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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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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What is the importance of hair characteristics in hair transplant surgery?

These characteristics are significant in that they determine to a great degree how much coverage of the scalp there is, in order to block light. When light is not blocked and penetrates through to the scalp, the appearance is of thinning or balding.

The other big factor here is the density, which is another topic unto itself. The density is the number of hairs or follicular units per unit area (square centimeters or square inches or whatever unit you prefer; the centimeter is the standard for physicians). Although this density usually gets most of the attention when discussing hair loss, hair characteristics are equally, if not more, important.

First let’s look at color. At first, one might think that the darker the hair, the better the coverage. This is generally not correct. Lighter hair usually goes with lighter skin, and the tow together tend to mask thinning very well. Darker hair can cover well, but in the case of poor hair transplant work (pluggy looking, or larger graft on frontal hairline) they may stand out much worse than lighter hair. We will discuss color in more detail when we discuss contrast.

Curl is another very important factor in coverage. Generally speaking, curly hair provides coverage in proportion to the degree of curl (i.e., wavy hair gives better coverage than straight hair, curly hair better than wavy, very curly better than slightly curly, etc.). This has to do with light blockage as well. The curlier the hair is, the more it creates a meshwork of sorts (kind of like a thatched roof) which “stands up” a little bit off the scalp and keeps the light from penetrating to the scalp.

Contrast has to do with the difference between hair color and skin color. The closer to each other the hair and scalp are, the better the coverage. In a way, this “fools” the eye of the observer into not noticing the decrease in density. If a person with blonde hair and light skin loses 50% or his or her density, they may appear much less affected than a person with equally light skin and jet black hair. In this case the dark hairs of the second example are highlighted against the light skin and it shows the sparseness of the hair. The person with the blonde hair reveals very little difference between the hair and scalp, in other words, the observer cannot detect where the hair leaves off and the scalp begins.

Last, let’s consider caliber. Thicker strands of hair provide more “hair mass”, which is a term doctors use to describe the total effect of length times caliber. The more hair mass in a given area, the better the coverage. This makes intuitive sense. Imagine covering a hut with logs. If you place 20 logs as a roof, which will give better coverage, skinny logs or big round ones with large diameters? Of course, the bigger ones, so the thicker hairs do the same over the scalp. And remember, what appears as thinning or balding is simply the appearance of light shining through to the scalp.

Tags: balding, blonde hair, caliber, curly hair, diameter, hair characteristics, hair loss, hair mass, hair transplant, hair transplant surgery, scalp, shaft, skin

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What is Maximum Medical therapy for hair loss?

People with hair loss, and certainly anyone even CONSIDERING hair transplant, may want to use a regimen of maximum medical therapy. This just means using a number of different medications that have different mechanisms of action to try to “cover all the bases”, so to speak. Attacking hair loss by targeting different aspects of the process is a way of using the synergy between various agents to maximize the effects.

Finasteride (Propecia and Proscar) is an agent that blocks the formation of dihydrotestosterone (DHT), a hormone that has been implicated in male pattern baldness (androgenic alopecia). This is a first line drug for men with thinning hair or balding. It is not beneficial for women; in fact, it can cause birth defects if a woman is exposed to the drug and gets pregnant. It has few side effects in men and has been used for about 25 years with a good safety record.

Minoxidil (Rogaine and many generic versions) is topical, or placed directly on the scalp. Side effects are few, and it has a synergy when used with finasteride. This may be used in men and women, and is considered by many to be the drug of choice in women with hair loss.

There is some evidence that an anti-fungal shampoo containing ketoconozol (Nizoral) may help slow hair loss. It can be used twice a week and has the added effect of decreasing dandruff and itching of the scalp. There are also a variety of over the counter preparations (Hair Cycle products) and internet-marketed preparations that are available. Many of these contain minoxidil and other ingredients. Some of these are topical androgen (male hormone) blockers; there is little scientific proof of their effectiveness, but many men swear by them, and they may work for some.

The most important thing one can do with these latter agents is read and read some more. Information from sources other than the manufacturers is likely to be more objective and may help one with informed decisions.

Tags: androgenic alopecia, anti fungal shampoo, balding, finasteride, hair cycle products, hair loss, hair loss solutions, hair loss treatments, hair transplant, hormone, male hormone, male pattern baldness, medical therapy, minoxidil, nizoral, proscar, rogaine

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What are the common used hair transplant techniques and how are they different from CIT?

Hair transplant surgery can be done using several different techniques, including old-style plugs, strip harvest, The Cole Isolation technique (CIT), and body hair transplantation (BHT). Plug harvesting is only mentioned for historical reasons; it is a very poor technique and should not be used in the modern era. Strip harvest using only two incisions became popular during the 1990’s, and is still widely used today. CIT is very new, having been used only the past 5 or 6 years, but is beginning to challenge strip surgery in some areas as a procedure with much less scarring. BHT is used mostly for adding hair to scalp hair surgeries, and in patients who have had much of their scalp donor hair removed. Scalp hair is always better, and BHT is seen as a complement to scalp hair.
Hair grows on the scalp in separate units, which are known as follicular groups or follicular units. They contain 1, 2, 3, 4, or rarely 5 or more hairs. During the CIT procedure, a special tool is used to take these hair groups out one at a time. The advantage is that no long incision or wound is made in the scalp, and therefore no long scar results. Also, there is very little pain after the surgery, and the hair grafts come out ready to place in the balding areas, with no trimming needed. Sometimes there are tiny white dots left where the hair s were taken out; these are very small and if the hair is more than ¼ inch long or so, the dots are invisible.
These hair grafts are then placed into tiny slits or holes made by the surgeon into the balding or thinning hair areas; in about 3 or 4 months the first of the “new” hairs begin to sprout and by the end of a year, the full result of the transplant will be seen!

Tags: balding, bht, cit, follicular groups, Grafts, hair transplant surgeon, hair transplant surgery, incisions, patients, plugs, scalp, scarring, slits, strip, the cole isolation technique, thinning hair

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