Author: Dr. William Rassman

Hi Dr,
In school we studied how MPB is autosomal and sex influenced, not X-linked. I also read that balding is mixed penetrance. Does this mean there is a possibility that an individual can get a mixture of hair/balding, from various relatives? For example if ones father has no hair loss but his maternal grandfather does.

Thanks for your time.

You are correct. You can inherit balding from either family lines and the genes may not express in your father or mother, but it may express in one or both of their parents. You could be a victim of these genes when you are old enough.

Patient SYZ regrets his original decision to get a hair transplant. With the plan he and his doctor put together, it would take two more procedures to complete his hair restoration. He came to the conclusion that he wanted the freedom that a shaved look would give him but the huge scar on the back of his head excluded that choice. When he found out about the option of treating the scar and the areas of his head that were thin with the Scalp MicroPigmentation process, he became excited (https://scalpmicropigmentation.com/).

The shaved look worked well for him and it was entirely possible. After undergoing a Scalp MicroPigmentation treatment, he was able to shave his head and keep it shaved. The pigment enhanced his hair line and gave it a consistency in color, thickness and appearance. It took three sessions to achieve the results and cover up the scar which is shown in these photographs here:

https://scalpmicropigmentation.com/scar-covering/#!https://scalpmicropigmentation.com/wp-content/uploads/2016/04/new_hair_institute-scalp_micropigmentation-patient_photo-005b-scalp_scar-wm.jpg

Hi,

About a year and a half ago I went on a diet and lost over 100 lbs during the course of a year. After about 6 months my hair started to thin out all over my head. I got nervous and started taking a multi-vitamin and a vitamin for healthy hair. Most of the hair I lost gradually returned but it was much darker and thicker. My natural color is light brown/blonde. The hair that grew back had a straw like texture. It was black and wiry.

I visited my family doc and a derm and both said the color change and thickening was odd. They did a full battery of blood work but it showed nothing. Now after about six to eight months of having alien hair the dark, thick, black hairs are shedding like crazy. 90% are gone at this point. What is left is the hair that is my natural color and texture. It is much thinner than usual because of the shed the past few months. I can see some light colored peach fuzz sprouting up where the dark hair fell out but that just started in the last two weeks. Luckily, I had super healthy, thick hair before this so if I style it correctly I still have coverage.

When it turned black friends asked if I colored my hair. Now that it is going back, I’m getting the same question. Docs suggested hormones. I did have a stressful year and a half. They said I could use rogaine or propecia. I didnt want to start either of those because from what I read they need to be continued for life. Very nervous about propecia especially if my hormones were out of whack naturally and have recently returned to normal on their own. I doubt that would help make things better. No doctor would say for sure it is MBP, not even a local hair transplant doc I went to a consult with. He said give it 6 months and come back. He never saw hair get thicker and black before and couldnt explain it.

Everything I’ve read about MBP talks about receding and gradual thinning. My hair went from perfect with no signs of loss or family history on either side to thin to thicker and black back and now to normal color but thin in just over a year and a half. I do not have any bald spots just my normal hairline of the past but a general lack of density because of what I lost. I’m frustrated and out of options as far as I know. I’m hoping you could offer some insight. I just want to know what I’m dealing with so I can decide on a course of action. Thanks in advance for your help.

Hair color change and texture change are not likely related to dieting, but perhaps your hair loss was “triggered” by the extreme dieting (a common condition). I can’t explain the reason for the wiry, black hairs that you’re describing. It is a little odd, and I’m sorry to say that I don’t have any further insight.

Diffuse hair loss and patterned hair loss are generally two different things. For example, if your hair loss is deemed to be telogen effluvium, then your hair will likely grow back in a year. If you have another exam (find another doctor that can give you answers after an in-person examination) and can get the MPB diagnosis, then medication like Rogaine or Propecia would be helpful. If you don’t have genetic male pattern baldness, Propecia isn’t going to help you.

You need to figure out what is going on before you can figure out how to treat it.

Before one gets a hair transplant you have to:

1-be balding

2- be over the age of 26 so that your hair loss pattern is defined

3- be prepared financially for more hair loss and more hair transplants

4- failed on conservative treatments like minoxidil and/or finasteride

5- My saying is: A good decision today is a good decision tomorrow’ that tells you that you should think more than once about doing hair transplants and make sure this is the right solution for you.

Hair direction after any hair transplant (FUE or FUT) is controlled by the surgeon. Sometimes the surgeon doesn’t put the graft in the correct position and when that happens the hair grows as he planted it (wrongly if he put them in that way). I see this more commonly that one would think because not all doctors who do hair transplants really understand this very simple process.