Most patients arrive here long before they're ready to think about surgery. They've noticed thinning at the temples, more hair in the drain, or a hairline that doesn't look the way they remember. The first job is figuring out what's happening — and whether it's normal.
You see something change. You ask: is this normal shedding, or pattern hair loss starting? The answer depends on pattern, family history, age, and rate of change. This stage helps you tell the difference.
You shed 50–100 hairs a day on average. That’s normal — every follicle cycles through growth, rest, and shedding phases naturally. Seeing a few hairs on your pillow or in the brush isn’t hair loss; it’s the system working as designed.
Pattern hair loss is different. It’s a slow, progressive miniaturisation of follicles in genetically susceptible areas — temples and crown in men, the part line and front in women. The hair gets thinner each cycle, then shorter, then eventually doesn’t grow back. By the time you notice, it’s usually been progressing for several years.
Receding temples (men): the most common early sign. The “M” shape begins to define itself; you notice your part is creeping back. Norwood II–III.
Crown thinning (men): sometimes the first thing other people notice before you do — usually because the crown is hard to see in the mirror. Norwood IV+.
Diffuse thinning at the part line (women): the part widens slowly over time; the scalp shows through more than it used to. Ludwig I–II.
Postpartum or post-illness shedding: sudden diffuse shed two to three months after a major stressor. Almost always temporary — see telogen effluvium for detail.
1. Take photos. Front, top-down, both profiles, back of head. Date them. Take new ones every 6 months. Photos under consistent lighting (natural daylight, no hat, hair dry) are the only way to track real progression.
2. Ask family. Family history is the strongest predictor. If your father, mother, uncles, or grandfathers had pattern loss, the odds are higher you will. Knowing the family pattern also tells you roughly where you’re likely to end up.
3. Read about the biology. Pattern hair loss is driven by DHT, a hormone derivative that miniaturises susceptible follicles. Understanding this explains why finasteride works, why the donor area is permanent, and why early intervention preserves more.
4. Don’t panic. Stage One is not the time to plan surgery. Most patients at this stage are better served by medical therapy and watchful waiting — surgery comes later, when pattern is established and stable.
The patient journey reads in six stages. The fastest way through it is to send photos — Dr. Jones reviews personally and you skip directly to the consultation.