Is this a cowlick or am I balding? I have no history of balding in my family and the cowlick is getting bigger. (photo)

Question

I have no history of balding in my family and this cowlick looking thing has always been present but now that I have taken a closer look at it I am paranoid that it is getting bigger or becoming a bald spot.

Joseph MacDonald, MD · Answer

The cowlick area of ones scalp can sometimes look thin just because of the fact that you can see scalp due to the direction change of the hair in that area. The only way to tell for sure if this is balding is to actually measure the caliber of the hairs as that is how male pattern hair loss develops, by miniaturization. I would suggest meeting with a qualified hair restoration physician.

Jeff Donovan, MD, PhD · Answer

It's difficult to say without an up close examination. Cowlicks don't naturally get bigger. So, if you truly feel something is changing, be sure to see a physician. Androgenetic alopecia (male balding) is the most important consideration but other conditions are also needing to be ruled out fully.

Karl Hekimian, MD · Answer

There may be some early thinning, though without serial photos over time it's hard to say.  If you feel it's getting thinner you should see a local hair restoration physician for a careful examination and to discuss ways to maintain your hair, such as minoxidil (Rogaine), finasteride (Propecia), platelet-rich plasma (PRP) and laser therapy (LLLT).

Jon Ver Halen, MD, FACS (license suspended) · Answer

Dear Brad1515,Hello and thank you for your excellent question.  Cowlicks typically do not enlarge, so it is possible that you could be experiencing some hair loss. I suggest that you start Finasteride and Minoxidil, as they are the only two medications for hair loss approved by the FDA. For women of child-bearing age, I use spironolactone instead of finasteride. Both medications have different mechanism of action, and I usually recommend both medications to my patients. Other adjuncts include low-level laser light therapy, PRP, stem cell, or other regenerative medical treatment. Also, you will want to ensure that you are not taking any medications that could be contributing to your hair loss. The main objectives with the combination treatments are to stabilize your hair loss, increase your existing hair fiber diameter, and stimulate some hair regrowth. After those options are completed, I recommend hair transplant, including FUE or FUT. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!
Best,
  
Jon Ver Halen, MD FACS
  
Harvard educated plastic surgeon
  
Texas “Top Doc” 2017, 2018
  
RealSelf100
  
America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 – 2018
  
BeautyAdvisor Top Contributor

William Rassman, MD (retired) · Answer

It is difficult to tell with the eye, but an instrument called HAIRCHECK can tell you the answer to your question. Find a doctor who has one

Is this a cowlick or am I balding? I have no history of balding in my family and the cowlick is getting bigger. (photo)

Answers (5)

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