Category: Hair Loss Causes

This patient had almost everything that could go wrong with hair transplantation including: Scalp reductions, multiple hair transplants and depletion of his donor area from the multiple surgeries in the past. More hair transplants were not an option. His results showed thinning but on the brighter side of things, he felt that he did not look bald when he kept his hair longer and styled it appropriately. He was still not satisfied with his hair and the coverage of his hair restoration procedures. He did not like the large multiple white scars on he back of his head which showed up on windy days or with swimming. He decided he would try Scalp Micropigmentation (SMP) to enhance his appearance, address the scars and have SMP under the thin hair on the top to make it look a bit thicker. He still has thinning hair but SMP helped hide the scar and gave him the illusion of more fullness on the top of his head.

This is a review of a mid 70’s retired healthy active man who wanted to look like the way he felt.
He had 1657 grafts to the front areas to give him a younger non-balding frame to his face.
The results were better than the patient and his wife anticipated. Actually his wife complained that when they went on vacation people came up and asked if they were mother and son!

This is a review of a mid 30 year old who wanted to have his hair line back. He had 1420 grafts to establish a hair line. He will likely return to make the corner areas more dense.

Lots of speculation! I don’t know.

I am 18 years old and I am seeing my hairline rising. Can we stop this change with Propecia?

The mature hairline is present in about 90%+ of men as they mature. I don’t have any experience with stopping the hair loss in the very front of the hairline that is typical of children. At 18, without seeing you, I don’t know where you are in the process; however, I don’t believe that the zone between the leading edge of your juvenile hairline and the place where a mature hairline will end up (see reference above) is mediated by the balding gene as this is not balding in the typical sense of the word. These hairs undergo Apoptosis (cell death) and that is programmed into your genetics. I have had young men on Propecia in the past, and I do not remember any of them where the transition from juvenile hairline to mature hairline was stopped by this drug.

Thank you for providing this opportunity to ask questions.

In many related posts, you sort of make the make the blanket statement “anti-depressants cause hair loss”.

Many manufacturers indicate 1-2% or even less risk of this occurring.

1. Do you feel that, perhaps anecdotally or in your practice, the incidences are actually higher?
2. Do you feel that men with AGA are even more prone to this side effect?

I would really like to start an AD treatment and I can accept the manufacturers stated risks, but considering how concerned I am about my AGA, your more experienced and specific opinion is very valuable to me.

On the contrary I generally make a blanket statement that genetics are responsible for hair loss in men. This is not common and as you said 1-2% is a reasonable informed guess based upon what has been published. I rarely see these issues in my practice, more so in emails and blogs. Actually do no not recall anyone I’ve seen at my practice complaining of hair loss from anti-depressant medications.

My standing “blanket statement” is that genes cause hair loss in men (androgenic alopecia – AGA is genetic). Drugs such as anti-depressants cause other well known side effects such as sexual dysfunction, decreased libido, etc more so than Propecia. Hair loss side effect from anti-depressants is likely what the manufacturers claim it to be.

I am 50 years old and balding. My neck droops, my joules show, by face is the opposite of tight and I have bags under my eyes. Can facial surgery and hair transplants fix these problems. Will these congeries cause scars that everyone can see?

If you feel you are looking older because of Jowls or a turkey neck or creases on your face and bags under your eyes that make you look old, you could be a candidate for a face lift and surgery on the bags under your eyes. Good hair on the sides is important to cover up face lift incisions where scars might form scars. The symptoms you listed can be addressed by working with a good hair transplant surgeon (for a hair restoration) and a good plastic surgeon. Hair covers incision scars from a face lift, even short hair provided that there is hair in front of and behind the ear where the incisions are made for the face lift. The bags under your eyes can also be treated with a good plastic surgeon and these surgeries usually do not scar. Good planning with your plastic surgeon is important.

Most men tell me that the hair transplant makes them look 10 years younger. Add to that the work on your face and your eyes, and you might be looking 30 again. If course, you did not comment on your ‘got’ and I am assuming that you are not heavy or looking for a liposuction.

This is a review of a patient who was happy with his hair transplant results but his linear hair transplant scar bothered him when he wore his hair short.
We kept his hair long (not shaved) and performed the SMP procedure under local anesthesia. The following results were immediately after the first session. He will need a follow up session for better blending.

Apologies in advance for yet another question on this drug, but I cannot seem to find a good answer to it!

I am just wondering how the dosage of minoxidil has an impact on the hair. The Rogaine 5% minoxidil foam I use recommends 1g twice a day. This seems to be based loosely on expected application to the vertex/scalp.

Now, like so many people out there, I predominately use it on the hairline (though I know results can be hard to come by here). I have some moderate, uneven recession which may just be maturing, but I know maturing can quickly shade into MPB, and I have balding in the family.

Since the corners of the hairline make up a smaller area than the vertex/crown, is it still appropriate to use the full 1g? Does it matter if the full 1g is used in a more concentrated, smaller area? Does using more than the recommended 1g per application dosage ONLY increase the risk of side effects, or can it also have adverse effects on the hair?

In other words, is 1g simply the limit they set to to achieve maximum effectiveness whilst limiting side effects (similar to how 1mg is used daily for finasteride), or does going beyond that have adverse effects?

I only ask because I tend to use the full 1g (half a capful) to cover both corners (0.5g each corner), sometimes more, and I worry this may do more harm than good if I am using too much!

On the flip side, I wonder how people with more advanced/diffuse thinning manage to use half a capful to cover all the effected areas, and achieve good scalp penetration? It doesn’t seem enough!

I think it should be quite simple by using the medication as directed. Rogaine 5% is a topical medication and it is to be used twice a day on the area of balding on the scalp. Applying it, unfortunately, is not a science especially when you have to put it one in areas you can not see easily. It is used for balding on the top and crown areas where it is most difficult to apply and it probably does not really work well on the frontal corners. I realize some people use it for growth on the frontal corner areas in hopes it may work. There is nothing wrong with this. If your head is big or the balding area is big, I would use more to cover the areas needed. I do not think there is an absolute limit that you can realistically apply and what you apply needs to get on your scalp, not your hair. I also realize if you use too much you may have some side effects such as a drop in your blood pressure so use your good judgement.

I am going bald in a pattern for sure but still got hair on the balding area, just thin hair! Can you transplant in to an area which still has hair. On my head I don’t see much space to put new hairs in. Would a transplant damage the hair I still have? So do I have to wait? I am mid 40s

You can transplant hairs to thinning areas and the hairs will grow. But your miniaturized hairs that are at the end of their life, may fall out as a result of the transplant. But you and your doctor need to discuss the potential for shock hair loss, how to prevent it and its risks versus the benefits. You need to be examined by a doctor and have a Master Plan for what you are trying to accomplish with the correct set of expectations. Hair transplants may or may not fit into you Master Plan.