Question for doctors, reps, and experts

[Spanker]

Is new growth (not ht growth but hair leaving the resting phase) thinner than mature hair? Are all the shorter thinner hairs on their way out or could some be on their way in?

 

Thee reason I ask is because when I part my hair, which seems fairly thick, I can see some shorter and thinner hair, some even look vellus, like one at the part every cm or two. So I wonder, are these hairs that are coming back through a normal cycle or are they just dying a slow death? Is it just a guess and the test of time? The hairs around them look look solid.

 

I am asking because I am debating whether or not to treat with rogaine for preventative measure in that area. Currently I just treat the hairline, but I have some of these smaller thinner hairs throughout most of my head.

[Spanker]

bumps

[gillenator]

Spanker,

 

Without viewing these hair shafts under a scope, it can be hard to tell.

 

A couple of things. Once transplanted hair completes its first full growth cycle, it will tend to re-emerge with mature caliber on the second round. Color, hair shaft diameter, etc most of the time will look similiar in characteristics as the donor hair where the grafts were taken from. In the first cycle after transplantation, the new hair shafts can appear weak, thin, and even kinky in texture. So if you had your procedures better than two years ago, the new emerging growth should look like terminal hair bacause it is terminal and considered DHT resistant. Some patients notice the strong differences in hair shaft diameter and color in the very first growth cycle and every now and then we read about it in these forums.

 

You could be seeing some diffused hair re-emerging that is DHT receptive natural hair that is getting weaker with each growth cycle. Vellus hair tends to lose pigmentation along with caliber with each complete cycle fulfilled. When it re-emerges, it typically looks exactly as you are describing.

 

This is why as MPB progresses, we do not notice the day-to-day changes in coverage and density. We notice it more over a period of years. Many of us repeat patients have subsequent procedures within the same recipient area because of this ongoing progression. As the diffused hair eventually gets thinner and provides less visual coverage, we notice the need to add additional coverage adding to the previously transplanted hair which stays.

 

Adding minioxidil can potentially provide some benefit as it re-invigorates the hair follicles and even stimulate some new growth from some follicles lying in dormancy. The risk that you face is some momentary shock from introducing minoxidil to a new area. In addition, many of the vellus hair may not cycle back along with some of the weakest diffused hair because after all, they are on the way out.

 

You must have had a fair amount of exisitng hair before your transplant which is about six months ago? Could some of the new growth be from some of those new grafts?

[zenmunk]

You could be seeing some diffused hair re-emerging that is DHT receptive natural hair that is getting weaker with each growth cycle. Vellus hair tends to lose pigmentation along with caliber with each complete cycle fulfilled. When it re-emerges, it typically looks exactly as you are describing.

 

This.

[Spanker]

This.

 

So hair that is terminal and starting a new cycle starts out thick in diameter?

[Dr. Glenn Charles]

I think that as new hairs continue to grow the hair shaft diameter can increase as they become a terminal hair. Therefore it can be confusing as to whether a thinner hair is on the way in or on the way out. However, hairs on the way out or going into dormant phase / sleeping cycle would not increase in length. Newly growing hairs would be increasing in length as well as in diameter.

[zenmunk]

So hair that is terminal and starting a new cycle starts out thick in diameter?

 

Just as Gillenator suggested, I was under the impression that non-transplanted, native hairs which are DHT-receptive start out thinner (not thicker) with each new cycle. That's part of the MPB progression. Dr. Charles added an interesting new perspective that it can be hard to tell if what you're seeing is a hair on its way in, or on its way out. As he indicates, time will eventually tell.

[gillenator]

So hair that is terminal and starting a new cycle starts out thick in diameter?

 

For many patients yes and why some patients with darker color pigmentation tend to notice it more. Not all of the terminal hair emerges with this same caliber but definitely will develop the same hair shaft diameter and length characteristics from where it was harvested (donor zone).

 

And this is also why some FUE docs will go to other donor regions like the nape area or the parietal zone to cherry pick terminal hair grafts that have a softer characteristic that tends to blend in better with the commencement of the hairline where the caliber is thinner and softer by nature.

 

Not all nape hair is considered terminal however and that is the dilemma of harvesting hair from that region. Still some patients prefer hair from that region to produce that soft hairline using single hair grafts.

 

I even know of several patients who had some of their hairline grafts removed because the caliber difference was too noticable for them. And typically it was hair that was harvested solely from the occipital zone where an extremely high percent of the strips are taken. Again, these were mostly men with dark hair on a fairer complexion.

 

And that was a very important point that Dr. Charles brought up concerning the length of vellus hair. The growth is definitely stunted as the growth cycles fulfill and one of the ways that we can know if it is hair on the way out. So you will know Spanker as your recent procedure matures with time.

[Spanker]

Thanks for the replies. Probably best just to wait and see the big picture. My hair throughout varies in caliber, even in the safe zone, and there is really no way to find a thin hair and follow its cycle.

[gillenator]

Thanks for the replies. Probably best just to wait and see the big picture. My hair throughout varies in caliber, even in the safe zone, and there is really no way to find a thin hair and follow its cycle.

 

Will look forward to an update when you hit the one year mark.