A Guide To Double Crowns: What Are They?

Quick Summary of Double Crowns

• Double Crowns: A double crown, is where someone has 2 distinct spirals in their crown. It is pattern of hair growth more present in those with Afro-textured hair.
• Causes: Double crowns are determined by genetic inheritance
• Managing Double Crowns: Double crowns can make it difficult to style hair especially as the hair spirals in different directions. Speaking with a specialist can help the best approach.
• Hair Loss Concerns: Double crowns do not cause or predispose someone to more hair loss, but they make thinning areas appear more noticeable especially at an early stage of hair loss

What is a Double Crown?

The crown of your head refers to the highest point at the top and back of your head. Most people will have a central area from which hair spirals out in a circular pattern (a single crown spiral). A double crown occurs when someone has 2 areas where their hair spirals from their crown. The hair can spiral clockwise or counterclockwise and this is determined by someone’s genetic inheritance.

Have a double crown is not common with the appearance more prevalent patients with afro-textured hair. Most spirals will grow in a clockwise pattern (75%) compared to a counter-clockwise pattern.

What Causes Double Crowns?

A double crown is determined entirely by genetics, with the pattern visible in newborns or babies when they start growing their hair. So, if someone in your family has a double crown, you might be more likely to have one as well³.

A double crown isn’t caused by hair loss but by genetic inheritance. My patients who have one can have difficulty styling their hair which we are able to advise on

Dr Fernando, Co-founder and hair transplant surgeon at the treatment rooms london

Managing a Double Crown

Having a double crown can make it trickier to style your hair. The main reason for this is because the hair spirals in 2 areas at the back of the head and the hair converges down the middle which can make hair stick upwards in odd directions that doesn’t lend itself to easy style.

Patients may want to allow their hair grow longer, allowing more volume to cover the crown area and enable easier styling in the hairline. Other methods to manage a double crown include:

1. Styling in a strategic hair parting: having a side parting that allows a side part to fall in a direction opposite to one of the spirals can help style a double crown easier
2. Having a ponytail: styling your hair into a ponytail will entirely disguise and ameliorate a double crown
3. Styling creams or gels can be used to hold hair in a double spiral to the style you want

Double Crowns and Hair Loss

While double crowns themselves do not cause hair loss, the spiralling of hair in 2 different areas makes any thinning more pronounced. This is particularly an issue for patients who suffer from androgenic alopecia or telogen effluvium.

Treatments for Hair Loss in Double Crowns

Treating hair loss in patients with a double crown is the same as for those patients who have a single spiral. Below we have outlined some medical treatments:

• Topical treatments: Products containing Minoxidil (Regaine) can help stimulate hair growth. The medication extends the anagen (growth) phase of the hair cycle, shortens the telogen (resting) phase, stimulates hair follicle activity, increases follicle size⁷.
• Prescription medications: Drugs like Finasteride are used for treating pattern baldness by reducing the hormone that triggers hair loss. Dihydrotestosterone (DHT) is a hormone that is derived from testosterone. In people with androgenic alopecia, DHT causes hair follicles to shrink and eventually stop growing back. Finasteride works by blocking the production of DHT. By reducing DHT levels, Finasteride can help prevent hair loss and promote hair regrowth⁸.

• Hair Transplant: Hair transplant surgery is a preferable option to individuals looking for permanent solutions. Surgery can be targeted specifically to areas of hair loss, unlike prescription medications. The procedure involves harvesting hair follicles from a donor area (usually the back of the scalp) and transplanting them to the thinning or bald areas like the crown or hairline. Two main techniques are used: Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE). Both methods have high success rates and can produce natural-looking results⁹.

• Low-Level Laser Therapy (LLLT): A non-invasive treatment that uses specific wavelengths of light to stimulate hair growth. LLLT is often delivered through different devices like caps, helmets or combs¹⁰.
• Platelet-Rich Plasma (PRP) Therapy: PRP therapy involves extracting a small amount of a patient’s blood, processing it to concentrate the platelets, and injecting the platelet-rich blood back into the scalp. Platelets contain growth factors that can help stimulate hair follicle activity and promote hair regrowth, making it a promising treatment for hair loss in areas affected by double crowns¹¹.

Conclusion

In conclusion, double crowns are a normal growth pattern in some people where there are 2 spirals in the crown area. The phenomenon occurs due to genetic inheritance and can cause difficulty in hair styling.

References

1. Wunderlich, R. C. and Heerema, N. A. (1975) ‘Hair crown patterns of human newborns’, Clinical Pediatrics, 14(11), pp. 1045–1049. Available at: https://doi.org/10.1177/000992287501401111
2. Plikus, M. and Chuong, C. M. (2004) ‘Making waves with hairs’, Journal of Investigative Dermatology, 122(4). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378646/
3. Brewster, E. T. (1925) ‘The inheritance of double crown’, Journal of Heredity, 16(9), pp. 345–346. Available at: https://doi.org/10.1093/oxfordjournals.jhered.a102632
4. Luo, J., Huang, H., Qiao, H., Tan, J., Chen, W. and Zhang, M. (2023) ‘GWAS identify genetic loci associated with human scalp hair whorl direction’, Journal of Investigative Dermatology, 143(10). Available at: https://doi.org/10.1016/j.jid.2023.04.008
5. Androgenetic alopecia: MedlinePlus Genetics (2023) [Internet]. Available at: https://medlineplus.gov/genetics/condition/androgenetic-alopecia/
6. Hughes, E. C. (2023) Telogen effluvium. U.S. National Library of Medicine. Available at: https://www.ncbi.nlm.nih.gov/books/NBK430848/
7. Suchonwanit, P., Thammarucha, S., and Leerunyakul, K. (2019) ‘Minoxidil and its use in hair disorders: a review’, Drug design, development and therapy, 13, pp.2777–2786. Available at:https://doi.org/10.2147/DDDT.S214907 
8. McClellan, K. J., & Markham, A. (1999) ‘Finasteride’, Drugs, 57(1), 111–126. Available at: https://doi.org/10.2165/00003495-199957010-00014
9. American Society for Dermatologic Surgery. Hair transplants. Available at:  https://www.asds.net/skin-experts/skin-treatments/hair-transplants
10. Avci, P., Gupta, G. K., Clark, J., Wikonkal, N. and Hamblin, M. R. (2014) ‘Low-level laser (light) therapy (LLLT) for treatment of hair loss’, Lasers in surgery and medicine, 46(2), pp. 144–151. Available at: https://doi.org/10.1002/lsm.22170
11. Paichitrojjana, A. and Paichitrojjana, A. (2022) ‘Platelet-rich plasma and its use in hair regrowth: A review’, Drug Design, Development and Therapy, 16, pp. 635–645. Available at: https://doi.org/10.2147/DDDT.S356858