At our monthly open house event this past week, a 40 year old man came in and complained about his recent onset of hair loss. He saw significant amounts of hair in his shower drain, as well as whenever he brushes and combs his hair. The open house events are almost like an AA meeting, where men can come to see hair transplant results of other patients, watch a surgery, and meet with a doctor. The other prospective patients saw him and in a friendly manner teased him, asking why he was there. His head of hair was as full as anyone would have hoped to get from a surgery with us. All of the balding men at the open house were envious.
The key to being a good doctor is to first listen to your patient, so when his turn came in to see me, I first listened to his hair loss reality. What he reported about recent hair loss was real, but the eye could not detect it, so we ran bulk measurements in 4 different parts of his scalp to see if he was actually losing hair. His hair loss was evident on the examination, which showed that he lost about 50% of his hair in the front, top and crown of the head when compared against his donor area. Contrary to what my eye showed me, his examination was absolutely confirmatory that he was in active hair loss. I placed him on finasteride with the expectations that the hair loss might stop.
I always say that a man can lose up to 50% of his hair before it becomes detectable. He has wonderful hair, medium thickness, heavy wave, black with just enough gray in it to bring great value to produce great cover. If his hair were fine, then he would probably be thin with 50% bulk loss.