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Does my balding pattern look established?

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I am a 31 y/o with substantial hair loss in my frontal third and crown areas. I've attached an image showing my hair at various lengths so you can see the full picture.

I'm sure I can expect to see additional thinning in the areas that have already thinned, but given that I still have full density in the surrounding areas, I am wondering if the hair loss area is pretty much established, and unlikely to expand to a larger area.

I am considering a hair transplant to fix the frontal third and maybe add a bit of density to the crown. However, I want to know if there is still a strong possibility of the crown loss region to expand or if I am likely to just eventually develop a bald spot of the same size as the currently-thinning region. Thanks so much!


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I wouldn’t say it’s established just yet. The sides could potentially drop and the crown expand in the future. I would say currently you’re a Norwood 5v, but could be a Norwood 6 in the future. If I had to bet I would bet that your crown expands in the future. You’re only 31 with many more years to bald. Are you on medication?

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@Melvin- Moderator

Thanks for the reply. I am currently not on any medication. I was on topical fin/min for ~6 months, and then switched to oral Fin (1 mg) for a couple of months. I've now been off all meds for 2 months. 

I happened to develop a serious anxiety disorder right around the same time I started the topical Fin, and it has persisted to this day. I assume it was just a coincidence because I had no other side effects from the topical or oral Fin. However, I wanted to get off the Fin just in case that was the cause of the issues. After 2 months off of it, I still have the same anxiety issues, so I think it is unlikely that the Fin was the cause... but I'm still hesitant to get back on just in case. Have you ever heard of Fin causing serious anxiety issues with no other side effects?

I am currently trying to decide whether or not to pursue the transplant I have booked with H&W for later this year. I think it's probably a mistake to do the transplant without being on Fin, so I think it'll come down to whether or not I decide to get back on. I'm also considering just accepting going bald. I tried shaving my head, and while I obviously prefer myself with hair, I don't think it necessarily looks bad shaved. I'm wondering if getting the transplant is just going to set me up for a life of constantly stressing about losing further hair...

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1 hour ago, IcedMan said:

I'm also considering just accepting going bald. I tried shaving my head, and while I obviously prefer myself with hair, I don't think it necessarily looks bad shaved. I'm wondering if getting the transplant is just going to set me up for a life of constantly stressing about losing further hair...

Once you get a first hair transplant you will then have to focus on this for the rest of your life (the financial cost, further hair loss and surgery, hair fibers perhaps, medication, etc). Not everyone is cut out for a hair transplant so if you can at all see yourself as shaving your head then I would seriously consider doing so. Shaving your head today is a sharp look and a very common one in society. Hair loss is progressive! Personally I highly recommend that you choose shaving your head before ending up with surgical scars (if you have surgery) preventing you from doing this in the future. Wishing you all the best.

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HT isn't really a one and done deal for most people, but you do take meds so it would last you very long. if you don't plan on keeping on meds, and you think youre ok looking shaved, and don't want to stress about losing hair... i think just shaving is a pretty good option for you.

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It appears that your hair loss is similar to mine with a bit more loss in the temple region.  I’d say your hair loss pattern is pretty well established and could be classified as a Norwood 6.  You may very well lose the remaining natural hair on top of your scalp but I’m guessing you probably won’t advance to a Norwood class 7. 

Would you say that your hair loss is still advancing or do you think it has at least slow down a little bit or stopped?  Are you taking any hair loss medication such as finasteride kr minoxidil? If so, how long have you been taking them and have you seen any improvement?  Keep in mind that finasteride is better at slowing down or stopping the progression of male pattern baldness than regrowing new hair.  However, it can also strengthen or thicken any miniaturizing hair.

Given your advanced hair loss and the fact that your temples are pretty well recessed, it’s important that you establish realistic expectations and understand what can be realistically accomplished.  

Depending on your donor hair, you may be able to re-create a conservative, mature looking hairline with some level of density in the frontal third of your scalp with a gradual fade into the mid section and a sprinkling of hair in the crown.  This may need to be accomplished in more than one hair transplant procedure depending on a number of factors.

if you’re one of the few with exceptional donor hair, you may be able to restore a pretty full looking head of hair (in the frontal half at least).

Just keep in mind that the crown requires an unrealistic number of grafts to achieve any real density.  On the flip side, a little can go a long way in covering a bald area.  While the crown may look thinner, you may be able to achieve enough coverage so that there are no bald spots.

I’d suggest consulting with a few leading hair surgeons to discuss your situation and determine what can be done given your situation.

Best wishes,

Rahal Hair Transplant 

Edited by Rahal Hair Transplant
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Rahal Hair Transplant Institute - Answers to questions, posts or any comments from this account should not be taken or construed as medical advice.    All comments are the personal opinions of the poster.  

Dr. Rahal is a member of the Coalition of Independent of Hair Restoration Physicians.

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