Retrograde Alopecia? Or do most donor areas have some miniaturization/normal? (Photo)

Question

I had a hair transplant at 37 to address my receding hairline and thinning temples. My surgeon noticed some minisurization too in my donor area during the consultation and emphasized to continue to use finasteride. After googling, I'm concerned about the possibility of retrograde alopecia in my donor area. I have naturally very very fine, wavy, wispy hair. Does it look like I have retrograde alopecia or just normal frontal alopecia? Is my transplant at risk? Should I add topical Minoxidil?

Sanusi Umar, MD · Answer

It's challenging to determine the presence of retrograde alopecia without a proper examination. To get a better understanding, your surgeon may recommend shaving the area to assess the extent of miniaturization.

Some degree of miniaturization in the donor area can be normal, and not every case leads to retrograde alopecia. It's great that you continue using finasteride, as it will help manage and prevent further hair loss, especially in the donor area.

Considering your concerns, you could discuss the possibility of adding topical minoxidil with your surgeon or a dermatologist. Minoxidil is known to stimulate hair growth and can be applied topically. However, its effectiveness varies among individuals.

Matt Tahsini, MD · Answer

Hello and thank you for your question.  It is difficult to assess your situation by looking at pictures.  I think you should see a reputable doctor for an in person consultation.  Best of luck to you.

Dr. T

Kulakarn Amonpattana, MD · Answer

Hello I'm Dr. Wipawan Vathananai, a co-worker of Dr. Kulakarn Amonpattana, from BHI Clinic, Bangkok, Thailand. 
Regarding your concern;1. I had a hair transplant at 37 to address my receding hairline and thinning temples. My surgeon noticed some miniaturization too in my donor area during the consultation and emphasized to continue to use finasteride. --I agree with him
2. After googling, I'm concerned about the possibility of retrograde alopecia in my donor area. I have naturally very very fine, wavy, wispy hair. Does it look like I have retrograde alopecia or just normal frontal alopecia? Is my transplant at risk? -- According to the photos, I think the 2nd photo you uploaded (which I assume that it is this one you concern about), is just your natural occipital hairline. In order to diagnose a retrograde alopecia, it might be necessary to see you in person or even shaving your hair to make the diagnosis. However, the hormones can affect all of the hair follicles on your head, it is just that the follicles on the occipital area are more resistant to the hormone and undergo the miniaturization less than the hair in the front and the side.
3. Should I add topical Minoxidil?Yes! Or low dose oral minoxidil is also another choice.

Retrograde Alopecia? Or do most donor areas have some miniaturization/normal? (Photo)

Answers (3)

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