When is a hairloss pattern established?

[mahhong]

Hey Guys,

 

Just a quick question that I'm wondering maybe someone can answer. I'm 27 and have been thinning for around 2 years (that I've noticed, though I strongly suspect it was going on before then undetected). I'm fairly confident my hairloss is MPB but it is also diffuse (with the strongest concentration of loss seemingly at the temples and crown). The hairloss has sped up over the last 6 months which I believe may be down to a very stressful job I undertook, but that's not really my question.

 

What I wanted to ask is how often is the "pattern" that emerges in diffuse thinning the pattern that the hair will actually end up being? For example, right now my hairloss appears to be heading towards something around a Norwood IV/V. My hairline is receding and my crown is thinning, but the "area" that is balding doesn't seem to be too large. I still have a good deal of thick hair across the sides and back of my head that goes up pretty high. I have attached a picture (taken in pretty strong sunlight through a window) that shows my loss, although I don't think (hope!!!) it doesn't look as bad a this from day to day!

 

Anyway, to my untrained eye I would approximate the pattern of my loss to something around a IV/V/Va - perhaps at worst a VI? What I'm hoping to know is, when the hair is diffuse thinning as mine and a pattern starts emerging, that pattern is a fairly accurate assessment of how the eventual hairloss will end up (assuming all "thinning" areas become bald!).

 

The reason I'm asking is really to know whether I can with any degree of accuracy assume what sort of pattern I'll end up as. I'm sure I'll end up going for a miniaturization test soon anyway but I wondered if anybody with a trained eye/experience could tell me the likelihood I'll end up in the pattern I am now, or whether anything could happen and the areas that don't seem to have thinned could just have easily start going too?

 

My father is a Norwood V at 51 but his hair receded in a different way to mine (much more pronounced loss in the crown/temples but less thinning in the mid-scalp). His father is probably more of a Norwood III vertex - stronger hair in the hairline and midscalp but a fairly large bald crown (but he takes oral minoxidil for his heart which may or may not have helped his hair). My father on my mother's side, however, was a full blown Norwood 7 by the time he was maybe 40-45. His hair, however, didn't thin diffusely either and at my age he probably had more hair than me.

 

As you can guess I'm worried an N7 is on the cards! But more than that, I'm just curious as in the last year a pattern seems to have emerged and I wondered if that pattern is "usually" how things turn out, or whether it's simply impossible to tell whether more hair from the back and sides will start going? I have rather naievely and optimistically assumed that because I seem to be diffuse thinning then all the areas of my head that are going to thin have already started and what's left will, by and large, remain that way.

 

Incidentally I'm not on any drugs/hairloss supplements (though that looks to have to change fast, doesn't it!). Look forward to hearing any thoughts!

[Spanker]

I would get on meds ASAP. I am not sure but have heard that if at your age hair has minituized at all, then enentually it will be gone, without the use of meds....I am not an expert....everythink I know about these things I have learned on this forum or google.

 

 

Good luck

[Sparky]

I agree, you should get some Propecia and Rogaine/Regaine asap, you most likely wont stop thinning at 27, imo, you'll carry on until your bald unless you get on the meds, they can stop it and reverse a fair bit of it aswell.

 

Whats the thinning like from your maternal grandfather?

[mahhong]

Hey Guys,

 

Thanks for the replies!

 

Although I am going to get on the meds I'm also fairly well certain, as you've suggested, the areas that are thinning will one day be bald (perhaps not so on meds, but genetically at least they're predisposed to be that way). But the areas where the hair does not appeared to have thinned - is there a good chance they'll remain fairly strong, or is there absolutely no way of knowing what'll happen to even the parts of the head which appear to have zero thinning?

 

Sparky - My maternal grandfather is dead now (died aged 82) but since I first remember him as a young child (around aged 58-9) he was totally bald and very much Norwood 7 (or, I don't know how medically these things work, but if not strictly an N7 then a very severe N6). How he went bald I don't know as I have no pictures of him in his 30s or 40s, but in his 20's he still had a very full head of hair and most definitely didn't seem to bald diffusely. My mother said she remembers him from her childhood as being totally bald so I'm assuming he was that way since his late 30's/early 40's.

 

Interestingly I have pictures of his father (my great-grandfather, or my mother's, father's father) and in his 40's he seems to have hair on the top of his head (though it appears to be thinning). My mother said by his old age he too was pretty much totally bald on the top of his head.

 

I know this sounds stupid but what's interesting about the pictures of both my grandfather and great grandfather is how low down the side of their hair the parting of their side parting hair style starts! Like, on my head my side parting starts fairly high up (if I style it that way) and most people seem to be that way. But their side partings were both only about 2-3 inches above their ears.

 

My mother's, mother's father seemed to lose his hair in more of a IVA pattern. I don't have many pictures of him but he appears to have strong back, sides and crown/vertex hair with his thinning starting from the front and moving progressively backwards. I can't 100% verify that, but that's what the 2 pictures I have of him strongly suggest.

 

Also, in terms of other genetic traits, I resemble much more strongly my father's side of the family. My grandather was lanky, thin and quite a "pointy" sort of person. I, like my father and his father, am stockier, rounder shouldered, put on weight easier and in the same places. I understand this doesn't necessarily mean anything, I just wondered if that makes me genetically more predisposed to be like them in hairloss as well?

 

Anyway I appreciate the replies! My main concern is trying to establish whether a Norwood 7 is still a perfectly likely pattern for me to fall into, or whether my diffuse thinning and the pattern that seems to be emerging from that is the more likely way my hair will go? Although I understand I'll have to visit a hair physician to get an honest, informed answer, ultimately I'm trying to get some opinions as clearly if I end up an N4/5/6 sort of pattern HT may be an option and a good option, where as if I end up an N7 an HT is much less likely to be an option worth exploring.

[mattj]

The thing is, if you'd taken a close look, say, 2 years ago, and pondered the same question as now, the current pattern would probably not have been evident. Likewise, in another two years the areas of obvious loss or miniaturization might have expanded. Every miniaturized hair on your head was once in good health and I really don't think there's any way of telling what will happen to currently healthy hairs.

 

Being examined for miniaturization would be worthwhile though. It could, if extensive miniaturization is found, give you advanced warning of what's in store. But of course it can't predict changes which have yet to occur.

[Spanker]

These are safe answers. Can anyone say at about what age a patter forms? I know that doctors base what kind of hairline they feel comfortable giving you based on age and pattern, but I am not seeing any solid answers. How can a doc make a decision without having some kind of age/pattern guess in mind?

[RCWest]

These are safe answers. Can anyone say at about what age a patter forms? I know that doctors base what kind of hairline they feel comfortable giving you based on age and pattern, but I am not seeing any solid answers. How can a doc make a decision without having some kind of age/pattern guess in mind?

 

It varies so much, Spanker. I've seen 20-25 year olds with definite NW6-7 patterns, and I've seen 50 year olds with just thinning in the front and crown but thick everywhere else.

[TC17]

mattj was right on target. We all want to believe that a doctor can look at our heads at age X and say that we will be NW pattern Y at age Z, but the truth is, that's not possible. There are some people who begin balding at age 20, go to a NW 4 by age 25, and never lose another hair. Others, like my family members, begin balding in their mid 20's to early 30's, and continue losing hair throughout their life.

 

I believe a lot of the misunderstanding stems from some posts that we all read on Dr. Rassman's blog where he says things that imply that the "final balding pattern" can be ascertained by around age 25. Miniaturization testing can certainly show a pattern developing that the naked eye cannot yet see, but like mattj said, it can't show what hasn't yet begun to miniaturize. No one, and no tool, can determine whether hair that is not yet showing signs of miniaturization, will eventually miniaturize.

[mahhong]

Hey Guys,

 

Thanks so much for all your comments. I guess the reason I thought maybe I could identify a pattern emerging was twofold:

 

1) Because obviously it's already in our genes as to our final balding pattern. I know a lot of people have the slightly erroneous (though understandable) belief that when you suffer from MPB you 'graduate' through the Norwood stages, almost like you're going from a I to a II to a III and it's almost genetically uncertain where you'll end up. Whilst it may appear this is the case, the amount of hair you're going to lose via genetic hairloss is pretty much established from birth and that's how it is. Of course, the gradual recession and miniaturization makes it appear as if the hair is doing its own thing, but the result is already certain (without drugs/surgery).

 

And following on from that:

 

2) Because it appeared to me that I have diffuse thinning it also seemed to me (and I could be making a massively wrong assumption here) that all my susceptible balding areas were near enough thinning already. Obviously you can't see for certain exactly where your balding will end up, because I have been diffuse thinning (rather than simply receding) I thought that perhaps it was making the extent of hairloss apparent earlier.

 

mattj - Not that this may mean anything, but it's interesting that whilst two years ago I wouldn't have been able to establish my 'pattern', I would also say that all the thinning hair that you see started near enough the same time in one go. I didn't suffer from temple/crown recession and then started to thin in other places, I would hazard a strong guess that all the hair that is currently thinning started thinning at the same time. To that extent it has seemed to me (whether or not this bears much on future hairloss) that I never really went through the motions of temple/crown loss and recession, but that everything started at the same time!

 

I guess, to try and put it in a succinct form, I was curious as to whether anybody has experienced diffuse thinning and then seen further thinning in areas that had remained strong previously? It just seemed odd to me, though it may be wishful thinking, that my hair has been thinning in this pattern since pretty much I first noticed my hair was thinning. I've never noticed "other" areas of my hair start to thin - within reason the pattern I have now was the pattern I noticed when I first started noticing loss about 2 years ago. It didn't "move" through my hair - it just seemed like a big clump on top started thinning and it's been that way ever since!

[biscuit]

It varies so much I think you have to plan for the worst and hope for the best.

 

Diffuse thinning is tough to predict. And if you thin too much it's almost impossible to make any HT work. I know a guy who is in his 20's who has coverage all over his head, but it is so diffused it would be a disaster if he got a HT.

[gillenator]

mahhong,

 

The most critical aspect to your case is the meds issue. Your father, grandfathers, did not have finasteride or minoxidil. But you do have them available and you stand the probability that it will slow down the progression of MPB, and hopefully to a great extent. Propecia works efficiently for a very high percent of men. I personally choose to cut Proscar into four pieces because it's much cheaper than paying the high price of Propecia. I must be responsible though to point out that Propecia was developed specifically for treating MPB in men and it is Propecia that is approved by the FDA, not Proscar. Did you ever ask yourself, "What would the men in my family have looked like if they had Propecia available to them way back when?"

 

Not sure how much of this you already know, but be sure to do your homework on effective hairloss meds. IMHO, there are only three worth anything. It's finasteride, the active ingredient in Propecia (1 mg) and Proscar (5 mg). Then there's dutasteride which can potentially inhibit both Type I & Type II DHT. Guys who try dutasteride usually purchase Avodart prescribed by their doctor. Minoxidil is the third and usually recommended at 5% strength and topical through the most recent popular Rogaine foam product.

 

The best way to predict the extent of one's hairloss including the potential "pattern of loss" can be best compared to one's family history. Your maternal grandfather hit class 7 and although he did not get there as quickly, you are probably headed there IF, and I repeat if you do not get started on finasteride at 1mg per day. There's no guarantee that it will save your hair but you'll never know without giving it one full year and following the daily prescription faithfully.

 

You can purchase a densiometer at Radio Shack for under $20.00 US OR simply buy a magnifying glass with a handle. Then take samples of your hands strands wherever you think you may have any "diffusing" going on. Then take several terminal hairs from your donor region in the occipital (lower rear) area of your scalp. You then can tape the strands close togethor on a sheet of white paper. That way you can compare all other hair samples to the terminal hair to notice any changes in "hair shaft diameter". Hair caliber is another term for hair shaft diameter. Any decreses in hair caliber will imply that it is hair that is miniturizing from the effects of MPB. As the years go by, you may notice continued decreses in caliber until that hair becomes so thin that it loses color and turns vellus.

 

The point is that you or anyone else will be able to examine your own hair samples over time intervals under high power magnification. A 30X empowerment is sufficient. If for example you continue to compare hair in the "sides" or "rim" area of your scalp, you will notice very little to no change signifying that that hair is terminal, meaning non-receptive to DHT. And most people do not lose hair in that area of their scalp.

 

Some guys can thin out in the rim area and even the occipital area which is supposed to be terminal hair. Yet some guys will in fact lose hair in that region as they get older. That is also why I am more of a skeptic when using "nape" hair from the neck area because nape hair is not necessarily permanent. It can be lost. How do you know if it will happen to you? You have to again take a close look at family history.

 

So if your maternal grandfather who turned class 7 has also thinned out in his rim, sides, or back donor area, then there's a good chance you will too. That's why the meds are so important for you in the equation. They can potentially buy you time. Hope this makes some sense my friend.

 

Best wishes to you mahhong...