Hair loss stable for 8+ years – is it still possible to regrow, or should I just accept it?

Hi everyone,
I’m a 30s male and have been dealing with hair thinning for many years now. I recently shaved my head and noticed that despite the thinning on the crown and mid-scalp, there are still a lot of miniaturized hairs visible.

I’m attaching photos of my scalp both shaved and unshaved. This has been my baseline for about 8 years – very little progression.

My questions are:
Do the black dots on my scalp mean that they are still alive? Why arent they growing?

Is it still worth starting treatment (Finasteride, Minoxidil, Microneedling)?
Or does long-term stability mean the hair loss has “burned out” and I should just accept it?

I’d really appreciate any input fro

m those who started late or had similar patterns.

Thanks in advance!