View Full Version : 32 year old, thinning in crown, considering HT, pics attached

10-24-2010, 07:37 PM
Hey all,

I'm 32, been considering an HT, doing the research, having consults, etc. Please see pics attached - my crown area is the problem area. I am happy with my hairline and the rest of my head. I've been on generic Propecia for a month, 1.25mg/day. I realize I need to wait a solid year to see any results - I am hoping that Propecia stabilizes the loss.

My consideration of the HT is to thicken my crown - and then stay on Propecia for the rest of my life (which sucks, but, what can you do).

I'd love to know if you think I am a good candidate. You'll notice that it's not complete bald in that area...but thinning...and the sworl pattern is clear...and so the doctor will have to fill in those areas carefully and I will just

have to hope that the native hair in that area doesn't shock out. Maybe it would be better to wait until completely bald in that area? Maybe it's easier for the doctor if one is more bald in that area before surgery?

Like many of you, I go back and forth due to the horror stories of HTs I read on this site. Sometimes I think I am a great candidate, but it's easy to get freaked out by people with nightmarish experiences. I would love to hear from someone who has had crown issues, had an HT, and 1 year later, 3 years later, 5 years later, is still super happy with the result and has no regrets. There might not exist any, but maybe they are out there. I have to think that some people have had great success stories, but they moved on with their life and don't visit or post on these boards anymore.

My realistic expectation (is it?) is that it looks pretty full in the crown. Maybe not perfect like when I was 15, but pretty full.

My life is great, I have a girlfriend who loves me, but I struggle with this. Maybe I should just come to terms with it and let it go. Maybe I should take the plunge and get the HT because it could really help fill in my crown.

I don't know if I fully understand shock loss. From my understanding, shock loss is loss of native hairs around the area in which donor hairs are placed to fill up that area (in my case, the crown). It could happen a lot, a little, or not at all. What are your experiences? Is shock loss permanent (ever? always?) This is the number one concern.

The number two concern is the "doll hair" concern - that the rest of my hair on the top of my head is bound to fall out anyway and I'll have an island of ridiculous looking permanent hair. But, as of right now, nothing seems to indicate diffuse hair loss. Just at the crown - as you can see.

I understand about the strip scar. My hair is usually at least an inch or longer in the back, and so I am hoping that it's not an issue. But perhaps that's what everyone originally thought...and their strip scar is still visible somehow.

Thanks so much for any advice, feedback, and guidance you can provide.

10-25-2010, 08:03 AM
We generally never advise patients to start with hair restoration in the crown area. This is because the crown requires so many grafts to achieve sufficient density and this could deplete a patient's limited donor supply prematurely. Another problem is, as you said, you are not completely bald- only showing signs of thinning- in your crown region. For this reason, you could end up doing more harm than good to the existing hair in this region; you may face an increased risk of shock loss with more limited regrowth potential if you proceed with a transplant.

I would suggest that you defer surgery for at least a year to see what the Propecia can do for you, and preferably wait until you can be sure your frontal area will not require any grafts. In the meantime, there are a lot of great products out there that can help conceal the thinning in the crown (and you're actually quite lucky this is the only place you are experiencing loss)- look into the Nanogen product line.

25 going on 65
10-25-2010, 08:12 AM
Only losing hair in the crown is a blessing for certain! That area responds well to medication.
Follow CIT Girl's advice, and also consider adding Nizoral 2% shampoo to your regimen as well as minoxidil. A year from now you will probably be very happy with your results.

But do keep an eye on the rest of your hair, because if there's loss in the crown then you'll probably start to miniaturize in other areas too unless you stay on meds.

Dr. Glenn Charles
10-25-2010, 08:26 PM
I have to agree with the advise given by CIT girl. Hair transplants are not going anywhere. To have hair restoration surgery in the crown at your age before trying Propecia would not be a wise game plan.