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Why Is There Less Hair Loss on the Sides and Back of the Head?

Why does that horseshoe of hair tend to stay in place while the hairline recedes? Learn more about DHT-resistant hair and why hair falls out the way it does.

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When it comes to male pattern balding, there is a clear pattern. The hair on the crown and front of the head tends to be the first to thin out and start shedding, while the back and side of the head may stay thick for much longer. This type of hair loss can end up with the tell-tale “horseshoe” ring of hair with little to no growth in the center. Of course, for some men all of the hair can eventually be lost, even the holdout “ring”, but the progression of loss nearly always saves the back and sides of the head for last.

So, just what is it about the hairs in this section of the scalp that causes them to hold out for so much longer? It turns out that it all comes back to DHT -- again. DHT is the known culprit in male pattern hair loss, and can cause miniaturization and the eventual loss of hair follicles that are sensitive to it. But, not all sections of hair are equally sensitive to the miniaturizing effects of DHT. The hair on the top, crown, and front of your head tends to be the most sensitive to DHT in men(especially if you are genetically prone to hair loss), while the back and sides of your hair are sometimes referred to as “DHT resistant” hairs. DHT is still around at all portions of your scalp, but the DHT-resistant hairs don’t seem to be as affected by it.

This strange portioned-out DHT resistance plays a huge role in how hair transplants are able to work, as it uses that ring of hair to your advantage. During hair transplantation, the thick, unwavering hairs from the back and sides of the head are referred to as “donor sites” and they function as the reserves of hair which will be moved from their current location up to the balding areas on the front and crown. The interesting thing here is that even though they are being moved up to the areas prone to DHT-related hair loss, these transplanted follicles maintain their DHT-resistance and will continue to grow without shrinking as though they were still located on the sides or back of the head. Hair transplant specialists refer to this beneficial phenomenon as donor-dominance of the transplanted hairs.

Hair transplants using DHT-resistant hair can be a good option if your hair has already progressed to only having hair on the back and sides of your head. However, the sooner you look into treating hair loss, the better off you will be. Hair loss is a slow and progressive process, and if caught early it may be able to be helped by oral or topical medications like Minoxidil, Finasteride, and off-label Dutasteride. You can have a free online hair loss consultation with Strut Health to see if oral or topical hair loss options are a good fit for your hair loss. If you are a good candidate for treatment, your medication can be shipped to your home with our free shipping. If you need adjustments or have questions throughout your treatment, Strut Health’s staff and doctors are available for free unlimited follow-ups.

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