What can I do for a receding hairline?
What can I do for a receding hairline? My hair line has been receding since I was in my 20s and I think it will get worse because my Dad has the same thing. It looks kind of like a wave. It’s receded on one side, comes back down in the middle and then recedes again on the other side. What can I do?
American Board of Facial Plastic and Reconstructive Surgery, American Board of Plastic Surgery
Dear Dan,
Thank you for your clinical post and
this is a very common question. Receding
hairlines are usually due to an androgenic male pattern alopecia or genetic
hair loss. Whereas females lose and thin
hair within the central oval of the top of the scalp and never go bald, lose
hair from the crown of mid scalp and significantly thin and even end up
completely bald. This is a genetic
condition that arises from an ineffective enzyme in the follicle cells of the
hair at the top of the scalp. This
enzyme called 5-alpha reductase cannot break testosterone down into useable
components and leads to a buildup of 2 3 dihydrotestosterone by fairly lethal
chemical element that over time terminates the follicles ability to produce a
hair shaft.
There are some medical non-surgical
treatments including the use of androgen blockers such as Finasteride and
Propecia. These block the production of
androgen at the level of the male testis which reduces the amount of
circulating testosterone and hence diminishes the buildup of 2 3
dihydrotestosterone and the local toxic effects on the scalp. Propecia and Finasteride are the only known mechanisms
to significantly delay or even eliminate male pattern hair loss. There are some risks associated with taking
androgen blockade and you should meet with your dermatologist or
endocrinologist to discuss these issues.
Other non-surgical methods such as Minoxidil which causes scalp
vasodilatation, injections of stem cells like PRP or plasma rich protein,
topical nutrient serums, nutrient shampoos and low-level light therapy can
augment the growth of hair, but not significantly delay the genetically
preprogrammed onset of male pattern hair loss.
To restore normal hairline or areas
of significant thinning hair transplantation is still the mainstay of
treatment. Hair transplantation can be
divided into strip graft harvest techniques or follicular unit extraction. Follicular unit extraction or FUE uses small
micro rotatory punches either automated or robotic to harvest the hair families
as they grow leaving a small circular defect that heals imperceptibly. Strip graft has been around longer, but
leaves a donor site scar. Centres
specialized in FUE can provide extremely natural hair restoration without a
donor site scar, but takes far more expertise, the investment and expensive
technology and very few centres in Canada are willing to invest in that.
At SpaMedica we have pioneered the
use of automated and robotic FUE and are Canada’s busiest and most reputable
FUE hair transplant centre. I would
recommend you meet with an FUE centre and a strip graft centre and assess your
options, but be reassured that natural hairlines and significant density can be
achieved with modern hair transplantation techniques.
Best of luck.
To find out more, please visit: https://www.spamedica.com/hair/hair-loss-and-baldness-treatments-in-toronto/fue-hair-transplantation/
R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto
American Board of Dermatology, Fellow of the Royal College of Physicians of Canada (FRCPC)
Hi DanReceding hairlines in men are often a sign of genetic hair loss, but part of these changes can also come from a phenomenon called hairline maturation. So, it’s important for young men to be aware of both of these changes. You’re right that there is a familial contribution – the inheritance comes from mom’s’ side and dad’s side. Treatments include minoxidil and finasteride, both of which are FDA approved. Treatments including low level laser and PRP can be considered. After 25, consideration can be given to whether a hair transplant could benefit. Hope this helps,DrDonovan