Determining a NW7 potential.

[Curious25]

Be interested to hear on what the community’s thoughts are surrounding this topic, given a higher frequency of cases displayed by top clinics being more adventurous with their extraction patterns, and venturing out of traditional ‘safe zone’ areas. 
 

Is there now a consensus that a patient destined for a high NW would exhibit signs of this at a particular age? 
 

Or 

 

Would it be more accurate to speculate, that you can determine a patient being likely to reach a high NW level, potentially in his 40’s or 50’s . . By signs in their 20’s or 30’s? 

[asterix0]

I think the general consensus is, the earlier you start balding, the more likely you are to hit Norwood 7. So definitely aggressive loss in your 20s is an indicator. 

A good indicator is the lateral humps. If those begin to drop, you know that more likely than not you will progress past Norwood 6 to Norwood 7. 

If you made it to Norwood 2/3 to your 40s or 50s, and are beginning to grey as well, then I think the chance is almost 0 you will hit Norwood 7.

 

[Al - Moderator]

31 minutes ago, asterix0 said:

If you made it to Norwood 2/3 to your 40s or 50s, and are beginning to grey as well, then I think the chance is almost 0 you will hit Norwood 7.

 

My brother was a NW 1 or 2 at age 40 and is now a NW 6 in his mid 50s.

 

[Curious25]

 

11 minutes ago, BeHappy said:

 

My brother was a NW 1 or 2 at age 40 and is now a NW 6 in his mid 50s.

 

 

You can have visual loss in a NW2 pattern, however have miniaturisation across a NW5 pattern of loss. 
 

So a person could come on these boards claiming to be a NW2, however a surgeon would categorise him as a NW5, based on what he saw from the microscope. 
 

I wonder if this was the case with your brother?

[JDEE0]

Good question and post.

I've certainly seen a number of top clinics and doctors essentially say that they can accurately guess by microscopically examining the donor zone at a certain age/level of baldness. There was a case with H&W (I think on here) ages ago with this being debated heavily and replies from Dr. Hasson saying as much. 

I think for the most part, it's probably true, providing that whenever they looked at your follicles under magnification, there had been enough time for androgen activity to visibly affect them. 

The point is that, no one just starts balding at X age unless there is some sort of epigenetic trigger. For MPB, whatever follicles on your head are genetically programmed to be affected by it, they will begin to be chopped away at from the day you start puberty and androgens began to flood into your body. People just notice it by a certain age as it took that long for their density in said area to drop by 30 or 40 percent (due to cumulative loss from androgen activity in the follicles AR), and now at age 35, 40, or whenever, they're thinking 'oh no, I'm going bald'.

With this in mind, well, you should be able to see the signs of miniaturisation being present in all of the the follicles that are genetically susceptible as long as you don't check before there's ever been enough time for it to show up visibly. i.e. if someone is destined to be a NW4 by age 70, this would be a pretty slow progression and if you checked them at 25 years old, I'm not sure if the surgeon would really have been able to tell at that point where they were headed to. Maybe the 'damage' to (or amount the follicle has shrank or miniaturised by) at that point in time was only 5, 6 or 7 percent etc. It's probably not enough to identify these areas as being susceptible even when looking through loupes or a microscopic camera, etc. This is my theory/the way I logically see it anyways.

As for the age thing as Asterix says, I personally don't think it matters so much as how early you bald as much as it matters at what speed you do (although I certainly agree that people who bald young generally *correlatively* go more bald than those who notice it later on). If you end up NW3 by 25, then those follicles were clearly very sensitive to androgens as they disappeared off your head in around 10 years pretty much. However, if you at the same time have no thinning elsewhere, or your follicles in your crown/midscalp are 100x less sensitive than your temporal ones, then you're not going to end up super bald any time soon, if ever.

Conversely, someone could have all their follicles genetically susceptible to MPB in a NW7 pattern, but their sensitivity and resulting speed of loss might be 10% of the other guys follicles in the NW3 pattern. Even though the first guy was noticeably balding by 25 and the other might not even look thin at all until he's in his 40's let's say, he would go NW7 in the next few decades because all of his hairs were destined to go in the end, albeit at a slower rate, whilst the NW3 guy would still be NW3 when he began balding decades earlier. 

 

[asterix0]

28 minutes ago, BeHappy said:

 

My brother was a NW 1 or 2 at age 40 and is now a NW 6 in his mid 50s.

 

That is quite unusual I would say, but like everything in life there are exceptions..

 

 

[asterix0]

3 minutes ago, JDEE0 said:

Good question and post.

I've certainly seen a number of top clinics and doctors essentially say that they can accurately guess by microscopically examining the donor zone at a certain age/level of baldness. There was a case with H&W (I think on here) ages ago with this being debated heavily and replies from Dr. Hasson saying as much. 

I think for the most part, it's probably true, providing that whenever they looked at your follicles under magnification, there had been enough time for androgen activity to visibly affect them. 

The point is that, no one just starts balding at X age unless there is some sort of epigenetic trigger. For MPB, whatever follicles on your head are genetically programmed to be affected by it, they will begin to be chopped away at from the day you start puberty and androgens began to flood into your body. People just notice it by a certain age as it took that long for their density in said area to drop by 30 or 40 percent (due to cumulative loss from androgen activity in the follicles AR), and now at age 35, 40, or whenever, they're thinking 'oh no, I'm going bald'.

With this in mind, well, you should be able to see the signs of miniaturisation being present in all of the the follicles that are genetically susceptible as long as you don't check before there's ever been enough time for it to show up visibly. i.e. if someone is destined to be a NW4 by age 70, this would be a pretty slow progression and if you checked them at 25 years old, I'm not sure if the surgeon would really have been able to tell at that point where they were headed to. Maybe the 'damage' to (or amount the follicle has shrank or miniaturised by) at that point in time was only 5, 6 or 7 percent etc. It's probably not enough to identify these areas as being susceptible even when looking through loupes or a microscopic camera, etc. This is my theory/the way I logically see it anyways.

As for the age thing as Asterix says, I personally don't think it matters so much as how early you bald as much as it matters at what speed you do (although I certainly agree that people who bald young generally *correlatively* go more bald than those who notice it later on). If you end up NW3 by 25, then those follicles were clearly very sensitive to androgens as they disappeared off your head in around 10 years pretty much. However, if you at the same time have no thinning elsewhere, or your follicles in your crown/midscalp are 100x less sensitive than your temporal ones, then you're not going to end up super bald any time soon, if ever.

Conversely, someone could have all their follicles genetically susceptible to MPB in a NW7 pattern, but their sensitivity and resulting speed of loss might be 10% of the other guys follicles in the NW3 pattern. Even though the first guy was noticeably balding by 25 and the other might not even look thin at all until he's in his 40's let's say, he would go NW7 in the next few decades because all of his hairs were destined to go in the end, albeit at a slower rate, whilst the NW3 guy would still be NW3 when he began balding decades earlier. 

 

Good post, I would only add that generally speaking if you have "only" recession but thickness everywhere else, this is in my opinion much different than people who start balding at the back from an early age.

Those are almost certain to be a high Norwood, or if you are also a diffuse thinner.

Classic recession in my opinion is the most unlikely to progress to a high norwood especially if the rest of your hairs appear thick and healthy. 

[JDEE0]

3 minutes ago, asterix0 said:

Good post, I would only add that generally speaking if you have "only" recession but thickness everywhere else, this is in my opinion much different than people who start balding at the back from an early age.

Those are almost certain to be a high Norwood, or if you are also a diffuse thinner.

Classic recession in my opinion is the most unlikely to progress to a high norwood especially if the rest of your hairs appear thick and healthy. 

Yeah, I would also have to agree with you there.

I would bet that there is a huge correlation between crown balding/thinning (especially at a young age) and going full on NW7 or at least advanced loss. In other words, receding hairlines seem to be able to fairly commonly stop at some point, but crowns seem to just expand in both directions until you're bald.

[TorontoMan]

2 hours ago, BeHappy said:

 

My brother was a NW 1 or 2 at age 40 and is now a NW 6 in his mid 50s.

 

he was probably just on meds until then and came off at 40 

[Bonek]

Quote

Those are almost certain to be a high Norwood, or if you are also a diffuse thinner.

That is super interesting. I could call myself a diffuse thinner (I'm 25 years old). But I always had thin hair there (inherited from my mom - she also has thin hair). But everywhere else I got thick hair. I wouldn't call every diffuse thinner to end up with high Norwood or maybe I'm just still too young, but as I already mentioned - I guess that I have same here since I was 20/21. 

Just my 2 cents (picture attached below).

[Al - Moderator]

On 10/17/2021 at 3:12 PM, TorontoMan said:

he was probably just on meds until then and came off at 40 

 

It was somewhat the opposite. He was starting to thin a bit beginning around age 40 I guess. but once he got into his 50's he had to take medication for non hair related health issues and I think that probably speeded up the hair loss process.

 

Approximately age 40 vs age 56