Month: May 2005

Is it true that sun burns on the bald scalp causes skin cancer? Can hair transplants solve this problem?

Sun is a known carcinogen, which means in simple English that heavy doses of sun exposure can cause cancer in susceptible people. Susceptibility varies with skin color and the type of skin you have, but if you have a full head of hair, skin cancers are far less common than on someone with a bald head. I remember that my bald spot would burn during the summers when I went on vacation. After having my hair transplanted into the crown, I do not remember getting a sun burn. I have had many dermatologists send me patients who have had many skin cancers on the balding scalp. The patients echo my own experience and I am often told that the hair transplant helps to reduce the sun burn. I suspect that anything that reduces sun burn will help deal with the cancer problem, but hair transplants alone may not be adequate cover, especially if the supply / donor ratio is low.

I am 44 and have just started to lose my hair. I have lost 70% of the first inch of my hairline and the back of my head started to thin as well. I started Propecia when I started to bald along with many other vitamins and minerals as well. Now I want to get all of my hair back. I visited a doctor who thought that the hairline I wanted was too low so he recommended that I put it higher. I don’t like what he said because the hairline he showed me was not me. My friends want to see me and I want to see me. Can I dictate where the hairline should be or must I listen to what the doctor wants.

Not having you in front of me is a problem, but I can make certain assumptions. At 44, with hair loss in the front and crown, you will probably not get very bald. However, since your hair loss started late in life, this assumption may not be an accurate reflection of your perception of the hairl loss you will see over time. What you must ask is the following question: “Given the worst case for hair loss in your future, can you live with the hairline that you have asked for?” If the answer is yes, then you must convince the doctor you will select to see it your way. I often argue with the patient but it is always a pro-patient argument challenging the patient to look at his new hairline many ways. Hair transplants are permanent, so that is both the good news and the bad news. In a consultation, you might say ‘black’ and I might respond with ‘white’, not because I believe ‘white’ but I want to make sure you understand all of the choices and consequences of selecting ‘black’ as the option. Clearly the relationship and trust you develop with your doctor will point you and your doctor to the correct decision. There are no absolute rules here, just judgments which we hope will be kind to us as we get older. Isn’t that what life is about?

My girlfriends and I don’t think that they have hair loss problems (at least not yet), but we would LOVE to have fuller hair so that we wouldn’t need to use hair extensions (which I assume all the celebs use because no one has hair like that!). Could transplants do this for us too?

It is important to understand that many of the accoutrements that adorn our bodies arose from our more primitive, less sophisticated past. The use of wigs date back to the Egyptians in the years between 4000-300 BC. They were used extensively by men and women. The Greeks were the first to popularize wigs and braids and they began the long torturous route to hair styles that cycled in popularity for the next few thousand years. In the middle ages (1200-1400 AD), single women showed their health and vitality by demonstrating full heads of hair, much of it coming from animals. Once married, only the husband could see the head uncovered, so it was the young single, female that had to appear healthy and capable of producing healthy children. As the populations started to concentrate more and more, the disease tuberculosis, took its course on the malnourished females whose heads were uncovered, so advertising ones health required hiding (1) a thinning head of hair with a wig or with braids and (2) the absence of significant body fat with clothing. Sexual attractiveness and a healthy appearance were inextricably linked. Paintings since the late renaissance, show women with much abundant body fat and full heads of hair. As tuberculosis is blind to socioeconomic conditions, the successful artisans were engaged by wealthier clients to create the illusion of health with abundant hair and lots of braids. As the hair became thicker, it hid elements of the face that may have reflected the signs of illness or malnutrition. Braids became common place and the use of wigs and other hair extensions remain part of our cultural heritage.

Now to directly answer your question, no, hair transplantation should not be used to increase the fullness of a normal head of hair, but the use of hair extensions and other such devices come with a price. That cost can be hair loss caused by the continuous pulling that these devices produce on the hair as they are attached. Hair loss from such attachments (Traction Alopecia) can be permanent. My advice to you is to respect your hair and watch carefully for any signs of Traction Alopecia.