Am I balding?

This is a 17 year old with a family history of advanced balding. He is seeing some hair in the shower and is frightened abut what his future holds for him. The question is reasonable and is best answered with a HAIRCHECK TEST with an instrument that some doctors have in their offices. This is an accurate way to answer this young man’s question as seen in this previous patient: https://baldingblog.com/2017/01/10/value-haircheck-bulk-measurements-two-patients-seen-today/

Here is a picture of the 17 year old who asked the question. His picture is similar to the example I showed above in the link I supplied.


2020-07-02 08:18:58Am I balding?

Losing Hair from Illness

When you lose hair due to illness, do you lose hair from all over your scalp or just on top? Is the location of the hair loss different than it would be with genetic factors?

Stress such as an illness can produce hair loss. This is explained because illness requires that your body conserves its resources to fight off the illness. Hair is a high metabolic organ, consuming considerable amounts of nutrients, blood supply, cardiac output, etc.. The body diverts is support activities and abandons those organ systems of low importance. Hair qualifies for that sacrifice. I might expect hair loss to be a generalized loss over your entire scalp, possibly including some body hair as well. That being said, the illness or the stress may have set off a genetic “switch” that probably kick started male pattern hair loss process when the gene is carried by the patient.


2006-10-26 09:18:20Losing Hair from Illness

Am I Looking at Hair Genetics the Wrong Way?

Hello doctors, thank you so much for taking the time to do this, I really appreciate it.

Let me start off saying that I am a male and 19 years old. My question is about family hair types and the balding gene. My father is bald (looks like NW6 or NW5V). When he was younger, he told me he had hair that was like mine in that it was wavy/not naturally straight. Now this is my question, does this mean I inherited his hair gene since my hair is like his? Does this also mean I will go bald because of this, or is this the wrong way to think about the genetics?

I read your other posts about a gene being inherited but not expressed, but I would really like to know in your professional opinion that if my hair is like my dad’s(in terms of style only, his colour was black but mine is brownish)did I get his gene for hair and hair loss?

Thank you so much.

I really have no clue as to how you will bald or when or if you will even bald at all. It’s just not an easy thing to predict based on what you’ve told me. Male pattern baldness is genetically inherited, but just because you and your father have similar hair characteristics, does not necessarily mean you will have the same hair loss pattern. The only real way to tell is by time. In time, you’ll know if you’re destined to follow your father’s balding pattern.

The next best thing is an examination by a qualified physician with a miniaturization study. With that, you should be able to get an idea of early thinning (if any) and slow it down with medication. Then with follow-up studies of your scalp, you’ll be able to see how the hair loss is progressing and the doctor should be able to make an educated guess as to where you’ll end up.


2010-07-22 08:52:50Am I Looking at Hair Genetics the Wrong Way?

I Lost My Erection After Reading About Finasteride and ED. Anyone Else Affected like This?

This is the classic nocebo effect. However, finasteride does reduce DHT which is the boner hormone, so don’t be too surprised if your dong isn’t 100%. This effect is real as it can impact the physiology of the body, showing you how powerful the mind actually is.


2019-02-20 08:59:53I Lost My Erection After Reading About Finasteride and ED. Anyone Else Affected like This?

Aminexil and Ovarian Cysts?

Hi Doctor,

Is there a relationship between Aminexil and ovarian cysts? I had an ovarian cystectomy last year and I started using aminexil recently which greatly improved my hair loss situation. However, lately, I’ve been feeling that the cyst may have returned.

I didn’t get it checked yet but I need to know whether to stop Aminexil or not.

I can’t blindly recommend taking or stopping a medication to someone other than my own patients. While many women with polycystic ovary syndrome (PCOS) use this drug, it is the condition that tends to produce ovarian cysts, not the aminexil. You’re already under the care of a doctor, so I’d ask him/her what you should do next.

“I love the idea of wearing a laser hat and growing my hair, does it work”?

LLLT is an option that really does not do much although because so many people use it and are vested in the effort, the reports are not very accurate. I studied patients with LLLT treatments in two forms. The first was an expensive LLLT machine which I offered at no charge to my patients but required them to submit to photography follow-up. The second modality was a Laser Hat. I also required them to submit to photography follow-up. All of the follow-up showed me no a single result that was objective by good photography. Some patients thought that they were better, but things like hair length and products used on the hair change your view of your own hair.


2018-01-08 01:49:18“I love the idea of wearing a laser hat and growing my hair, does it work”?

Angle of Hair Growth (Photo)

The angle of the hair growth is determined by the surgeon who creates the recipient sites. The direction of the recipient sites, which is made with a needle, has an angle that will eventually dictate the final hair growth direction. I can’t tell from these photos the direction apart from the curl to your hair. I would have to look closely at the angle that the hair exits the skin to determine if the angle is correct. I have seen many hair surgeons create the hairline like the wheels of a bicycle spoke, circular from a mid-point in the center of the head. When it is done this way and the hair is straight, it is impossible to make it normal looking.

 


2018-09-14 09:44:32Angle of Hair Growth (Photo)

Major Hair Loss After 5th Hair Transplant

OK, I will start at the age of 18. I took accutane and started losing hair 6 months later. I was scared so I got a hairpiece. At 30 I was talked into a HT. I then recieved 5 more over 5 years but I do not see a large portion of what was transplanted. I had great results after the fourth surgery but it seems that I am at a great loss at the moment. I am 9 weeks into the last surgery and see a “lot” of hair loss. I mean worse than I ever was. I am on everything.. propecia, minox, avacor, nizoral. I spoke with my doc and he said wait, its just a shock. I have a full head of hair except for the first 1 1/2 inch frontal. I am thinking about going back into a hairpiece after $30,000 and lots of heartache but I cannot take this roller coaster anymore. I can’t sleep, work, or think. I’m 36 and feel lost on what to do….help

Going to a hair piece to deal with a temporary problem of shock hair loss may end up making it permanent. You may have made mistakes in the past, just do not make them now. Shock hair loss is very, very, very rare after the first procedure with a person on Propecia. The few times I have seen it, the process reversed at the time the new hair came in. I would expect you to be where you want at about 8 months.


2006-02-03 12:49:06Major Hair Loss After 5th Hair Transplant

Another patient with finasteride, minoxidil and microneedling 9 months (photo)

This man used finasteride, minoxidil and microneedling for 9 months and clearly increased the density of his forelock. His hairline did not return to normal so I wonder if he used the microneedling on the original hairline as well but that failed to regrow?


2020-08-13 10:01:15Another patient with finasteride, minoxidil and microneedling 9 months (photo)

Malpractice Information

I had a hair transplant that deformed me a number of years ago. I have been depressed and angry, hiding under a baseball hat much of the time. Now, I want to get back at the doctor and make him pay me for my suffering. He had no right to do this to me and had I know what I was getting, I would never had the surgery done. How does one find a lawyer to represent me in a malpractice case against the doctor?

This is a hard question for many reasons. First, you are angry and I understand the anger, but you did make the choice to have the procedure and must recognize your role in enabling the doctor, even though you feel that you were a victim. The old axiom, ‘buyer beware’ holds for anything you buy, even a hair transplant. I am not sanctioning what happened to you, for I have seen hundreds of men in your situation and I have great compassion for someone who wanted to take charge and improve their appearance, and find themselves going south when they wanted to go north. Unfortunately, the old procedures did not meet the standards of many people. Today’s surgery is much better and the standards are good enough to meet even the most critical buyer.

First, I must qualify my credentials by saying that I am not a lawyer, just a well informed doctor. Every State has a ‘Statute of Limitations’ which means that you must file an action within (usually) 2-3 years of the point when you realized you were damaged. I will assume that your surgery goes back to the old days when big plugs were done (10 + year ago). You can, of course, go back to the doctor who did the work and ask him to fix it. A good doctor should try to make things right, but with your degree of anger, you must first address your anger and try to determine just what you want to do about the problem that you are living with. Alternatives to a malpractice suit include: (a) Complaints to the State Medical Board (which in California are always investigated by representatives of the State Attorney General’s office), and (b) Complaints to the Better Business Bureau (this is a place that new patients will often go when checking out a doctor).

Focus on the positive! I generally tell patients who have had the older work to put together a priority list of things that bother them. The more that they are bothered, the higher on the list these complaints should be. If you direct your energies to fix your problem and make it right (overcome the problems) then you can go on with your life. I have written extensively on repairs for the older type of work (see Medical Publications) and have many examples of repairs done on our website (see: Repair Work Photo Gallery).

There are many problems with going the malpractice litigation route that you are asking about. I do know a little about the difficulty in a hair malpractice suit, as I have been an expert witness in the past. I am familiar with two cases that ‘succeeded’, one was settled for less than the cost to fix the work, and the second (poor outcome from scalp reductions) got one of the largest awards in California $140,000 (to be paid over 20 years). He took it all in cash up front (which meant that it was discounted to less than half) and he had to pay his lawyer. The patient ended up with less than $20,000 for himself. Considering the time and energy he put into it, it may have been a poor decision to go that route. The crime here was that he suffered a second time, living the nightmare in court activities for a number of years starting from the time he filed the case. Malpractice cases (particularly in the cosmetic hair business) rarely succeed. The problem for litigation is:

  1. The ‘Standard of Care’ is what the plaintiff must prove was not practiced. In the old days when plugs were the standard quality and although the standard was a ‘sub-standard’, litigation was rarely successful as the sub-standard was the standard that had to be met.
  2. Even if a surgical procedure fails to work, the ‘victim’ must prove that they were damaged by that failure. Assume that a modern hair transplant is done and it failed 100%, the question might be asked what was the damage? Other than the money, anger and the humiliation, there may be no damage that can be demonstrated.
  3. Juries have been less than sympathetic to the balding man’s plight. The patient starts from an ‘underdog’ position and any anger he has (particularly with no real evident and obvious damage) the less sympathetic may be the jury. Remember, the jurors really want to be home, on vacation or someplace other than listening to a bald man’s problems.
  4. Jury decisions in hair transplantation malpractice cases have not produced the larger monetary awards that make it worth the the lawyers’ time. As such, the lawyers are generally reluctant to take them on.

The burden must therefore be on the patient to do his homework, to find a reputable doctor who is known for his good work and whose past performance that can be verified. Becoming a victim today with all of the information on the internet, and the open house events at offices like ours, make it easier for today’s transplant candidate to practice by what is suggested in the phrase “Buyer Beware”. With the power of information at his command today, such problems can and should be avoided.