anywhere else.
I know you’ve said that Propecia and Rogaine’s effectiveness is limited to the crown and the top area of the scalp. But I don’t seem have any miniaturization in those areas.
Should I even bother exploring treatment with Rogaine or Propecia if I’m experiencing only corner recession?
The best results from these medications are seen in the crown / top, but there are definitely cases with visible regrowth in the hairline. I wouldn’t suggest that it is likely for most men to see that type of result, though. In other words, it’s rare for decent hairline regrowth to be seen… but not impossible.
Is it common for actors coming to you and your contemporaries to ask to have their juvenile hairline back? Do you do agree with this procedure and can it be made to look natural? (I’m assuming a movie star would need a completely natural look).
Thanks!
Many men want their juvenile hairlines back. They do not have to be actors. The relevant point is whether they are mentally and psychologically prepared to have a juvenile hairline for the rest of their lives. There have been actors that requested this, but so do some men of many different professions.
If you are 21 years old with early balding, you would not know where your hair loss will end up, but I understand that such a young man would remember very well where his hairline may have been just a few years before. For this and other reasons, most of the time I advise against putting back the juvenile hairline. But there are patients that insist and are fully accepting to the permanence of a juvenile hairline.
If I am comfortable that the patient will not develop an advanced hair loss pattern (higher than a Norwood Class 5) and I’ve estimated that the donor supply is adequate to follow the worst case pattern that the patient might develop (my opinion), I would consider creating a juvenile hairline on the patient. It’s really a case by case scenario, though.
Hi Doc,
I am 17 and I have been very anxious recently about a receding hairline and I am wondering if it will get any worse.
I have what appears to be a NW2 hairline with very fine thin hairs around the corners of the hairline which have receded. My hair is already very thin and fine and when I was younger the corner of my hairline where blonde as opposed to my dark brown hair which I’m unsure if that has any significance. Thanks.
Is there a chance I am not balding or will I see more hair loss in the future?
Link: Photo
It is clear from the picture, your age, and your concern that you need to see a good doctor to help you. At 17 years old with what appears to be a Norwood Class 3 balding pattern, it is a concern to me as well. It’s possible you won’t lose more hair, but there’s no way for me to know that just based on a hairline photo. You need to have an examination.
Since you indicated you’re in the UK, Dr. Bessam Farjo has offices in London and Manchester and I would suggest that you contact him, as he is local. You should also get a parent involved.
I’m nearly 18, and I wondered if this is the start of a receding hairline, or my mature hairline.
A few pictures attached, one with shorter hair, the others with longer, pushed back to reveal as much of the hairline as I can. My hair is naturally fairly thin anyway, but the corners of my hairline seem thinner.
I think we’ve been getting more and more of these really poor quality photos asking for a diagnosis lately. For the readers that want to send us photos, the images should be clear and have decent lighting.
So while I can’t really tell much about your hair loss (if any) from these pictures, I think most readers would be envious of your hairline. It appears to be a juvenile hairline with a widow’s peak.
Hello Doctor,
I am 21 years old and I have a deep hairline. Ive always had a deep hairline. There are little blond hair in front of it, everywhere.
My question is, does it look like my hair is receding? My father is 53 and has a full head of hair. Both my grandfathers only started loosing their hair when they got “really” old.
Thanks !
I cannot say if you are receding or if you are balding, but based on the photo you sent it looks like you have a Norwood 3 pattern. For certainty, send me a picture with your eyebrows lifted so that I can measure the distance from the highest crease. The V shape hairline that you do show, reflects the mature male hairline.
Click to enlarge:
I’ve always been curious regarding the UK actor David Tennant. He’s 41, and has a very good head of hair, but I can’t work out if he has a mature hairline or not? I’ve looked online and found some pictures, so was wondering what you think?
Here he is when he’s younger, I reckon he’s about 20/21 or something. – Photo
Then these are, I’m guessing from over the past 10-15 years, the last one being last year, and the one before being around 2009. – Photo 1, Photo 2, and Photo 3
To me, it looks like he has a mature hairline even when he was young?
Here he is a profile shot – Photo
I’m not familiar with his work, but IMDB tells me that Scottish actor David Tennant might be best known to US audiences from his starring role in the television series Doctor Who.
He has a strong mature male hairline with a widow’s peak. There is not sign of erosion, suggesting that this will last him a long while. This is not a hair transplant.
How did Arnold Schwarzenegger maintain his hair especially in his younger heavy steroid using days. It seems if DHT was the cause of hairloss he would have lost it all from all the testosterone they were using.
Over the years as Arnold aged his hairline did recede quite a bit but this was when he was much older and I believe he sorted it out with a hair transplant. Similarily Frank Zane in his younger days had a full set of hair presumably on a ton of juice – and he seemed to have lost it in his old age too.
Arnold probably does not have the genes for balding. It’s simple.
I don’t know that his hairline really moved all that far back. I’ve seen some photos from his younger bodybuilding days with a similar hairline to what he has now. His hairstyle back then seems to be hiding the corners, making it difficult to see. The straight across hairline from the Terminator movies was likely Hollywood movie magic to create the character’s look (why give a robot from the future a mature hairline?). Or maybe he had work done. I don’t know.
Dr. Rassmann:
Your site is an excellent resource. Thanks a bunch.
Is it possible to have a norwood three pattern with no frontal recession? In other words, can deep corner recession alone constitute a Norwood three?
Yes, deep recession in the corners with a normal central or low central hairline can co-exist when the forelock is persistent. This is actually quite common. The forelock is genetically coded differently than the frontal area in some families.
Some women develop changes in their hairlines as they age that make them look more masculine due to receding corners. These defects are very evident in women with very dark hair and light skin (like the Asian patient below), more so than in women with blonde hair and white skin or brown hair with olive skin tones.
These changes occur with many women who undergo plastic surgery, as their hairlines are often negatively impacted by face lifts and brow lifts. The changes tend to become noticeable rapidly after their plastic surgery is done, while others who did not have any such cosmetic procedure will barely notice the changes as they occur very slowly over the years. There are many women who show miniaturization in the corners of the hairline that may eventually lead to the type of changes shown here.
We love doing these surgeries as the patients are most grateful.
The before photo is below on the left, the after photo is on the right. This was done in a single procedure of 1800 grafts, mostly in the corners with some work in the frontal hairline. The after photo was taken about 18 months after her surgery. Click to enlarge.
Hi. I’m a 20 year old male, soon to be 21. My hairline was fairly straight if I remember correctly, but now I’m taking notice of recessions on the sides of the hairline. The middle part that has not receded is pretty large. What are my odds of this being only hairline maturation? Thanks for your time.
It could be just a mature hairline developing, but I have no way to know that just based on your description. You’ll have to just keep looking at it over time (but try not to obsess about it). You can compare it to the mature hairline photos in this post. If you visited me or another doctor in this field, you’d likely get some help defining the problem you see.
Why is it that when a baby’s hair is growing in, it starts with the pattern of the receding hairline? Thinner on top with a forelock and nothing at the temples?
On another note…is the hair at the temples and crown slightly thinner in even non balding people? I notice that women and children also seem to have lighter/thinner looking hair at the temples.
I just had my first grandchild on May 1st, and she was born with a Norwood class 4A balding pattern… so of course, the jokes ran around that we were going to transplant the new addition to our family. The proud daddy laughed and laughed. Over the course of 4 weeks, the hair loss pattern got better and now she almost has a full head of hair. I don’t have an explanation as to why some babies are born with less hair that quickly grows in, but it’s not uncommon. Some of my own kids were born with a gorilla look (hair-wise) instead of the class 4A pattern on my granddaughter. Don’t focus too much, as things in the hair side change rapidly in babies.
With regard to your second unrelated question, I don’t really see much of a difference around differing parts of the scalp, but hair in the very frontal hairline and the neck is often finer.
Dear Dr Rassman,
I’m confused! In this previous post (Receding Hairline Corners — Is It Just a Mature Hairline? ) you say that the person in the images now has a ‘mature’ hair line. But when he is holding his hair back I can clearly see a lot of smaller (miniaturised) looking hairs hanging down.How can this be maturing? I thought you said in another post that generally you don’t see smaller hairs like this at the leading edge of the hair line unless it is maturing?
In the transition from a juvenile hairline to a mature hairline (like mine), the leading edge often has small vellus hairs in greater quantities than further back.
In a transplanted hairline, the leading edge has very few vellus hairs that makes for a hairline with few softer hairs. In men with coarse hair, I place more single hairs in the frontal edge to try to make up for the missing vellus hairs as this could become detectable on close examination in men who have coarse hair. When I do a hair transplant on a coarse haired man, to adjust for this, I place more one-hair grafts in the frontal transition zone and break it up more that I would normally for a man that has medium or finer hair.
How would you classify Andrew Lincoln’s hairline?
Andrew Lincoln, probably best known for his role in The Walking Dead, has a hairline that looks very straight (possibly due to styling or Hollywood “magic”) in some photos, but in other photos his hairline looks like it could be a Norwood class 2 or 3. Your guess is as good as mine without seeing his hair wet or up close.