Author: Dr. William Rassman

Over the years, I have lost 30 or 40 percent of my transplanted hair. I am a 72 year old male. I first had 300 plugs put in the frontal part of my scalp at age 40. About half of the hair fell out over 10 years. I was told that it was because the plugs were too large and did not get the proper blood flow. I then had 3 FUE prcedures done over a 8 year period in my 60’s. The first two were 1200 grafts each and the the last procedure of 1000 FUE’s was done at age 69.

All total, about 30 percent or more of the these grafts have fallen out and not come back. My hair now looks like it did after I had the first FUE transplant. The doner area still has hair. At first I thought that the doctor took hair from too high from this area but my hair loss has not gone down that far.

Do you know what would cause transplanted hair to fall out and not come back or, is there anything I can do to keep from loosing any more transplanted hair? Could it be that there may be something wrong with my scalp on top of my head? or ?

The first Doctor who did the plugs was one of the first to do plugs. The second doctor that did the FUE’s had been doing follicle transplants for 15 to 20 years and had a good reputation. I was going to ask my doctor about this but the second doctor passed away last year.

Any help or information is greatly appreciated.

Thanks

Hair taken from the back and sides of the head is permanent, but the permanent zone is only 2 1/2 inches high in the back of your had and many doctors years ago, harvested hair that was not permanent with punch excision and the old open donor method of harvesting. I have seem many of these patients over the years with this problem. You are correct that the old plugs have oxygenation problems and they often lost hairs within the plugs in the short term after a hair transplant. About 1/3 of the population lose about 1/3rd of their permanent hair. If this is you, you should see a loss of hair in your permanent zone. This problem seems to be more for people of your age than younger men and it is called senile alopecia. If you have senile alopecia, there is nothing that can be done about it. You might try minoxidil, as it tends to prolong the hair cycle and could prevent the death of some of these hairs.

i am eighteen years old and have noticed that my hair all over the top of my head and even on the sides to some degree has become finer. I already have naturally fine hair but it has gotten even more fine, however i still have a full set of hair. Does hair becoming finer always mean it is undergoing miniturization and balding or can it just be naturally occuring with age and not undergoing balding?

There is no clear way to tell without a physical examination and history. If you are miniaturizing rather than going to a finer hair, the regularity of the mapping will tell. Real miniaturization will have variable hair shaft widths while a change to a finer hair will show complete regularity in hair shaft widths. A fine hair can undergo miniaturization.

I am a Pacific Islander who had dreadlocks for about 6 years. I noticed small, developing bald spots approximately a year ago. I recently cut my dreads since I noticed that the bald spot is growing. Is it abnormal for my scalp to be itchy? I have always had dandruff, could this be to blame? Sometimes it is particulary itchy at the bald spot? Could this be new growth or perhaps the cause of my baldness? Are there any treatments that can be sought for traction Alopecia?

Having dreads or braids can cause traction alopecia, which is not reversible unless it is caught early enough. For those who are lucky enough to catch it before it becomes irreversible and the dreads or braids were not in for extended periods of time, you may experience regrowth of hair. If this is the case, it could take up to year for hair to regrow.

Your scalp should not itch with new growing hair. I do not believe there is a correlation with itchy scalp and new hair growth. As you mentioned, this may be dandruff or other skin/scalp problem and I agree with that belief.