Hair Restoration Blog

Q:

I just had a few questions following the consultation,

As you said I have slightly more miniaturization in the crown than the donor area, but still in normal range, what would cause me to have more in one area than another other than MBP, is that normal for non MPB scalps?

• Could finasteride worsen the hairline due to the rise of testosterone, or is that irrelevant?
• Are there any safe and minor treatments to slow the progress of maturation or reverse it that you would recommend at this stage?

A:
I will be sending you a letter with all information that we discussed during our consultation at US Hair Restoration Beverly Hills Office.  You may have very initial signs of MPB, but the numbers for miniaturized hairs are not far from high normal.  Let us wait and see your progress before putting you on hair loss medication finasteride.  Early stages of male patterned hair loss may not always be obvious enough in our scalp microscopic evaluation to be differentiated from having upper normal levels of miniaturization.  Propecia (finasteride) is a great hair loss medication to prevent balding, but I know many people who went on it without the proper documentation of their miniaturization.  These hair loss patients may have to take it for the rest of their lives without knowing that they have really needed it to start with.

The main cause of hair loss is DHT (Dihydrotestosterone) and not testosterone, so finasteride can not deteriorate your hair loss or hairline maturation changes. Maturation of hairline is a natural phenomenon and should not be mistaken with balding.  We do not want to stop it.  I do not recommend any medications to stop the maturation of hairline either.

Q:

I am wondering if it is possible to place a more curved hairline on the corner areas.  I believe — but I am not sure — you have already commented on this, saying something to the effect that:  since the original hairline did not go down toward the temples (which, I believe you said is pretty typical — that the hairline does NOT go down to the temples), any new hair transplanted in that new area would either not grow or would not look natural (right).

A:

Before adulthood we have curved hair on the temple corners.  That is called a Kiddy Hairline or childhood hairline.  Our hairline matures as we grow up.  This is called maturation of hairline.  The male hairline generally converts from the kiddy hairline to a mature one at around 16 to 24.  When we transplant in the corners, we try to imitate a mature hairline and not the child hairline.  We can be a little flexible when it comes to designing the hairline, but remember that transplanted hairs are permanent and although a curved and lower hairline may look normal at an early age, it might seem unnatural and inappropriate in a fifty year old man.