Hair changes direction in the back of your head. If your hair is fine, this might explain the see-through area. If it is early balding, minoxidil is a good medication to apply to the area it it bothers you.
Here is a picture of the donor area of a man who asked me: How much donor hair do I have? He asks: You have talked about the Donor Bank in your writings, so I would like to know how many grafts are in my Donor Bank and what will be my lifetime supply of grafts for hair transplants in case I should become very bald?
First let’s see where the permanent zone of hair can be found. It is called the permanent zone because even the baldest of men, never lose hair in this zone (see photo below). The zone measured from 2.5-3 inches in height and extends around the entire head from temple prominence on the right side to temple prominence on the left side. We generally assume (safely so) that this hair will always remain (regardless of the balding pattern a man develops). Back in the late 1950, a doctor ‘Orentriech’ discovered that if this hair is moved anywhere on the body, even into a bald area of the scalp, it would grow as it would have grown in its home location in this permanent zone. That is why it is called the permanent zone of hair.
There are two important numbers to determine from the hair in this zone (1) the hair count per follicular unit (these are the groups of hairs that contain one or more hairs each in them) and the thickness of the hair shafts of this permanent hair (never look at the hair you are losing as normal hair as it often gets thinner and thinner). I quantify the thickness of each hair shaft in the permanent zone by feel (experience helps here) or with a micrometer as Fine (~40 microns or less in thickness), Average (~60 microns in thickness) or Coarse (70+ microns in thickness).
I generally take a picture of the donor area with the hairs cut short enough that I can count the number of follicular groups in the field of view and how many hairs are in each group (see below). This field of view of the donor area of one of my patients was taken with a purchased lens as an attachment for my cell phone (https://www.amazon.com/gp/product/B07S5YPPQX?pf_rd_p=ab873d20-a0ca-439b-ac45-cd78f07a84d8&pf_rd_r=CCSSMZGDS79G6AG31TT9) at a cost of $16, something you should consider purchasing.
First let’s do some simple math: There are 34 individual hair groups (shown in the area shown in the photo) which contain from one to 6 hairs each (each are counted and labeled for you). The total hair count in this field is 85 hairs. If we divide the number of hairs by the number of groups 85/34= 2.5 hairs per Follicular unit (a Follicular Unit is essentially what we call a Graft in a hair transplant surgery). The average Caucasian has 2.2 hairs per Follicular Group so the man shown here has a hair count that is 13% higher than average. I can tell from this number that this man has 125,000 birth hairs on his head regardless of how much hair he has already lost. I felt his hair for thickness and measured it. It measured 60 microns which is essentially an average weight hair.
Now let’s look at more detail at this picture. There is a single hair shown that I labeled ‘m’ for a miniaturized hair. So this man had approximately 1% miniaturized hairs. The number of miniaturized hairs can be as high as 20% and the donor area is still considered healthy. As we get older (into your 50-90s) these hair groups may drop hairs so that the count could be slightly lower and the hairs that we often drop will often be miniaturized before they fall out. Everyone experiences hair changes with age, as donor area hairs may get ‘finer’ so that they contain less hair bulk per hair shaft. If these hairs are used for a hair transplant, whatever happens in this permanent zone, will happen in the hair transplanted hairs as well.
The calculations of his total donor bank supply is a bit more complicated. Each person has a fixed number of Follicular units (about 50,000 for an average sized head) and the hairs in these follicular units can be counted. Generously assuming that the size of the donor area is between 20-25% of the total hair baring scalp (let’s use 25% as a number for calculations here), this patient has 31,250 hair in his permanent zone or 12,500 follicular units (grafts) of which he can transplant theoretically no more than 60% of these hairs (follicular units or grafts). The 60% number is based upon an average hair count, but because this man has 13% more hair, he can actually move 13% more grafts bringing his total available lifetime hair to 7,500 * 1.13 = 8,475 grafts available during his lifetime.
Experienced surgeons like me who have been measuring hair densities since I first entered the practice and defined it in the literature, have learned when they can increase even this number safely. This is where surgical judgment comes in. I would like you to try to make this important assessment of your Donor Bank so that you will be able to (1) test the doctor’s knowledge of what he says about your donor supply, (2) be confident that your donor quality and quantity is adequate to meet your short and long term hair transplant needs.
I’m currently only 17 and I noticed recently that my hairline is starting to go. It’s not so noticeable at the moment, but does bother me a bit. I’ll drop some pictures so you can get an idea. I have no idea what to do right now and I want to stop it and regrow to make it thicker in the areas in a bit thin. I currently only take a multivitamin everyday since that’s all I feel safe taking until I get some solid advice. I know about a derma roller, finasteride, and minoxidil but I’m not sure what I need to take. Please let me know!
First I would advise you to find a good caring doctor who will build a Master Plan with you to allow you to maintain your hair for many years. Getting a HAIRCHECK test is a good thing because it will quantify the amount of hair you have lost so far. Things like the Dermaroller with minoxidil works well. So does finasteride but make sure that you really have hair loss and are at the beginning stages of hair loss before you commit to these treatments which have to be maintained.
If you are going to stop it, then stop it when the decision is made. Tapering it off, will give your finasteride dependent hair more time to hold, but the inevitable will happen if the hair is finasteride dependent.
NO, hair is not alive so cutting it does not damage the hair shafts under the skin where new hair is generated.
I originally answered this as yes and that if he had a few sexual side effects in the past, he might have them now. The readers was combative saying: How can you make such a powerful statement? On which facts are you basing it ? On the M.D. at the back or ?
There are tons of scientists, doctors, studies and reports that say the chances in getting sides are getting bigger with every pill you take, with every year you age!
I don’t want to be rude, I’m sure you have your experiences, but do you know the person in cause, his medical history, etc ? Have you seen his blood work or something at least ?
Also, are you a “future reader”, or a doctor ?
And also, if he takes it tomorrow and after a year or maybe less or more he comes and complains about sexual sides, are you gonna stick with this statement or are you gonna tell him “it’s just in his head” ?
With age, more and more men normally develop ED. It is believed that 30% of men who are 30 have some degree of ED, 40% of men who are 40 have some degree of ED, 50% of men who are 50 have some degree of ED. With that said, the longer you take finasteride, you might fall into the normal changes that occur on men’s sexual function as they age.
Nice comment and congrats. Many women with hair loss are not good surgical candidates, but it seems that you were. I would caution many women reading this post to be careful when considering a hair transplant, for hair loss in the female is not like male hair loss.
The idea I had is, that I want to implant hair into my frontal micropigmentated area, but since I am young(only 23-Norwood 3 almost 4),I know that I will keep on losing my hair and the donor area is limited, so I am interested in speaking with my HT doctor, and convincing him to transplant me a smaller amount of hair only enough to give the impression of hair which will be accentuated by the micropigmentation. I think this could be a good idea, as I am ok with having a short haircut, like in the photos.
My problem is that I do not know if it would work for my frontal balding area, as most people who have combined SMP and HT seem to have had it done in their crown area.So I am really curious if any of you guys could give me any advice or opinion, as I am sure most of you know how depressed this whole ordeal this can make someone feel ,and any response would be greatly appreciated. I will try posting some photos down bellow of me and the length of hair of hair I’m interested in keeping and the bald/micropigmented area.
If you do Scalp Micropigmentation on the areas you showed, you must shave your head or it will not look good. I would advise against a hair transplant at this time. If you have a hair transplant later on, you can do this on top of your SMP. I just did someone this week who took this route. Having had SMP a few years ago, he decided recently to transplant the hair he needed above it so he could let his hair grow out.
Many women are now coming in to get their hairlines reshaped or lowered. The face needs a good balance and proportions of facial features include the framing of the face with (1) a well positioned hairline and (2) good eyebrows to highlight the eyes. We have been doing both hairline lowering hair transplants and eyebrow hair transplants with great success. Women are happy when they look in the mirror and see the person they want to look like, as shown below immediately after the surgery.
Every once in a while, once a month, I simply search “hairloss treatments” to see if anything new happened, or maybe a new treatment, but all I get is recent articles like “does ___ cause hairloss?” “can vitamins help with hairloss?” “can saw palmetto halt hairloss?” Bull**** articles like these make me pissed off, not because of the articles themselves, but because they are repetitive articles that i see every month when I search this shit. What happened to Breezula? WAY-1001? Guess we’ll never have a good safe, non-fearing treatment. Guess everything comes with a price.
Back in the 1980s, there was a ‘product’ called the Helsinki Hair Growth Forumlae that may have been the first modern product claimed for the hair growth pitch to hit the US market for magic hair growth cures. As the first, it sold like ‘hotcakes’ and it took more than 10 years for it to lose its unique market position because the FDA dinged them for claims that could not be proven. I look them up, and they are still selling hair products, just no magic claims.
If you look at newspaper in the late 1800s and early 1900s, you will see a lot of products selling cures for hair loss like magnetic hats that you wear at home. People never liked the idea of being bald so they easily reached out to anything that was offered. Today, with the internet, we have the ability to discern the difference between fact and fiction, but many people have realities that they want to believe and will often buy into anything that sounds ‘reasonable’ with low risk and possibly low cost solutions for hair loss.
There are now many doctors who have become the salesmen for sometimes shady cures, but because they wear a white coat, or have the MD after their name, they become believable. I have to be careful how much I say about the doctors who are making promises that they can’t deliver on but I can tell you, the readership, ‘Let the Buyer Beware’ as there is no fast, cheap fix for hair loss that I know of.
Inert hair fibers like Toppik do not cause harm to the hair. Hair spray does not do damage provided that when you style your hair that you don’t tug your hair as tugging on the hair can pull out the hair at its roots and in the long term cause permanent hair loss and/or hair damage
I’ve been taking generic finasteride for around 5 years (since I was 25) and I’ve maintained the hair that I had when I started taking it. I also only had a minor side effect (orgasms seem to be a bit weaker, not too much but enough to notice) but the plus of keeping my hair outweighed this negative.
I read a scientific paper yesterday about the long term effects of neurosteroids and 5a alpha reductase inhibitors and it got me a little worried. Then I went down the rabbit hole of posts on places like Medium and Vice about how the drug ruined their lives and it was difficult for me to get some sleep last night and I was seriously considering just going cold turkey but even there you get people saying that stopping finasteride could give you PFS symptoms as well.
Not really sure what to do now, as much as I like having my hair I don’t want to screw up my brain and body over the long term.
Currently, I’m thinking of dropping down from 1mg to 0.25mg a day as I saw a graph showing that DHT inhibition only goes from 68% to 62% but what do you think?
Almost all of my patients who were on finasteride for years and who have stopped the drug for man y reasons, have often seen significant hair loss and regretted stopping the drug.
FUE scars can show on a shaved head, especially if you had (1) many FUEs and (2) a large punch used to create the FUEs. If you shave your head you will see the areas where the follicular units were removed. Longer hair can always grow out to cover it. For people who have significant scarring in their donor area, we often do Scalp Micropgimentation (https://scalpmicropigmentation.com/). The people with most detectable scars, when the surgery was performed with small punches, are those people who may have had a lower donor density so that the missing follicular units are more detectable. In people who have higher donor densities, there is enough hair not to notice the missing follicular units.
Finasteride works best on someone of your age. You are not too young. It is best if you can find a doctor with a HAIR CHECK test to get a good baseline for the future.