Balding Blog

I’m having an FUE procedure and i’ve seen plenty of people on youtube who are able to rock really short fades, pretty much bald fades after getting one of these procedures done (the haircut where you cut really low on the sides and back and gradually up it a little more), and I was wondering, in case I happen not to be able to pull it off, is it a possibility to get SMP (Scalp micropigmentation) over the punch holes (the FUE scars) so it blends in better?

Yes, SMP works wonders for FUE scars, when done properly. I wrote most of the medical literature on this ( https://scalpmicropigmentation.com/ ). Also read this extensive article: https://newhair.com/wp-content/uploads/2018/11/Journal-of-clinical-and-aesthetic-surgery-Article.pdf

You know how with senile alopecia or DUPA, the hairs miniaturize but don’t (usually anyways) actually shrink to the point where they fall out and stop growing altogether? They miniaturize to a certain extent but then stabilize in a miniaturized state and are still retained (hence why you don’t see people with DUPA develop totally bald scalps because the hair is still there, just much thinner). Well, can the same thing occur with patterned hair loss? Where the hairs in the thinning areas of the scalp (vertex and/or hairline depending on the Norwood level) miniaturize to certain degree but then stabilize at that point and don’t continue to miniaturize to the point that they fall out and totally stop growing altogether? Or in patterned hair loss, miniaturizing hairs in a thinning area of the scalp will most definitely shrink to the point of no more growth?

You are drawing a lot of conclusions about DUPA. DUPA may be another form of Senile Alopecia or just a variation of genetic hair loss? I don’t know, but I doubt it. DUPA might progress over time, possibly leaving very little hair on the head. i have seen this in women but never seen a man with such advanced DUPA that his entire head became very thin. DUPA is different because it impacts the Donor area and every other place on the head. Someone can have genetically patterned hair loss and then develop DUPA, which I have seen. These men are in a tough spot, as their patterned hair loss may progress to full balding, leaving a fragile donor area.

I have read a few articles stating that for most norwood 7 men they would display that pattern by the time they reach 26. Would you have a reference picture of what that would look like? Im assuming they generally would not be fully bald by that age.

Two scenarios point to a Class 7 pattern of balding.
1- The aggressive balding pattern fully appears by the age of 26-

2- The balding pattern is evident with thinning and miniaturization down to the rim of permanent hair around the top and back of your head which suggests that your pattern will eventually become a Class 7 pattern.

You need a good doctor to manage your balding and if you want a hair transplant, to help you get realistic expectations for what you can achieve as determined by your donor density and your hair bulk.

I live in a small town in a 3rd world country and have to order finasteride from another city as its not available in my town. I had already ordered some but due to city level quarantine, the courier service is closed and I don’t have any fin left. How long before it loses its effects?

When stopping finasteride then the effects may last 3 weeks before you start seeing ‘catch-up hair loss’. Call your doctor’s office and they should renew the medication for you. The US postal service is working during the crisis and the pharmacies can mail it to you.

Doctor,

I’ve been searching this blog for some time and can’t find the answer to this everlasting question: Can the “quality” of the shedding hair tell anything about what’s happening with the hair loss? Does losing shorter, miniaturized hairs say that one is balding more rapidly than one who sheds healthy terminal hairs? I’m saying this because you diagnosed me with an early Norwood 3A pattern last year, and I have been on Propecia ever since. But it seems that the hair that I shed from the front is thick on the end, and thinner near the root. Does this indicate miniaturization or just the hair cycle?

I don’t think I’ve miniaturized further since you last saw me on October of 2007, but only a re-exam from you would tell.

Thank you for your time.

Clearly you should see me at about a year for your annual re-examination. The thick hairs you are shedding are most likely part of the normal cycling that we go through. We generally lose about 100 hairs/day and that it probably what you are seeing. It does not make sense to me that the hair thickness on the scalp side of the shed hair should be finer than the distal end. If you bring the hair into the office, I can measure it for you with a micrometer.

If you look at the face as a picture, the top of the frame is the hairline. A picture that has a frame missing on top, is not a good picture. This man has a normal, mature hairline which is 100% transplanted. Nobody ever knew by looking at him, nobody.

There is something called a normal hairline. Some doctors think that putting the hairline high, reflects the age of the patient. I, on the other hand, believe that the reason a person does a hair transplant is to get back his youthful look. There are many men who develop a mature hairlines so as a surgeon, that is what I build when I put back the hairline. Hairlines were defined in an article I wrote which you csn read here: https://newhair.com//pdf/2015/phenotype-article-published.pdf

No, there is no such thing as a shampoo which blocks DHT

I would like to know-does pumpkin seed lower dht level all over the body or just from the scalp?c an topical application of it mean dht will only be lowered from the scalp?

To our knowledge, this is the first randomized, double-blind, placebo-controlled trial to investigate the efficacy and tolerability of PSO in men with mild to moderate AGA. This study shows that PSO supplement during 24 weeks has a positive anabolic effect on hair growth and that this is due to the possible effects of 5-reductase inhibition in patients with mild to moderate male pattern hair loss. The authors concluded: “this double-blinded study did involve 76 subjects and, to the best of the authors’ knowledge, is the first study to examine the long-term efficacy of PSO on AGA. The study shows that PSO could improve AGA and that it should be considered a potential alternative treatment. However, replication will be needed in order to confirm the results of this first-stage study and additional studies are required to elucidate the mechanism responsible for the positive effects of PSO on AGA.”

Ref: Evid Based Complement Alternat Med. 2014; 2014: 549721.

Effect of Pumpkin Seed Oil on Hair Growth in Men with Androgenetic Alopecia: A Randomized, Double-Blind, Placebo-Controlled Trial