ive had steady hair loss around my belly button hair area for about 2 years now, it just keeps getting thinner & continues on a steady pace. i dont care all that much about losing hair in that area, but my concern is the reason for it & will it spread to other areas? is this normal? thank you
Often the belly is an area that is rubbed by belts or articles of clothing. These can cause traction alopecia. Have you gained weight and increased your belly size?
I have had two hair transplants. The last one being about 3 years ago. When I get highlights put in my hair, the hair experiences a lot of pulling during the process. If the transplanted hair is accidentally pulled out (in such a manner) does it grow back or is it gone forever? Thanks!
I’ve written about this in the past, but I recall a time when one of my patients was mugged about a year after his hair transplant. During the robbery they held him by his hair, beat him badly and when they finished beating him up, they pulled out his transplanted hair. He came to see me immediately after the beating and he was missing about 3 square inches of frontal hair (all transplanted). It grew back in 6 months.
An acute pulling out of the hair will not cause it to be lost, but chronic pulling will cause traction alopecia. There are many things that are chronic hair pulling experiences, most notably wigs at the points of attachment. These men who have such attachments will develop bald spots on the scalp that are permanent.
Do hairs visibly fall out when you are balding? for example if you would move your hand throughout your thinning hair would there be a few hairs that would show on your hand most of the time?
Sure, I’d suspect running your fingers through your hair if you’re thinning would leave you with hairs on your hand. You will see the hair in the shower or sink, but a lot of hair will fall out throughout your day without you even realizing it.
In a recent question you write: “A 25 year old man already showing thinning in the Norwood Class 7 pattern will not benefit from Propecia unless it is caught early and still it may not do much more than stop the loss from occurring.”
Is there any difference between “thinning in the Norwood Class 7 pattern” and “diffuse pattern alopecia?”
And what’s a good way to determine if you are catching your thinning early? If you have hair all over your head, but your scalp is starting to be seen in the mirror, is that early? Or ?
Let me clarify things a bit. If you are 25 years old and already a Norwood class 7 (it does happen), you will not benefit from Propecia because there is no hair left to save. If you still have some hair, and show signs of Norwood 7 with significant miniaturization present in that pattern, then Propecia would help hold on to the hair longer. Norwood 7 has a definite pattern to thinning of hair loss. A diffuse pattern is just as it states — you are thinning all over (even in the sides and back of the scalp).
A good way to determine if you are thinning early is to have your scalp hair examined for signs of miniaturization. Get the scalp mapped, then have it done again in 6 months to compare the results.
Their is always so much talk about DHT being the root cause of Male Pattern Hair loss nearly everywhere one reads. I was just curious if their has been any other recent discoveries, excluding DHT, that may contribute or cause the condition?
For the genetic condition, it is the DHT that acts on the genetically sensitive hair follicle that causes hair loss. There are nother recent discoveries that I’m aware of relating to what you’re asking.
I have researched that after the hair transplant surgery, there are some patients who are experiencing a common side effects which is Shock Loss. I would like to know if this is the fault of the surgeon during the incission? Is there a way to prevent the further trauma to avoid more hair loss after the transplant? I am thinking of having this procedure done, but very much concern of loosing more hairs after the hair transplant. Please educate me. Propecia is commonly prescribed to patients before the surgery, but do you have to take this drug for the entire life or the remaining hairs will soon fall out
Shock loss is a hair loss process that accelerates immediately after getting a hair transplant. It usually occurs in the first 4 months after the surgery. Generally, Propecia will protect against most post-surgical hair loss from shock and it should be taken for a period to discuss with your doctor. The longer you take it, the better, but as hair loss is a progressive process it will kick in again when you stop the drug.
I generally recommend for patients to stay on Propecia for 9 months minimum just to deal with the threat of the shock loss, but that is not a hard rule. Everything depends upon your examination and the relationship you build with your doctor. I generally think that if you are serious about preventing any loss, men with genetic loss are best treated long term (lifetime is long term) with Propecia (finasteride).
Hi Dr. Rassman,
my husband has thinning hair on two of his front corners of his head Norwood 2-3. And he went to a doctor for a consultation about the problem, they suggest dense packing the two corners. However my husband doesn’t want to have the corners densely packed in case the rest of his hair in the center thins out in the future, which will look odd (Having two thick corners and a thinned out center). He feels this approach is too aggressive and wants a little more hair there just enough so it doesn’t look like it is receding. Is this a realistic approach to restoring the two corners? Do doctors normally make special request such as this?
Regards
I can’t say much about this particular case, as I don’t know enough about it (the level of miniaturization throughout the scalp, the age of your husband, etc). Generally speaking, as a surgeon I don’t dictate what hair restoration design should be done on someone. I listen to the patient first, and then build a plan that makes sense for both the patient and the doctor. It’s a back and forth process so that everyone is happy with the outcome.
It sounds like the doctor your husband met with wants to dictate what he needs and I would personally run for the hills… or at the very least, get another opinion. The results of this surgery will last a lifetime, so your husband is smart to be cautious.
I have a question about the norwood scale pictures. When the pictures show very little hair, is it supposed to represent literally that amount of hair, or any noticeable amount of thinning? I suppose an example would be 3 vs 4v. Does 3 mean there is no thinning at all and 4v mean they still have a decent head of hair, but the hair on top is thinner?
I’m sorry this question has been very hard to word, and i hope it makes sense.
The Norwood chart is just a list of patterns showing how men bald and probably where they stop in the balding process. But in the 1970s when Dr. O’Tar Norwood updated Dr. Hamilton’s initial studies, he surveyed a large number of men and clearly most were in some phase of the balding process.
It is not a progression of hair loss. For example — you do not go from Norwood 2 to Norwood 7 as you age. If you are going to be a Norwood 7 you will likely have thinning in a Norwood 7 pattern. You may not “look” like a Norwood 7 now (with all the hairs gone), but you may show early signs of it, especially when you look at your hair under a microscope. This is the reason why we always endorse a miniaturization study. I hope this clarifies things a bit.
Just wondering about your opinion on SHBG (Sex Hormone Binding Globulin) and MPB. In short, I’ve read studies and theories stating SHBG binds to free testosterone reducing levels of DHT. I know exercise and low insulin have been shown to significantly increase SHBG. Perhaps exercise and a low-glycemic diet may be beneficial towards slowing or preventing hairloss.
The study below shows balding men had low levels of SHBG, unlike men without alopecia.
Sex hormone-binding globulin and saliva testosterone levels in men with androgenetic alopecia.
“Sex hormone binding globulin (SHBG), plasma testosterone and saliva testosterone were measured in sixty-four men with androgenetic alopecia and in forty males within the same age range without alopecia. There was a significant reduction in SHBG levels in bald men, compared with controls. Plasma testosterone levels were not raised in bald men, but their salivary testosterone levels were significantly higher than in controls.“
This is interesting stuff, but I do not know what value it brings for the balding man and woman. We will not exercise just to change SHBG levels. It makes for great academia.
Hi Doctor
I am male age 47 and my hair has been thinning very very rapidly over the last 5 months. Prior to this I just had normal daily hair loss which was unnoticeable. Is this normal at age 47 and also do you think propecia will grow back my hair given that i’m 47
Thank you
I am unclear as to why you are losing your hair so rapidly. What you’re describing is not usual, but certainly male pattern baldness is a possibility. Medications such as Propecia may help, but that is ONLY if you have androgenic (male pattern) balding. You need a good examination and a diagnosis before thinking of treatment options.
