Retrograde Alopecia

[DrTBarghouthi]

Dear community,

I am quite sure many forum users here have come across the term retrograde alopecia from various posts and discussions. This is a form of hereditary hair loss that affects areas in the donor above the ears and around the nape of the neck. While it is generally quite common to see, it is important to note that diagnosing on photos can be quite tricky because of the tendency to style the hair shorter around that area after a haircut for example. Many patients would have had a recent hair cut where the area around the nape has a faded cut or shave and that can lead to some confusion as to whether it is retrograde or not. It is therefore important to note that an in person microscopic evaluation is the gold standard so as to detect actual miniaturisation and thinning of the hairs there compared to actual donor hair.

[NARMAK]

Thank you for setting this topic up doctor as quite a few members have this concern they may be dealing with retrograde alopecia which generally in some individuals seems very visually apparent. 

I have a slightly different question which perhaps you are best placed to answer. In your experience, is it retrograde alopecia that can be extremely confined to a specific area. 

For example, the temple triangles? 

For the longest time i have wondered why my temple points washed out so quickly and i believe it may have been a very specific and localised form of Retrograde Alopecia. My hairline was very normal and strong generally in the frontal area but the temp triangles almost completely washed out by by my teens. Is that something retrograde alopecia can result in or morso a very rare outcome of localised hair loss perhaps? 

[DrTBarghouthi]

I believe that thinning in the temporal triangles is not a feature of retrograde alopecia. Th temple points can regress as part of mphl or in some cases can be deficient congenitally or what is referred to as triangular alopecia. 

[Melvin- Admin]

@DrTBarghouthi

I know you created a video for Instagram. Perhaps you can link it here.

[NARMAK]

13 minutes ago, DrTBarghouthi said:

I believe that thinning in the temporal triangles is not a feature of retrograde alopecia. Th temple points can regress as part of mphl or in some cases can be deficient congenitally or what is referred to as triangular alopecia. 

I've never ever come across that term "Triangular Alopecia". Thank you for sharing it. 

I'm off to go rabidly research it now lol. It affected me as a teen and i have to say affected me greatly as a result of losing my temple points at such a young age to looking older but never really placing my finger on why until many years later now. 

[DrTBarghouthi]

24 minutes ago, NARMAK said:

I've never ever come across that term "Triangular Alopecia". Thank you for sharing it. 

I'm off to go rabidly research it now lol. It affected me as a teen and i have to say affected me greatly as a result of losing my temple points at such a young age to looking older but never really placing my finger on why until many years later now. 

Yes. Worth looking it up. Might well be the case. Not common but does exist. 

[DrTBarghouthi]

30 minutes ago, Melvin- Moderator said:

@DrTBarghouthi

I know you created a video for Instagram. Perhaps you can link it here.

Will do. Should i copy a link? @Melvin- Moderator

[NARMAK]

5 minutes ago, DrTBarghouthi said:

Yes. Worth looking it up. Might well be the case. Not common but does exist. 

I had a look. Apparently affects less than 1% of people or so. The images on Google didn't quite match with how mine looked. My temple points seemed to more aggressively recede and wash out like we see in higher Norwood cases. However at present from the consultations i had for my Hair Transplant, it seems like i'm classed still as a Norwood 2.

Well, hopefully the next 12 months after my procedure i can happily show off the results and the clinic can make a thorough diagnosis perhaps for me on the temple points. 

[MrFox]

11 hours ago, DrTBarghouthi said:

Dear community,

I am quite sure many forum users here have come across the term retrograde alopecia from various posts and discussions. This is a form of hereditary hair loss that affects areas in the donor above the ears and around the nape of the neck. While it is generally quite common to see, it is important to note that diagnosing on photos can be quite tricky because of the tendency to style the hair shorter around that area after a haircut for example. Many patients would have had a recent hair cut where the area around the nape has a faded cut or shave and that can lead to some confusion as to whether it is retrograde or not. It is therefore important to note that an in person microscopic evaluation is the gold standard so as to detect actual miniaturisation and thinning of the hairs there compared to actual donor hair.

So is this form of hair loss caused by DHT as well? It seems like it is not a very well understood form of hair loss. 

[DrTBarghouthi]

1 hour ago, MrFox said:

So is this form of hair loss caused by DHT as well? It seems like it is not a very well understood form of hair loss. 

Yes judging by findings on a scalp analysis, you can see obvious thinning similar to DHT affected areas in other parts of the scalp. Also looking at people who leave it on, you can see ongoing progression to complete loss of hair in those areas over the years. So yes it does certainly seem to be DHT mediated.   

[Hair4Days]

What’s the best way to diagnose this? I personally taper my neck and temples when i get a haircut so it’s always lighter then the rest of my donor. I have a usb microscope to examine my hair, but is it better to use it when those areas are grown longer or is it okay to examine when it’s shaved down (to a number 1)? 

[Melvin- Admin]

6 hours ago, DrTBarghouthi said:

Will do. Should i copy a link? @Melvin- Moderator

Yes, copy and past the link. 

[DrTBarghouthi]

24 minutes ago, Hair4Days said:

What’s the best way to diagnose this? I personally taper my neck and temples when i get a haircut so it’s always lighter then the rest of my donor. I have a usb microscope to examine my hair, but is it better to use it when those areas are grown longer or is it okay to examine when it’s shaved down (to a number 1)? 

The main thing is to see if that area has more thinning hairs than the donor area above it for example. You could assess a difference in thickness between both areas and this will give you an indication that a process of thinning is going on. You can spot differences in hair thickness even if it is cut short on a microscopic camera.

[DrTBarghouthi]

20 minutes ago, Melvin- Moderator said:

Yes, copy and past the link. 

Thanks.

https://www.instagram.com/tv/CcnDqq4oKDS/?igshid=YmMyMTA2M2Y=

[Britanium]

Thanks for the link @DrTBarghouthiI have added you on Instagram 👍🏽