View Full Version : Planning for future hairloss

05-11-2010, 11:39 PM
A tough thing to do I know, but what are the most effective ways we know of predict how bald a person will get? I had an online consult once with Dr. Rassman and he felt at that time the best way to predict future hairloss is by microscopic examination of the hair on the scalp to find miniaturization.

But we also know that hairloss can come in spurts and is sometimes rapid, sometimes delayed.

I am now 30, and my hairloss at this time seems to be confined to the frontal hairline. I have been on finasteride for about 8 years. I think it has slowed down but not stopped my hairloss. My hairline has thinned a bit over the last 3-4 years but it's not bad and it's been fairly minimal. Never tried Rogaine. I would consider dutastaride if there were a cheaper generic option available.

I am seriously considering my first hair transplant to soften and strengthen my hairline, and I think FUE would be a better option than strip for me.

I have done my research though and I know that once I start this, I have to be committed to it for life. How often is it that a person has ONE transplant then stops because he doesn't need another one? And in my case, my father, and grandfathers on both sides have significant hairloss, probably norwood 5-6. I was told that I am currently a 2-3. And in another online consult I had, the ht doc recommended about 700 grafts.

Anyone want to offer some feedback? Thanks. I love this site btw.

05-12-2010, 02:36 PM
There really is no exact 100% perfect way to predict future hair loss. Dr. McAndrews estimates the final hair loss pattern by taking into account the hereditary factors, as well as using a microscope to see where miniaturization is already taking place. Every person is unique and that unique combination of genes is what determines your fate.

You also mentioned taking Dutasteride, but you are correct that there are no generic alternatives. Have a consultation with a dermatologist who deals in hair loss to discuss all of the facts, pros and cons for both Propecia and Dutasteride to help you make an informed decision. Dr. McAndrews is on the Merck advisory board for Propecia and also takes Propecia. We see alot of misinformation about the side effects here and all over the internet. He also takes Propecia himself, which he wouldn't do if he didn't think it was 100% safe.

There are many factors that go into determining if FUE is better than strip. If you are not on hair loss meds (Propecia/Minoxidil) we know your hair loss will progress. FUE is great for small procedures and for patient's who will most likely need just one hair transplant, but not ideal when we know we'll need to do multiple procedures down the road.

There are a lot of patients who have one transplant and never need another one, but in our experience, these patients are on the medications to stop or slow their hair loss. Dr. McAndrews says the average person loses 4% density per year, so whatever benefits you receive from a transplant are typically gone in 4-5 years. Then you are just doing procedures to keep up with the loss and eventually you run out of donor hair. That's why it's so important to look at the long term implications of hair transplants, not just the short term benefits.

Hope we've been of some help!

05-12-2010, 07:56 PM
does the average person lose 4% density per year with or without being on meds?

Dr. Glenn Charles
05-16-2010, 04:19 PM
The average patient that has androgenetic alopecia might only lose the 4% per year in certain areas and not others. You are still probably thinning in the hairline area with time because Propecia does not have as profound effect in that area. Unfortunetely, nobody can predict a patients future hair loss. We can only make estimates based on the patients current state of hairloss and the family history. We can also look at the percentage of miniturization.