Doctors on Hair Loss & Hair Transplant surgery.

I am a 36 year old American Indian female with very long black hair. I have noticed that i have been losing my hair on top by my center part. I have bi-polar disorder, i have been on the same prescription for two years. I have always had extremely thick hair and now it feels so thin. What do you think could be causing this and what can i do to get my hair back to it’s normal fullness? I do not get periods anymore, i had a uterin embolisation three yrs ago. I am very vain about my waist length hair. Please help me.

There are many medications that can cause hair loss. It would be helpful to know what medications you are on.

With women hair loss can begin in your 30s, 40s, or 50s due to normal female pattern hair loss. The cause of this form of hair loss is not as well understood as male pattern hair loss. It will generally leave an intact frontal hair line with loss beginning just behind this. Over time it continues into the top and the very back of the top scalp. It can also involve the sides and back of the scalp in some women. All women with hair loss should rule out hormonal diseases including hyperthyroidism, hypothyroidism, and an elevated level of male hormones. You should also be checked for iron deficiency anemia that can come from heavy periods though this does not seem possible in your case. Laboratory testing includes a T4, TSH, FSH, LH, DHEA, CBC, Ferritin level. Some connective tissue diseases such as lupus can cause hair loss so you might check a WESR and an ANA. If you are having joint problems such as arthritis, this might point to a connective tissue disease.

If all these tests are normal, consider two 4mm biopsies of the affected area that should be read by someone who is a dermatopathologist experienced in reading hair biopsies. It is important to obtain intact hair follicles when taking these biopsies and they must be taken from where you are having hair loss. These can often identify the cause also tell us if you have a more difficult form of hair loss to treat such as a scarring alopecia such as lichen planopilaris.

Someone experienced in evaluating hair loss might be able to help evaluate possible cause of your condition by performing an examination of the hair shaft diameters and a hair pull test.

Tags: biopsies, cause hair loss, dermatopathologist, gene, hair follicles, hair loss, hair shaft, hormonal diseases, hormone, losing my hair, pattern hair loss

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I have heard that it is possible through gene therapy and biological methods to make straight here permanent curly. Do you know if this is on the market yet for cosmetic purposes and if so please can you provide contact details of the clinics.

There are many potential gene therapies being investigated now. One company in San Diego (which researchers do not name) is supposedly working on a cream to help regrow hair using gene therapy. They evidently are also working on one to turn grey hair back to its dark original color, and one to cause a “permanent permanent” (straight hair turned curly). These are a ways off from being released to the public, if they even prove to be effective.
If they do work, at least partially, they would then have to go through FDA approval, which may take years and cost tens of millions of dollars (although there would certainly be plenty of investors in a product that would cure baldness, for example).
Also, there are many ethical questions that are only now being raised regarding gene therapy. Some have to do with creating “cosmetic or aesthetic perfection” for those who can afford it, and creating an underclass of “cosmetically challenged” humans, who cannot.

Certainly no one is going to forbid someone from marketing a cure for baldness, or a “genetic permanent”; however, these possibilities are at this point just that: possibilities. The press tends to take these things and run with them, but they are often exaggerated and made to seem closer to mass consumption than they really are.

Tags: baldness, biological methods, cure for baldness, fda, fda approval, gene, gene therapy, hair loss, therapy

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When and how does the new hair grow in after my hair transplant ?

Many people ask this question during and after their hair transplant; some actually think the hair will all continue to grow and they will have their “new head of hair” immediately. Unfortunately, most individuals have to accept delayed gratification as part of the transplant experience!

When the grafts are placed in the balding areas, they indeed may continue to grow for a few weeks. However, by about three weeks, the hairs begin to rapidly shed and soon most all of them are gone. The good news is that the follicle cells, the ones that make the new hair shaft that grows up and out, are still lying dormant under the skin.

At about three to four months, the first hairs begin to sprout through the scalp. At first, all new hairs will be finer, and slightly less pigmented than they will eventually be after some growth time. It is important to note that the grafted hairs do not all begin to come in simultaneously; they generally sprout in a “staggered” fashion, which means that each month some new sprouts will be noticed emerging from the scalp, until they all have grown in! Full growth will have occurred, on average, after about 10 to 12 months; full ingrowth may sometimes take a little longer on second and subsequent procedures.

Of course, the full cosmetic effect may not be apparent right away. This is because length and caliber of hair, as well as density, contribute to coverage. Once the hair has grown long enough and each shaft has become thick enough, then the full coverage will be apparent and the welcome decrease in the appearance of thinning and baldness will be noticeable.

Tags: appearance, balding, balding areas, baldness, density, Grafts, hair growth, hair shaft, hair transplant surgery, ingrowth, thinning, transplant experience

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I had hair transplant procedure a week ago and I’ve note that the hair is still growing in the grafts. Does this mean the hair has been accepted and that it will continue to grow?

Following hair transplantation hair in the grafts will continue to elongate for about 10 days. Some of this may be continued hair growth, but it also reflects a move toward anagen effluvium. In anagen effluvium the dermal sheath begins to contract and move toward the surface of the skin much like an accordion. This shortening of the dermal sheath will push the bulb of the hair shaft toward the surface of the skin. Therefore, some of the elongation of the hairs is not due to growing, but rather due to a contraction of the dermal sheath toward the skin surface.

Once the dermal sheath contracts, the hairs will either begin to shed on their own beginning in two to three weeks after the transplant. Some of the hairs will continue to rest on the surface of the skin for a prolonged period of time. Eventually the scalp skin will either begin to form a wall around the resting, non-growing hair, or the scalp will form a pustule or pimple like reaction that will eventually burst and the non-growing hair will exit the skin with the exudate from the pimple or cyst like structure.

It is probably a good idea to minimize the number of the cyst like structures that you get because they represent unnecessary inflammation. Inflammation may not always be a good thing. In theory inflammation might sometimes lead to an autoimmune response toward one’s own hair and this in turn may compromise future graft growth.

In order to minimize inflammation, we generally recommend that patients begin removing non-growing hair fragments beginning three weeks after the hair restoration procedure. The best way to manage this is to aggressively wash the scalp with soap and a wash cloth. Non-growing hair will come out easily like removing a pin from a soft stick of butter. Growing hairs on the other hand must be plucked and it takes a good bit of force to accomplish this.

Sometimes hairs do continue to grow following a hair transplant without ever going into the resting phase, but it is unlikely that you will see more than 10% go into the resting phase. It is far more likely that the hairs will shed. Occasionally hairs almost shed, but then continue to grow. We can easily recognize these hairs because they have a dark tip that is coarse followed by a narrow constriction that is of lighter color. This is followed by a gradual darkening of the hair shaft and increase in hair diameter once again. We call these hairs that exhibit signs of this trauma pol pinkus hairs and they are a sure sign of recently transplanted hairs that have continued to grow.

Tags: anagen effluvium, cyst, dermal sheath, dr. john p. cole, Grafts, hair diameter, hair growth, hair restoration, hair shaft, hair transplant, hair transplant surgery, hair transplantation, inflammation, non growing hair, patients, pimple, resting phase, scalp

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