How to Approach Male Pattern Hair Loss
- Written by Hair Transplant Surgeon Ali Emre Karadeniz
We don't instantly start losing hair, the initial stage is what we call the miniaturization phase and in this phase the hair becomes thinner. The hair is not immediately lost, the thickness of the hair is lost and thus the coverage is reduced.
First of all, we have to understand the physiology of hair loss and how it occurs. We don't instantly start losing hair, the initial stage is what we call the miniaturization phase and in this phase the hair becomes thinner. The hair is not immediately lost, the thickness of the hair is lost and thus the coverage is reduced.
If we make a scale of density between 0 and 100, we generally don't realize until our hair loss reaches 50% and that's a significant amount. In that region where hair loss is between 100% and 50% most of that hair loss is attributed to thinning, that's miniaturization. If you go under the microscope and count the number of hairs you have per area you'll find a similar number to the original density only that the thickness of the hair is significantly reduced. After that, these hairs permanently die. When we reach below 50% we also see a significant reduction in the number of hairs.
The second thing is we have to diagnose the pattern of hair loss. This hair loss can be a localized type of hair loss as in for instance receding of the hair line where we see the hairline receding like a shore or a bald patch being created at our crown or both of those happening at the same time. The other type of hair loss is the diffuse pattern, in the diffuse pattern there is some type of thinning going all across front to back. Whichever type hair loss you have predominantly determines also how we approach the treatment.
Also we have to understand whether this is a mild hair loss or an advanced hair loss. To generalize, mild hair loss is the hair loss whether you can treat with only medicine or even if surgery is necessary the prediction is that the donor capacity would be sufficient to give a decent amount of coverage if not a full head of hair throughout one's life. Or it can be advanced hair loss, advanced air loss means the donor capacity will not be able to give one a full head of hair even if it seems that the donor hairs can fix the problem today. If we predict advanced hair loss in the long run even if we think we can fix the problem on that day we know that the donor resources will be insufficient in the long run.
The treatment options can be medical treatment which means using medicine or it can be surgical. However, there's one thing we need to understand is that hair transplantation does not prevent hair loss. In reality surgery is not the treatment for hair loss it's the replacement for lost hairs but it's not the treatment for hair loss. The treatment of hair loss is medical so you can only reduce your hair loss, slow down your hair loss, and stabilize it by using medicine (Read more: Is It Required To Use Minoxidil Or Finasteride After Hair Transplant?). After that, there is the planning and design, this includes a long-term plan considering the progression of hair loss and the design includes all of the considerations that I mentioned previously like the patient's age, hair loss pattern, hair quality etc.
The goal is to stabilize hair loss to improve coverage while retaining a natural appearance causing the least amount of tissue damage and scarring and using the donor resources economically. In this post, I try to give you a general overview on how we approach male pattern hair loss.
Written By Dr. Ali Emre Karadeniz, MD, PhD
Ali Emre Karadeniz, MD (Dr. K) is the only American Board of Hair Restoration Surgery Certified Turkish plastic surgeon. He has performed over 2000 hair operations. He is an active member of the International Society of Hair Restoration Surgery (ISHRS).