Miniaturization and Hair Loss

Miniaturization and Hair Loss

February 27th, 2008

Miniaturization of hair or thinning of hair shafts is a part of the hair loss process. When hair becomes miniaturized, it gets finer over time before falling out. Microscopic evaluation of the scalp and hair can help determine the rate of miniaturization on human hair. Balding in men and women usually is not obvious until significant miniaturization is present.

Mapping of scalp hair miniaturization in a typical
man with hair patterned alopecia (baldness)

The appearance of baldness will not be visible at least 70% of hair is miniaturized. A miniaturization study is part of the hair loss evaluation of a patient and could be used as predictor of future balding in a given area. Significant hair miniaturization is seen in patients who are in the active phase of hair loss and this evaluation could determine a patients’ response to a certain type of medical treatment.

Microscopic evaluation of scalp:
Patient has significant miniaturization
That can predict future hair loss

At US Hair Restoration, mapping of the patient’s scalp hair is done for all patients in order to evaluate patient’s hair before initiating any medical treatment or surgery. Young patients with significant miniaturization are prone to losing their vulnerable hair after a hair transplant surgery due to the stress of surgery on skin and hair follicles. This phenomenon is called shock loss and occurs less in patients with minimal amounts of hair miniaturization.

Hair transplant surgeon of US Hair Restoration continuously follows the progress of patients through miniaturization studies when they are on a treatment plan to gauge hair gain or loss. This way we can objectively evaluate the effectiveness of our treatment. If you are balding and are willing to do something about it either by hair transplant surgery or medical treatment, you should have your hair mapped for miniaturization to have a baseline assessment of current hair loss status. This way we can assess the effectiveness of medications and predict in which areas you will have the most hair loss. This can help your hair transplant surgeon cover areas or future hair loss so that you are not obliged to take on multiple surgeries to chase the balding hair.

Patient’s scalp is evaluated by digital microscope:
Miniaturization study is needed before starting medical treatment

If patient has 10 to 20% miniaturized hair, it could be normal and not part of the balding process. Scalp hair goes through two main phases: Growth phage (Anagen) and resting phase (Telogen). The Growth phase in scalp hair of normal people can take between 1 to 6 years, where the resting phase is about 4 to 6 weeks. When we lose one hair to the telogen phase, another hair will grow from its follicle which will be represented by a few tiny hairs showing hair cycling, in the area and not necessarily the balding process.
Presence of over 20 percent hair miniaturization in a general area could be quite normal. It is common indication of active hair loss in the area. Higher numbers of miniaturization could represent active hair loss and progress of balding in the future. If you are a balding man with significant miniaturization, you should take finasteride after mapping your scalp. The effect of medical treatment of baldness is very gradual and may take at least six months for any detectable improvement in miniaturization of hair.
Article from Hair Loss Q&A web log.