I recently heard from a patient who heavily documented his balding with 18 microscopic photos at different parts of his scalp, but mostly in the mid-scalp. I have attached ome of these photos below. His questions related to the miniaturization he saw on the photos and wanted my opinion on his interpretation of the miniaturization. He counted each hair in each field and each follicular group and how many hairs each follicular group had.
Note that there are large hairs (we call these terminal hairs) and hairs with smaller hair shafts (we call these miniaturized hairs) and there are very small short fine hairs (we call these vellus hairs). Note in the photos that in the far left (middle) there are two follicular groups that have two hairs each, but one hair in each group is much smaller than the big fat ones next to them. These Follicular groups are in the process of losing one out of two of its hairs from genetic balding. Maybe these groups had three or four hairs at one time, but they might have reduced that number from 3 or 4 to 2, and now they are going down to one. This is how the balding process works, hair by hair.
I further told him: You are in some ‘state’ of the balding process. To find out where you are actually at, I perform a HAIRCHECK measurement on all of my patients and from this measurement I can tell to within 10% just how much hair you already lost by region. If you are not in California, find some doctor who has the HAIRCHECK instrument and can do the testing for you. Taking the drug finasteride is the single most valuable thing you can do provided you do not get the side effects; however, before making that decision I would get a HAIRCHECK test.