So hair loss in men is 95% genetic MPB. How about hair loss in women? from tressless
You are correct that most hair loss in men is genetic. Women are far more complex as things like birth control pills, hormones, stress, genetic factors, thyroid disease ………. cause hair loss and these women often need extensive work-ups to find out the cause of their hair loss. Of interest, 50% of women post menopausal have genetic hair loss.
Over the over again, women from all over the world are writing to me asking, “What can be done for me?” I will list alternative options below, but I want to warn those of you who are reading this material to recognize that none of this is proven to solve the hair loss problems of most women. If it works, it may work in selective women, those that have a more clear androgenic (male-like) component of their hair loss. In addition, some women with combined genetic hair loss and Polycystic Ovaries (PCO) develop male-like patterned hair loss and could be candidates for the hormone treatments discussed below. I am loathe to recommend these treatments, because I do not personally feel comfortable with recommending hormone altering therapies, as some of them may impact ovarian, breast, and uterine cancer risks — so with that warning, please read on.
Finasteride use in women:
There have been articles on the failure of 1mg of finasteride to impact women’s hair loss. Now, for the use of higher dose finasteride than normally prescribed in men, the Iorizzo article (see references below) concludes, Sixty-two percent of the patients demonstrated some improvement of their hair loss with the use of finasteride, 2.5 mg/d, while taking the oral contraceptive. It is unclear whether the success was due to a higher dosage of finasteride (2.5 mg instead of 1 mg) or to its association with the oral contraceptive containing drospirenone, which has an antiandrogenic effect. These two drugs may complement each other and to get the effect, they both may be needed. Further studies are necessary to understand which patterns of female pattern hair loss respond better to this treatment, for I am sure that all women will not respond the same way. The article leaves us confused. It is not clear which are those who can be treated and there are no statistics on safety and side effects (this was not the focus of the article, however). The entire article is based upon conjecture, something that the authors recognize is the problem that the limited study creates. What concerns me is that with the promise that 62% of women may be helped by Propecia, desperate women with the help of inexperienced doctors will start taking finasteride without understanding the long term impact of these drugs on women. Maybe downstream, we may see a Vioxx type side effect with regard to cancer. With that said, there is a suggestion in this article that finasteride may have value for women and if this can be seen with better, more controlled studies, then this may be a breakthrough. I suspect that women with a ‘male pattern’ to their hair loss may experience more benefit over those without it. This is conjecture (an educated guess) on my part.
Antiandrogen treatment for hair loss in women:
The second article (see references below) starts off, “It has not been conclusively established that female pattern hair loss (FPHL) is either due to androgens or responsive to oral antiandrogen therapy.” This opening correctly set the tone of the article. Two different medications were used: spironolactone and cyproterone acetate. Neither was clearly better than the other. Discussion of the authors said, “The treatment under a doctor’s care went for 16 months. 44% had improvement, 44% had no improvement and 10% had further hair loss“. Many dermatologist are presently using spironolactone and cyproterone acetate and there is selective enthusiasm for these drugs, but it is not universally accepted as the mainstay for treating women’s hair loss. Doctors come under a great deal of pressure to do something. The question here is will spironolactone and cyproterone acetate treatment provide enough benefit for the costs and the pain of the injections that are required with repetitive treatments over a prolonged period of time?
References:
I found this humorous clip from i love lucy where ricky thinks he’s going bald and lucy gives him a hair growing treatment. Very funny!
I love this. Thanks for sending it! This is a clip from season 1 of “I Love Lucy” that originally aired in 1952. There’s not much more I can add here, so just watch the video below and enjoy!
I doubt that the dermaroller will harm your skin because it does not go very deep. Future transplants are much deeper in the scalp than the dermarollers.
2019-01-31 05:09:172019-02-20 07:04:20Is It True Dermarolling Can Hurt Potential for a Future Transplant?
I hear about the self-confidence issue all of the time. You would not believe how many wealthy, very successful people I have performed hair transplants on and the reason driving them is almost always the issue of “self confidence”. A few well known people in the world of tech, some CEOs of fortune 500 companies and some very famous actors, had hair transplants by me in the very early part of their career. We have become friends and the actors, as a good example, absolutely believe that the hair transplants transformed them in terms of their “self-confidence” giving them the freedom to be themselves and to do what they do best without worrying about hair loss. Issues of self-confidence is not something men talk about to just anybody, but to the man in the mirror, they tell it the way it is. Even Donald Trump has a hair problem and I am sure that is part of his insecurity. The post below from Reddit shows the importance of family and friends in opening up and talking about hair loss problems.
2017-08-24 12:15:322017-08-25 08:55:02Having hair is often an issue of self-confidence
JAMA Internal Medicine study estimates that the number of deaths attributable to cigarette smoking for 12 smoking-related cancers and found that continued progress in reducing cancer mortality requires more comprehensive tobacco control (in other words, best if you stop smoking). These cancers include cancers of the: Lung, Esophagus, larynx, kidneys, liver and bile ducts, leukemia, mouth and pharynx, stomach, bladder, and uterine cervix.
I loved the question about the salesman and the consultation [see: Hair Salesman]. I am a professional salesman selling high end cars, and I fully understand this issue. When one is selling a car or a service, the businessman asks: how many people does one have to go through to get a sale? Now with that said, How many prospective candidates do you go through to make a sale?
We call this conversion rates. Taking 100 people coming through, how many will sooner or later (within 2 years) make the decision to have a surgery. I have found that the number for my practice is between 33-40% and for other doctors working for me it is about 25-30%. My ‘conversions’ are higher because most of the people who come to see me know about my reputation in advance and often have made up their mind in advance of the visit. I am often the last doctor that they will visit. Still, my conversion numbers are low because I turn down most women (they often can not be helped), young men (who are too young and therefore too early in the process), people with unrealistic expectation, etc.. A salesman would view that the right conversion rate should be the majority of people coming through the door-whether they truly needed the surgery or not. When I had worked for another medical group who had employed a full time sales force, the conversation rates ranged between 50-95%! They would have fired me for my low conversion rate if I was one of their salesmen. That tells me that those doctors who employ salesmen, insulate themselves from the patient. These doctors build more a money focused practice than a people focused practice. My style is to use the medical forums and meeting, my website, the internet and activities like this BaldingBlog to communicate and educate, then have the prospective patient come to see me after they are informed. I have built a boutique practice where I have Hollywood stars and heads of state or CEOs of large companies as often as blue collar workers.
Take a look at the photos posted on Reddit.com. I believe that this man’s hairline filled in due to the drugs he was taking.
Update: 2 Years on Finasteride, 6 Months on Minoxidil from tressless
2018-03-16 13:36:212018-06-22 05:56:17Two Year Follow-Up on Man Taking Finasteride and Using Minoxidil
Hair transplants work very well when you are balding. I had hair transplants for my crown, and no one knows unless I told them. I performed hair transplants on 6 relatives, including my wife and daughter-in-law, and they were all happy with them. There is a balance between your concerns about balding and your sense of need to do something about it. Hair transplants are not for everyone. Even though I invented the FUE, I still perform half of our hair transplants with strip surgery, often in older men or men who are going to develop an advanced balding pattern. The decision to do an FUE vs FUT is a personal decision for each patient.
The pictures only show your over-harvested donor area. If I understand you correctly, you had the FUE with an over-harvested donor area to fix the SMP you had done. The only way to correct the over-harvested donor area is with SMP. Nothing is perfect, but our overall satisfaction for SMP is very high in our hands. You need SMP for your donor area because that is why people are looking at you.
I regret my micropigmentation + FUE transplant. (Pics) from tressless
2019-06-04 15:07:002019-06-04 15:07:30Unhappy with SMP and FUE (from Reddit)
