EXPERT GUIDE

Crown Hair Transplant

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Medically reviewed by Dr. Sternberg Written by David Stelzer on 2 Feb 2021

Hair loss is a gradual process that will last for many years and is often times only noticed long after it has begun. The most notable sign amongst men is hair loss in the crown area of the head. But how can baldness in the crown of the head be treated? Which treatment options are effective and which ones do not work?

What is the crown area?

The crown, also known as the “vertex”, is the very top of your skull located towards the back of the head. When you speak of balding in the crown area there is often a relatively extensive amount of hair loss on the upper part of the head. This is commonly referred to as the ‘monk’s bald head’ or tonsure in the field of hair transplantation and is an advanced stage of male pattern baldness.

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Hair thinning in the crown

In most cases, hair loss on the crown is the result of androgenic alopecia.

Androgenic alopecia can lead to different forms and patterns of hair loss. Beginning with a receding hairline, hair loss can either spread over the top of the head or develop in individual ‘islands’. In extreme cases the final result of progressive hair loss is a tonsure or ‘monk’s bald head’. However, there are other causes for a tonsure, which should be investigated in order to effectively combat hair loss with the appropriate treatment.

According to the Hamilton-Norwood Scale which classifies the hair loss degree of men hair loss in the crown area occurs from the 3rd type upwards:

Typical male pattern hair loss: The norwood scale.

After our recent hair transplant study most of the patients who are interested in a hair restoration have a norwood-scale type of 4. Men with a high testosterone level are more prone to suffering from hair loss beginning at a young age. The younger a man is when they begin having hair loss issues, the more likely it is they will develop a tonsure. Men are not the only ones who suffer from this condition, women will often begin seeing hair loss in the part of their hair, which can then progress into a tonsure in extreme cases.

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You should either let a specialist advise you in order to find the most effective treatment for your hair loss or you can simply do our online hair loss analysis (takes about 1 minute). You will then receive your personal result with the best treatment options for your hair loss. Make hair loss analysis now

Treating crown hair loss

Cosmetic products, like shampoos or oils, are unfortunately ineffective treatments for hereditary hair loss. Hair transplantation is considered the only effective treatment option in this case.

In the initial stage, a change in diet or PRP therapy can be used to slow down the tonsure. There has unfortunately been no treatment developed that has proven to be effective at permanently stopping the progression of a tonsure. Even medications do not offer a permanent solution.

The use of medications can lead to serious side effects and an impairment to the quality of life. In addition, when the patient discontinues the use of the medicine the balding will resume and any hair growth will be lost.

Most common prescribed hair loss treatments

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Drugs to treat hair loss in the crown

Initially, hair loss at the back of the head can be effectively treated with medication, delaying the need to undergo hair transplantation.

If the hair loss is initially limited to the tonsure, a medicinal approach using DHT-inhibiting shampoos, finasteride or minoxidil can be recommended after an analysis by a specialist.

The drugs finasteride and minoxidil have proven to be particularly effective for the treatment of balding in the back of the head, and in the majority of patients they lead to a noticeable improvement in the hair quickly. In addition, medications can also help to slow down or even stop hair loss completely. Unfortunately, with this type of disease it is not possible to predict with any certainty when the affected person can expect to see visible, bald areas.

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Hair transplantation for the crown

Hair transplantation is one of the most effective treatment methods, this is because a change in diet or PRP therapy can only slow down the hair loss during the initial stages. But these methods cannot regrow hair. However, with a hair transplant hair follicles can be placed into the bald spots.

Androgenetic hair loss with tonsure formation cannot be stopped completely in most cases and therefore it is not possible to avoid baldness. Medications can lead to serious side effects and therefore do not serve as a permanent solution. In addition, with hair restorers any hair growth progress will stop when the medication is discontinued, which can lead to an impairment in the quality of life.

Most common hair transplant method

The most commonly used methods for modern hair transplantation are the FUE and FUT methods. In order to achieve an optimal result with a hair transplant, it is important that the donor hair is distributed evenly with proper placement. It is important to consider the hair composition and direction of hair growth of the existing hair and it must be reconstructed aesthetically. This is especially complicated due to the natural swirl on the crown of the head, it requires a great deal of effort to recreate this with a transplantation.

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Hair pigmentation in the crown

Another treatment option is hair pigmentation, SMP (scalp micropigmentation) is one of the most successful therapies for hair loss.

It is possible to create a visual impression of scalp hair with this method and, in addition to a hair transplantation, to create the illusion of density. No additional donor hairs are needed.

The SMP method of micropigmentation is offered in every country nowadays, it is one of the most effective methods to disguise hair loss. A density of 30 grafts/sq cm can be constructed so the impression of very full hair can be created.

Before and After hair transplant

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Hair transplantation costs for the crown area

If the hair loss affects a larger area, as in the case of a tonsure, a large number of grafts must also be transplanted. As a result, the cost of hair transplantation to cover a tonsure is quite high.

The final costs also depend on the location of the procedure and the reputation of the doctor performing the procedure. With a pronounced tonsure, it costs an average of 6,073.50 USD in UK, while the hair transplant procedure in Turkey is only about 3,644.10 USD. One of the reasons for this is the labor costs in Turkey are much lower than in the UK. Our current hair transplant cost study on medihair highlights the differences in total cost between countries and the individual costs per graft.

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Chances of success for a hair transplantation in the crown area

Hair transplantation is one of the most promising methods to treat a monk’s bald head. It does not matter whether one suffers from a tonsure accompanied by a receding hairline or not, there will be no new hair growth in the balding area without medical interference.

With the help of a transplantation, hair will begin to grow again on the affected area and will continue to grow permanently. Hair growth can take several months after a transplantation before it begins to show and therefore requires a little patience.

Emotional impact of a hair transplant on a patient

To accelerate the healing process, hair implantation can be combined with PRP therapy. Furthermore, the after-care of the treated area influences the result of the therapy.

With a 95% certainty of permanent results, there is no other treatment method, which is so effective in disguising a tonsure. After healing, the hair will grow naturally once again. However, even the treatment of a tonsure through a hair transplantation has its limits. In the case of a tonsure, it cannot be assumed that the affected area is the only area where balding will occur.

In most cases, the progressive hair loss affects the hairline in particular. This is one reason why most patients are advised to lower their expectations for full, densely packed hair at the tonsure. It is more “cosmetically important” to regrow hair near the front of the head, as the bald spot on the crown is less noticeable.

It is very important to reconstruct the hair whorl of each individual, which is located at the crown of the head. The thinner hair and whorl pattern at the crown makes it extremely complicated for a doctor to recreate.

Frequently Asked Questions

Do hair transplants work on the crown?

How many grafts does it take to fill the crown?

Does the Crown take longer to grow after a hair transplant?

Sources

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