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Hi, Dr. Rassman. Thanks for answering all of our questions.

My question is, How likely is it for someone to “settle in” to a level of hair loss (Norwood 3A, for example) and not see any more rapid loss for a period of time (years, for example)? Do some people get to a certain level of hair loss beyond a mature hairline and stay that way without medication? Or is your fate essentially sealed after you reach a certain level?

Let me clarify what I see as your misunderstanding. The Norwood chart is not to be seen as a progression of hair loss chart, but rather the final patterns seen in a large male population.

Some people do seem to go from a Norwood class 3 to a 4 and then to a 5 pattern, but you may just “settle in” to your Norwood 3A state, as an example. There is really no 100% certainty, but a good doctor with a good miniaturization study and examination can give you a better assessment of what hair may go with time. Here’s the Norwood chart so we’re all on the same page:

Your “fate” was sealed in your genetic code when you were conceived many, many years ago. Very few patients become a Norwood class 7 pattern, and even the balding patients who start as a class 5 may not go much further, even at the age of 100 or so. So for example, there’s no “point of no return” that says if you reach class 4 by this certain age, you’re guaranteed to be a class 7 later in life.

I have a question concerning today’s blog post. you mentioned that “exclamation point” hair is a sign of a disease but isn’t that what happens when miniaturization occurs in general? doesn’t the shaft get smaller, generally at the root first? that’s what’s happened to me. does this mean i have a disease? i doubt it. i got my thyroid checked when i first noticed hair loss and everything seems fine. i guess what i’m asking is, what’s the difference? thank you!

The term “exclamation point hair” is a term of medical art (see more info and a diagram at American Academy of Family Physicians). You are correct that as the miniaturization progresses (it would have to be rapid progression) one could theoretically see the reduction of shaft size, which is normally a very, very gradual process. It rarely can be picked up visually as you report.

With regard to sexual side effects, we have been led to think that topical Finasteride is safer than systemic Finasteride (the pill). However, from this post, that is clearly not the case. Stopping the medication should solve the problem. From what I gather reading your post, you are still using topical Finasteride. I would call your doctors and ask them about it.

How to and how long to recover from fin sides. from tressless

J hairs reflect a defect in the placement of grafts. There is a question if all of these J Hairs will eventually grow or not. We don’t really know.

Fake brands probably have too much filler in the pill and less medication. The filler is inert and should have no impact on you

These scars may occur as a complication of an FUT strip surgery. Sometimes they just happen and sometimes it occurs when the wound is closed under tension. Wait a period of six months and then, if it does not go away, you might have to consider doing something about it like Scalp MicroPigmentation which works very well for scars in the donor area provided that it is not too large. There is a good chance it will grow hair within six months.

You may have touched upon this question before but I was looking for clarification. In an early post (I’m talking a few months ago) you mentioned how a norwood class 3 would rarely, if ever, progress to a norwood 6/7. By this, can a norwood 3 consider himself quite lucky in the sense that he’s probably not going to experience crown loss? What exactly did you mean by this?

Everybody is different. If you have stabilized your hair loss pattern at a Norwood class 3, then you will probably not progress to further balding.

You are born with certain traits ranging from eye color, skin color, dimples, to hair loss patterns. I would not say having one trait is better or luckier than the other. I believe about 8% of men are born with a Norwood 6/7 trait. Does that mean those men are unlucky? For example, Michael Jordan is likely a Norwood 6. Would you consider him unlucky?