How do I tell miniaturized hairs under microscope?
Here is a photo of DUPA and you can easily see the thin miniaturized hairs that seem to dominate the field of view because it is a case of DUPA: https://baldingblog.com/do-i-have-dupa-photo/
2021-07-01 01:53:092021-07-01 08:55:43How do I tell miniaturized hairs under microscope?
I was wondering if there is a way I can treat my impulse in picking out my scabs from my scalp. I am starting to develop bald spots in the front area of my hair. Other than that, I have lots of hair, and don’t think that my hair will ever thin. Also, if I stop picking at my scabs, will the hair ever grow again at the aformentioned bald spots? Or will I have to use aids like propecia, if they would be of any help?
Thank you
You describe a condition known as trichotillomania. It is a sort of obsessive-compulsive disorder and there may be help. But first, you need to see a doctor who can diagnose you and manage your obsessive behavior, one step at a time.
So I’ve been to dermatologist and started using fin and minoxidil. He used some camera to see whether I have hair follicles on my temples and it turns out that I have a lot (basically I could go back by 0.5-1 norwood if I grew them out). From what I understood my dermatologist seemed to suggest that there is hope in regrowing this hair. But I’m not sure whether I understood his words correctly. It’s said a lot that fin is going to let you “preserve what you already have at the moment”. And that minox works on scalp only. But I’ve been instructed to use fin, dermaroll once a day and use minox on both crown (which has very little loss) and temples. Does it mean I’m trying to regrow hair on my temples this way? Most articles mention that hair regrowth on the temples is unlikely as hair follicles are probably already dead (unless you lost your hair just recently). In my case I’ve lost hair on my temples quite within 4-5 years mark but most of the follicles seem to still be there. Does it mean I can expect regrowth?
A proper examination of the hair for balding is (1) the use of a video or hand microscope, (2) the use of a HAIRCHECK instrument which will measure the actual hair bulk in different parts of the scalp, and (3) see a good doctor who specializes in this field. With all of that done, you can be confident that you have done everything you need to do to make a proper diagnosis and commence treatment. Hair may or may not regrow with drugs like minoxidil and finasteride.
2019-08-15 04:25:282019-03-26 18:25:46How do I make the proper diagnosis for hair loss?
First of all, I’m a huge fan of your blog, it helped me a lot.
I visited a surgeon a year ago and he said he would do the surgery for me, but finally i did not have it done. I’m 24 and I haven’t noticed any hair loss for a year or so. I’m only balding in the front and it’s not too bad either.
I’m thinking of doing it now. But I read here that it’s usually not suggested to have it done at this age. Does usually mean that there are exceptions and occasionally you have patients at this age? How do I know my surgeon has my best interest? I actually do trust him. He is a member of ISHRS and seems very trustworthy. He said he usually doesn’t do it for young people, but that I have a lot of hair in the donor area and that since my hair is bright and curly, it’s easy to hide the balding.
We put together this post to help people like you to select a doctor: Selecting a Hair Transplant Doctor. You have to apply judgment in filtering out the variables discussed in this reference.
At 24 years old, you are at the marginal edge for doing hair transplants. Ask yourself — what is the rush? Is it bothering you enough to do something about it now or would waiting another year help you make the decision?
Basically from what I’ve seen discussed, when people get hair transplants, they move hair from the sides/back of head to the top. This sometimes leads to scarring, so what people do is the keep the sides/back a bit longer to conceal it. If i were to get a hair transplant would I still be able to get skinfade haircuts like this or would I be required to keep the sides/back long due to scarring or any other reason
The answer to that question is: (1) depends upon your donor density, the higher it is, the less the problem, (2) it depends upon hair thickness, the higher it is, the less the problem, (3) it depends upon how many FUE grafts were taken and transplanted and (4) it depends upon your hair length, the longer it is, the less will be the problem.
2020-03-02 12:42:002020-03-02 12:42:25How do I know if my donor area will look bad after FUE?
I am a male in my early 20’s and I just came across your website. I have been on propecia for maybe 3 years and I have a feeling it is loosing it’s power. More so in the front of my scalp. What is another option? I received a book from a dermatologist and in it he lists some other medications. I don’t have the list handy but I would like to send you the list so you can let me know what you think.
I want to know about telogen effluvium. How do you know if you have it or if you are going bald? I read on the net that for telogen effluvium there is an overall thinning of the scalp but not baldness and that the hair comes back. But how long before the hair comes back? I am guessing if the hair doesn’t come back within a year then you are going bald I guess.
congrats on the site once again. Really helpfull.
It would be hard to judge about the efficacy of Propecia. You don’t know how you would look if you were not taking it. It is true that some patients experience better results than others, but your hair loss may get even worse if you stop taking it now (by catching up to the point of loss you would have experienced if you’d never taken it at all).
As discussed here before, the effect of Propecia on the frontal area is not completely studied. Current studies on Propecia indicate good result on crown and back of scalp. Other options are minoxidil and hair transplantation. Propecia and minoxidil are the only FDA approved medications that should be used for treatment of hair loss.
Human hair is in growth or anagen phase most of the time (between 3-6 years), and following that enters to a resting or telogen phase (about 3-6 months). The hair loss that we experience on a daily basis is due to shedding of hairs that are going into telogen phase (10% of our hair population at any one time). Telogen effluvium is triggered when a physiologic stress or hormonal changes cause a large number of hairs to enter to telogen phase at one time. Telogen effluvium is characterized by diffuse hair shedding. It is usually caused by a metabolic or hormonal imbalance or medications. Typically, recovery occurs within 6 months without any treatment. If your hair didn’t come back after 6 months, you should see a dermatologist for further evaluation and to rule out the other causes of hair loss.
At your age, with frontal balding, I would expect that you have genetic hair loss. The diagnosis is made by mapping out your scalp hair for miniaturization. This will show regional miniaturization weighted to the frontal area as you are describing. If the diagnosis is telogen effluvium, it will not show that pattern and it will be more generalized beyond the frontal area into the permanent zone.
2006-11-29 15:34:242006-11-27 14:54:19How Do I Know If I Have Telogen Effluvium?
You will know if you have breast pain, swelling or lumps. Then see your doctor.
2020-05-22 04:00:472020-05-18 11:46:36How Do I Know If I Have Gynecomaastia?
Hello doctor,
I am 22 year old and i had a hair transplant yesterday. I was told by my surgeon that 2560 grafts have been implanted. My question is how do i know if 2560 have been planted or not? Thanks
As the doctor’s staff are preparing the grafts, there should be accounting sheets that allow the technicians to count and sort the grafts by the number of hairs in each graft. Ask your doctor to show you the sheet and the doctor should be easily willing to do this.
While you do have to have some level of trust in the surgeon and his staff, these accounting sheets will show that the number of grafts, once counted and sorted, have been reviewed and prepared by a large staff of people.
It’s rather sad that a day after your surgery you are having trust issues with your doctor.
2013-12-06 12:00:242013-12-06 07:25:49How Do I Know I Really Got All the Grafts I Paid For?
Hello Doc,
I had my first hair transplant 6 months ago in Texas and I received 1613 hair follicles in the frontal region (That’s what my Doctor claims 1500 + courtesy grafts). I lost all the transplanted follicles within first 2 months and I see few hair follicles growing in the sides.
From the day one I had doubt that I didn’t receive the number of follicles I paid for (1500). I felt I received only 1000-1100 grafts, My buddy did count the number of incisions made 2 days after the surgery. I also went to a hair transplant surgeon to get a second opinion but the surgeon refused to do the counting as he felt it was unethical thing to do. However he convinced me that I would have received the number of Grafts I paid for. He also told me the incisions are microscopic and I cannot count it accurately. As the days went by scabs started to form and I did my research by comparing the photos of people who received same number of grafts as me in the frontal region.
After all the research I’m still convinced that I didn’t receive what I paid for and I feel cheated. It took me great pain and sacrifice to get that surgery and I feel its not even worth it. I have decided to wait for few more months to see, how may hair follicles will grow and how far it covers my bald spot.
My question to you is
1) Is it normal to feel what i’m going through
2) Can someone count the number of incision/grafts accurately after the hair transplant ?
3) Lets say if I get a HT from you, How Am I insured that I receive what I paid for ?
4) Do HT surgeons really cheat ? or Am I just being paranoid ?
5) Lastly In case im really cheated , What Can I do ??I don’t mean disrespect you or the HT surgeons community But I’m very disappointed with my situation. Please answer all my questions and relieve me from this confusion.
Thanks in advance.
I don’t know if it’s “normal” to necessarily worry about getting cheated, but I suppose that depends on your level of trust with the doctor.
On occasion, I have been requested to count the grafts for someone that wasn’t my surgical patient. I had one of my patients feel that he was cheated and took a professional photograph of his head the very next day. He had a large photo printed and placed pins in the wounds that he could see (in the photo, of course) and found that only 50% of the wounds were pinned after the analysis was done. So I managed it by showing him: (a) the count sheets of the 5 individual technicians who did the cutting of the grafts from the strip and we added them up together, (b) I had him come in to watch a surgery on his second day to see if he could identify the wounds in all lighting conditions with good photographs (he could not), and yet he watched us place the grafts to know that the counting process is intricate. He saw that there were two counts that were done simultaneously — one by me audited by an assistant working next to me as the sites were made, and one by the staff cutting up the hairs and grafts from the strip. I invested a great deal of time to address his concerns. I am not sure, to this day, if all of my efforts were successful.
In three people that came to see me to count their hairs and grafts on the 3rd-6th day after surgery, in two of them I found that the counts did not match up. One was off by over half of the amount claimed, one had 90% of what was paid for… and the third was on target.
On another patient, I counted the grafts and the hairs that grew 8+ months after the surgery (the man was relatively bald in the front and top where the grafts were placed) and found that many of the grafts did not grow to the numbers transplanted (about 2000 grafts out of 7600 graft he paid for), and the hairs in each graft had low hair counts. This was done under the assumption that everything on his head in the transplanted area were grafts. I had inside information on this last patient from one of the doctor’s technicians who claimed that this was far more common in that particular doctor’s practice than he could stomach, so he quit working for there.
There is little recourse for the patient if he feels that something improper has occurred, as an investigation would be difficult. I think that most doctors are honest and try to do their best when they deliver a service like a hair transplant or, for that matter, any cosmetic procedure. This, of course as I have said many times before, is a buyer beware issue, and each and every prospective patient should do their research before making a final doctor selection.
This is what you should look like:
2021-10-08 08:42:512021-10-10 10:01:34How do I remove scabs from a Hair Transplant?
