Hts and hair loss patterns

[bonkerstonker]

Over the years I've seen a lot of people on here load up on grafts in the front 3rd of their scalps 4000 grafts in the front is quite common nowadays but I always feel that this is a big risk simply because if your front 3rd is completely bald and the rest solid and thick it doesn't mean the rest won't fall out eventually leaving you short on grafts to sort out.

 

We all know some follicles are more sensitive to dht but does anybody know for a FACT or is there any scientific proof that some areas of the head go bald first because the hairs there are more sensitive to dht or could it be that some areas of the scalp happen to have greater amounts of dht? So the question is does the scalp have roughly the same amount of dht and is dht found in the back of donor area.

 

Also Merck always harp on that propecia lowers one type of alpha 5 enzyme which lowers dht but do we think propecia lowers testosterone too? I can't find anything saying it does but I'd imagine it must lower it slightly too.

[Spanker]

Good question. I think everyone is different in balding speed and area. U think that when you get into your 30's and still have a solid crown that it is doubtful you will be slick back there. However, someone in there mid twenties that pack the front with 3 or 4 thousand grafts is rolling the dice a bit.

[bonkerstonker]

I don't think anyone will be able to answer with certainty I've done quite a bit of research on it and there's nothing much wrote as fact.

 

From my research reading between the lines it appears that dht is present all over the scalp as most articles imply and refers to some areas having more sensitive dht effectable follicles but there's no mention anywhere on actual scalp areas having more dht.

 

With regards to the finasteride testosterone question I may ask Merck as there is no mention of testosterone lowering effects with finasteride in any articles but it doesn't say it won't either.

[KO]

Quite the opposite actually. Men on finasteride have 10% HIGHER testosterone. On dutasteride higher still. Look at the prescribing information for propecia.

 

It is believed that hairloss is caused by sensitivity to the DHT that is in the hair follicle, rather than simply high DHT levels. Check out the HairDX people, and the research they cite. Pretty interesting.

[bonkerstonker]

Quite the opposite actually. Men on finasteride have 10% HIGHER testosterone. On dutasteride higher still. Look at the prescribing information for propecia.

 

It is believed that hairloss is caused by sensitivity to the DHT that is in the hair follicle, rather than simply high DHT levels. Check out the HairDX people, and the research they cite. Pretty interesting.

 

 

Nice work so can i take that as fact that finasteride doesn't lower tesosterone it just lowers alpha 5?

 

With regards to the other part i know that it's only the follicles in the horse shoe mpb shape that are dht effectable but i'm wondering if dht is still present in the follicles from the donor back and sides, do you have any links to hairdx people and prescribing info for propecia. Thanks

[KO]

I don't have the prescribing info sheet on me, but if you go to the propecia.com website it has it. It's in the Info for Doctors section. But rest assured, both fin and dut raise T levels.

 

 

I'm not sure whether follicles in the horseshoe have DHT, I think they do....but I suspect they simply are not as sensitive. REmember though, even the "safe zone" can thin out little by little, so it's not totally immune.

[mahhong]

People go bald in vastly different ways. Some thin diffusely in the entire balding area, some recede very gradually, so that the hair in the crown may stay thick right into their 30s and 40s.

 

As for why this happens, it's still not totally understood. In regards to DHT though (based on what I thought I knew, so I could be wrong) it is that hair follicles are genetically determined to be sensitive to DHT and to respond by becoming inflamed and slowly choking the hair. DHT in and of itself couldn't be the lone cause, because all men create DHT yet not all men go bald. If it was due to "elevated" levels of DHT, then it would be a much more measured case of simply bringing those levels down to "normal" parameters, which is unfortunately not how it works.

 

It's a complicated chain of events that scientists still don't fully understand. The follicles become inflamed and damaged and this causes the hair they produce to gradually weaken, thin and the cycles to become shorter. DHT is involved in this, with follicles genetically susceptible to the effects of DHT being effected, but DHT is just one part of what is probably a complex chain of events. There is brand new research that an enzyme called Prostaglandin D2 is also involved in this chain of events, but exactly how and why is not understood yet.

 

In regards to how HTs figure into this, you're right that it's not wise to pack your donor hair into the visible balding areas because there is a chance you will continue to bald further in your lifetime and you don't want to get to the point where you don't have enough donor to deal with it. This is one of the central dilemmas to hair transplantation and the planning you do with your doctor. Drugs can slow down or perhaps even halt the balding for a period of time (years, perhaps decades), meaning that doctors can transplant into the frontal third with more confidence the remaining hairs will stay and not thin drastically in a short space of time.

 

A good doctor shouldn't let you pack large amounts of hair unless they are very confident your balding won't get out of hand. It's also based on things like available donor, bulk analysis and miniaturization testing. But if there is even a remote chance you will be higher on the NW scale, a doctor should only really transplant as if that was going to happen, meaning they won't put 4,000 grafts upfront just because you're not balding in the back at the moment. They'll estimate the donor reserves you have and base it on that; so (for argument's sake) if you have 6,500 grafts comfortably available they might suggest 2,500 in the frontal third, but if you're fortunate enough to have say 9,000 grafts, they might be happier putting 3,500 up there. My point is; whether your hairloss has stabilised or not and whether you're on drugs or not, doctors should still analyse the possible worst case scenario and plan with that in mind. If you have a small family history of minor balding, you're 40 and you have great donor, then maybe the doctor will consider being a bit more aggressive with your procedure. But if you have a larger or more severe history of balding and you have other factors against you, chances are a doctor will be conservative and start with coverage and acceptable density with the view to maybe taking a second pass to add more density if the hairloss continues to be stable.

 

There is unfortunately no exact science with hairloss, even with all the research and drugs available! That's why you have to be realistic, be vigilant, and find a good doctor!