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The only way a hair transplant is normal looking after it is performed, is to transplant the natural growing groups that hair normally grows in, in their anatomical groups, i.e. the follicular Unit. The average Caucasian averages about 2.2 hairs per follicular unit and the typical human has approximately 50,000 of these follicular units on their entire scalp. So if the average hair count per follicular unit is 2.2 hairs/follicular unit, then the typical Caucasian man has approximately 110,000 hairs on their scalp. For the typical Asian, the follicular count remains at ~50,000 but the average hair count per follicular unit drops to 1.9 hairs/follicular unit for a total hair count of ~95,000 hairs. This is an average, but the range could be wide ranging from 75,000 hairs – 120,000 in any given population.

This is a picture of a 6 hair follicular unit (rare in most people) but worth showing because it shows new hairs in their growth phase. Notice that two of the hairs are shorter than the other four (marked with arrows). These are new anagen hairs growing into this follicular unit increasing the visual hair count by 1/3rd from 4 to 6 hairs. That means that possibly a few months before this follicular unit was excised, it probably had only 4 hairs that were visible. The two new anagen hairs arose from stem cells within the follicular unit. It is likely, that if we allowed this to grow (and were able to follow the hair count in this follicular unit over a year or so), the hair count may actually drop as some of these longer hairs (terminal hairs) may actually turn into their sleep phase (telogen).

Hi, I didn’t understand if Saw Palmetto can decrease dht levels in blood and if it can do a visible results in hair health. Because i know that finasteride is the n#1 remedy used for AGA. Saw Palmetto should be a sort of ‘natural propecia’, less effective but without relevant sides as finasteride. But i really don’t understand if a man can have results in hair density and regrowth taking only saw palmetto. I mean if the starting situation of hair is not so bad (a little thinning hair but not bald at all).

There are many studies that show that Saw Palmetto is a very weak and poor DHT blocker for hair loss. Intersting read: https://baldingblog.com/general-questions-on-dht-blocking-supplements-have-birth-defect-risks/

This man shows the value of the combination of both finasteride and minoxidil

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The American Indian that came over the Alaska Bridge a thousand or so years ago, have no balding. I believe this is the only large population that doesn’t see genetic balding

Great results! Nothing more to say as your photos show the value of what you did.

(male)
I want to rule out other possible causes for my hair miniaturization to ensure that it is definitely genetic since I am not aware of any bald men in my family. My iron and thyroid levels are fine. I read that a urine analysis will evaluate my nutritional state. Is there anything else I should get tested? Like hormones for example?

In general, genetic hair loss in men shows up as a specific pattern (hence the name “male pattern baldness”). That is why there are diagrams and pictures (Norwood) to show what these patterns look like. A fairly competent doctor can determine what genetic male balding is by merely looking at the person. If the hair loss is relatively early in the process you can look at the hair under a microscope to see if there is a miniaturization pattern or a bulk measurement that can give tell you if you’re thinning. You don’t need a blood or urine test for this.

Other types of hair loss, such as from low thyroid or anemia, will present as diffuse thinning with no specific pattern. There is a hormone test to check your thyroid levels, but there is no hormone test for genetic male pattern balding. This can be confusing because a hormone called DHT (dihydrotestosterone) is the cause for hair loss in men, but only if they have the genes for MPB. The quantity or levels of DHT will not determine if you will bald since the underlying issue is genes.

There is a genetic test for balding, but it is not a straight forward test to interpret since it only give you a probability score. The easiest way to test for balding is a good old fashioned physical exam. Finally, I must point out that the gene for balding can skip generations and there is no specific rule on how it is passed down.

Very nice regrowth with the combination of microneedling, finasteride and minoxidil. I believe microneedling makes all of the difference

It is likely that you have alopecia areata. Take a look at this reference: https://baldingblog.com/how-does-a-dermatologist-check-for-miniaturization/ which shows the in-office examination results from using a trichoscope for the evaluation and diagnosis of this condition. This patient shows the classic critical diagnostic finding with a trichoscope or exclamation mark hairs

This appears to be very impressive early results from using minoxidil, finasteride and Microneedling for just 7 weeks. Hair length does play a role in what we are seeing.