Day: January 1, 2023

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I Was Disappointed With My Doctor With My Surgery. What Do you Think My Results Will Be?

Had, what I feel was very successful strip surgery graft to frontal area at beginning of year. Full natural hairline . In light of this, pursued transplant to crown at different center (for geographical/practical reasons) Was disappointed that rather than 1,500 or so grafts promised only 900 were done. Reason given was lack of scalp laxity. Multi unit hair grafts were used for a total of 4,500 hairs. Crown area is question was about 14 sq in (35 sq cm) My hair is somewhat coarse, not particularly fine. I’m not fair skinned. Was interested in your opinion as to what your best guess would be in terms of final density.

math

I am not here to “guess”. You have specific numbers and it is merely about doing the math.

It is worrisome how 900 grafts will total 4500 hairs. This equals 5 hairs per graft. This is highly suspicious since most people have an average of 2 hairs per graft.

Your 900 grafts in a 35 sq cm equals 26 grafts per sq cm. If you really have 4500 hairs in a 35 sq cm that would be 129 hairs per sq cm.

An average non balding scalp may have 100 grafts (200 hairs) per sq cm.

If you had a successful surgery with one doctor and had a disappointing experience with the second doctor, maybe you should follow up with the first doctor.

 

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I Was Diagnosed with PCOS Six Years Ago and I’m Losing My Hair!

I am 23 years old. I was diagnosed with PCOS when I was 17 and was placed on birth control pills. I started to take them regularly, but they started making me sick, so I quit taking them and didnt take them for several years. Just recently I went back the the practitioner who diagnosed me with this and she placed me on a slow-release iron tablet daily along with a new birth control that has iron in it.

I have started losing hair around the middle-back of my head mainly around the crown area. It looks like my part is getting a lot wider, and the part is spreading down to the back of my head. I used to have really thick curly hair but now it is getting thin around the top, and in some patchy areas.

At first, since I am a Registered Nurse, I thought stress was causing it. The last time I went to the doc, she said I was anemic with low iron levels, hence putting me in daily iron, so I thought my anemia was causing it. I’ve been on and off birth control, so I thought that could be another cause.

Am I too young to use a topical treatment such as Rogaine? or Sephren? Sephren is an oral and topical treatment for hair loss in women. What do you recommend? I feel like I am losing more and more hair by the day and it really stabs a knife into my self image and self confidence. I’m desperate for some answers. I wish someone would lead me in the right direction so I can start growing hair in those thinning spots. I don’t want to be bald by the time I’m 30. PLEASE HELP!!

Polycystic ovary syndrome (PCOS) causes hair loss in women who can also inherit the genes for balding/thinning. It is a very difficult condition to treat, as the treatment is often unsuccessful. Since you’re already under the care of a doctor, I’m not sure what I can offer. You need a good doctor/patient relationship.

Hormone therapy might help with the PCOS-related hair loss, though since you mentioned stress and anemia, those are other potential reasons for your thinning hair. I just have no way to know what is causing your loss, or whether it is a combination of things. You aren’t too young for minoxidil (also known as Rogaine, which is FDA approved to treat female hair loss), but the oral Sephren is just a vitamin supplement with no peer-reviewed published clinical evidence that it works.

There is a new cosmetic treatment that we’ve mentioned here called Scalp MicroPigmentation (SMP) which we offer to address the thinning problem in many women. One such patient can be found here.

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I Was Diagnosed with MPB After a Scalp Biopsy

Greetings Dr. Rassman,

I’m age 26, Male. I was diagnosed with MPB through a scalp biopsy. My hair loss is not evident to anyone who is looking at my head. I believe I have only lost a bit of density on the top. My hair loss started about 6-7 months ago. I first noticed a loss of density and then an increase in hair fall during normal activities. I was proscribed finasteride and am taking it.

My hair is relatively long (approx 3 inchs in length). Many of the hairs that I find while combing and shampooing appear to me to be thinner and are definitely less pigmented at one end than at the other. The “older” top inch of the hair is jet black while traveling down the shaft you will find it becomes brown in color at the “bulb” end. It also appears to be slightly thinner at the bulb end. I can tell this with the naked eye but comparing both ends of the individual hair on a white piece of paper.

Can miniaturization take place in one hair cycle or do hairs become less pigmented and smaller in shaft diameter as they enter the telogen phase?

In general, androgenic alopecia / male pattern baldness (MPB) is not diagnosed from a scalp biopsy. A scalp biopsy is usually only used to diagnose and confirm scarring types of alopecia (not MPB). MPB is diagnosed by looking for a pattern in one’s hair loss… which explains why it’s called male “pattern” baldness.

Individual hairs are never followed by tagging them so I really can’t answer your question. I believe that a single hair cycle can be miniaturized at a follicular unit level or die off at that level after telogen occurs. Pigment often is reduced in miniaturized hairs, but not as they enter the telogen phase if they were good, solid terminal hairs prior to that cycle.

I would stick with the finasteride, as per your doctor’s recommendation. I’ve seen many, many cases of this drug working very well for treating early hair loss at the top of the head, like you’ve described.


2014-05-14 13:03:43I Was Diagnosed with MPB After a Scalp Biopsy

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I Was Diagnosed with Mild Alopecia Areata After I Was Prescribed Propecia

Im 24 and I noticed my hair thinning approximately two years ago. However it was hardly noticable. My dermatologist said it was due to hereditary and put me on Propecia. About three months later my hair began to fall out rapidly (about 200 plus hairs in the shower alone) from all over my head. It later slowed down to around 80 plus in the shower and has been consistently falling out at this rate for around a year. It seems to be affecting the top of my head more that the sides but it is hard to tell since it is diffuse loss. I saw a hair specialist who diagnosed me with mild diffuse Alopecia Areata. He prescribed a topical to apply once at night which in a few weeks stopped my hair loss completely. My question is will the hair I’ve lost ever grow back?

The diagnosis of diffuse alopecia areata is best made with a skin biopsy. Have you had that done? You have two diagnosis of genetic balding and alopecia areata…. both are not good from a hair loss perspective, but both can be treated. You need a confirmed diagnosis first and foremost. The treatment of alopecia areata is highly specialized. Some doctors use steroids to suppress the reaction in hope that the autoimmune process can be reversed. I wrote about a special treatment for this disease before — see Alopecia Areata in a Patient with a Miracle Cure (with Photos).

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I Was Diagnosed with Mild Alopecia Areata After I Was Prescribed Propecia, Follow-Up

This is a follow up to “I Was Diagnosed with Mild Alopecia Areata After I Was Prescribed Propecia” The dr never did the biopsy because he said there was strong evidence that I had alopecia areata due to small patches on my face and amount of grey hair present. He wanted to try the simple stuff and since my hair has yet to start falling out again didn\’t feel the need to do one. However I have yet to see regrowth in two months of being told to stop using the topical. It was Fluocinonide .05%

The hair loss from alopecia areata may take months or years to reverse — or it may not reverse at all. You need to have good communication with your doctor on this issue. The diagnosis does not require a biopsy, as a good doctor knows what to look for in most situations. Patience is a virtue in waiting out the course of this disease. Topical steroids have value when used by a knowledgeable doctor and some may use fluocinonide (a prescription item) as one of these steroids. See Wikipedia for more on fluocinonide.

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I Was Diagnosed with Lichen Planopilaris

Hi,

I recently went to a dermatologist to be diagnosed with AGA despite no family history (even 3 generations back). I am a 29 year old male, who has been overweight for a few years (~50-60 lbs)and generalized anxiety disorder. I was prescribed “Valium” and a beta blocker called “Propranolol” in December 2009. Sometime in 2011, my head began to itch, sometimes more, sometimes less. By February 2012, I noticed suddenly that there was a thinning patch on my crown and my scalp looked red and inflamed and itched more often.

The dermatologist also took two 4 mm punch biopsies from two sites on my vertex and pathology sent them back as AGA w/ active “Lichen Planopilaris”! I had never even heard of this before. My research just shows me it’s extremely rare, is incurable and for the most part will ruin my life unless I enjoy being bald. What am I supposed to do? Everyone else is calm about the situation, and my derm says he doesn’t yet “buy it” that it’s lichen due to my clinical presentation (Are transverse biopsies ever wrong?)

I’ve read you can’t even restore your hair with HT if Lichen is there because it will just destroy that hair too. How does this Lichen disease come about? I’ve read beta blockers can cause lichen planus, and i’ve been on a low dose for 4-5 years now. I’m not sure what to do, I don’t know why I’d have LPP or where it came into existence from. If its me reacting to the drug, would my hair restore itself if I came off of it after years?

Does LPP also cause miniaturization of hairs because that’s apparently happening as well. How statistically unlucky does one have to be to have both AGA with no famiily history + some rare LPP disease that will scar my head for life?

I’m lost and confused and so far no one has begun any treatments for anything. I know I can’t take propecia, and I know steroids won’t be tolerated well in my body if I have this lichen disease of unknown origin.

Have I received a death sentence for my scalp? The crown/vertex is thinning and a small thinning keeps developing down the parting of my hair. My hairline itself hasn’t receded at all since puberty… The top of my scalp is generally pink/reddish at all times with a little red itchy bump scattered sporadically around my whole scalp.

Thank you for reading my desperate post. I’ve gone from the extremely thick course hair I’ve had my entire life and model with, to losing what feels like 70% of it in the course of 15 months at age 28-29. It is imperative that I restore my hair to its previous glory. I do have pictures if you are interested.

Unfortunately, much of what you said is true. Transplanting hair into an area of active disease will kill the hair grafts. Most doctors will not do a surgery like a hair transplant where the odds are against the success of the procedure. I don’t know the specific statistics for those that have lichen planopilaris, as it is a rare scarring alopecia and difficult to treat.

There are some options: hair pieces, Scalp MicroPigmentation / SMP (which requires you to shave your head for best results), and topical concealers like Toppik.

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I Was Diagnosed with Female Pattern Baldness, But Could It Also Be From Tight Rollers?

I have noticed dramatic hair loss in the last 6 months bang area. I went from having long thick bangs to short hairs and visible scalp. I went to a hair loss doctor and he said I have female pattern baldness. I believe this is the core problem-but could it also be that I am continuing to brush vigorously with a brush dryer and using tight rollers when hair is wet. Will the hair re-grow now that I have stopped doing this?

Tight rollers or pulling or brushing your hair vigorously can cause hair loss that may be permanent. The only way to tell if your hair will grow back is to wait it out. It may take about one year for you to see regrowth. If you do not see regrowth after a year then it is likely permanent.

If you were diagnosed with female pattern hair loss, it is possible that you have a combination of genetics and traction alopecia from the pulling… but I have no way to know that for certain.


2013-11-20 13:12:44I Was Diagnosed with Female Pattern Baldness, But Could It Also Be From Tight Rollers?

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I Was Born With Little Hair and Feel Cheated

I am a 57 year old female. I have five sisters and five brothers. All were born with full heads of hair. Both my father and mother had a lot of hair. Especially my mother. For some reason I was born with little hair. I always felt I was cheated. I started wearing a hair piece at 22yrs. What would have caused me in my mothers womb not to have had as much hair as my siblings. Thank you

There are genetic conditions that are present that give very little hair to a normal scalp. You need to be evaluated. Genetic testing (probably expensive) might be a place to look, but first a good examination by a competent doctor should be where you start.

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I Was Born with a Permanent Bald Spot (with Photo)

Hi,
I was born with a permanent bald spot that will not regrow hair. I’m sorry that the photo is not high quality, it is near the back of my head to the side.

Click the photo to enlarge:

 

Was there a question for me? I don’t know why you have this bald spot, whether it was indeed from birth or perhaps a trauma to the scalp in your childhood that you don’t remember. But if there’s no hair that you remember growing there, I would agree that it is more than likely permanent.

If you can live with it, let it be. If you want to address it, please give my office a call at 800-NEW-HAIR. We can fix it with a limited hair transplant or Scalp MicroPigmentation (SMP). As it is a smaller spot, SMP would likely work well to eliminate the contrast between skin and hair color (plus the results would be immediate, as it is not a surgical procedure).

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I Was Born with a Bald Spot and Want to Cure It

I’m 34 yrs. old and I was born with a scar on my head I had surgery and as I grew older it turn into a bald spot and hair never grew. Is there any cure for any type of bald spots?

Surgery would probably be your only solution. There’s no cure for bald spots or hair loss, and if you never had hair in this spot you likely won’t get it to regrow from medication use.