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Can Hair Miniaturize In Just a Few Weeks or Is It More Gradual?

Hello Doctor,

I know there have been various posts on this topic and please feel free to ignore the question given that you have already provided comments. Also, I wanted to thank you for the blog as it has really allowed my to expand my knowledge of hair loss and related topics which is greatly appreciated.

I had what I though was a thick head of hair on the top of my head and historically my worries over thinning was limited to a receding hair line. Recently I got a short hair cut (borderline buzz-cut) and seemed to notice that in certain house lights I can see some of my scalp. That being said other lighting I cannot see through at all including when I am outdoors. I am not sure if this is a function of how my hair is parting, the use of hair products which I read can ‘clump’ hair together giving a thinner look or whether there are legitimate concerns to be had.

My question(s) relate to the miniaturization process and the speed to which it can occur. I recall from a previous blog that hair will grow at a rate of about ½ inch per month and would it be possible to have ‘normal’ hair on the top-half of a follicle and a miniaturized bottom? Is the process of miniaturization more gradual or can you go from thicker to thin in a matter of a few weeks?

I can sympathize that people are different and will go through the process at different paces but I am looking for some general comments based on your experience. For further information, my hair tends to be quite straight and sticks up when short and could this growth pattern contribute to a thinning look i.e. sits in such a position that gives a thin look? I should note that I am 33, currently taking Propecia but nothing else in the way of medication.

Regards

I am not sure how fast miniaturization occurs. I would think it happens over weeks to months (not days). It is a gradual process. I do not know of any documented studies on how fast miniaturization occurs. Usually we follow patients on a yearly basis (not monthly).

If you would like to conduct your own research, you can buy a handheld video microscope and take pictures of a specific area over a period of time and document the results. We wrote a 3-part tutorial on doing this a few years ago — Mapping Your Own Scalp for Miniaturization.

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My Hair Thickened on Propecia

I started to notice my hair “changing texture” when I was 23. By 26, I was noticing a “cowlick” on the left side of the crown of my head for the first time. Then the right side. At 28 I started propecia. My hair looked okay dry, but the thinning was apparent when it was wet.

I am 29 now and I feel I have less hair but each remaining hair is thicker. Is it possible the thin hairs I lost will come back in as slowly has they thinned? I don’t know if I am paying for slow hair regrowth or false hope when I buy fin.

Regrowth at the hairline, which is where I assume you’re talking about, is rare. I can’t comment on whether you have less hair now than you did a year ago or even whether it is thicker, because I don’t know you or have any mapping to go from.

You need to see a good doctor who specializes in hair. If you’re buying a prescription medication, you should have a prescribing doctor — so I would discuss this with him/her.

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Can I Bring the Temple Peaks In with Surgery Without Filling in the Hairline?

Dr. Rassman,

I am 26 y/o, I have a very high hairline with uneven and very receded temple points. I do have some thinning on top and a family history of hair loss, but I believe that medication has been very beneficial for me. I take it every three days and have had almost the same benefit as everyday but without the side effects.

My question is regarding the temples (or sides) of my hairline. With a very high AND wide hairline, I feel its making me especially conscious of my hair loss. I’m wary about having anything done to the top of my hairline because I’m sure I don’t want to be stuck coming back for multiple surgeries if/when my hair continues to fall out.

If I were to have something done to bring the sides (temples) of my hairline in to better frame my face and add symmetry to my hairline, would I be right in thinking that this can be done and could achieve a natural looking result without lowering my hairline? and in the case that I do continue to lose hair on the top, it wouldn’t require that I come back for additional surgeries?

This is an individual decision between doctor and patient. What is best for you will depend on many factors — for us, these factors can be analyzed and recommendations given.

Yes, a good hair transplant surgeon can replace the temple peaks. An experienced surgeon is critical for making sure it is done right and for making the proper analysis of what to do. You never want to have a cosmetic surgery with results that look unnatural, so an experienced surgeon with a good eye will be able to tell you what’s achievable for your particular case.

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My Head Got Bigger?

hi there.
im a 17 year old boy who is worried about receding. i have a full head of hair but it is a bit thin in the left hand side at the temple. i have been told it has always been like this. my mothers dad went bald before 30, my dads dad did not go bald. but my dad has receeded a bit on top. when my hair is dry u cannot see my scalp but when wet it parts alot and seems thin!!also i was told that my head may have got bigger which may make it seem like it has receded! am i worrying over nothing??

Growing boys with growing and maturing heads, do not thin out their hair. You should get your scalp mapped out for miniaturization to find out if you have early genetic hair loss.


2006-06-23 08:22:41My Head Got Bigger?

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Can I Get a Propecia Prescription From My General Physician?

Dr. Rassman,

I am a 35 year old man who has become very stressed at the thinning of my hair. I always had very thick hair, even into my late twenties, but now, I am receding and thinning in the front and on top. It has become very noticeable due to the way I like to style my hair. (gels, spikey, short messy look) I now use disguisers such as Toppik and Pro-thik.

After reading up on it a lot, I have decided to try finasteride. My question is, can I get a presciption from my general physician? I have also been reading up on HT but the process and cost scare me.

Any words of wisdom would be greatly appreciated. Thank you.

Your family doctor certainly can write the Propecia prescription for you.

You indicated that you live in New York — so before jumping into drugs and not really knowing what you are doing, see Dr. Robert Bernstein in Manhattan and let him map out your scalp for miniaturization. Then you will know if your have genetic balding and if the Propecia is helping.


2006-09-11 16:23:32Can I Get a Propecia Prescription From My General Physician?

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Can I Have Several Smaller Scars Along Langer’s Lines Instead of 1 Large Linear Scar?

Dr.Rassman/Dr.Pak,
Is it possible for an FUT patient:-

– to have several small (5cms) donor-strip scars rather than the normal one large scar, and would such scars heal better if they followed Langer’s lines?
– to have donor-strip scars incorporated into existing scars (in permanent zone)?
– to have, using your experience and artistry, donor-strip scars with the appearance of naturally-occurring scars: the normal scars that most people receive from the everyday knocks and bumps of an active childhood/adulthood (falling out of trees, falling off bikes, sport injuries, fisticuffs, etc.).

I appreciate that all surgery inevitably leaves scarring and even with the standard of your work some compromise is necessary. But, perhaps like many men, I’m uncomfortable with the thought of having scars that are so obviously due to hair transplant surgery – even though such scars can be covered by wearing longer hair and/or camouflaged by SMP. However, if the scars could be disguised as accident-related scars much of the anxiety of having FUT surgery would be removed and, within reason, any amount of scars would be acceptable.

Thank you.

Multiple small scars were offered in the past, all placed horizontally in Langer’s lines (the lines in the skin where collagen fibers are naturally oriented). Some were significantly less detectable; however, they may not be very efficient if a lot of hair is needed (as in the Norwood class 6 or 7 patients) and multiple small scars often have some hair loss associated with them.

I frankly do not know of any doctors offering this approach. If for any reason, you are a person that widens scars, this approach would leave your head full of scars.

I had three strip surgeries all in the same place for my balding crown, but only one scar remains that is so small, few can see it. In my situation, having only one scar was the right decision and I did not need Scalp MicroPigmentation (SMP), as I did not need to hide what was already hidden.

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My Surgeon Said I’ve Exhausted My Donor Area After Multiple Hair Transplants

I am a 60 yo male. I’ve had multiple transplants via the strip method, most recently 2years ago. I’m pretty pleased with the results, but there is an area on the top toward the front where my hair is thinner than surrounding areas. It does not involve the hairline.

My surgeon told me I had exhausted the donor site after the last surgery. My ballpark guess is that 100-200 grafts would make a big difference.

1. Am I a candidate for FUE given my history?
2. If so, are 100-200 grafts a realistic expectation?
3. Do patients on Coumadin have to stop it prior to FUE surgery?

Thank you

You might be a candidate for 200 graft FUE style, but we would have to evaluate you first. Each case is unique.

If you are on Coumadin (warfarin), I would consider still doing a limited FUE procedure, but you will almost certainly have some more bleeding than normal. This has to be discussed one-on-one with either Dr. Pak or myself.

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Can I Start Propecia Now or Should I Wait for My Scalp Infection to Go Away First?

Dr. Rassman,
Ive had a skin infection for about a yr on my scalp. Ive been on many prescription meds like Ketoconazole, Selenium Sulfide, Salicylic Acid and Clobetasol. Ive gone through symptoms from heavy irritation, flaking peeling of oily skin on the scalp and hair-loss, scaling, buildup, dead skin-white buildup. Lately I primarily have inflammation and buildup but it is very little and very tiny and very thin flaking during combing when scalp is dry. I’m concerned about my hairloss, thinning, shortening-Its noticeable now and continues to progress from the hair line to about 1 inch inward but is not perfectly symmetrical. Most of the hairs that fall out are with the bulb attached and I do notice very tiny hairs remaining at my previous hairline. The only thing that gives me relief is clobetasol, because I still have lots of irritation/inflammation which Ive been taking for 2 months with 6% salycilic Acid. Is it a good idea to start Propecia or should I wait for the scalp infection to go away? I took a blood test that came back Normal. Thanks

Sounds like you have a major hair/dermatological problem. These medications (like the clobetasol) are heavy duty stuff. I can only guess at your diagnosis. Taking Propecia (finasteride 1mg) will not hurt and might protect you from some of the ‘stress hair loss’ you are experiencing. I would check the use of Propecia with your doctor, but I suspect he/she would go along with it.


2008-05-29 14:20:19Can I Start Propecia Now or Should I Wait for My Scalp Infection to Go Away First?

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My Transplants Seem to Be Thinning and I Can’t Find a Doctor to Prescribe Dutasteride

I am a 50yr old male that has had six strip surgeries over the years. I have continued to thin and even the transplants have seemed to thin. Most noticeably is the mid scalp area. I would like to try low dosage Dutasteride (Avodart 1 pill weekly) along with propecia, which I have been on for about 15 years. The problem is I can not find a doctor willing to write a scrip, and I have been to several Dermatologist as well as my primary care doc. All say they are not comfortable with it. The low dose seem reasonable. I feel I must give this a try before it is too late.

Any advice? Thanks very much!

If you are continuing to lose hair, it just may be from your genetic predisposition to male pattern (androgenic) balding. All drugs have limitations and drugs alone cannot completely stop hair loss. There is a reason why most doctors (including me) do not routinely prescribe dutasteride. Dutasteride is not FDA approved for treating androgenic alopecia and it has a higher side effects potential than Propecia.

As for your continued thinning, including the transplants — this is unusual. I haven’t seen your before/after photos and I haven’t seen your case file, but if the grafts were taken from the donor area (and not higher or lower), they should not fall out with your hair loss progression.