en
TR 
SK 
ITA 
FR 
DE 
ES 
BG 
RO Retrograde alopecia thins the donor area from below. Pattern loss is usually described as advancing from the front and crown downward. Retrograde alopecia moves the other way: the lower edge of the occipital region and the hair above and behind the ears become progressively finer, narrowing the safe zone from underneath.
It is missed because nobody is looking there. Attention in a consultation goes to the hairline and the crown, and the nape is dismissed as short hair or a haircut line. The change is gradual, hidden by whatever grows above it, and often only obvious once the head has been clipped for surgery — by which point the donor plan has already been made.
| Region | Retrograde pattern |
|---|---|
| Nape, lower occiput | Thins upward; the first area affected |
| Above and behind the ears | Fine hair; the safe boundary contracts |
| Central occiput | Usually preserved longest |
It changes the arithmetic of a lifetime plan. The safe donor area is already assumed to contract as pattern loss advances; retrograde alopecia contracts it faster and from the opposite direction. Grafts taken near that lower edge can end up standing in thinned scalp, and the donor left for later is smaller than the original estimate.
Checking it costs one look under magnification at the nape and around the ears, before any graft number is quoted.
Related terms
For how the donor region is measured and protected, see the donor area guide. For how the overall pattern is staged, see the Norwood scale.
