I have diffuse hair thinning and am wondefring if hair loss can stop by itself?
This question was posed by a hair loss sufferer on our hair restoration forum and answered by Dr. Michael Beehner of Saratoga Springs, NY who is one of our recommended hair restoration physicians. His professional answer is below.
If one of the various well-known patterns of male pattern baldness expresses itself in its early stages, it is virtually unheard of for it not to progress gradually to a more severe degree of baldness. About the only exception to this might be the man who only has a minimal fronto-temporal recession (level II on the Norwood scale). Occasionally one of these will “lock in” and stay there. It is true that many men have periods of their life during which it seems the hair loss progression accelerates and other periods in which it seems to stabilize, but in my 19 years of following balding men, when you see any man 5 years later who was not on hair loss medication such as Propecia (finasteride) or Rogaine (minoxidil) or who received a hair transplant, there is a progression of hair loss. The two age plateaus where I see most men start this process is first in the early 20’s when many, including myself, start to recede in the front corners and at the same time thin in the crown. The second is in the 40’s, when a fair number of men, who previously thought they were immune to hair loss, also start to thin in front and in back.
Dr. Marritt, a well-known now-retired hair surgeon from Colorado, was a movie buff and used to follow the careers of many actors who fell into this category, including Clint Eastwood, Johnny Carson, Alan Ameche, Paul Newman, and many others.
The person who replied concerning “diffuse hair thinning” was right on, as this one always progresses. A good way to tell at the time of a consultation if an area is going to progress later to hair loss is simply to look for hair miniaturization under magnification (we use 30x power in our office). If one sees more than 5% miniaturized hairs, you can be fairly certain that area is someday eventually going to clear out.
There are basically 5 main pathways of hair loss progression: (#2 is probably the commonest):
- Diffuse hair thinning all over on top
- Hair recession in front along with crown thinning, with eventually a band of hair across the top (mid-parietal bridge) and a weak frontal tuft of hair, with eventual disappearance of these and a resulting U-shaped area of baldness. (Norwood Scale basically follows this pattern)
- Norwood “Variant” hair loss pattern: in which it erodes away at the front hairline edge and progresses backwards, usually sparing the rear crown/vertex.
- The reverse, with the a balding crown and then the hair loss progressing forward behind an intact front hairline (see Al Gore)
- Residual frontal forelock pattern of strong hair with loss to both sides and all behind it.
Mike Beehner, M.D.
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