What shall I do? Hair transplant or Minoxidil only? (photos)

Question

I am like Norwood scale 6 or 7. 10 months ago (October 2018) I started using Minoxidil 5% twice daily. In last 10 months I started to get very thin baby hair very slowly. Now I’m wondering what shall I do? Go for a hair transplant or keep continue to use Minoxidil to see how it turns out in another 8 to 12 months. Please see photos attached. Would appreciate everyone’s valuable opinion.

Sanusi Umar, MD · Answer

As you are probably already aware, the Norwood 6 to 7 levels are considered to be the most severe stages of male pattern baldness. Although you may be noticing some fine hair growth, it is quite unlikely that this will result in the density and coverage that you would find to be most ideal. At my practice, the Dr.U Hair and Skin Clinics in Los Angeles, we offer body hair to head transplant for severe baldness, since at the Norwood 6-7 stages, the amount of head hair remaining on the scalp would be insufficient for producing significant improvements in coverage. As opposed to depending on Minoxidil, this is a far more reliable approach for achieving desired forms of improvement

Donovan Rosas, MD · Answer

Hair restoration is like a train...there are many cars and they are all headed in the same direction. The closer you are to the engine the faster you will reach your destination (i.e. the caboose is the last t pull in).
There are a number of modalities available ranging from supplements, topical therapies, medical therapy (Rogaine/Propecia) and PRP.
Patients may try one intervention at a time beginning with the least involved and add or replace as they see results. Each has positives and negatives and not all will be equally effective.
Hair grafting is the final and most definitive solution, however this should be delayed until you have reached a stable hair pattern. This is due to the fact that the grafted hair is permanent and if you have not reached a stable pattern you can expect further losses and the need for more grafting to avoid the appearance of a double hairline (grafted hairline followed by losses and the receding natural hairline).
With regards to your specific question, I would forego hair transplant until you have stabilized. Otherwise, you may be committed to further grafting in the future as your pattern evolves. That being said, you demonstrate a fairly advanced pattern which can be limiting with regards to options. Minoxidil is not going to be a definitive solution. Hair grafting may also be of limited utility (limited donor sites).
As always, discuss your concern with a board certified plastic surgeon (ABPS) with experience in hair restoration.
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame

Artur Kierach, MD · Answer

Your hair loss stage has progressed to an advanced stage. It appears the minoxidil has promoted the hair follicles to grow fine, stunted hairs. It is unlikely taking your hair loss pattern along with the time frame these hairs will mature into anything more than you see today. A hair transplant moves hair from what should be a genetically safe hair zone. Not affected by the male pattern baldness gene. To the area of hair loss. Your hair characteristics need to be able to sustain a natural result from one or more hair transplant procedures. This requires planning. Your next step should be to visit a specialist for your hair characteristics to be measured against your goals and expectations in undergoing a hair transplant.

Matt Tahsini, MD · Answer

Hello, thank you fo the great question. Minoxidil alone isn’t going to be enough for you. A transplant could be possible depending on if you have enough donor area. You’ll need to see a hair loss expert to determine what is the best path forward for you. I wish you the best of luck.

Glenn Charles, DO · Answer

The little bit of peach fuss type hair growth you are seeing from the Minoxidil is all that will happen. These hairs will not turn into full terminal hairs. You should do some Hair transplant consultations to see if you are a candidate for the procedure. It does appear from the photos that you have a very large area of hair loss and a smaller area of available donor hair. There is a good chance you do not have enough donor hair to get coverage over the entire area of hair loss.

Sara Wasserbauer, MD - Account Suspended · Answer

Minoxidil alone will not get you to where most people want to be. Hair transplant would be an option with the understanding that you will not be able to get coverage over your entire head. I would recommend meeting a hairloss specialist to go over your options.

William Rassman, MD (retired) · Answer

The supply of donor hair in a Class 7 pattern patient (you) is only 20% of the total original hair. Only half of it can be used. That means that 10% of the original hair will have to cover the balding area (80% of your scalp). Unless you have great donor density, the math does not work out. If you combine it with Scalp Micropigmentation, the reduction of contrast can make it work.

What shall I do? Hair transplant or Minoxidil only? (photos)

Answers (7)

More Hair Loss Treatment Questions

Will Minoxidil absorption increase if I apply when it is wet after a shower?

Do I have retrograde alopecia or DUPA? What is the best treatment option for me? (photos)

Receding hairline or just a mature hairline and how can I maintain it? (Photos)

Does Dutasteride cause hairline and temple region recession? (Photo)

WE SEND PRETTY
EMAILS