How would you classify Josh Duhamel’s hairline on the norwood scale? It has a receding look to it but could it be just his mature hairline?
Josh Duhamel (pictured) has a normal mature hairline without hair loss beyond the juvenile hairline. His hairline is typical for non-balding men, and overall (based on the photos I’ve seen) he’s got a great head of hair. There’s no balding here.
Do you think that Dolph Lundgren has had a hair transplant? Does he have a norwood 2 hairline?
Thank you Dr!
I would guess that the answer is no on the hair transplant and yes on the Norwood Class 2. For starters, anyone in Hollywood with a transplant scar at the back of his head would likely never cut his hair that short (note the photo below on the left from late 2006). Even an FUE procedure would produce a small set of punctate scars. In addition, the density I can see appears normal, indicating that it is not a hair transplant… but pictures could be misleading.
Photo sources: Dolph at Rocky Balboa premiere (2006), Dolph (unknown year), Dolph in Rocky IV (1985)
Hi Dr Rasman – many thanks for the very appreciated blog.
2 years ago I underwent an aggressive hairline FUE procedure – 3,000 grafts all in the hairline with temple closure.
I’ve recently started shaving my head and, despite the white-dotted donor area, I feel much better about myself. I’d love to continue shaving my head – the problem is the recipient area. My recipient hairs, though not particularly dense, are much thicker than the natural hair behind them and begin with a very sudden, ‘flat’ line. The texture of the skin is bumpy and *may* form a small ridge at the start of the hairline; it’s difficult to tell whether it’s scarring, or just hair follicles pushing up the skin.
If I were to remove the grafts, is there any hope of restoring a natural-looking, albeit bald area where my current transplanted hairline is? If so, what sort of treatments would you suggest?
Thanks again for the site
Oh wow! 3000 grafts to the hairline and temples does sound very aggressive, if not impossible from my personal experience. The bumpy skin texture you describe can be scarring from your surgery and if it is scarring there really is no treatment for it. I am not implying you had a bad surgery, but hair transplant surgery is not reversible. Hair transplant surgery is permanent and you need to have a good foundation and understanding of what you are getting yourself into, as well as the long term complication and issues (such as scarring and shaving) before you regret the decision.
There are doctors who do 3000 grafts routinely in a small area of the frontal line and I have seen the work. The hairlines I have seen are straight and many times I doubt that the patient actually got the 3000 grafts they paid for, which makes me question the integrity of the doctor. These hairlines can be repaired by creating a good transition zone in front of the harsh tight hairline, but that assumes that the hairline was not placed too low in the first place. Often in some of these patients the hairline is too low, making a good repair very difficult. Each case is different and I would love to see you either in consultation or good digital photographs of your frontal hairline.
Dear Mr Rassman,
First of all thank you for your very informative and helpful site.
I am 30 years old and lately I started worrying about my temples. I have a feeling that I have rececing temples and want to take action in case this is the case. Unfortunately I do not have old photos taken from the right angle to compare. Could you please tell me what you think and my Norwood class according to the attached photos. I do not have any balding or thinning on top.
By the way, you can use my photos on your blog if you please.
Kind regards
Click the photos to enlarge:
First of all, thanks for allowing me to publish these. What I believe you’re talking about are the corners of the hairline, not the temples. The temples are below the corners (above the ear) and those look fine in the photos you provided. People seem to get the temples and corners confused all the time when labeling them.
It appears that your hairline is now convex in shape and the central area does meet the side areas, suggesting that the maturing hairline is locking into place. If there is no miniaturization present, I would do nothing other than observe your hairline yearly. This is a Norwood Class I or II.
Hello;
I read your blog from time to time and I remember you saying that propecia doesn’t really work in the frontal area. As someone who is hoping for regrowth in the front that’s a gloomy assessment. However there are a few studies that offer hope, here is one and if you google search “finasteride frontal study” you’ll find more.
Finasteride in the treatment of men with frontal male pattern hair loss — “RESULTS: There was a significant increase in hair count in the frontal scalp of finasteride-treated patients”
From what I am understanding, it doesn’t work in on the temples but it’s common to see results in the frontal area as well as the back. As someone who is on 1/4 Proscar every other day I can tell you I am seeing some regrowth nearing month 3 now and I am hopeful that by month 6 I will have achieved even more. Also, for what it’s worth…not a single side effect.
I know that finasteride does slow or stop frontal hair loss. With regard to regrowth, in many men who have visual frontal balding, the degree of growth in my experience has been less than enough to produce hair that can be combed. I have had hundreds of patients on finasteride, and although a very small subset of them have grown enough hair to see a difference in the hairline, most have not. The drug will work the same on any hair follicle that is undergoing genetic hair loss, but the frontal area is often ahead in its balding (more so than the crown), so maybe the failure to see substantial grown in the frontal area reflects where the balding is by region. All I can report is what I see in my patient population and although I have seen remarkable frontal hair growth in some, the percentage of patients who show it is very small.
Hi Doc,
I started propecia 5 months ago for a receding hairline. My hairline appears to still be a norwood 1, but it is closing in on the second one very quickly. I don’t think the propecia has helped at all. I don’t even think the recession is slowing down. Is there any way the propecia could help from here on in, even if it hasn’t even slowed down the hair loss in 5 months?
Propecia (finasteride) will not stop the appearance of a mature hairline, as that is what it sounds like you’re describing to me. You should send me photos and I will give you a more definitive answer. Mature hairlines are convex in shape, while juvenile hairlines are concave.
Paid advertisements (not an endorsement):
Hello Dr. Rassman! I am a big fan of horror writer Dean Koonz. According to his biography, he had a hair transplant because he was “tired of looking like G. Gordon Liddy.” His “before” picture is here and his “after” picture is here
I don’t know, I’m having trouble believing that those results are from a hair transplant. I’m thinking hairpiece but I thought I’d get an expert’s opinion. I see his picture on the book jacket every day and I can’t help but wonder!
Based on the photos you sent (which I’ve cropped and shown at right), author Dean Koontz’s hairstyle sure is shaped like a bad hairpiece… but that reflects personal taste and maybe it does the trick for him. I don’t know any details about his procedure so I couldn’t really guess as to what is actually going on there. Former Illinois state governor Rod Blagojevich has a similar look and I do not believe that he has a hairpiece.
In the years that I have been involved in hair treatment, I have seen everything imaginable with regard to what the consumer wants his look to be like. It is not unusual for balding men to have facial hair and when many of them get their hair back, the facial hair goes away. With regard to hair pieces, almost nothing shocks me anymore!
On the NHI patient photos site, patient DTA has had a significantly improved hairline from his previous norwood 3 hairline. I was under the impression (from reading this blog) that your clinic took a more conservative approach to hairlines than other clinics but from the results it appears the hairline was significantly improved.
Could you please inform me on what type of method was used (FUE, strip or both), how many sessions such a hairline took to complete and how many grafts?
Thanks
 Before |
 After |
This patient had 4 procedures totaling 7390 grafts, all using the strip technique. The lack of graft and procedure count was an error on the NHI site that has since been corrected. He started getting transplanted before the FUE technique was available. Many times the patient just wants more fullness, so the graft count goes up.
As for the conservative hairlines, we create hairlines for men that frame the face and look masculine, like the patient above. I don’t understand why some doctors will transplant a straight line of hair for a 40 year old man (for example), when that type of hairline is usually seen only in children and women. See also: If I Get Transplants, I Want a Perfectly Straight Hairline.
Why do many latino males have very low hair lines?
I’ve noticed that many Latino’s maintain a juvenile hairline for most of their life. You’ve mentioned in the past that Native Americans are genuinely different from any other race because of their genetics, they do not bald whatsoever. Is it possible that many Latino’s do not bald because many have these native american genes as well. Many Latino’s are what is known as “mestizo”, which means they have both European and Native ancestry. Does that explain why they have good hairlines?
I’m not a geneticist, but I believe you could be on to something. There are many Latinos who have concave shaped, strong hairlines. Your theory sounds good to me.
Thanks a lot for this site, good sir. I have a question related to TE and MPB. I have diffuse thinning on the top of my head. While I haven’t been to a miniturization check, I would say some (though hardly all) of the hairs that fall of my dome are thin. I went through a 2 month phase where I lost very thick and dark hairs, but this has stopped (I guess they’re gone?)… I am possibly a NW 2, but I’ve always had a high forehead. The hairline has receded, but there are still hairs at the base of what is basically the original hairline. Basically what I’m explaining is a very unclean hairloss at the top of the head…the hairline is more of an abstract idea than a line, if you follow me…it’s very irregular and uneven.
Does TE ever “act” in this way? Or am I just kidding myself and it’s MPB? Father with hair, mother with hair, mother’s father with hair, father’s father with hair…
Cheers
I don’t think I quite understand what you are describing. I would be happy to examine you and then I will understand what you are talking about. As you state you have not gotten a miniaturization check, which could point to genetic balding. Moreover, it may be something very early, as you categorize yourself as a Norwood Class 2.
From what you describe, it sounds like you’re losing your hairline due to genetic causes and have a few remaining hairs that haven’t fallen out in the same area. A telogen effluvium likely won’t be focused at the hairline.
