When hairs become miniaturized, are those hairs necessarily doomed to fall out and not be replaced? Or, can some men maintain miniaturized hair indefinitely?
I honestly don’t know. There are no set rules and I’m not aware if anyone has ever scientifically studied this in detail. We see finasteride hold on to miniaturized hairs for years and likewise some patients will be able to hold on to them with minoxidil.
In general, we know that for non-balding men and women, miniaturized hairs do exist. Those miniaturized hairs fall out eventually and a new hair grows in its place that most likely will be miniaturized as well. The percentage of miniaturized hair in non-balding men and women are low (under 20% or so) and if one looks at the length of these hairs, they are often short. The shortness tells us that these hairs are the vellus hairs that are found in the follicular units.
When you are balding or thinning, this percentage of miniaturized hair is much greater and many of those miniaturized hairs fall out, never to return after a few cycles.