Doctors on Hair Loss & Hair Transplant surgery.

I’m a woman over 40 and was diagnosed with androgenetic alopecia ten years ago. My 16 year old is losing her hair. I took her to the derm and was told that it is stress related. The doctor said that she did not see the genetic pattern. My daughter is losing her hair on the sides above the temple and also in her part. Isn’t this genetic pattern? I don’t know if I buy the whole stress theory. The doctor spent 5 minutes with us and ran her fingers through my daughters hair. Can stress hair loss mimic androgenetic?

There might be a stress component, but it is not a common cause of hair loss except with alopecia areata, which tends to be well circumscribed and circular in shape. There are different kinds of stress. There is mental stress and there is physical stress such as a severe illness or significant trauma. Physical stress can produce a global form of hair loss.
The fact that mom has the diagnosis of AA increases the chance of the daughter having a similar problem, however at 16, she is a bit young for that. Other possibilities are polycystic ovary syndrome; one would expect other signs of androgen excess with this (facial hair, acne, increased body hair, etc). The sides of the scalp are not a common area for androgen excess to present itself. Female pattern loss can involve the sides of the scalp however.
I am unsure what is meant by “above the ear”. If the loss is in the fronto-temporal recess, it could be androgenetic alopecia; if it is on the sides (parietal), that is unlikely and it may be a diffuse patterned or unpatterned alopecia.
The loss through the area of the “part” may indicate a Ludwig pattern of AA, which is a more typical “female” pattern, as opposed to the “male” pattern of temporal recession and loss of the hairline.
A thorough workup with a physician specializing in hair loss would be your best option at this point. You should look for any changes in density or hair diameter. You could follow this up with a biopsy properly performed. Make certain to perform some lab tests to look for anemia, androgen excess, iron deficiency, or a thyroid dysfunction.

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I am 27 and first noticed that i had hair loss about 24..My dad also has hair loss so its should be caused by genetic. About 1 year ago,i already had very little hair . I have been using Minoxidil 5 %, and Propecia, and it helps to control the hair loss but recently i realize that there is excessive hair loss even though i use it faithfully. I tried other ways of different treatment but i dun see any results. I recently saw this product “provillus’,its main ingredient is saw palmetto. It is said that it is similar to propecia but it doesn’t affect your sex drive ,Is this true? Can you please advise me on what other methods can i try,i recently just bought a laser set,do you think it will be useful?

Hair Loss is a multi-factorial problem. This is probably why some people respond well to DHT inhibitors such as Propecia and why others do not respond as well. Some people respond well to Minoxidil or Rogaine, while others do not. We recommend treating your hair loss with as many options as possible to cover as many potential causes of hair loss as possible.

You can purchase saw palmetto over the counter in a health food store and take the pills each day. Saw palmetto is a DHT blocker. We recommend you use this.

We also recommend you shampoo with Nizoral Shampoo at least once a week. Leave the product on for 5 minutes prior to rinsing. The product is a topical agent so it needs skin contact to do its job. We also recommend Hair Cycle shampoo and conditioner 4 to 5 times per week. Again, leave this product on 5 minutes prior to rinsing. Hair Cycle is an anagen stimulator so it will help you keep the hair in the growing phase longer. This should help you prolong the life of your hair. Hair Cycle is also healthier for your scalp since it lacks sodium laurel sulfate, which is the agent creating lather in most shampoos. This lather is the equivalent to engine degreaser and it is not healthy.

Other products you might consider include topical spironolactone.

The laser comb is expensive, but should help. We are working on a less expensive model.

You might find that decreasing the dosage of your Propecia to three times a week on Monday, Wednesday, and Friday has less of an affect on your sex drive.

Please note that Rogaine Foam is a new version of topical minoxidil and seems to produce less skin irritation. It also is better absorbed and does not leave your hair oily or greasy the way most minoxidil solutions do.

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I am now 19 months post surgery from a body hair transplant with you. I noted significant improvement at the 9 month mark, but minimal since then. Can I expect more growth and more density from the body hair transplant I had with you 19 months ago. I live in Spain.

It’s always difficult to say if hair always grows. It really does not matter if it is head hair to body hair. It’s a bit easier when you place head hair on a bald scalp, however. The same is true for body hair. With body hair we’ve learned a few things. One is that lower densities can produce better yields than higher densities. What does this mean? Well, sometimes a yield of 60% to 70% is the best you will see with body hair and it could be 30 to 40%. With head hair on the other hand, the yield is always 90% or less. Usually the lowest you will see is around 70%. Again high densities seem to play a role in lower density with head hair. I’ve seen body hair results that surely look like 90% yields however. We also know that anagen hairs produce a higher yield than telogen hairs. I’m not certain why.

You have to understand the dynamics. Head hair is 80 to 90% in anagen. Body hair is 40 to 60% in anagen. Therefore, in reality, the best you should see from a head hair transplant is 80 to 90% and the best you should ever see is 40 to 60% from body hair. That does not mean that 10% of head hair and 40 to 60% of body hair died. It means that those percentages should always be resting or in telogen. As one hair cycles out, another cycles in and begins to grow. That’s the dynamics.

I think that most body hair transplant results to date seem to follow scalp hair in terms of growth, though we did recently get a 4 year photo of a patient that certainly seemed much better than his 14 month photo. What this means is that at about 8 to 12 months, the result probably peaked with minimal improvement thereafter.
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I have a seemingly strange question. Has anyone tried taking advantage of medical donors with hair transplant procedure?

That’s a good question and one that we’ve thought about previously. I suspect one of the big concerns with this would be trying to match the donors. With life and death situation such as kidney and liver transplants, medical insurance will take care of the testing. With hair transplants, the procedure is not medically necessary so most insurance companies shy away from paying for hair transplant surgery. When someone dies, they check their organ donor status. If they are a donor, they are tested. If there is a suitable match in another state, the organs are air lifted to the patient. Such protocol for hair would be extremely expensive. Also, one often has immunosuppressive medications to prevent organ rejection. This would be quite expensive to the cosmetic surgery patient, as well since insurance companies would not pay the fee for on going immunosuppressant treatment.

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My reason for writing to you is over the past 8 to 9 months I have noticed an “excessive thinning” of my hair. My hair has also been dried out and brittle. I am a natural dark haired individual and do bleach my hair. I have been doing so for over 20 years with no negative affect.
I moved to south Georgia in September - into an older home, which has well water. I immediately noticed the texture of my hair changing. It became much drier and hard to style. I was told it might be because of the well water and the pH of the water.
What is your opinion? Are there any tests I can do on the well water? Would that cause hair loss? Is there any other tests to perform that might indicate something bad or missing in the water that would be so negative on my hair.

There multiple reasons people loose their hair. With female hair loss the causes may include hormonal problems. One should consider a thyroid problem. This could be due to an elevated thyroid or a low thyroid function. A change in medications might stimulate hair loss in women with female pattern loss and this should be considered too. One would generally see female pattern loss prior to age 62 if this were the cause.

I think you should consider the well water as a possible cause. There are numerous heavy metals present in well water and you can absorb heavy metals through the skin or through ingestion. There would include thallium, arsenic, mercury, copper, cadmium, or bismuth. A half gram of bundled hairs kept in their normal orientation (tops toward the top) sent to the National Medical Services in Willow Grove, PA can evaluate your hair for arsenic.
A low pH can sometimes cause copper in the pipes to precipitate out into the water and this can result in an accumulation of toxic levels of copper in your system.

You could have your physician work you up for heavy metal exposure. Blood levels, urine levels, and hair levels will generally tell you if you have been exposed to heavy metals. Often times you will have neurological findings or symptoms with heavy metal exposure.

Lab tests in addition to a heavy metal analysis include thyroid function tests, a CBC and ferritin level to evaluate you for iron deficient anemia, a dihydroepiandrosterone level to check you for elevated male hormones, a testosterone level, a FSH and LH. If the work up comes back negative, you could consider a properly performed biopsy. The dermatology department at the Medical College of Georgia in Augusta could perform most of this work up.

Heavy metal poisoning produces a characteristic form of anagen hair loss. A dermatologist should be able to assess you for any particular hair shaft abnormalities. Heavy metals were often found in pesticides and herbicides that could have found their way to your well water.

Of course hair coloring can make your hair brittle and cause breakage. This could be a factor currently and might result from a change in salons who use different chemicals or leave the agents on for a long period of time.

I usually see progressive female pattern loss begin after pregnancy or in the 40s to 50s. I do not see it begin in 62 year old women typically. Often times there is a family history, which means your mother would have exhibited these symptoms. Medications high in progesterone can stimulate hair loss in women prone to this form of hair loss. Any therapy would be directed at the cause. Therefore, it is best to determine the cause first. I think most of this work up can be done closer to your home. If it comes down to a biopsy, it probably is better for me to take, but I’d get the lab work up first.

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