I have asymmetric frontal hair loss. Is this MPB or something else? Should I consider a hair transplant?

[gemini]

Hey community!

I'm a 33 year old Asian male. I've noticed that my hair loss has been asymmetric, more on the right compared to the left (photos are mirrored). I haven't been able to find other people with similar experience and so I'm wondering if this is MPB or some other condition.

History & treatment: My hair loss started when I was around 26. I noticed hair falling off in the shower and on my pillow and it was mildly progressive. Friends started noticing when I was 28. The loss is more of a thinning and not yet a recession of my original hairline. I began minoxidil (nightly) when I was 29, followed by LLLT (292 laser cap, 30mins 3x/week), Biotin (10,000mcg daily), and dermarolling (1.0mm) when I was 30, and lastly finasteride (0.5mg/day) and oral minoxidil (2.5mg/day) when I was 31. I'm 33 now and have been very diligent with the medication and treatment ever since. I've noticed stabilization and mild improvement (~10%).

Thoughts? Should I consider a hair transplant?

Edited January 2, 2020 by gemini

[Dr Abhinav Kumar]

Seeing your hairline- The only possibility is Male pattern baldness. Sometimes the loss is more on the parting side due to continuous traction. Baldness may be assymetric. The only rare possibility is frontal fibrosing alopecia, which can be confirmed by biospy. However frontal fibrosing alopecia is more common in females and usually involves the eyebrow, which is not your case. However to remove any doubt, a scalp biospy by a dermatologist is not wrong and is harmless. I would not need such doubt clearing though but its for removing patients doubt and for legal safety. Sometimes , you dont know why the results havent come. I have seen two such cases in my career, but rest assured 99% , its male pattern baldness. You are 33 and your baldness is not more than Norwood grade IIa. You can go for hair transplant for sure. A receeding hairline cannot be stopped by finasteride though . A aggressive face appropriate hairline seems a possibility in your case. However i would recommend , now going too low as it would look age inappropriate at later age.

regards

Dr Abhinav

HT Surgeon

MD dermatologist

[Lohvisa]

My male pattern baldness was also more prominent on the right side, probably due to traction/slept alot more on the right side of my face. Hair loss is not supposed to be symmetrical, like everything else about us is also asymmetrical in some regards.

[paddyirishman]

In my opinion it's to early for a HT. You have not receeded enough, you still have plenty of hair even on your temples. When you receed more have a look at it again.

If you have a HT soon you will be wasting your doner , where you will receed further then your back on the table again, and again.

Do nothing for now, have a look at it in 3 years time.

.......Paddy......

 

[LaserCap]

Your hairline is no longer in a "juvenile" position.  Not only has your hairline receded, you are also losing in the area right behind it.  Please to consider is the fact, if you've lost - you'll continue losing. So the first thing you should do is speak with the doctor about medical therapy.  This should help slow down the loss.  (Are you thinning anywhere else? It is difficult to tell from the photos you've provided).

You are fairly young and should enjoy your youthfulness ASAP.  I would start doing research and pay attention to results of patients similar to your own.  There are plenty of great doctors/artists our there that can create density from the get-go.  What part of the Country are you in?

By the way, I would not call your hairline asymmetric.  You've lost a lot of hair and only have a few stragglers.  When meeting with a doctor and you start formulating a plan, do mention "you do want an asymmetric hairline." Symmetry is not good nor natural when considering transplants.  This only results in a "wig" type of look.