Month: January 2023

The use of general anesthesia for a hair transplant is not a good idea because a hair transplant takes many hours and general anesthesia risks go up the longer you are under it, plus the costs would be very, very high. The use of local anesthesia like you dentist uses, is the only way to do this. Pain should not be a problem as most people feel nothing once the local anesthetic has been administered.

You have what is called traction alopecia and the only treatment for this is hair transplantation. A good doctor in this field needs to determine if you have enough donor hair to perform a hair transplant to cover the bald areas. Most people have enough donor hair.

Hello Doctor,

I know there have been various posts on this topic and please feel free to ignore the question given that you have already provided comments. Also, I wanted to thank you for the blog as it has really allowed my to expand my knowledge of hair loss and related topics which is greatly appreciated.

I had what I though was a thick head of hair on the top of my head and historically my worries over thinning was limited to a receding hair line. Recently I got a short hair cut (borderline buzz-cut) and seemed to notice that in certain house lights I can see some of my scalp. That being said other lighting I cannot see through at all including when I am outdoors. I am not sure if this is a function of how my hair is parting, the use of hair products which I read can ‘clump’ hair together giving a thinner look or whether there are legitimate concerns to be had.

My question(s) relate to the miniaturization process and the speed to which it can occur. I recall from a previous blog that hair will grow at a rate of about ½ inch per month and would it be possible to have ‘normal’ hair on the top-half of a follicle and a miniaturized bottom? Is the process of miniaturization more gradual or can you go from thicker to thin in a matter of a few weeks?

I can sympathize that people are different and will go through the process at different paces but I am looking for some general comments based on your experience. For further information, my hair tends to be quite straight and sticks up when short and could this growth pattern contribute to a thinning look i.e. sits in such a position that gives a thin look? I should note that I am 33, currently taking Propecia but nothing else in the way of medication.

Regards

I am not sure how fast miniaturization occurs. I would think it happens over weeks to months (not days). It is a gradual process. I do not know of any documented studies on how fast miniaturization occurs. Usually we follow patients on a yearly basis (not monthly).

If you would like to conduct your own research, you can buy a handheld video microscope and take pictures of a specific area over a period of time and document the results. We wrote a 3-part tutorial on doing this a few years ago — Mapping Your Own Scalp for Miniaturization.

I went to a surgeon for a consultation, and he said the following in an email to me afterwards: “Your Norwood classification is possibly Norwood 3. You may not look like this, but you are showing a similar pattern. Your Norwood classification is not meant to be seen as a progression of hair loss, but rather a genetic predisposition (like the color of your eyes).” Is this true? I thought this entire time that when you start going bald, you always end up going completely bald (at some point). This is an important question to have answered because it will determine if I end up getting transplants or not. Is it actually possible to lose hair up to, say, Norwood 3, and then the hair loss completely stops? Or is this bullshit? I’m currently 26, and the surgeon said to me that, by the time you are in your late twenties, it is relatively easy to predict what classification you fall under by just using the microscope to identify currently thinning hairs, and that most men who ended up completely bald showed clear signs of hair thinning throughout the head in their late twenties.

Yes, many people with a Class 3 pattern of hair loss will retain a Class 3 pattern of hair loss for their entire life. The original classification system was to define the end stage of hair loss patterns, not necessarily transition stages of hair loss, although some people do get transitions from a Class 3 pattern to a more advanced pattern of hair loss.

Thanks in advance for taking time to answer my question. I am 18 years old and have been noticing hair loss on the back of my head (in the crown area) for about 10 months. I guess it has gotten worse with time, I am still getting the same comments/questions from friends, “Are you going bald?” It’s not the best question to be asked at 18 years old. I am having trouble accepting the fact that I am loosing my hair because I would venture to say that I am physical-look-conscious. haha. I have an appointment with the dermatologist in about 2 weeks. The hair I have lost isn’t all that great, but when looking specifically at the area you can tell 2 thinning patches, one on both sides of my head. Will I be able to grow my hair back to normal or will I be able to stop the hair loss? What can I do on my own to help myself either grow hair, reduce the loss, or make it look as though I am not loosing hair? I was under a lot of stress over the past year, but I don’t believe that hair loss would just happen in those areas if I lost my hair due to stress, or could it? Thanks again for reading and answering!

Stress can induce hair loss. The place where the hair loss occurs is usually the weakest hairs first, then the less weak hairs in the ‘patterned’ hair loss that men experience. Where it is lost is genetically programmed in each and every man. If you are losing hair in the front, then if you get stressed, the frontal hair may experience accelerated hair loss. If you are losing it in the crown and not the front, then the crown may experience accelerated hair loss before the front is impacted. What I just said reflects genetic balding, not some other condition causing hair loss. Women do not have patterned hair loss, so they can lose hair anywhere with stress.

Genetic hair loss is not like a straight line if you plotted it out. You inherit a pattern and at different ages some hairs will undergo miniaturization and eventually fall out. So yes, hair loss can accelerate, then slow down and then accelerate again. If you are treating it, you may be treating a stop and go process. Many of my patients tell me that even when they take a drug like finasteride, they may start losing their hair in spirts and stops.

Not happening. Cloning has a history, and when used in mice they died back in the early 1990s. These hairs were cloned in a petri dish and placed into hairless mice. The hairs grew in all directions, many ingrown, causing infections that killed the mice.