The Back and Sides of My Head Are Decreasing in Density

Hi guys,

I started thinning when I was 19 and this continued slowly up until I turned 25 when it became far more aggressive and has continued in that vein for 18 months now. I had tried Minoxidil over a year to seemingly no effect and I had significant side effects from using finasteride. Overall in the past 18 months I’ve gone from a Norwood II to a Norwood IV and adjusting has been extremely difficult.

The back and sides appear to be decreasing in density at a similar rate (although they have more hair than across the top, as you would expect) and for that reason I’m very concerned I would not be a good candidate for hair transplant surgery.

I guess my question is whether this is attributable to only androgenetic alopecia, or could there be an additional problem? (be it some sort of telogen effluvium etc)

Thanks :)

The basis of good clinical medicine is to establish metrics (measurements) that give baselines from where we started. If you take such measurements yearly, you will be able to document the degree of thinning and this will help in the diagnosis.

Your story is not one that I hear too often, but to give you any insights I would have to examine you, take a good history from you, take bulk and miniaturization measurements of your scalp (sides and back, as well as front and crown). I can say that the back and sides of the head should not be decreasing in density, but only after you are examined can I do a better job of answering your questions.