norwood 8 ?

[Guest josh - b]

greetings forum members,

 

On my day to day business i frequently come across a gentleman in his fifties whom i always looked upon as somebody with your regular norwood 7 hair loss pattern.

However this week i noticed his balding pattern was actually more pronounced and progressive than your standard n7...that is, it had receded back to about 1 inch above the nape of the neck.

Looking at his almost non existent donor supply zone there was no doubt in my mind that if he had strip performed in previous years then i would be staring at a big smiley face scar.

(I sorely wanted to approach him and discuss this unusually excessive hair loss pattern but fearing that he may not be a regular contributer on these forums i decided against )

 

My question however is... how safe is this dht safe area?

 

The gentleman i referred to has a perfectly normal balding pattern to the ordinary joe on the street but believe me, even to my admitably only semi knowledgeable eye it had dropped way below what is deemed the safely acceptable area from which to extract from.

[notgoing2gobald]

I know EXACTLY what your talking about. I know two gentlemen in their 60's who have ABSOLUTELY no donor hair left. They are well beyond a NW7. The crown has receeded far down and the nape of the neck has receeded up: as in the bottom of their hair line in the back is about level with the middle of their ears...

 

I have also seen plenty of other men in their 60's with this similar pattern. I always wondered what their balding pattern was in their 20's, 30's, 40's, etc... I myself used to post about this very concern. Never got a solid answer.

 

All in all I would have to conclude that NO ONE knows who will indeed end up like this; even the top notch docs on this site (whether it be H&W or Feller, or whoever). They might be performing 3 surgeries on someone they think will end up being fine, but later they could lose all of it.

Bottom line: I think---***and HOPE*** that most of these guys who end up like this, do so much later in life. Hopefully 60+.

 

I only wish there was some sort of poll on a site like this that would show what progression these men had earlier in life and at what point it ended up less than an inch of donor hair at the back of their head...

 

GREAT POST JOSH B, WISH MORE WOULD TAKE NOTICE OF THIS LEGIT CONCERN...ESPECIALLY DOCS...

[notgoing2gobald]

there was a poster with a TON of insightful knowledge and I was hoping he would tell us what women want..

 

CAN HE?!?!?!?

[NervousNelly]

Actually gentleman, this topic has had a lot of previous hot discussions. I'm sure Bill will be able to provide the link to the old threads.

 

It is certainly a reality and this is why we are so cautious about recommending a HT to someone in their 20's. Even at older ages there is always a chance that this could happen.

 

I personally believe that unless there is some new drug or technology, we might start seeing many guys with big scars in donor. The statement of HT's being forever isn't necessarily always accurate. Even those that don't progress in that manner do tend to thin considerably. How many 70+ men do you know that have thick donor? This stuff does have risks that are both immediate and long term.

[hoose]

People in previous generations did not have access to finasteride; I think finasteride can be effective long term in maintaining the crown/vertex and donor areas, especially since those area are less sensitive/resilent to dht than the frontal area; I'm realistic that propecia will not maintain the temples/hairline/frontal zone over the long term, 10+ years--it will slow/stabalize but not totally prevent the progression; those people you mentioned seeing that were "nw 8" are genetic freaks; I feel as a general rule, if somebody is on finasteride the chances of them going to a NW 8 or the donor area drastically thinning is slim; I know finasteride is relatively new still as far as studies; most studies for MPB have not gone beyond 5 years; also I know there are no guarantees and we all have to consider are genetic predispositions etc..these are just some of my thoughts; comments....

[Dewayne]

Just this past Friday night I sat behind this guy on my church bus who is only in his mid-40's, and I swear he only has about a 1/2 inch strip of hair in the lower back of his head. I wondered what a ht dr. would tell him.

 

But, from looking at my dad and uncles I don't see that in my family. My dad has a good donor area, but none on the top.

[Bill - Seemiller]

This is a legitimate concern which is why planning for the long term is key and often times, young patients are not good hair transplant candidates.

 

There is not much beyond a norwood 7 however, unless some other medical condition is affecting the DHT "safe zone".

 

In my opinion, there is a universal DHT safe zone.

 

However, as we age, even that could thin a little.

 

These are certainly things to consider before deciding to undergo hair transplant surgery.

 

Good discussion.

 

Bill

[notgoing2gobald]

One big problem is that NO ONE knows who is going to end up a NW7. It looks to me like most docs take out strips outside of a NW7 area. So a patient who is relatively young might end up not only revealing his scar later but also losing his transplanted hair.

Regarding the people who are beyond a NW 7 being genetic freaks and/or having an underlying condition: well, then there are a TON of these people. I see these guys all the time. I think it is much more common than many people on this forum have either seen or are willing to accept.

I mean, don't you guys see this stuff too? I see these men all the time. As a matter of fact, just off of the top of my head, I know two guys who are probably in their late 50's to early 60's who could in NO way get a ht, because their donor area is so low. Typically in these men you notice that its not only the crown that has receeded far down, but also the nape area recedes up. So they are losing it in both directions. Burning the candle at both ends.

I see it all the time.

[chucky]

I have a friend who started thinning about the age of 20 and he is norwood 7+ and is only about 34 now so he would have been well sick if he had a ht.

But as others have said how many could have kept their hair with meds.

[notgoing2gobald]

Chucky,

you have friends?

 

would you say that he doesn't have enough donor for a transplant?

did he lose his hair rapidly?

man, this doesn't get discussed enough.

By the way, I PM'ed you to maintain our wonderful conversations (Tuesdays with Baldy) but you lazy balding ba$tard are too slow to respond. So, Ill ask you here since its relevant: Your around 40 and still have good coverage on top and are on meds. How long (tell me again) have you been on them and at what age did you notice thinning?

[chucky]

I have a few friends

He would be able to get a strip out of whats left but where would he put it as it would have no cosmetic effect on his head as it is completely bald.

His hairloss runs in his family and it was very aggressive.He was a diffuse thinner from about 17 then by 20 it was going and by 27 he was completely bald and the safe zone continues to decrease.

[notgoing2gobald]

oh and you still can't comment on our personal, private letters? What do you want me to chase you like a 'lil dog and continually message you, harrass you, and ask you questions?....

Quote, Chucky---..."he would be able to get a strip out of whats left but where would he put it"...

tell em to give it to Armani and get a thin mustache hair line, dense packed .5cm deep..., or put it in my prosciutto quesedillas cus' everything and the kitchen sink is goin' in there tonight...and it tastes grEAT!!!

 

or maybe Armani can make him some kick ass temples that will reach his eye brows out of the strip?...no?

[chucky]

I`ll ask a silly question ,are you on the vino tonight by any chance.

[notgoing2gobald]

AH--HaHahA--HA-HAAAAA!!!!!!!!!

still no answer?

is there a correlation with a balding and slow/mentally retarded gene?...

[vincehair]

My father is a NW8 easy

[notgoing2gobald]

his age?

when did he begin his fateful descent?...

[vincehair]

Pops is 71 this year. I have no idea when he started losing his hair. Not that close to the man. I do know however and noticed in my teens that he let his hairloss turn him into an asshole and changed his life forever. He wore a piece for maybe 10-20 years. He was a NW6-7 until maybe 5 or 6 years ago.

[notgoing2gobald]

this is the MILLION dollar question. at what age do these men reach this state?

in my mind the possibility is there for any of us to reach it. But, when weighing the cost/benefit analysis one has to know how many "good" years one has.

if your pops is 71, then in my mind this is a positive answer. As I assumed (hopefully reasonably) that those who are destined to this desert dry follicular state do not reach it until they are 60+...I, for one, would be willing to take this risk...

just wish there were more conclusive polls/studies regarding these conditions so we could have a more conclusive prognosis...

 

Based off what your saying, he was a NW5-6 into his 60's, correct?

[youngsuccess]

I read this on baldingblog; it is Dr. Rassman's opinion:

 

"Actually, men who become a full Norwood Class 7 balding pattern usually have significant balding by the time they are in their early 20s. If the balding is mild at 30, chances are that the balding will not be advanced as you get older.

 

Obviously this is a generalization and cases vary but I think the age at which you begin balding plus the amount of time you've been losing your hair can be helpful indicators. One of the major exceptions to this argument is that some guys don't show any signs at all until after 40. It seems most men who get some level of MPB are afflicted earlier, insidiously creeping throughout 20s and early 30s, but there are some who think they're safe until it comes out of nowhere.

 

I remember reading somewhere else on that site that the percentage of balding men who actually progress to a NW 7 is very small. I guess you never really now who's safe, but for the guys who are already significantly thinning or bald at 18, I think it's safe to assume that descending into upper Norwood territory is a strong possibility.

[notgoing2gobald]

I think dr. rassman's site is very informative and insightufl.

I just wonder what he meant SPECIFICALLY as to "significant" balding by the time they are in their early 20's...I mean, if your a diffused thinner, what PRECISELY would constitute significant balding?

 

Your post makes total sense as you stated the fact that these are generalizations and some guys don't show any signs until after 40.

So, just for reitteration purposes: I wonder about Chuckys friend who's safe zone continues to decrease even though he is so young?

 

I wish there were some more solid polls on this; i.e. men who reach the NW7+ and their hair loss relative to age...

Guys who have NO donor hair for a transplant (from my observation) also lose their donor from the nape up..bottom of the neck up...I've heard that it is normal for this area to thin anyway, even in younger guys, but I just wonder how all this plays out...

[youngsuccess]

"So, just for reitteration purposes: I wonder about Chuckys friend who's safe zone continues to decrease even though he is so young?"

 

Hmmm... regarding Chucky's friend:

 

"He was a diffuse thinner from about 17 then by 20 it was going and by 27 he was completely bald"

 

I think this is clearly someone who was in danger of progressing to a NW 7 and beyond; nothing unusual about someone like this losing below the crown and sides. You can kind of, KIND OF look at these cases in a comparative sense I think. If you're a norwood 3 at 30, do you have less of a chance of getting to a NW7 than someone who was completely, shiny bald at 27? Probably. Yeah it sucks that there is no guarantee of anything, but at some point, if you and a good doctor are trying to develop a plan, you have to take some kind of risk. Otherwise, just consider FUE; at least if the donor thins, you will loose the grafts up top and won't have a linear scar in the back, leaving you just looking... bald.

[notgoing2gobald]

ya I definitely don't think there are ANY conclusive answers regarding this. Or anything close. wish there were...

 

for someone like myself Im a diffused thinner. I have shared pics with others on here and they are like---"where would they place 'x' amount of grafts"...but the thing is its diffusely thinning all over on top on me AND I think in the crown too. My point being: just because your not shiny bald on top by 30 doesn't necessarily mean that you are not going to have extensive loss later because you might just have a different pattern...

I realize that (from your posts) young success that your saying the same thing. Just stating this out of frustration that there are not more decisive prognosis for these conditions/ questions...

many people "look" to meds as a remedy to these un-knowns, but the TRUTH is meds themselves are an unknown as far as a long-term (i.e. over 10 years) solution.

PLUS any unknown side effects of long term effects..

 

Many people on here say they wish when "they" were younger they had the oppportunity we now have today. In my mind, many technologies/ remedies that were new and seemingly great had this same appeal in any industry throughout history. Its only later, that time itself proved they were not that great....

 

I just hope that greater session size of graft transplants and these meds (which might be temporary at 10 years best) don't prove to be consistent with other new found rejoices of technology...

only time will tell and life itself is a gamble.

myself: leaning towards the short term (i.e. 10-25+ year) positive gain of more hair as it is worth the risk of reaching my normal natural bald state + a scar in my 60's+....

RAMBLING...

[youngsuccess]

I agree: analysis of hairloss based on pattern and age in the end relies upon mere speculation. Combating hairloss is an inexact science and hair transplantation is an imperfect art, if you consider the potential risk factors. That being said, with a good doctor and the right plan, I think most people who get this done nowadays with the right expectations will be happy with the results in the longterm sense.

 

I think 10-25 years is worth the risk of having some degree of scar detection possible when you're older. 60 really is nothing at this point though... that's like the new 40. Oh well, I think you are giving all this enough thought that you will make the best decision for yourself in the end.

[notgoing2gobald]

I think your right...

Hell, if your wrong then well ALL start a "scarring forum" in 20 years to replace the "balding forum"...

 

ALL decisions in life are a (calculated) gamble...

[chucky]

Great discussion this,i will try and get a picture of my mate when i next see him.

 

As for family history this can be misleading as well. I have two brothers,one was completely bald by 40 he`s now 50 something,my other bro is about 50 now and has a full head of hair.Then theres myself who has loss mainly in the crown like my father and his father.I`m 40 shortly,life seems to pass by so quick.