Melvin L. Mayer, MD

The most important thing for you to do is PREVENTION!! Minoxidil 5%, Laser Cap, and/or finasteride 1 mg /day.

Remember that prevention is "time sensitive" and that hair transplantation is NOT "time sensitive" -Give prevention at least 1 year of treatment. I think you will see some strengthening without doing surgery!!

After about 5 years of PRP usage for hair loss, my favorite time to use PRP is intra operatively. In my opinion it seems to help diminish surgical stress loss, improve healing time and helps strengthen miniaturized hair. This is only a clinical impression from the past five years. Of course what is great about PRP is that it is natural and we don't see side effects with its usage!

Looking at your pictures I suspect that you have early Androgenetic Alopecia-- You are very wise getting on prevention early!!

I have been doing hair transplantation for 29 years and during this time I have not found any treatment as effective and relative safe as finasteride 1 mg daily. Your hair may strengthen during the first year of finasteride, then you should be able to maintain until you decide you don't want to take finasteride any longer -- I have many patients who have taken it successfully for over 20 years.

I would treat conservatively for about one year using Minoxidil 5% twice daily and a Laser Band. That will give you maximum improvement from medical therapy. Then if more hair is needed transplants would be an option. Follicular Unit grafts usually grows well in these areas if needed.

From the description of your recent loss of hairs with tiny hairs with black bulbs these are typical "Exclamation Hairs" which are seen usually in a condition called alopecia aerate . This condition is not helped with hair transplantation -- You need to see a Dermatologist for treatment as soon as possible.