Long Term Class 6 pattern, what happens under the skin?

From what I’ve read, the underlying theory for advanced classes not responding as well is due to scalp fibrosis, however that is understood to be reduced by an increase of bloodflow and microneedling. If scalp fibrosis is the culprit as to why NW6~+ don’t respond as well then hypothetically in time, enough microneedling and enough of an increase in bloodflow should result in an increase in hair growth right? I’m certainly getting vellus growth in my hairline at the sides and towards the middle front.

That being said, after almost an entire year on my regimen, I’m having what seems to be my first shed and it’s almost exclusively my intermediate hairs that have grown from vellus in my frontal mid scalp region. What has me excited is that I’m not getting any bulbs pushed up like when you lose hair so it seems like this is an expected healthy shed. I’m excited to see what replaces them in the next 3-6 months!

When an area of the head has been bald for quite a while, it loses its blood flow as the body regulates blood flow where it is needed. Normally, hair is a high metabolically active organ, so it commands blood flow. When the hair dies off with apoptosis (hair cell death as we believe it does), then the body figures that the blood flow can be better used elsewhere. This means that the skin of a older bald area, becomes atrophic and looses all of its support infrastructure for the hair which includes blood vessels and fat.