24, male. Does this look like retrograde alopecia? Hair transplant question advice. Norwood scale I fall under? Prices? (Photo)

Question

Basically around 19-20 years old I started noticing a decrease in hair on the sides of my head. I never thought too much into it until I started paying more attention to it. I’ve went to 2 dermatologists who really had nothing to say. I also am interested in a slight hair transplant on my hairline. I had a barber years ago use a straight razor on my hairline that caused permanent hairloss and an angled hairline beside it slightly maturing around 20. Also how many grafts do you think I’d need?

Jae Pak, MD · Answer

If you are considering a cosmetic surgery it would be in your interest to see a doctor for an examination to make sure you would be a candidate.

John Peter Cole, MD · Answer

Retrograde alopecia usually affects men over age 50 and usually starts on the back of the scalp rather than the sides of the scalp.  
There are a few tests you could do to evaluate the sides of your scalp.  The first is to evaluate the density on the sides and compare this to the density in the back of the scalp.  You should look for miniaturization of hair follicles on this exam.  The next test is to perform a hair check on the sides of the scalp and compare this to the back of your scalp.  This test is also called cross sectional trichometry (CST).  your hair needs to be a few inches long to accomplish this test.  
Usually density is less on the sides of the scalp.  This means that the CST will be lower on the sides of your scalp.  
A third test would be to take some grafts out by FUE (follicular unit extraction) on the sides of the scalp to look for resting or telogen hairs.  
The number of grafts you need will be dependent on the surface area you desire to treat.  You currently have a nice mature hairline.  You don't really need to do anything.  However, without knowing where you want to place your hairline, it is impossible to give you a graft recommendation.  Regardless, you don't need many grafts.  At your age, I recommend you leave the whole transplant idea alone for now.

Robert Whitfield, MD · Answer

I recently did a case similar in age range and recession issue.  Typically a 1000 grafts will improve your anterior hair line.  The SmartGraft system is my choice.  The donor site will heal in less than a week and there will be no visible scarring.

William Rassman, MD (retired) · Answer

You need to see a doctor and get miniatuirization studies of your area of thinning. Your biggest enemy is the progressive t hinning leading to a balding pattern that is not evident at this point intime. The degree of thinning that you are experiencing would suggest that you should see a doctor who most likely will get Bulk Measurements of your hair to determine the degree of the thinning that you may be presently having. If the diagnosis is early genetic hair loss (the most common cause of hair loss in young men and you are probably following your father's balding problem), then the best treatment would be the drug finasteride which is highly effective in men of your age and may not only stop the hair loss but possibly reverse it. If you are developing a more advanced balding pattern the best test to get is the HAIRCHECK instrument test which will determine the Bulk Measurements of your hair and this will show, over a one-year time frame, how effective the treatment will be.

24, male. Does this look like retrograde alopecia? Hair transplant question advice. Norwood scale I fall under? Prices? (Photo)

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