I Think I’m Destined to Be a Norwood 7

Dr Rassman,

After reading through your blog posts I noticed something you mentioned a few times, about young men in their 20’s who show signs of an early Norwood 7, and how Finasteride may not help them.

This has alarmed me somewhat as I am approaching 23 and have been noticing my hair loss for 2 years now. For the majority of that time my crown area was unaffected, however I now have thinning there which extends down the back of my head, seemingly to the point where a Norwood 7 donor area would be at it’s highest.

I realise this is hard to envision so I have included a picture which I’m happy for you to publish. Aside from this area of my head, my hairline has moved back (it would look similar to that of a Norwood 2 hairline) and is thin, although not disastrously so.

Given that it seems (at least to me) that I am set to be a Norwood 7, am I wasting my time on finasteride, or any treatment for that matter?

Also if you could shed (pun not intended) some light on the thinning I seem to be experiencing at the nape of my neck (which is accompanied by thinning in the sideburn/ear area) I’d be appreciative.

Thank you.

First things first, thanks for allowing us to post your photo! Click it to enlarge.

I’m pretty sure we’ve never said finasteride wouldn’t help a young man with early signs of Norwood class 7. In fact, we strongly advocate finasteride over surgery for early thinning in young men.

You’re 22 years old with what sounds like a mature hairline, but with respect to your photo, I have a hard time seeing that you will become a Norwood 7. Did a doctor tell you this or is this just what you’re assuming based on what you’ve read? Did you get your scalp and hair mapped for miniaturization? If not, you should have it done and it should be repeated every 6-12 months to see what is happening to you.

Finasteride should be part of your treatment if you’re losing hair, but it’s most important to find a good, caring doctor to manage your hair loss. You should also want that doctor to be able to create your Master Plan, which will help you make the right decisions and help understand what is happening to you.

At this point though, I’m going to have to take your word on it that you see hair loss, because just based on the photo you sent, I’m not seeing what you’re seeing.