I Found the posts that you referenced from your galleries very informative. Can you show more such illustrations that show the balance between balding patterns and the various hair types in hair transplant patients and scalp micropigment patients?

Thanks for the comment. I realize that showing is more believable and more educational than talking about these point that we so often covered in baldingblog over the years.

Blonde woman with very fine hair and thinning corners after one procedure. A second procedure was done just after these photos were taken: http://baldingblog.com/2014/09/05/female-hair-line-lowering-rounding-surgery-temple-recession-correction-with-photos/

One large session (2678 Grafts with medium weight hair and a Class 5A balding pattern): http://baldingblog.com/2014/08/06/one-session-of-2678-graft-hair-transplant-with-photos/
Note that this patient’s average hair weight reflected twice the hair bulk per hair as a person with fine hair. The thicker the hair shafts, the more likely a single session can address the presenting balding pattern.

I was just wondering if a diet high in sugar causes hairless. The reason I’m asking is because i looked up online and it says that sugar increases DHT which leads to hair loss.

I often write the Internet is a great source of information as well as misinformation. Are you trying to find answers or trying to quell your guilt from a high sugar diet? You don’t need to ask this question if you look a bit more online. But if you’re looking at a source to assuage your concerns, hair loss in men is mostly genetic. Hair loss is not related to sugar.

I had a hair transplant of 2900 grafts 14 months ago, but my his is too thin. The doctor recommended that I have another procedure of about the same size to address the thinning look that I have. Is this the right thing to do?

I am going to assume that you have fine hair. As you did not send pictures with this email, I went into our picture file and found two people who had fine hair and a single large session, one younger man has a single 3226 graft procedure with us (see: http://newhair.com/photos/patient-bba/) and the second older man had a large single session (see: http://newhair.com/photos/patient-bfa/). This younger man was happy with his thin looking results, and although he could have done another procedure to thicken it, he decided (for financial reasons) to hold off doing it again for the moment. The second older man was fully satisfied with his results. In both procedures one more procedure could have addressed the thinning problems and I am assuming that your results are similar to the shown results of these two men if the growth was 100% of what was transplanted.

Fine hair and large balding patterns require more grafts to get a thicker look thatn people with average weight or more coarse hair (see: http://newhair.com/photos/patient-aqq/). Graft counts can rise in the 4000-6000 graft range and it is not unusual for such people to get 2-3 sessions to see ideal results. Of course, more transplant sessions are expensive and many people just don’t gor for more surgeries for financial reasons. In 2009, we developed scalp micropigmentation which adequately addresses a ‘fuller look’ on such patients without further hair transplants. In our gallery site (scalpmicropigment.com), we have many examples of such patients on this site. One good example of SMP addressing a post hair transplant result with thinning hair can be seen here: http://scalpmicropigment.com/#!portfolio-item/patient-149/. The cost of SMP is far less than hair transplantation and is a good alternative, but it is a look of fullness, not the reality of it. Is is an option worth considering for you as a non surgical alternative to address your problem and it would be a good option for those patients with thinning hair that we referenced above.

I’m 26 and I was curious about the shape of my hairline. On my left side, there is a noticeable gap, whereas on my right it’s pretty much a stark “V” line (or what *would* be a “V” if the other side were consistent). The corners are a bit above an average mature hairline but, in that sense, I don’t find it too noticeable (I’ve seen people my age that are in worse shape in that regard).

I suspect this has to do with my fathers’ side. Looking at them now, i notice that both my old man and my uncle (both in their 50’s) have a similar shape. Aside from their prominent foreheads, my uncle seems to be pretty thick everywhere else, while my dad is only now starting to get thinner. Frankly, I can make peace either way. What would concern me, though, is ending up like my grandfather (their father) who was an early NW3 (by his early 30’s, looking at old pictures).

Does any of this info indicate at all a specific direction in which I would be headed?

Perhaps your question may be better suited at a fortune tellers shop.
Most men and women are not made perfectly symmetrical. Some have mismatching arm or leg length, crooked nose, odd shaped hair lines, etc.
You also cannot predict how your hair will turn out based on your family tree.
Just because one’s mother, father, or grand parents were smart and had graduate degrees and succeeded in life does not mean one will follow in their foot steps.
As you say, make peace!

hello. I had a question about hairs that fall out of my scalp. Occasionally I see a hard skin bulb on the end of the hair shaft.. This can easily be pulled off and is just dry dead skin cells.. Could this be accelerating my hair loss?

The white substance you are referring to is likely a collection of dead cells mixed with the oils produced by your sebaceous gland.

It has no significance or correlation with genetic baling or acceleration of hair loss.

Non-balding men and women get it. But if you are rapidly losing hair due to inherent male pattern balding or obsessed and preoccupied with the idea that you are losing hair, you will obviously notice more hair falling and notice more of the white bulb and will search the Internet for answers. In doing so, the cleaver marketing agents will take advantage of this curiosity and insecurity and claim it may be a sign of bad hygiene or some disease process and offer their product for sale.

These are cleaver animations put forth by the International Society of Hair Restoration Surgeons which simply and nicely explain hair loss issues.

 

Part 1: Scarring Alopecia and Young Male Hair Loss – Bill’s Story

Part 2: Male Pattern Baldness – John’s Story

Part 3: Traumatic Hair Loss – Pete’s Story

The old wives tale that garlic can prevent the common cold may have some support. According to MPR “In a recent review published in the Cochrane Library, researchers were only able to find one study that met their inclusion criteria. In this trial, 146 subjects were given either a garlic supplement (180mg allicin content) or placebo once daily for 12 weeks. In the garlic group, there were 24 occurrences of the common cold (111 days of illness) while in the placebo group there were 65 occurrences (366 days of illness).” Recovery periods were no different between the two groups. Garlic was believed to have antimicrobial and antiviral properties and this limited study supports this. The common cold is common as “children have six to eight colds per year and adults have two to four”. There is a substitute for Garlic called Allicin dosed at 180mg although I never prescribed it.

I recently sent an e-mail (that was posted in your blog) about my Propecia usage and my stylist noticing hair regrowth. Here’s the latest non scientific endorsement:

I flew back to my home state today to spend some time with my dad (a physician) who is recovering from a successful liver transplant, as well as my mother. Both made several direct comments about my hair: how it looked MUCH thicker, that the hairline up front had filled in, etc. They couldn’t stop talking about it.

True, my hair is styled much differently (upward….no longer combed forward) and I have it highlighted…..but this is after seeing me in December over the holidays. Again: for all readers….I’ve been on Propecia less than a year….I’m pushing 40……but IT WORKS……it just takes time. All the FREAKY, paranoid e-mails are going to scare off others. As I mentioned, when I hit the one year mark, I’ll shoot some pix to you….

People will always be worrisome about any medications, and that’s normal. The Internet has many put-down comments on finasteride (Propecia) that many of our patients coming in for a first visit seem to be anti-Propecia programmed when we first meet. It’s good to have some success stories posted to try to balance much of the negative reporting we see almost daily on the Internet. There are many men with good results from this drug (my son is one of them). Thanks for sharing your insights.

Curr Opin Endocrinol Diabetes Obes, 2014 vol. 21(6) pp. 493-8 5?-Reductase inhibitors in androgenetic alopecia Yim, E; Nole, KL; Tosti, A

PURPOSE OF REVIEW: The authors will review the current literature on efficacy and safety of 5-alpha reductase inhibitors (5?RIs) for androgenetic alopecia (AGA).

RECENT FINDINGS: The 5?RI finasteride and dutasteride are effective in treating AGA and promoting hair regrowth. 5?RI can be given orally, topically and more recently through mesotherapy. However, there has been an increasing concern about permanent sexual adverse events such as impotence and infertility. Most of these reports are published as case reports, and two studies reporting persistent sexual side-effects after discontinuation of finasteride had serious method limitations, as patients were recruited from a website. To our knowledge, permanent sexual adverse events have yet to be published in higher quality studies, such as randomized controlled trials. Although patients treated with 5?RIs have an increased incidence of sexual adverse events, these events decrease if discontinued or over time with continued therapy.

SUMMARY: Sexual side-effects are uncommon and resolve spontaneously in most patients even without discontinuing therapy. Significant effort is underway to find delivery systems that optimize delivery and reduce systemic absorption of topical 5?Rs including hydroxypropyl chitosan and liposomal and nanoparticulate systems.

The following is a comment from one of our readers:

…”I think the following recent review in a respected, high-impact journal night be of interest to your readers. It underscores some of the points previously made by your reputable bloggers related to an issue of continuous concern: that sexual side effects from finasteride are uncommon and that reports of permanent effects after discontinuation are essentially case reports (or letters to editors) with significant methodologic problems.“