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Minoxidil has made this bald spot bigger and made my natural healthy hairs thinner it’s been six months and the hairs in the bald spot that minox grew don’t look good and my healthy hairs have not thickened, should I stay on and give it longer or come off now ?

Minoxidil doesn’t reverse the hair loss you have, but it grows new hairs. Additionally, many of them are very small hairs and are not enough to build bulk. Observations show that it peaks its value at about a year with continuous use.

Dear Dr. Rassman,

How is this possible? I’ve noticed this celebrity whose entire forhead is bald except for a little stubborn patch in the middle. It doesn’t make any sense. How can the entire forhead go bald while a little patch remains? Does not DHT miniturize all the hairs? Here is the picture of the celebrity below and another picture I found with a gentlemen who has the same pattern.

Celebrity – John C. McGinley

PG.com patient

I’ve been asked about this before, and I always point to David Letterman, who has a persistent forelock and hair loss around it. This is a genetic trait (shown well in your photo references) which is common in some families. I see it quite often.

Finasteride gets its peak results in 18 months, although many people see the hair loss slow or stop in a few months

I appreciate your helpfulness! Keep in mind a lot of this is performed on rodents and in vitro. However in 2015 there was a study on females that supplemented with fish oil and saw a significant positive impact with a sample size of 100+ if I recall correctly.

https://pubmed.ncbi.nlm.nih.gov/25573272/

 

I have quite a few more but they are quite dense in information but if you’re interested I can show you.

https://pubmed.ncbi.nlm.nih.gov/22440736/

https://pubmed.ncbi.nlm.nih.gov/14668211/

https://pubmed.ncbi.nlm.nih.gov/16304452/

https://pubmed.ncbi.nlm.nih.gov/9973380/

Firstly your site has done wonders to increase my knowledge. However, I first noticed losing my hair at the age of 27 in the crown. I am now 37 and the loss has increased dramatically all over, so much so that I am receding into my bald crown. My hair grows unevenly but now only hair on the top grows but at different lengths and rate. My receding hairline is now moving into the middle of my head which is now very thin. Miniturisation is throughout. I thought that this process would have slowed into my late thirties. Should this be the case or is this a very long balding process? In fact it has sped up over the last 18 months, Is this normal? Been on propecia 4 1/2 months with little effect. In my situation will propecia have some impact at all? Thank you very much

First of all, I would expect that you should see slowing of the balding process about now. The full value of Propecia takes a full year or so. We use general rules about balding and although most men slow down their balding process in their 30s, some don’t follow the doctor’s rules. Hair loss is a progressive process in most men, but fortunately it slows down to a ‘crawl’ by the time most men reach their 40s. You should be followed by a good doctor with yearly miniaturization studies. At the least, it will give you a good metric as to how you are doing. Good photography will also help define what is happening to you. You need to have a good dialog with a doctor who can work you through the process you are going through.

If I was to get a hair transplant but my hairloss progressed to the point I had to shave my head how visible would the scarring be at the back? Would I have visible white dots on the back of my head or do they fade

Scarring from FUE is inevitable; however, the amount of scar may not be enough to see it or make the donor area see-through. The scarring that you can see or the see-through donor area is the result of too many FUE grafts being harvested. If you think about the average donor supply having 12,000 follicular units (grafts in a surgical sense), then if you remove only 3000 of them, you are only removing 25% of the total donor supply. In a medium weight hair, that can be tolerated provided that the punch size used is not too large. But if you extract 6,000 FUE with FUE, then the numbers reduce by 50% and problems may arise, especially if your hair is fine in character.

The number of grafts to cover the crown depends upon the thickness of your hair (fine, medium or coarse). As the balding area includes the swirl where the hair changes direction, it often takes more grafts to recreate it. I would guess between 1500 grafts (for coarse hair) and 2500 (for fine hair).