At what point does the crown usually drop?

[SD1984]

Just a few general questions I'm curious about if anyone can help as I begin to plan for my future with a HT and what not. I am referring here of course to the back part of the crown that drops and thins out. This is typically only seen in Norwood 7's if I'm not mistaken.

-Does this only happen with NW7's?

-At what age would you think one can be considered "safe" from the crown not dropping and not going NW7?

Thanks

[LaserCaps]

There is no set date.  And it can happen to other classifications as well.  

Plan for the future? Never really thought about it in those terms.  If you have no history of hair loss and you have huge amounts of hair, why would you even worry about it? But, everyone in your family is bald, then OK.  So my first question, are you experiencing any loss? How old are you? Do you have family history of hair loss?

Most doctors in the industry tend to believe that patterns do not show themselves until the mid 20's. The reason is caution.  You do not want to start transplants too early because this can truly lead into a disaster.  Consider an 18 year old who is starting to mature the hairline.  Goes to a transplant doctor who fills in the temporal areas.  5 years later the patient loses the rest of his hair and is only left with two horns worth of hair.  So what can you do?

Medical therapy is typically the correct course.  Propecia/Finasteride, Rogaine/Minoxidil, PRP and Laser are the modalities we normally discussed when dealing with this condition.  Have you met with any doctor regarding the issue?

Consider posting photos of your entire head.  There are many people here who can share their opinion and provide some guidance.  

 

[SD1984]

Thanks for your reply. I have other threads with photos. I am 37 years old and am seriously considering a minor transplant at this point. I have tried finasteride and unfortunately the medication did not agree with my body. I am now looking into oral minoxidil as a last resort. I currently use topical minox which may have helped slow down loss a tad over the years, not sure though. The bad news is that hair loss is strong on my fathers side with multiple NW6's and even one NW7. Mothers side all great hair. The good news however is that my pattern is pretty obvious by now. I am likely a future Norwood 5a, possibly even 6. But at the same time, a 7 technically is possible way down the road if my forelock goes and the crown drops. But i'm really trying to think about the norwood scale here as it's presented, bc only at NW7 does the crown drop, and of course there is zero frontal hair left on norwood 7's as well. Given how "decent" my forelock still is, it would be hard to imagine me completely losing all of that, which in turn means the crowd would drop, too.

I think my point and overall question is- Is it possible for someone to have a completely dropped crown AND still have some sort of forelock left? I can't say I've seen that much if at all.

Point is, I'm hoping to eventually end up with a decent frontal third and mid scalp over the course of what would be two surgeries, would the hope that I only have true baldness in my upper crown and the back of it never drops creating that dreaded bald curve down in the back..

[LaserCaps]

Dipping down in the back, we refer to it as a "very deep pattern," with little to no donor left.  Normally people that have that type of pattern tend to keep a forelock, (diamond like-if you play cards), and little else.  So, let's say you do no medical therapy and end up being a deep 6, it would behoove you to consider working the frontal third so at least you have framing to your face - and still keep a pattern appropriate result.

[SD1984]

Well I'm confused a bit. You're implying that crown hair can be a part of donor hair, no? it's interesting bc my crown, in the very back, is covered, so it looks like I have this nice huge donor area. But in reality when you lift it up with a comb you can see the true donor area and strong hair which is a very narrow area. My donor capacity is probably 5000 max. I've already been told by a top doc its around 4000 max before it would look suspect. For the life of me I can't think of any public figures that have that true norwood 7 horseshoe with the deep drop at the crown AND a semi decent forelock left. If you can, let me know.

 

[JDEE0]

The back part of the crown also drops down into the back of the head in a NW6 pattern too, just not as far down as a 7, along with the upper sides still being in tact and not too receded either. 

I don't think you can ever really be too 'safe' or sure that you've reached your final pattern, but I do generally think for most cases you will have a pretty good idea long before you actually get there.

I think that, for most people, by the time around about a decade has passed since you began balding (which is probably late 20's/early 30's for people affected by MPB to any significant degree) you'll have a decent idea of where you're going to end up. Purely because, if in that time frame one section of your scalp (let's say the temples) has completely thinned out but the rest hasn't at all and looks the same as ever, you know that these other area's are far more androgen resistant. Otherwise they would have gone the same way or at least began to show signs of doing so in that period.

As such, I think you can safely say you have an idea of where you'll end up once you've been balding for some time and you can overall see which areas are affected on your scalp. Well, at least in the medium-long term, as it does seem to me that once unaffected areas can catch up in the long-long term after decades and decades. 

Look at people who had only frontal hair loss in their late 20's or so such as Joe Rogan, who has ended up a NW6 or 7 by the looks of his shaved horseshoe pattern. His back and sides etc. looked pretty thick/strong even at 30+ and he has ended up pretty advanced. 

At the same time, you have people who were approaching a NW3 sort of pattern at the same age as Joe who haven't really progressed much further in decades, look at Steve Buscemi and Jack Black for example, both could've probably had a transplant late 20's/early 30's to fill in their temples and still be fine today without really 'needing' a touch up. Their loss has worsened over the years, obviously, but not by a massive amount. 

On top of this, you have people like Ralph Fiennes who had a pretty amazing head of hair, pretty much NW1 beyond the age of 30, but then went to a NW5 plus over the next 20 odd years. Similar story for Eric Cantona who seemed to have decent hair into his 40's and then went fairly advanced by the looks of things. 

What I'm trying to say is that, yeah you can get a general idea of things, but ultimately I don't think anyone knows and it's still very much possible in the LONG term to end up a NW7 when it didn't look like that would be your pattern at one point in time. Just because someone showed a clear NW5 or 6 pattern without any signs of dipping lower to a 7 at say, age 35, doesn't mean that genetics won't speed up and change things by say age 50, 55 or 60 etc. Hence why the use of meds is so important in my opinion. 

I believe that if you use meds whilst your hair is still largely unaffected by MPB then you have a good chance of holding on to them indefinitely, probably to a point at which if they do ever begin to thin out, you'll likely be entering old age and although I'm sure you'd still want your hair in your late 60's onwards, it would be a begrudgingly acceptable outcome at that point, at least for me. I don't think it will come to that anyway as I believe we will essentially be able to fully prevent further loss for as long as we live with new treatments that should come out over the next 5-10+ years or so, but we'll see.

 

 

 

Edited September 3, 2021 by JDEE0

[ML488]

Nothing is absolute with the NW scale. When you say the crown doesn't drop until NW7, that doesn't mean that NW6 it can't thinned badly with the slight forelock still intact. Lord knows I've seen that many times. But no i dont think the crown completely drops on any norwood aside from 7 (i.e. Joe Biden). If you really look at Biden's hair overall, it is pretty weird. The guy has the full fledged norwood 7 horseshoe but a decent hairline. Why you ask? He had a transplant of course as we all know. If he didn't have the transplant guy would be full on NW7. Not to mention he never would be president either.

As far as the age when you are "safe" from NW7 happening there really is no concrete answer for that either. You are 37 and still have the back of your crown intact, ok, but even though hairloss slows down around 40 (so I've read), you better believe that when you're 57 that things will likely be much different especially if your hair loss is already advanced.

Edited September 4, 2021 by ML488