Month: December 2006

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Hair Loss InformationFUE Robotics – Hair Loss Information – Balding Blog

You recently responded to a question on the balding blog that FUE will soon incorperate robotics. I’m trying to picture how this would work…. Will patients be required to wear a certain helmet of some sort so that their head remains completely still? Do you think that general anesthesia and paralysis would be necessary?

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R2D2As you do not want to have a mobile robot like R2-D2 chasing the patient around a room, there must clearly have some head immobilization apparatus to hold the head steady. A smart robot will be programmed with enough pattern recognition to be able to adjust to slight movements. Heavy sedation (not general anesthesia) for the long, arduous process will also be needed. There will not be a helmet because, again, the robot needs to be smartly programmed. I have seen this robot in action. It looked like a scaled down version of the robots used in industry today (e.g. car assembly).

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Hair Loss InformationWhy Do All Young Hollywood Actors Have Great Hairlines? – Hair Loss Information – Balding Blog

Hi!

Do you think that it is common that young and famous persons take propecia prior to any experience of hairloss?

The reason for my question is that I am so astonished that rather young people in hollywood (say between 20-40 years), all seem to have a full head of hair! I cannot even come up with almost any names of young actors with an obvious receding hairline (as they get older), except Jude Law!

If they do not use propecia, how could this kind of luck of a full head of hair even excist, when balding is such a common problem amongst “ordinary people”??

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There is no difference between vulnerability of Hollywood actors to keeping hair and the normal population. If there was, I would imagine all balding men would be taking acting lessons to get the positive benefits of that profession. I think that those men blessed with good hair have better opportunities for acting than balding young men. Once they make it, they do what they need to maintain good hair. That might include wigs, transplants, or Propecia.

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Hair Loss InformationPsoriasis in Donor Area – Hair Loss Information – Balding Blog

I have psoriasis (as know, non-curable) in a part of my potential donor area. Does this rule me out as a candidate for a transplant from that location? Is it possible to use other parts of the donor area since I have good overall density?

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Psoriasis does not move, so it stays where ever it originally was (in the donor area in your example) and will not be transplanted to the recipient area. The psoriasis needs to be under good control if one is to use the skin from impacted areas for the donor site. One could be selective where the donor is taken from, but this will reflect supply and demand relationships for the donor supply and the size of the bald area.

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Hair Loss InformationDermatologists Specializing in Alopecia? – Hair Loss Information – Balding Blog

In one of your comments you noted that there are certain dermatologists that specialize in the treatment of alopecia areata. Could you please provide the names of any that you are aware of (particularly those on the east coast as I live in the DC Metro area). Thanks.

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You need to go to your family doctor and ask that question. Each doctor in each city has worked out the referral patterns for their patient’s best interests. I have a good doctor referral that has built a reputation — Dr. Richard Strick at UCLA in Los Angeles. You might check with the National Alopecia Areata Foundation for other sources.

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Hair Loss InformationMaturing Hairline Questions – Hair Loss Information – Balding Blog

Hey, thanks for taking my question. I’d like to know if I’ve got a maturing hairline or if I’m going bald. I’m 20 years old and I’ve recently noticed my hair is thinning away around my temples, and that on the right side of my head the hairline is beginning to rise a little bit higher than it is on the left. The rest of my hair is as thick as ever. Just a few questions:

1. Is this probably a maturing hairline? I’ve read other questions and I noticed you said it develops between 17-29. Seeing as I’m on the younger end, does it make a difference how long it takes? Meaning, if you develop one at 17 do you start continued balding faster than a person who develops it at 27?

2. Do hairlines mature symmetrically?

Thanks!

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Hairlines often do not mature symmetrically. If you do not have balding, then the maturing hairline will develop when it develops. No two people develop it at the same rate. My youngest son took 9 years to evolve, yet others will evolve it in a matter of a year to two. I do not know if Propecia will slow it down, but it is logical that this could be a side effect of Propecia.

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Hair Loss InformationMy Grandfather, Father, and I All Have the Same Mature Hairline – Hair Loss Information – Balding Blog

Hi Dr,
I have a mature hairline (since 15) , and my dad and his dad both have the same hairline. No one on my mom’s side has/had a mature hairline. Is this an indication that I will take after my father?(he still has lots of hair)

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Sounds like it. Is there balding in the family on either side? That could impact what will happen to you if there is.

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Hair Loss InformationAny Speculation on Worst Case Scenario of Dutasteride Side Effects? – Hair Loss Information – Balding Blog

Ok I know you can’t give me a complete answer for obvious reasons, but based on your currently knowledge and educated speculation, what do you think are the most likely possible side effects from using Dutasteride in the worst case scenario? Would it simply be a case of Finasteride x 10 (i.e. loss of libido)? I really wouldn’t mind just hearing your speculation, as i’m well aware that it hasn’t been fully tested yet.

Also would it be a simple case of getting a prescription from my local GP?

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Dutasteride is a selective inhibitor of the type I and II isoforms of 5-alpha-reductase, the intracellular enzyme that converts testosterone to 5-alpha-dihydroxytestosterone (DHT). In comparison, finasteride acts as an inhibitor of only type II 5-alpha-reductase, and as a result, it is more specific, target oriented, and has less side effects.

If you are taking dutasteride for other indications, keep on taking it and you may get some hair growth as side effect. Based on current evidences, I can not recommend dutasteride solely for the prevention of hair loss, because:

  1. It has not been well studied for this purpose and as a result is not FDA approved for hair loss treatment.
  2. The optimum dose of dutasteride for hair loss prevention is not determined.
  3. The side effects of dutasteride are much more compared to finasteride.
  4. And finally, if you are considering its cost effectiveness, this is not in the picture anymore with new price reduction of finasteride (thanks to generic 5mg).

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Hair Loss InformationCortical Steroids and Effects on Hair Loss Medication – Hair Loss Information – Balding Blog

I have been reading that many skin problems, such as seborrhoeic dermatitis, may be associated with hair loss in balding males. For instance, the scalp can become itchy/flaky in regions of the hair thinning/loss. The application of cortical steroids (Luxiq, etc.) are often given to ameliorate the symptoms of the dermatitis, however can they have a deleterious effect in furthering your hair loss?? Do you know if these cortical steroids act to aid or hinder the effect of typical hairloss medications, such as Propecia?

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SnakeYes, steroids can be a cause of hair loss in some people. Hair is a skin organ, but hair is only part of the skin elements. When the surface of the skin turns over faster than normal (we shed skin slowly and uniformly on a daily basis and replace from below, what is lost on the surface). Compare this to a snake, which sheds its skin all at once and replaces it before the shedding occurs. When skin is shed more rapidly, it builds up flakes of skin and some people call this dandruff. When it gets bad, it is called seborrhoeic dermatitis. It can be caused by external factors such as infections and fungal diseases as well. Steroids work well to control the autoimmune elements of the seborrhea, when it occurs, and antifungal agents or other treatments are needed (for example) when infections are present.

Many people think that seborrhea or dandruff is associated with hair loss, but this is not true unless the person picks on the skin and produces traction alopecia. When a scalp becomes balder, it becomes dry more easily. When there is hair present, flaking builds up in the forest of hair, so that when the skin turnover occurs more rapidly, the dandruff becomes a real social problem. For those interested in the chemistry of the relationship between cortical steroids and hair loss, please see:

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Hair Loss InformationUlerythema Ophryogenes and Hair Transplants – Hair Loss Information – Balding Blog

1.I have a condition called Ulerythema Ophryogenes, i was thinking of getting hair transplants but i was wondering would they just fall out.

2.Also how often do eyebrow hairs usually fall out and regrow

Thank you for your help

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According to eMedicine: “Ulerythema ophryogenes, a rare cutaneous disorder, is characterized by inflammatory keratotic facial papules that may result in scars, atrophy, and alopecia. This disorder has been described in association with other congenital anomalies such as Noonan syndrome, Cornelia de Lange syndrome, or Rubinstein-Taybi syndrome.”

Unfortunately, this is a rare condition that not many doctors (especially hair transplant doctors) have significant experience with. That being said, if you have this condition and also have genetic androgenic alopecia (or male pattern balding) your donor hair (in the back of scalp) should be considered permanent hair. There is no reason for me to believe that a hair transplant may not be successful. There may be a slight increased risk of scarring or discoloration on the recipient area.

With respect to the eyebrows that may be lost with this condition, a hair transplant may also work, but with the same caveat as outlined above. The growth rate (or the cycle rate) of eyebrow hair is different than that of scalp hair and it follows a one to two month cycle.