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[/bq] Most cells in our body have a ‘death’ time programmed into them. For reasons unknown, part of the hair on the scalp in about 45% of the male population may have programmed earlier death (the balding pattern seen in balding men). This patterned hair loss does not impact the hair around the sides and back of the head, the 3 inch wreath of hair we call permanent hair. Men generally do not lose hair on the sides and the back part of their scalp, because it is a genetically programmed trait not to lose the hair. This fact allows hair to be transplanted from the back and side of the head (permanent hair) to the balding areas. Furthermore, hairs on the side or the back of the female scalp are not generally considered permanent and when they have female genetic hair loss, it is usually a more diffuse type of hair loss impacting the hair all over the head. This is why most women are poor candidates for hair transplantation as they do not have this permanent wreath of hair around the sides and back of the head.

There has not been a good explanation that I’ve heard for this permanent rim. There was an interesting book I recall titled Sex, Time and Power: How Women’s Sexuality Shaped Human Evolution by Leonard Shlain, who had proposed a connection that might explain male patterned balding. He postulates that man’s history really goes back to tribal living when we had 150 people in a tribe (no large civilization existed at that time). He noted that 7% of men had extreme balding, and the same number of men were left-handed, color blind, and gay. He postulated that in the days when men hunted, there were left-handed spear tossers, men who could see through the camouflage of animals (color blind), men whose heads would go above the bush to spot game animals would not frighten the animals (animals knew to run from men and balding men did not look like men to these animals). The same number of men had to stay ‘back at the camp’ and protect the women (gay men). Not a bad guess, eh?

I keep seeing this pop up. I am 19 right now with a NW2.5-3 and just started taking finasteride. My plan is take fin for a year then — assuming I respond to finasteride normally (just maintain hair, am not a non-responder/super responder) — get a hair transplant at 20/21ish. Why would this be such a mistake? The finasteride should roughly maintain my hair for a decade or so, right? I’ll be able to live and experience a normal young man’s experience. Once it gets bad, I can just shave it once I’m older (which is not nearly as big of a deal), or I can get another procedure. Or hell, maybe there’ll finally be a cure for this shit disease by then lol. I just don’t get why it’s considered such a big mistake. I would honestly almost rather be bald than have these shitty temples, even if my density is still solid.

It is not wise to get a hair transplant at 20 years old because you can’t make a Personalized Master Plan as your future hair loss pattern doesn’t appear for most men until 25 years of age. Without a good plan, you start the transplant, use up the donor supply (which is limited) to deal with your short term problems and then when you keep losing hair you are out of luck as there is no more donor hair left. By then you might not just be bald, but freaky looking (nobody should look freaky). I have seen too many patient who did hair transplants at 19 or 20 and ended up regretting it.

The younger you are, the better the finasteride works. This applies in most men; however, there are a few men who are going to develop advanced balding patterns by their mid-20s or earlier and the effects of finasteride on them is much less valuable. Look to your father or grandfathers patterns of balding to see if you may fall into this category.

This is a recent comment from my post back in 2005: https://baldingblog.com/2005/12/01/hair-club-for-men/

I wore the hair club wig with the front french lace for 10 yrs. It works well if you learn how to maintain it and use the blue tape up front and hard glue in back. Your head needs to be dry when applied. Put the tape on the wig first and then roll hair piece onto scalp. You can swim etc for about 2 days in it. Every two days the front needs a retape. Use 90% alcohol to clean and retape. Do this with it still glued to the head in back. This can go on for a month like that.

It is great for the club and nights out. Nobody will know you have it on if done right.

People at work will eventually figure out it is a wig at some point. There are too many prying eyes in the bright light. Use a style that covers all the hairline for best results. Watch your color match and use bright light to test it out.

All in all, a good choice when done right and bad otherwise. Now in my mid fifties I don’t wear anymore. I just use a No 1 cut all over except the top. Definitely not as attractive as a man with nice hair though now.

I’m going to talk to the doctor about my type of hairloss and why I am thinning on Dutasteride. I’m going in for a free consultation and I’ll see what they have to say, whether I have normal MPB, DPA, or DUPA. I’ll keep you guys posted.

DUPA (Diffuse Unpatterned Alopecia) was first published by me in 1996. When it occurs in men, it impacts the donor area and as a result makes these patients poor candidates for hair transplants. Back then, doctors transplanted these men when they were balding and most of the time the transplants were failures, often leaving these men with scars and hair transplant deformities. The diagnosis is made with a hand microscope looking for miniaturization in the hair in the back and sides of the hair which is generally immune to balding. It can sometimes respond to finasteride, but it is not predictable. The cause is unknown.