Permanent Vs Temporary Hair Roots

On our scalp we have two types of hair roots; permanent, the androgen resistant roots and temporary, the androgen sensitive roots. Usually the permanent hair/roots remain on the back side and the sides of the head, up to 2-3 inches above the ear lobule. Rest of the hair roots on the scalp, i.e. on front, top (vertex) are temporary. In some males, the roots just below and back side of the top of head and nape of neck, i.e. posterior hair line are temporary also. Only expert and highly intelligent surgeons can distinguish between the permanent and temporary roots. When we call it temporary, it does not mean that these hairs will definitely fall. Who will become bald at which point of time is difficult to predict. But whoever is a male, is a potential for baldness, because of the male hormone – Testosterone running in his blood. Many people think that, the baldness is due to some hormonal imbalance, which is not true. The male hormone testosterone is responsible for giving us the male qualities. And this same testosterone is responsible for the male pattern baldness. Why this happens in case of human males and not seen in other male animals is not known.

In male pattern baldness (MPB) also called Androgenetic Alopecia (AGA), the temporary hair gradually becomes thin and the area eventually becomes completely bald. The age of onset varies between 18-35 years of age. Once the baldness started the speed also varies from person to person. The age of onset, speed and severity are variable. If the baldness is running in family then the chances of getting bald is more, but it is impossible to predict accurately the course of familial baldness also.

In surgical hair transplantation, the aim is to transplant permanent (hormone resistant) hair roots from the back side of scalp to the bald scalp. Sometimes permanent roots are extracted from the beard and chest also. As we know, beard roots are thick and stay permanently. Chest roots are unpredictable in their growth rate.

While performing hair transplantation, the surgeon should be very careful not to transplant the temporary roots. Mostly it happens when with over enthusiasm for any reason the surgeon harvests hair from the UNSAFE donor area, too much towards the vertex or too much towards the nape area. If these temporary roots are planted on bald area, they will grow definitely. But when the natural process of baldness will progress, there will be loss of temporary roots from the back side of head. At the same time there will be also loss of these temporary roots on the front, where they are planted. 

On an average, in FUE and DHT technique a maximum of 2000-2500 roots can be extracted and planted in a single session of 6-8 hrs. Very rarely roots beyond this number can be harvested without going into the temporary UNSAFE area.