2020-07-02 03:49:272020-06-30 22:20:38A Generation Gap Statement says it all!
I’ve Had No Hair Loss Over the Past Year and a Half — Is Now the Time for a Transplant?
Doctors,
I have been taking proscar, religiously, cutting it up into quarters for the past 5 years. I have had moderate success in keeping what I have, but not any new hair growth. My temples have still receded and a little bit of the front part of my hairline has receded. However, in the past year and a half there hasn’t been any hair loss whatsoever. I am 29 years old, if I haven’t seen any hair loss in the amount of time I mentioned does that mean I have reached my final hair loss pattern and I will no longer experience hair loss, and I can go for a transplant procedure?
The last thing I want to do, go for a procedure and then all my native hair falls out and I am left with only transplanted hair. That is why I am sometimes confused as to how long one should wait to get a transplant and how would one know what the “final” pattern is at such a young age like mine.
The real question is: Is this your final hair loss pattern? You can guess at this, but at 29 years old, that might be difficult. Well-delineated patterns often show the final pattern. That means if you are (for example) a Norwood class 3 pattern, the area where the hair is should not have any miniaturization when looked at under a video microscope, and the hair behind it should not have bulk reductions as measured by a HairCheck instrument.
If you had clean borders and no loss of hair bulk behind your existing pattern then you could assume (not 100%) that for the moment, the hair loss should have stopped. The problem is that many people who see it stop may find that it picks up again years later. With the combination of what I discussed here with the continuation of the finasteride treatment, you may be one of the lucky few. If you are in Southern California, I would be happy to do these tests for you in my Los Angeles office.
A Perfectionist’s View of Transplants
I am 50 with early gray coming on the sides and black hair in the front. I have had 10 hair transplant procedures over the past 8 years [not at NHI]. I go from happy about them (when I had bald areas and then they went away) to unhappy (now). I am bothered about my left frontal hairline in particular. It is obvious to me that it is transplanted. I am not an expert, but I know it is not right, yet it is not the pluggy look like your book shows in the back section. I comb my hair forward to cover the hairline which I should be showing off, not hiding. What is wrong with it and can it be fixed with 100% certainty?
It is clear that you are a perfectionist, for only a perfectionist would notice your problem. The problems are that the grafts in the frontal line are two hairs each, the hair seems to point outwardly, rather than forward and the frontal grafts are a straight line that line up like soldiers. These two problems are not uncommon when a transition zone of single hairs is not created at the leading edge of the hair line. The concept of a hair line should not be taken literally, for there is no ‘line’ in a natural hair line. You were created with a zone of single hairs that transition from a bald forehead to a full frontal hairline presentation. A good hair transplant doctor must create the same transition zone to accomplish the natural look. With your black hair, these changes are more noticeable than if your hair color was lighter, making it easier to detect a transplant. As the gray hair moves forward, the problem will become less noticeable, but I suspect that you do not want to wait a decade or more for that to happen.
The second problem is outward directional growth of the transplanted hair. Judging from your photos, that problem is the result of a radial placement of some of the recipient sites when the procedure was first done. The direction of the hair growth is totally controlled by the surgeon who made the recepient sites. Additional grafts placed in a better position and direction might influence the hair that is growing outwardly. Using the concept of ‘following the crowd’, the normal direction of the new hair can be transplanted to influence how the existing hair will lay.
The third problem is the ‘line-up’ of the hairs in a straight line that is easily detected. The frontal hairs should be irregularly placed so that no line is evident.
The last point of your question talks about certainty in outcomes. Any surgical procedure has risks of failure, so certainty in medicine is more an act of God than an act of a doctor. In my experience, the success rate for building a good transition zone is very, very high. The hope would be to complete the transition zone in one session with 500-600 single hairs in the front. Sometimes more is needed, particularly if your hair is coarse, black and straight. What you need is comfort and that is established with a visit to the doctor’s office. As a perfectionist, you will interview your potential new doctor with an open mind, but keeping some skepticism and doubt, so the doctor will have an uphill battle for your confidence. Ask the doctor to show you people he has done with black hair, you can look at the transition zone and see if you see a ‘line’ in the hairline. I always say, what you see is what you are ‘gonna’ get.
I’ve Used Propecia for a Decade, But Should I Be Worried About Breast Cancer Risks?
Hi. I am using Propecia 1mg for around 10 years now with good results (no hair loss) and no adverse effects (e.g. less sex drive). Lately I read a report that says there is a slight risk of Male Breast Cancer in people using Finasteride. I understand that only 3 (inconclusive) breast cancer cases worldwide have been reported using Finasteride 1mg. I have read that your opinion is that there is no risk from from using Finasteride 1mg in terms of Male Breast cancer. Is this correct? If you were in my shoes would you continue the usage of Propecia, without any concern? Thanks a lot.
There is no evidence of breast cancer from the use of Propecia, as far as I am aware. The reports are not clear and inconclusive of a direct correlation. If you are worried about your risk, it is best discussed with your doctor where he/she can assess your family and past medical history, as well provide a good physical exam to give you a professional opinion.
The Internet is a great source of information, but it can be very confusing with a sea of equal misinformation and facts taken out of context.
2013-04-17 12:10:442013-04-16 13:13:34I’ve Used Propecia for a Decade, But Should I Be Worried About Breast Cancer Risks?
Abdominal Pain And Hair Loss
Hello Dr Rassmann,this blog is great.
Sir suppose a person has genetic hairloss for around last 3 years. If he also has abdominal pain for around last 6 months, so is it possible that his abdominal pain can increase/accelerate his genetic hairloss but without causing acute/chronic telogen effluvium?
I am not sure how you can make a correlation between abdominal pain and hair loss. Abdominal pain is not related to genetic hair loss or any other type of hair loss from my experience.
I Just Had an FUE of 4200 Grafts. Do I Have a Problem with My Donor Area? (Photo)
Many people have donor densities that will not support 4000+ grafts. They will develop a see-through donor area, reflecting donor site depletion. This may be your situation, and to deal with this, you might have to keep your hair long in the back of your head, or see a doctor and get scalp micropigmentation if this bothers you.
2018-06-04 06:41:032018-06-04 10:58:21I Just Had an FUE of 4200 Grafts. Do I Have a Problem with My Donor Area? (Photo)
Accutane and Hair Transplants
Can you receive or do you recommend getting a hair transplant while on Accutane (isotretinoin)? My understanding is that the drug disrupts cell division and skin regeneration. Will this delay healing?
Yes, having a hair transplant while you are on Accutane it is not a good idea. You should wait a year without the drug ensure that the transplants will work and grow well. There is no point in spending money and your donor hair if you are not going to have good results.
Keeping Hair Past the Age of 30
Dr. Rassman,
I read a while ago that if a male keeps most of his hair by the time he is thirty, he probably won’t go completely bald. It has something to do with testosterone levels. Is this true? If so, is it also true for individuals who keep theie hair by the use of Propecia or Minoxidil?
If you have not lost any hair or have any miniaturization of the hairs on your head by the time you are 30, then it is most probable that you will not lose it. The drugs you mentioned only slow down or reverse hair loss and they will not impact hair that is normal. Hair loss has more to do with DHT than testosterone, but if there is more testosterone, then there could be more DHT. Drugs like Propecia (finasteride), block the effect of DHT and it is the DHT that causes balding when the defective genes are in the person.
2006-09-12 08:35:582006-09-12 08:53:49Keeping Hair Past the Age of 30
Add at Ankara Airport Turkey
2019-09-21 06:41:552019-09-21 06:44:53Add at Ankara Airport Turkey
L-Arginine Increases Growth Hormone — Is That Going to Mean Hair Loss?
I’ve seen all of the questions about l-arginine, and I even asked one before, but I was only referred to another answer which didn’t answer my particular question. I’ve heard that l-arginine increases growth hormone. This doesn’t sound too good. Does an increase in growth hormone mean hair loss is a possible result?
Thanks. I appreciate it.
There are reports that L-arginine increases growth hormone secretion, but it is unproven. Throughout the internet, L-arginine is a suggested treatment for hair loss by promoting hair growth, but if this is true and it does increase growth hormone, I would worry about growth hormone induced hair loss. These two statements appear contradictory, but it does reflect complex interactions that are presented throughout the internet.
For more, see: