Author: Dr. William Rassman

I am an active 17 year old high school cheerleader and my hair which used to be thick, is now falling out and becoming thin, like my mother, my grandmother and two of my aunts. They tell me it is in the family, but not when they were my age. What should I do? If I go to a doctor, how do I find one?

Genetic causes of hair loss in a 17 year old female, is unusual. You were correct to ask your female relatives at what age the condition first appeared with them. I would first have a good doctor see you and look for medical causes of hair loss (there are many). The following problems are amongst those that should be considered: anemia, thyroid disease, connective tissue disease, various gynecological conditions and emotional stress. It is also important to review the use of medications that can cause hair loss, such as oral contraceptives, beta-blockers, Vitamin A, thyroid drugs, coumadin and prednisone if you are taking any of these. Many other medications can also contribute to hair loss so if you are taking any drugs of any type, then that should be looked into as well. The following laboratory tests may be useful if underlying problems are suspected: CBC, Chem Screen, ANA, T4, TSH, STS, Androstenedione, DHEA-Sulfate, Total and Free Testosterone.

It is possible that a medical condition may be the cause of your hair loss, so before you jump to conclusions that you are following your female relatives’ fate, I would have you checked out for these conditions. Also, please read my previous blog entry, Female Hair Loss.

Dr.Rassman,
I’m 22 and have been taking propecia since I’ve been about 19. It has definately slowed or stopped my hair loss, but I am still pretty unhappy with my hairline. I don’t think I would need a very large scale hair transplant at this point, my hair is only thin in the front, and I was wondering whether you thought it would be a very bad idea to get a transplant at my age and given the circumstances.

For starters, please see Hair Transplants in Young Men.

As you see from this previous response, I do not have a problem transplanting a man of your age. It is important to read and understand the above link and we would have to develop a relationship. When both of us are comfortable with the analysis and the depth of understanding I require, then we can consider a hair transplant, provided it is indicated and not harmful to you.

I began to lose my hair in the frontal region of my head, shortly after beginning to take accutane. Is there any thing that will help?

Hair loss from Accutane is a known side effect. First you must weigh the options of stopping the Accutane. Your doctor should be able to help you make the right decision. The lost hair may return, so you need some time to observe what happens. If the hair does not come back within 8-12 months, then you might need a complete evaluation with a doctor like me, who specializes in hair loss.

I have previously discussed Accutane on my blog, which can be found below:

• Hair Loss and Accutane
• Hair Loss and Accutane, Part 2

It has been about six weeks since I’ve posted an entry about hair cloning, but I’ll revist the topic again because I get quite a few requests for information. People generally want to believe that cloning is just around the corner.

Why can’t we clone hair, since scientists can clone a sheep? When can we expect to get a cloning treatment and how will it be done?

When it comes to cloning, hair follicles are in a tough spot. They are too complex to be simply cultured because follicles are not whole organisms like Dolly the sheep. The focus of cloning for hair is to move cells that can stimulate growth from a normal hair follicle, to an abnormal (genetically impaired) hair follicle. Although this is not actually cloning, the growth stimulating cells from the normal hair follicle can potentially be multiplied in a Petri dish and then moved to the area of genetically impaired hair. Some of these cells are capable of turning themselves into hair, bone or muscles and this has been shown in what I will call ‘uncontrolled experiments’. Because people who are balding always have some non-genetically impaired normal hair, we do not need a person to person transfer.

There are problems that are yet to be solved. The primary problem is to identify which cells are to be moved. Other problems are once the cells have been identified. We must ask, “Can we successfully create enough of these cells to work with, and is there certainty that the cells that are created and moved will maintain their capability to stimulate growth in the genetically impaired hair follicles?” It is anticipated that whatever process we come up with, there will be a type of medical ‘soup’ which the doctors will inject into the genetically balding areas of the scalp. When they are injected into the balding scalp, they must consistently be able to stimulate hair growth. Unfortunately, the success of this entire process has been relatively low so far. There have been some successes, but these have not been replicable, suggesting that we do not have control of the process. We also have to be 100% sure that this process is safe. Do we know that these cells will not produce a cancer or other problem? Safety and effectiveness is critical for any FDA approval and it will take years for this to be worked out. Don’t hold your breath, no matter what you hear!

For more information, Dr. Bernstein wrote an article about hair cloning in our 2004 NHI Newsletter, available here. Adobe Reader is required to view the file.

To read more newsletters, medical publications, and the PDF version of The Patient’s Guide to Hair Restoration, please see the NHI Medical Publications page.

Dr,
I recently saw you on channel 4 news describing a new procedure of hair transplantation where there is no incision done.I have had procedures done going back 15yrs.Approximately 5500 of the old grafting technique.my frontal hairline and down the middle needs to be enhanced.I still have gaps and have lost more hair since my last procedure 8 yrs ago.Could you please tell me a little bit about the new procedure or where I can read up about it. I should also set up a consultation appt.
Thanks

You are referring to the news item from April on the FOX Procedure, also known as Follicular Unit Extraction or FUE. This is a technique that I introduced in the medical literature in the summer of 2001, and published in 2002 in an article titled Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation. The procedure essentially removes the follicular unit one by one without a traditional incision. More information can be found on newhair.com: FOX Procedure, FOX Megasession, and Medical Publications. Newhair.com is probably the most comprehensive hair restoration-related site in the world, with the greatest amount of original content and patient photographs, so please poke around the site to see exactly what we offer.

The FOX Procedure is an exciting new technique for minimally invasive hair transplant surgery, but it is not for everyone because:

1. the costs are higher
2. it is better for less bald people
3. it is very difficult to perform and very few doctors are willing to step up and build the expertise
4. not all patients are good candidates for this procedure because of the type of collagen that they have in their connective tissue (10% of people are in the category).

The procedure has the advantage of having almost no post-operative pain, and very fast healing with full activities within days of the surgery.

As you are local, I would recommend that you visit me in my Los Angeles office, which is only about 8 miles away.