Does it work better in certain areas, like receding hairlines or the crown?

The question of whether hair loss treatments work better in certain areas of the scalp—such as the frontal hairline or the crown—has been the subject of numerous studies, clinical trials, and personal testimonials. Not all regions of the scalp respond the same way, and this is due to anatomical, genetic, and hormonal differences. While many products are marketed as universal solutions, scientific data reveal that where a treatment is applied can significantly influence its effectiveness. Understanding these differences is crucial for setting realistic expectations. Many users begin treatment hoping for uniform results across the entire scalp, but the scientific evidence suggests that some areas have a greater capacity for regrowth than others. Recognizing this distinction not only improves treatment adherence but also helps prevent unnecessary frustration and allows for more personalized therapeutic strategies.

The Crown: A More Responsive Territory

Clinical studies have consistently shown that the crown—the top and central part of the head—tends to respond better to treatments like minoxidil and finasteride. This area is known for being commonly affected by androgenetic alopecia, also called male pattern baldness, and paradoxically, it's also one of the most responsive to hair regrowth therapies. A key study in this area was conducted by Olsen et al. in 2002, published in the Journal of the American Academy of Dermatology. In this randomized, double-blind, placebo-controlled trial, 393 men with moderate to severe androgenetic alopecia participated. The study lasted 48 weeks, and participants applied 5% topical minoxidil twice daily. Results were measured through hair counts in a 1.0 cm² target area on the crown, as well as standardized photographic assessments.

The findings showed a significant increase in hair count at the crown—an average of 18.6 new hairs per cm² in the treatment group compared to a decrease of -2.2 in the placebo group. While improvements in other regions were not ruled out, the crown was clearly the area where visible and measurable regrowth was most pronounced. A limitation of this study is that it did not provide a detailed comparison with the frontal hairline, so its findings should not be broadly applied to all areas of the scalp without caution.

The Frontal Hairline: A Persistent Challenge

In contrast, the frontal hairline—commonly referred to as the “receding hairline”—poses a greater challenge for science and treatment. This area, located just above the forehead, is often one of the first to show signs of hair loss in androgenetic alopecia, and also one of the least responsive to conventional therapies. A 2015 study published in the Journal of Dermatological Treatment by Blume-Peytavi et al. evaluated the efficacy of 5% minoxidil foam in women, but its findings are relevant for understanding response in the frontal region. The study included 252 female participants diagnosed with female pattern hair loss and lasted 24 weeks. Methods of evaluation included hair counts and clinical photographs. While there were general improvements, hair density in the frontal region remained significantly lower compared to the crown and parietal areas.

The reduced responsiveness of this area is linked to the density of dihydrotestosterone (DHT) receptors in frontal follicles. DHT is a hormone derived from testosterone and is considered one of the main agents responsible for follicular miniaturization. Follicles in the frontal area tend to be more sensitive to this hormone, which complicates their regeneration even in the presence of treatments that are effective in other areas.

All Hope Is Not Lost: Individual Response and Emerging Therapies

Despite the consistent trend of better results in the crown, individual variation does exist. Some people report significant improvements in the frontal region, particularly when using a combination of therapies. According to the specialist site Perfect Hair Health, combining treatments such as minoxidil, microneedling, and nutritional support can enhance response in the frontal area. This is supported by a 2013 study conducted in India and published in the International Journal of Trichology, which found that combining microneedling with minoxidil led to a 400% improvement in hair growth compared to minoxidil alone. The study involved 100 male patients with androgenetic alopecia and was conducted over 12 weeks. It used clinical photographs, hair counts, and subjective assessments from participants. Although promising, the study's relatively short duration and lack of long-term follow-up limit the strength of its conclusions about sustained efficacy.

So, Does It Work Better on the Crown Than the Hairline?

Based on current evidence, the most accurate answer is yes: most available treatments show better results on the crown. This includes medications approved by institutions like the FDA—such as minoxidil and finasteride—as well as complementary therapies that have shown potential in clinical studies. The frontal hairline, meanwhile, remains a more difficult area to treat, with results more dependent on therapy combinations, treatment consistency, and individual biological response.

References

Referencias verificadas (formato APA 7):

Olsen, E. A., Dunlap, F. E., Funicella, T., Koperski, J. A., Swinehart, J. M., Tschen, E. H., & Trancik, R. J. (2002). A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. Journal of the American Academy of Dermatology, 47(3), 377–385. https://journals.lww.com/ijot/fulltext/2013/05010/a_randomized_evaluator_blinded_study_of_effect_of.3.aspx

Blume-Peytavi, U., Hillmann, K., Dietz, E., Canfield, D., Garcia Bartels, N., & Hoffmann, R. (2015). A randomized, placebo-controlled, double-blind trial of the efficacy and safety of 5% minoxidil foam in women with female pattern hair loss. Journal of Dermatological Treatment, 26(2), 156–161. https://doi.org/10.3109/09546634.2014.921886

Dhurat, R., Sukesh, M., Avhad, G., Dandale, A., Pal, A., & Pund, P. (2013). A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: A pilot study. International Journal of Trichology, 5(1), 6–11. https://www.jaad.org/article/S0190-9622(02)00124-X/abstract