Diffuse thinners

[UnbaldEagle]

TW: The red pill

So the basic premise is this: I don't think """anyone""" who is a diffuse should be looking at the Norwood Scale for guidance. I've been a diffuse thinner since 19 and even though I never went beyond a NW3 as far as the hairline and the crown was concerned, there were times when I'd look in the mirror and constated that if I end up losing hair all around at the same pace I'll be completely bald, a NW7 if you wish in a very short time. Luckily I've maintained on treatment, but I'm under no illusion that should all treatment fail, I'd be sooner bald than my regular non-diffuse receding peers. Therefore I think it's only fair I should consider myself a NW6 or 7 who is currently benefitting from treatment and HTs. 

What do you guys think about diffuse thinning? Are we a lost cause?

[DenverBuff1989]

I have an acquaintance who is a significant diffuse thinner and when i observe his hair in real life i think what a nightmare it would be for him to get a HT. 

That's just a personal observation though; I feel like if a diffuse thinner did their research and made all the right moves and went to the right doctor, etc. They could be helped. 

[Enhancer]

This is my dilemma.  Only a NW2.5, which I would like a minor procedure to define, but I know I'm diffuse thinning in the NW7 area.  It doesn't look like it, but I can feel it.  I had a plan to start meds and observe for 3 years (no sense in getting a transplant if the loss has not stabilized) but now after 3 years I do not feel any more confident.

The loss has been slow, but will it speed up? Will the meds continue working?  Have they even been working to begin with? I'm 36 already, how long should I live with the insecurity?

These are questions no one can answer.

[Melvin- Admin]

You’re absolutely right in your thinking, I too was fooled by my hairline. For the longest time I would say I was a Norwood 2, but the reality was a diffuse Norwood 6. 

Now, are we a lost cause? No, but you either have to be committed to medicine, or lose most of your hair before you consider having surgery.

[TorontoMan]

Are diffuse thinners often the ones who are most likely to get a rebound from medication?

[UnbaldEagle]

21 hours ago, Enhancer said:

This is my dilemma.  Only a NW2.5, which I would like a minor procedure to define, but I know I'm diffuse thinning in the NW7 area.  It doesn't look like it, but I can feel it.  I had a plan to start meds and observe for 3 years (no sense in getting a transplant if the loss has not stabilized) but now after 3 years I do not feel any more confident.

The loss has been slow, but will it speed up? Will the meds continue working?  Have they even been working to begin with? I'm 36 already, how long should I live with the insecurity?

These are questions no one can answer.

Hey man,

IF you genuinely believe you are balding in the NW7 area, there's not much to be done really. Treatment or not, you're just delaying the inevitable. Especially if you're diffuse. I'm 2 years younger than you and for the past 5-6 years I've nuked most, if not all DHT and testosterone out of my system. Getting a HT will buy you some more time before getting back to ground zero. 

[Melvin- Admin]

10 minutes ago, UnbaldEagle said:

Hey man,

IF you genuinely believe you are balding in the NW7 area, there's not much to be done really. Treatment or not, you're just delaying the inevitable. Especially if you're diffuse. I'm 2 years younger than you and for the past 5-6 years I've nuked most, if not all DHT and testosterone out of my system. Getting a HT will buy you some more time before getting back to ground zero. 

I wouldn’t say that’s true, there’s cases of Norwood 7s getting a decent head of hair, of course “decent” is subjective. But for example Rahul, he’s got a respectable head of hair. 
 

 

[UnbaldEagle]

Just now, Melvin-Moderator said:

I wouldn’t say that’s true, there’s cases of Norwood 7s getting a decent head of hair, of course “decent” is subjective. But for example Rahul, he’s got a respectable head of hair. 
 

 

Sorry, I didn't mean it like that. If you already lost everything and get your first HT then, sure, there's Rahul-like miracles. What I meant is holding on to your existing hair long term with treatment = delaying the inevitable. Even a HT at a "young" age is haphazard if you are truly a NW7 because your donor will miniaturize too. Give enough time (decades) and you'll be where you would have ended up earlier.

[Ajamilo]

10 minutes ago, UnbaldEagle said:

Sorry, I didn't mean it like that. If you already lost everything and get your first HT then, sure, there's Rahul-like miracles. What I meant is holding on to your existing hair long term with treatment = delaying the inevitable. Even a HT at a "young" age is haphazard if you are truly a NW7 because your donor will miniaturize too. Give enough time (decades) and you'll be where you would have ended up earlier.

How do we know if we end up in norwood 7? 
can the doctors see that trough microscope?

[UnbaldEagle]

4 minutes ago, Ajamilo said:

How do we know if we end up in norwood 7? 
can the doctors see that trough microscope?

Yes, they can see the miniaturization. But the pattern is somewhat obvious most of the times. 

However if you are losing hair everywhere except the sides and the back in a DIFFUSE pattern, hence in a NW7 horseshoe pattern, it doesn't matter where your hairline is currently. You are a NW7. 

Edited December 25, 2020 by UnbaldEagle

[Enhancer]

8 hours ago, UnbaldEagle said:

Hey man,

IF you genuinely believe you are balding in the NW7 area, there's not much to be done really. Treatment or not, you're just delaying the inevitable. Especially if you're diffuse. I'm 2 years younger than you and for the past 5-6 years I've nuked most, if not all DHT and testosterone out of my system. Getting a HT will buy you some more time before getting back to ground zero. 

Maybe buying more time is all I would need.  I am considering lately to just get the front hairline densed up, then throw a system in the back years down the road when the day comes.  I'm 36, on dutasteride, and no scalp can be seen when my hair is dry, if I wait until I'm full bald, I'll be waiting for a long time, and life is short.

[Mycroft]

I think it's not necessarily accurate to assume that treatments will only buy you a few years. This is going to be completely dependent on so many unseen and unknown factors over a huge period of time that it's really hard to say.

As an example, I've got an uncle who has diffuse thinning across the top but still has a lot of hair present even though it is being affected by miniaturization. Probably a 5/6 pattern, but still good enough density and coverage that it looks decent as a shortish buzz cut. I share a lot of physical similarities with him, and even my hair issues seem a bit similar. I'm likely looking at the same scenario based on what I can see on my head. Zero medical intervention, and he's around 60. For him, this was clearly a very slow burn, and I suspect if he was on even basic medical treatment (not even something more aggressive like Dutasteride) his hair would likely look great.

I've also seen crazy outlier incidents where someone was able to grow a noticeable amount of hair with oral minoxidil after being slick bald on top of their head. Someone with a response like this could potentially be set for life if they catch it early enough and are able to continue tolerating the treatment.

On the other hand, somebody who has aggressively quick diffuse thinning or a poor response to medication is likely only going to delay the situation a bit. The biggest crapshoot in hair loss in general is that none of us can REALLY be sure what's going to happen down the line. A Non-diffuse norwood 3 could turn into a six at at age 65 even if he has no family history to support that, or someone from a family where hair loss is expected could somehow end up being a Ronald Reagan level outlier. There's just no way to know.

I don't think diffuse thinners are better or worse off than anybody else, but there are pros and cons to every situation.

Diffuse thinners probably don't notice as early and will let things go longer than someone with a more clear cut pattern, but will likely have more cosmetic punch from medication when they get on it. However, diffuse thinners are also a riskier proposition for surgical intervention although I have certainly seen good outcomes. Someone with a clear pattern has more coverage issues initially, but high pattern diffuse thinners will eventually have much greater issues due to the large number of weaker hairs.

I do want to clarify that I think someone who is a legitimate diffuse NW7 is likely going to be showing signs of miniaturization in that area of the crown early on when examined with a microscope. A true NW7 is somewhat rare, and in reality 6 is the highest that MOST people will progress to.

Honestly, the biggest hair loss issue in the world is the lie people tell themselves that they're not subject to androgenetic alopecia. If you're a man, you've got it. Period. It's just a question of how severe it is, and that goes even for those hair god outliers. Whatever miniaturization they have experiencedis just so cosmetically insignificant as to be imperceptible, but I guarantee it's still there in some spots.

@UnbaldEagle, I'm curious about your comment that you've nuked almost all DHT and testosterone out of your system. Are you transgender?

 

Edited December 26, 2020 by Mycroft

[UnbaldEagle]

@Mycroft, thank you for detailed response. I guess I need to apologize, I just reread my previous posts and they reek of negativity. No idea why, it was not my intention. I'm just two weeks post my HT and I constantly obsess over my hair. Being a diffuse thinner it's just a never ending dilemma. @Enhancer summed it up well, it's this insecurity that's ailing us, what if the meds stop working, what if MPB just decides to level up, etc. I'm grateful that there's people like you who think otherwise and even tried to reinforce it anecdotally. I hope you're right. Lately I've seen so many diffuse thinners on treatment losing ground that it just makes me think we're hit harder by this curse. And when we're losing ground it's not like going towards a NW3 from a 2, it feels like going all the way to NW6/7. 

Also, what you said about surgical intervention concerning diffuse thinners is very accurate. But I wonder, what's the best course of action? Go for a low density HT, thinking that would be serving you long term and possibly matching your future loss? It seems like I ended up with a rather densely packed frontal region and I wonder how that complicates things in the future should I continue to thin out diffusely behind it.. 😕

As for your last question I'd rather not answer that if you don't mind. 

Edited December 26, 2020 by UnbaldEagle

[Mycroft]

2 hours ago, UnbaldEagle said:

@Mycroft, thank you for detailed response. I guess I need to apologize, I just reread my previous posts and they reek of negativity. No idea why, it was not my intention. I'm just two weeks post my HT and I constantly obsess over my hair. Being a diffuse thinner it's just a never ending dilemma. @Enhancer summed it up well, it's this insecurity that's ailing us, what if the meds stop working, what if MPB just decides to level up, etc. I'm grateful that there's people like you who think otherwise and even tried to reinforce it anecdotally. I hope you're right. Lately I've seen so many diffuse thinners on treatment losing ground that it just makes me think we're hit harder by this curse. And when we're losing ground it's not like going towards a NW3 from a 2, it feels like going all the way to NW6/7. 

Also, what you said about surgical intervention concerning diffuse thinners is very accurate. But I wonder, what's the best course of action? Go for a low density HT, thinking that would be serving you long term and possibly matching your future loss? It seems like I ended up with a rather densely packed frontal region and I wonder how that complicates things in the future should I continue to thin out diffusely behind it.. 😕

As for your last question I'd rather not answer that if you don't mind. 

I completely understand you not wanting to answer, and in general I think negativity goes with the territory when it comes to hair loss discussions. Nobody thinks it's a positive thing, and we're all here because it distresses us.

Diffuse thinning can be tough when your response to medication is subpar, or if you're worried that you will lose more ground. Realistically, this same issue is a concern for sufferers of Non-diffuse loss as well, even if they think they're safe. That's why it's generally important to try to plan for the long term, and to a certain extent to assume the worst case scenario in terms of possible progression. Hypothetically, budgeting your grafts assuming you may have to cover a Norwood 6 area would be a pretty "safe" plan, and arguably you might be able to loosen up a bit later in life as it's less likely (though not impossible) that you're going to suffer a sudden aggressive loss in your older years.

As far as the transplant route, I think a diffuse thinner's best bet is to go for smaller procedures as needed to reduce trauma to existing hair, and to not jump the gun chasing native density. I'd honestly start looking at surgeons who have a good portfolio of diffuse cases and get multiple consults with advice on how to proceed with your journey. Probably wouldn't be a horrible idea to get an in-person consult with a surgeon periodically just to gauge how they think you're progressing (or not) so you have a more objective assessment.

Realistically, if you've got DPA and not DUPA, you are probably seeing the progression hit harder in certain areas than in others. That is, you may be able to see the NW6 pattern but you've only really lost major coverage in, say, your hairline area. I don't think that your choice to address the front first is a poor choice if you had minimal coverage, and that's probably how I'd keep addressing this going forward.

The trick now is to work with a doctor you like to form a long term plan. Be blunt in your request for an opinion. "I had X grafts into this area but think I have potential to become a Norwood 6. How many grafts do you think I have left? Do you feel this would be enough to provide adequate coverage if I lost most of the remaining native hair in this pattern? What is your recommendation?"

Don't be afraid to be detailed and thorough in your questioning. In fact, you should insist on it. Any doctor who blows off the thorough questions is probably not somebody you want operating on you.

Like you, I'm constantly distressed by hair loss as an issue. It's a horrible weight on my mind, even though most people would probably say I still have a good head of hair. If I didn't lose any more hair for the rest of my life, I could be content, but it's the uncertainty that kills me. Still, there's some comfort to be found in sitting down and coming up with a plan informed by the recommendations of doctors you respect. Knowing what your next step would be and what is likely to be achieved can be of some comfort.

Tying back to the original post, the Norwood scale is woefully incomplete in terms of documenting patterns of hair loss. It's a shame because most of the alternative options aren't much better.

 

Edited December 26, 2020 by Mycroft

[Enhancer]

@UnbaldEagle you had basically done the same thing I'm going to do - dense pack the front regardless of diffusing.  That might not be bad after all, the hairline is the place where concealers do not work as well.  Since my hair is always longer and swept back author shelby style, I am hoping the extra hair in the front will keep the back dense for a long time to come.  However I am well expecting for my luck to run out, hopefully not for another 10 years, which is why I would never get a FUT as a diffuse thinner, keeps the option of shaving open.

[Hair4Days]

On 12/24/2020 at 2:48 PM, Melvin-Moderator said:

You’re absolutely right in your thinking, I too was fooled by my hairline. For the longest time I would say I was a Norwood 2, but the reality was a diffuse Norwood 6. 

Now, are we a lost cause? No, but you either have to be committed to medicine, or lose most of your hair before you consider having surgery.

How much hair do you think a diffuser needs to lose specifically before they get a transplant ? 

Edited December 27, 2020 by James C

[Al - Moderator]

Over the last few years I've become a big proponent of using beard and chest hair. A lot of people say you should only use body hair as a last resort, but I think it's much better to use it from the start for those who think they are headed to NW 6 or NW 7. What you don't want to end up doing is using all your scalp donor and then going to NW 6/NW 7 and having some of the hair that was transplanted fall out plus the area still expanding and then needing to basically redo your hair transplant with body hair. If you have a lot of body hair just use it at the start mixed in with some scalp hair. beard hair lasts basically forever, so you won't have to worry about it once it's transplanted. 90 year old NW 7 bald guys still grow thick beards. You want that hair on your head. It doesn't look anywhere near as bad on our head as most people think it will.

If you can get 5000 to 6000 beard and chest grafts then that's that much less scalp grafts you have to use. I'm saying this from experience after having multiple hair transplants when I was younger only to end up a NW 7 and now redoing the entire transplant over with body hair.

[UnbaldEagle]

@Mycroft, thank you for your detailed response once again, I must admit reading it made me have a less dim view of our situation. Truly you've given a different perspective. I agree with you about the importance of having a healthy long term plan, also focusing on smaller procedures. It's safer for your existing hair, whereas larger procedures could permanently shock your surrounding natives. Clearly a big concern for diffuse thinners. Although it sucks thinking you'll possibly have 4-5 or more procedures during your lifetime as opposed to the 1-2 large ones high NWs do. Honestly, this is something else that doesn't excite me, there's just too much downtime with a HT, starting with a few weeks off from work and social life in general (1-2 months in my case, I never wanted anyone to know) to a few months of concealing it the best you can and then the waiting game. And have that multiple times throughout your life. I mean if that's the price of having hair, fine, but sometimes I envy slick bald guys who let's say go to Eugenix and have a one and done successful megasession with scalp and body hair.

I'll follow your advice and will definitely reach out to a surgeon and ask those questions. That should somewhat alleviate the gnawing uncertainty. 

A few weeks ago I wrote down a few possible scenarios, ranging from best to worse case obv. Best would be getting a great result from HT, maintaining on treatment and addressing a slightly thin crown eventually (that's the only area where I've gotten significant regrowth from past and present treatments), although I probably shouldn't bother with that. The worse thing that could happen however is losing all hair apart from transplanted if treatment stops working, I don't think I have any scalp donor left and absolutely no body hair.  The thin beard I have is a courtesy of minoxidil, if I stop applying it it will start vanishing again. So yeah, this is the worst thing that can happen and I just don't have a plan for this endgame. 

Do you really think it's less likely to experience an aggressive onset of MPB as we get older? What about meds losing efficacy?

[UnbaldEagle]

Also, @Enhancer and @Mycroft, it's reassuring to know you guys think it's actually a good plan to start with the front first regardless of what happens behind it. I guess a scattered transplant is riskier if the natives do bid their farewell eventually. 

[UnbaldEagle]

@BeHappy, where are you currently in your BHT journey? How many you've had so far?

Also, what you're proposing is interesting, although I have some doubts. For instance, if you are truly a NW7, your sides will drop and your crown will dip if you don't take medication. If you take antiandrogens however, your transplanted body hair will thin out. So no meds, but you'll have to have a lot of BHTs. Also, a full blown NW7 on average requires about 10K for full coverage, no idea if anyone has so much donor beard. Would chest hair last "forever" too? I know leg hair also suffers senescent thinning as we age. 

Do you believe your translanted hair has thinned out throughout the decades? 😕 

One more thing regarding body hair. Bernstein posted a study once that the transplanted will take on the characteristics of the surrounding natives in a couple of years, such as becoming wavy or straight, etc. I'm curious if this would happen to body hair too eventually, like growing longer maybe? As far as I know that's one of the main issues. 

Would really like to know your experience. 

[Mycroft]

1 hour ago, UnbaldEagle said:

@Mycroft

Do you really think it's less likely to experience an aggressive onset of MPB as we get older? What about meds losing efficacy?

You'll see age 35 thrown around a lot as a generic reference for this, and there's some general truth to that although there are no definitive rules. By this point you will often have an indication of your full pattern if your alopecia is milder, and people with aggressive loss may have already lost most of the hair they're going to lose and be a full blown Norwood 6. All this to say, your loss (or at least rate of loss) tends to stabilize somewhat with age.

Medication doesn't exactly lose efficacy per se. When you're losing ground 99% of the time it's just that there has been a slow, progressive creep of loss and it has advanced far enough for you to notice (kind of like you don't notice thinning initially until you've actually lost a good chunk of hair). So the goal is to get that progression to be as slow as possible, if not to stop it entirely. How successful you are is probably going to depend on how aggressive your treatment is, how aggressive your loss is, and so on. The more hair you start with, the better your odds of maintaining long term. Beyond that, more extreme methods like surgery can be used to help regain ground as the need arises.

 

[Al - Moderator]

On 12/28/2020 at 1:37 PM, UnbaldEagle said:

@BeHappy, where are you currently in your BHT journey? How many you've had so far?

A bit over 4600 body hair grafts split almost evenly between chest and beard. I have another session coming up in January. I'm hoping to get another 800 to 1000 grafts done.

 

On 12/28/2020 at 1:37 PM, UnbaldEagle said:

Also, what you're proposing is interesting, although I have some doubts. For instance, if you are truly a NW7, your sides will drop and your crown will dip if you don't take medication. If you take antiandrogens however, your transplanted body hair will thin out. So no meds, but you'll have to have a lot of BHTs. Also, a full blown NW7 on average requires about 10K for full coverage, no idea if anyone has so much donor beard. Would chest hair last "forever" too? I know leg hair also suffers senescent thinning as we age. 

 

I am a true NW7. My sides have dipped very far down and what's left is thinning too. Without body hair grafts I would be completely bald where some the strip scars were (I had multiple strip scars). I also have some retrograde balding and I lost hair upwards from the back past the lower scars there as well. This is why most of the previously transplanted hair from the strip scars has fallen out. It lasted 15 years until the hair loss progressed past the scars, but it was never a good hair transplant anyway and never gave me any real coverage. Eugenics and Umar are already doing what I'm saying, although to a lesser extent as they usually use less body hair than I would, but they are doing it and getting good results so far. I think more places need to be incorporating body hair in the original planning.

I took finisteride for about 11 years, but I was already a NW7 and still losing hair. Yes it was thinning out my chest hair, but I don't know about my beard. My thought was there was no point in continuing finisteride if I'm still losing hair and already a NW7 and needed to use body hair to get any improvements. I hated being on medication continuosly anyway and I'm so glad I'm not on it any more. I do think I lost some head hair faster since being off of finisteride, but again, what was the alternative? I didn't see any other choice. I'd rather have body hair covering my head instead of scars covering my head.

 

On 12/28/2020 at 1:37 PM, UnbaldEagle said:

Do you believe your translanted hair has thinned out throughout the decades? 😕

Yes. A lot of it is gone now which is why I had no other choice than to go with body hair. But it did grow for a lot of years and thinned out just like it would have if it was still in the donor area and never moved.

 

On 12/28/2020 at 1:37 PM, UnbaldEagle said:

One more thing regarding body hair. Bernstein posted a study once that the transplanted will take on the characteristics of the surrounding natives in a couple of years, such as becoming wavy or straight, etc. I'm curious if this would happen to body hair too eventually, like growing longer maybe? As far as I know that's one of the main issues. 

Yes. As time goes by it gets harder to tell the difference. The length has never bee an issue. It actually grows faster and longer than my head hair. I have a few scattered hairs that don't like to comb the right way or that still have a bit of roughness to them, but I don't know if that's because it was body hair or because of all the scarring I had on my head that it was transplanted in to. Years ago I had 5 scalp reductions so we are transplanting over all that, most of the previous transplanted hair is gone and being transplanted over those scars, some of the strip scars are being transplanted into, I had I think over 100 3.75mm plugs of scalp removed and sutured closed years ago to try to eliminate some spaces between grafts etc, etc, so I had a lot of scarring.

The thing is though that you can't tell by looking that it's not real head hair and since a NW7 doesn't have much hair anyway there's not really any hair that you are tryng to match or blend in with, so if it's not the same texture as it was when you were younger and had hair does it really matter?

 

 

[lovinitl9]

On 12/29/2020 at 5:37 PM, BeHappy said:

A bit over 4600 body hair grafts split almost evenly between chest and beard. I have another session coming up in January. I'm hoping to get another 800 to 1000 grafts done.

 

 

I am a true NW7. My sides have dipped very far down and what's left is thinning too. Without body hair grafts I would be completely bald where some the strip scars were (I had multiple strip scars). I also have some retrograde balding and I lost hair upwards from the back past the lower scars there as well. This is why most of the previously transplanted hair from the strip scars has fallen out. It lasted 15 years until the hair loss progressed past the scars, but it was never a good hair transplant anyway and never gave me any real coverage. Eugenics and Umar are already doing what I'm saying, although to a lesser extent as they usually use less body hair than I would, but they are doing it and getting good results so far. I think more places need to be incorporating body hair in the original planning.

I took finisteride for about 11 years, but I was already a NW7 and still losing hair. Yes it was thinning out my chest hair, but I don't know about my beard. My thought was there was no point in continuing finisteride if I'm still losing hair and already a NW7 and needed to use body hair to get any improvements. I hated being on medication continuosly anyway and I'm so glad I'm not on it any more. I do think I lost some head hair faster since being off of finisteride, but again, what was the alternative? I didn't see any other choice. I'd rather have body hair covering my head instead of scars covering my head.

 

Yes. A lot of it is gone now which is why I had no other choice than to go with body hair. But it did grow for a lot of years and thinned out just like it would have if it was still in the donor area and never moved.

 

Yes. As time goes by it gets harder to tell the difference. The length has never bee an issue. It actually grows faster and longer than my head hair. I have a few scattered hairs that don't like to comb the right way or that still have a bit of roughness to them, but I don't know if that's because it was body hair or because of all the scarring I had on my head that it was transplanted in to. Years ago I had 5 scalp reductions so we are transplanting over all that, most of the previous transplanted hair is gone and being transplanted over those scars, some of the strip scars are being transplanted into, I had I think over 100 3.75mm plugs of scalp removed and sutured closed years ago to try to eliminate some spaces between grafts etc, etc, so I had a lot of scarring.

The thing is though that you can't tell by looking that it's not real head hair and since a NW7 doesn't have much hair anyway there's not really any hair that you are tryng to match or blend in with, so if it's not the same texture as it was when you were younger and had hair does it really matter?

 

 

hey happy,

thanks for all of the help. would it be possible to upload some photos of your hair so that we could see how well the body hairs worked for you. I am also looking forward to working with them. thanks so much

 

[Melvin- Admin]

1 hour ago, lovinitl9 said:

hey happy,

thanks for all of the help. would it be possible to upload some photos of your hair so that we could see how well the body hairs worked for you. I am also looking forward to working with them. thanks so much

 

I believe he has photos in his profile. He is a true Norwood 7. Incredible story and journey. Hopefully, he’ll be willing to share it with us all some day.

[Ajamilo]

On 12/28/2020 at 9:14 PM, Mycroft said:

You'll see age 35 thrown around a lot as a generic reference for this, and there's some general truth to that although there are no definitive rules. By this point you will often have an indication of your full pattern if your alopecia is milder, and people with aggressive loss may have already lost most of the hair they're going to lose and be a full blown Norwood 6. All this to say, your loss (or at least rate of loss) tends to stabilize somewhat with age.

Medication doesn't exactly lose efficacy per se. When you're losing ground 99% of the time it's just that there has been a slow, progressive creep of loss and it has advanced far enough for you to notice (kind of like you don't notice thinning initially until you've actually lost a good chunk of hair). So the goal is to get that progression to be as slow as possible, if not to stop it entirely. How successful you are is probably going to depend on how aggressive your treatment is, how aggressive your loss is, and so on. The more hair you start with, the better your odds of maintaining long term. Beyond that, more extreme methods like surgery can be used to help regain ground as the need arises.

 

So finasteride will have negative effect on body hair?