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Hi Doctor Rassman. I had a hair transplant a few years back by a very respectable doctor, and while I’m generally quite pleased with the results, my hairline is a bit asymmetrical. How normal is it for a natural hairline to be higher on one side?

Thanks!

In nature, the hairlines of non-balding males are usually symmetrical, but occasionally they are not. I do not have statistics on this. In the balding hairline that is receding, it is common for one side to recede higher and faster than the other side.

I have, even under the best of conditions, noticed the hairline slightly off balance after the transplant. I routinely draw the hairline and then have the patient (and if he’d like, his family and my surgical staff) provide input and between all of us, we usually hit it correctly. Just this week, I saw a patient who had the hairline higher by 1/8th inch on one side. Here’s his photos — click to enlarge:

Before (left) / After (right):

The after photo is 8 months since I did a single surgery of 2328 grafts. Upon seeing the slight unevenness, I offered to fix it the following day at no charge. He was visiting California from across the country and I wanted to address it before he went home. It took 249 grafts on the one side to balance it out. I won’t have photos of the final hairline for a while since the procedure was just done, but here is the area I’m talking about:

Hey so I’ve always noticed that the right side of my hairline goes up a little farther than my left side. I’ve also noticed that the temple “triangle” has been shaped differently. As long as I can remember (and looking back at photos from when I was in HS), my hairline has never been straight. My maternal grandfather had a full thick head of hair, but my grandmother’s father was bald (on my moms side).

Is it possible that I have just a funny hairline and that I’m not going bald? All around my head the hair seems to have a uniform thickness and I really only see some hair in my towel after I shower. How can I tell if my hairline is pushing back?

You’d have to take measurements and compare them over time to see if the hairline is receding, but having an asymmetrical hairline isn’t unusual and doesn’t necessarily mean you’re losing your hair.

As for seeing hair on the towel — that can be normal. We lose 100-150 hairs a day normally as new hairs grow in. With styling product in your hair, sometimes those hairs can get trapped on the scalp and a hot shower will break up the gel or whatever you might use and release those hairs… and the towel or the drain is usually where you’ll find them.

Photo source: Flickr

I am slightly curious as to why many rockstar’s have such great hair and i can never tell if their hairlins is juvenile. I dont suppose you can tell me what class is Ian Watkins from lostprophets (Rock band) hairline appears to be?

To me it looks low at the middle but thinning on the sides? This man has always had a great head of hair and i dont think he is balding..just on this picture particularly it made me wonder though.
Photo: Ian Watkins

Thank you very much for your time Doc.

I looked at the photo of Ian Watkins, but it’s difficult to tell from one angle like that. I then used Google to try to find more photos, but all of the ones I see have his hair longer and covering the hairline. So truth be told, from the photo you sent it looks like a typical mature hairline, but I really don’t know for sure. I doubt he’s got any balding beyond that. He’s got good hair.

As for why rockstars have great hair, well, it is part of the image. There are always going to be musicians that have hair loss, but many of them will shave their heads bald, wear hats, take unique approaches to styling, or go the surgical route to restore their hair. I’ve performed transplants on musicians that want to keep the look their fans are accustomed to. Many record labels are more willing to sign a band if they have the image that goes with the marketable sound.

A guy like Art Garfunkel (of Simon and Garfunkel) probably would have a tough time getting signed on his own in today’s music business, but a rocker like American Idol runner-up Chris Daughtry can shave his head and be just fine. I’d imagine if Daughtry grew his hair out and showed off his thinning hair, it could make him appear older than he is and thus would not be easy to market in the way the record label wants to. Some other musicians have long hair that falls forward, covering the corners of their hairline and giving the illusion of a young, juvenile hairline. Then there are artists like Moby, who shaves his head but leaves just enough growth to see that there isn’t much hair there at all. Different looks work for different types of artists. It’s all about the marketing.

Update: Actually, TMZ says that Daughtry is growing his hair out now, but we’ll see what his scalp looks like when its time for an official photo shoot or when he’s making a music video.

Snippet from the article:

Sure, two of the most badass actors of recent American cinema — Bruce Willis and Samuel L. Jackson — opted to shave their heads before they went bald naturally.

But there are still plenty of successful men out there who resist the pressure to mask their hair loss, and the best among them are proudly rocking power alleys.

What the heck are power alleys, you ask? Just check out Jackson and Willis’s matching hairlines in “Die Hard With a Vengeance”. In 1995, they could have been the power-alley poster boys.

Read the full article: Power Alleys — How Powerful Men Go Bald

There’s nothing groundbreaking mentioned in the article, but it does provide a short list of celebrities with hairline issues. The term “power alleys” is a fun way to describe hair loss in the corners of the hairline, otherwise known as a Norwood Class 3 pattern. Plus, my colleague Dr. Robert Bernstein is quoted briefly in it.

Actors Jude Law (pictured at right) and Danny Glover are counted as those with “power alleys”, along with sports figures and politicians. See the list and photos at Asylum.com.

I inherited a strange hairline characteristic from my Maternal father, one side is and always has been far higher than the other, however it skipped his son. Does this mean I will have the same pattern of hair loss as my grandfather? I ask because everyone in the family except for his son (my uncle) has a pretty good head of hair. Should one even consider uncles and great uncles when looking at their family tree in terms of hair loss or is that too far off?

These may be independent variables and could genetically express themselves differently in the sequential generations. I do not believe hairlines and hair loss are linked genetically, so you can have one without the other (the variable is hair loss).

Hello Dr Rassman, just a quick one here. Does Taylor Lautner look to be displaying the signs of early MPB, or is he simply sporting a mature hairline? What Norwood class do you think he would he be?

I’ll include a few photos from different angles to illustrate my point (and a half year increment)-

June 2009: photo

January 2010: photo 1, photo 2, photo 3

I had to look up who this young man is (he’s in one of the Twilight movies), but it looks like he’s got a normal juvenile hairline, so a classification for hair loss does not apply. His rounded corners, which is typical of an immature hairline, has been lost in his recent photos but otherwise, I suspect he had the exact same hairline at 12 years old. There’s no early balding from the photos I’ve seen. He’s young though, so who knows where his hair will go.

Hey Doc,

My juvenile hair line was asymmetrical. The right side of my hair line was higher than my left.Now im starting to develeop a mature hairline. Do you think my mature hairline will be asymmetrical? Have you ever seen a asymmetrical mature hairline?

thank you for you great site.

Only time will tell. It is possible that when and if the juvenile hairline is lost, that you will balance out what you see.

Hello Dr. Rassman! I’ve found your blog to be extremely helpful and I’d like to ask you a question:

I’m 19 years old, and I’ve noticed thinning at the corners of the hairline, with thinner, shorter hairs, extending (as far as I can tell with close inspection - no microscope available yet unfortunately) about 1.3″ above the highest crease of the wrinkles at the corners, and it doesn’t seem to go any further than that (the hair also feels thinner at the corners) and the middle of the hairline has settled two thirds of an inch above the highest crease without thinning behind it.

I’ve come to understand from various blog posts that there are more smaller (or vellus) hairs at the hairline than at any other spot on the head, which leads me to my question: If developing a maturing hairline means the hairline moves back an inch or so, does the mature hairline position have the vellus hair common in hairlines before/during the maturation, or do some of the hairs in the mature hairline become vellus hairs during the maturation process?

I hope you find the time to answer this question, with kind regards from Israel.

Vellus hairs are short, fine, light colored, often barely noticed hairs, which develop on most of the human body… and on the scalp they are part of the follicular unit. Some people might call it peach fuzz, and these hairs are not only on your frontal or maturing hairline, but they’re also found almost everywhere on your body — except lips, backs of ears, palms of hands, soles of feet, certain external genital areas, navel, and scar tissue.

The leading edge of any hairline has hairs that are often thinner than the hairs further back. That is why a doctor must create a transition zone when he/she transplants the frontal hairline, or the transplanted hairline will look like unnatural. Obviously, nobody with a hair transplant wants the world to be able to tell their hairline was created by surgery. As you are only 19 years old, determining your future hair loss prospects may be a bit difficult just by trying to judge the frontal hairline and seeing fine vellus hairs. You probably need a miniaturization study, a physical exam, and a good family history to start any sort of guess work.

Excellent blog - dispelling the myths and hysteria around the web. For that, I thank you.

I have a question about the classification of hair loss - i.e. the Norwood Scale. I have a high forehead and temples, I have always had a high forehead even as a child and my temples developed into an adult hair line in my late teens. Looking at the NHI site my hair line is similar to some of the Norwood class 3s. However, I know for a fact that it hasn’t changed in at least 10 years (i have photos) and I am pretty certain it is the same as when I was 20 (give or take a few hairs). I am now 33. The thickness has not obviously changed either. But according to Norwood I am losing my hair. Any thoughts?

Thank you in advance

If you have a hair hairline, it does not mean that you are balding. High hairlines are genetic in both males and females. If you wrinkle your brow, the highest crease is where your hairline was when you are 12 years old, but in the mature hairline, the mid-point rises about 1/2 inch in the mature hairline and that is not balding on the Norwood scale.

Assuming that you have balded to a Norwood class 3 and stayed there, it does not mean you are going to progress from a class 3 to 4 to 5 to 6. It is merely Dr. Norwood’s description of how men look.

Dear Doc,

I’m an 18 year old male and worried that my hairline’s begun to recede. I don’t have any particular family history of balding, both my grandfathers had most of their hair and so does my mother’s brother. Its only my father who is balding (he is 50 and has lost lots of his hair on the top of his head).

I’ve noticed that when I run my hands through my hair I occasionally lose one or two. Also when the hair is wet i tend to lose a few if I run my hand through my hair. I don’t see more than two or three on my pillow when I wake up.

I’ve always had a high hairline with temples higher than the rest of my hairline, but I think its starting to move back slowly.

I also have little red spots near the receding areas of my hairline, almost like acne (I have very little acne on the rest of my face). Looking at my pictures, would you say this is just a mature hairline or the start of the balding process. Also sorry for the long e-mail, but I’ve tried to list everything I can. I’d appreciate some advice on what I can do, as my hair is still very much part of my identity, and I don’t want to spend the next couple of years worrying and counting hairs.

Many thanks

While I thank you for permission to post these, usually I require a frontal view with the eyebrows lifted high so that the creases on the forehead show. You supplied two side views with the eyebrows lifted and a poor quality photo that requires me to guess. I’ll take a stab at it anyway. Click the photos to enlarge.

It does look like you are developing a mature hairline, but there is also a sign of some thinning that goes further back than just the leading edge, suggestive of miniaturization behind a maturing hairline.

You need to get your scalp mapped out for miniaturization and see if there is thinning behind the leading edge and how far back it goes. This is suggestive of early male pattern balding at a level where a drug like Propecia (finasteride) can stop it. See a doctor who cares about you and what may be early balding.