Author Archive for Gregory Pistone, MD

Dr. Pistone's contributions to the field of hair transplantation and excellence in patient care earned him the honor of being selected by his peers to be recognized as one of Philadelphia Magazine's "Top Plastic Surgeons." He has been featured in countless newspaper and magazine articles and has made numerous television and radio appearances answering all questions pertaining to the art and science that is hair restoration. Dr. Pistone has had a successful private practice since 1984, has served as Chief of Dermatology within the Thomas Jefferson University Health System, and is currently on the faculty of both Thomas Jefferson and Drexel University Schools' of Medicine, where he teaches physicians-in-training about hair transplantation. Dr. Pistone has a private practice and state of the art surgicenter in Marlton, New Jersey (near Philadelphia), as well as a consulting office in Center City, Philadelphia. Dr. Pistone is a member of the International Alliance of Hair Restoration Surgeons and recommended by the American Hair Loss Association. Visit Dr. Pistone's Website:www.drpistone.com

Female Hair Loss at 32 - Can I Have A Hair Transplant?

As a woman with thinning hair I cannot begin to tell you how much I appreciate the opportunity to ask experts questions about my situation. Here’s my story. I am 32 and for the past six years my hair has been getting thinner and thinner. I have not had children and have never taken oral contraceptives. I’ve had every possible blood test known to man and every thing appears to be normal. I have never been diagnosed with Female Pattern Baldness but I think that this is what I am going through. I would like to have a hair transplant but read on The American Hair Loss Association website that most women are not candidates. Is this true?

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Hello, I’m sorry to hear about your hairloss. I know this can be quite be distressing. First, I’m going to assume you have had all the appropriate blood tests and have been evaluated by a Board Certified Dermatologist. You say you have had numerous blood tests but not been diagnosed with Female Pattern Baldness. Have you been given a diagnosis or possible explanation for your hair loss? If you have not seen a Board Certified Dermatologist, preferably with an interest in hair loss, or Hair Restoration Physician that would be my first suggestion. A scalp biopsy would help provide a more definite diagnosis and this is necessary before discussing treatment of course. Assuming you are diagnosed with Female Pattern Baldness, then we would have several options to consider. You certainly would deserve a trial of Minoxidil 5%. Spironolactone, a diuretic with hair growth effects, could be added as well. If you are post-menopausal some doctors use finesteride, although this is only approved for use in men but has been reported to be sometimes effective in women. Read more

Currently Taking Propecia, Should I Also Take Avodart?

I am 18 years old and notice male pattern baldness taking place. I am currently take propecia, but still notice that my hair is receding at the temples. This is really bothering me, it is all I think about and my self- esteem has gone down. Should I take Avodart along with propecia? I really don’t want to go bald. Please if there’s anything else I can do please let me know.

Hello. I certainly understand your concern but I suggest you take a step back and take a deep breath before considering any aggressive and potentially harmful options to treat your hair loss.  First, from your description, it’s likely that you are the only one who notices your hair loss at this point.  So I suggest you get an objective opinion from a reputable hair restoration specialist before doing anything else.  Second, if you are thinking about your hair loss all the time then I strongly suggest you speak with a professional therapist who can help you put this issue into perspective and keep it from becoming an obsession.  I would certainly continue the Propecia and consider adding minoxidil 5%, even applied along the hairline.  It does sometimes help there.  At your age, I would strongly advise against Avodart.  This medication, which has not been proven to be any more effective than Propecia, does have disconcerting side effects in some men such as a significant reduction in your sperm count.  Your hair restoration specialist will be able to follow your progress objectively with photographs and modify your treatment when needed.

Gregory Pistone, MD
Member, International Alliance of Hair Restoration Surgeons

Botched Hair Transplant - Please Help

As the unhappy recipient of three botched hair transplants, I can not believe that I’m thinking about going down this road again, but at this point I do not think I have any other choice. After reading through your website is is apparent that I made a poor choice in picking a surgeon in the past and I’m hoping that I can be helped. I had three hair transplants by Dr. Gary Hitzig in New York. The outcome is disastrous. The transplanted hair looks very unnatural, it is impossible to style normally and the back of my head looks like a road map. I am forced to wear cover up makeup both in the back and on top of my head. Before I had the hair transplant I was not that self conscious about my appearance. I just thought it would be nice to have more hair, but now life is much more difficult for me and I find dating impossible.

Can I be made to appear normal again? I am not asking for a full head of hair. I just want to be able to walk out of the house and feel comfortable in the world again. Dr. Hitzig took that away from me and I have been a little gun shy to seek more surgery after my experience with him. Read more

14 Years old and Losing My Hair - Can I Use Propecia?

I’m a 14 year old high school freshman and I think I’m losing my hair. Is it possible to go bald at such a young age? Can I take Propecia or do I have to wait until I am 18?

While it is unusual to lose your hair at such a young age, I have seen a number of such cases. And usually, I have found there is a very strong family history of extensive hair loss in such situations, although this iscertainly not predictable. I am not comfortable prescribing Propecia or any other DHT blocker to a young man Read more

My 52 Year Old Mom Had A Terrible Hair Transplant

My mother had a hair transplant with terrible results. She is 52 years old was was told by her hair transplant surgeon that she was a perfect candidate for the operation. She has lost so much hair I the last year and the transplant looks very unnatural and sparse. She is very depressed to say the least and wishes she never had the hair transplant. Do you think it was the doctors fault that the hair did not take or is it my mother’s age. Can anything be done to rectify the situation. Thank you for your help.

Hello. I’m very sorry to hear you mom is disappointed with her results. I’m going to make the assumption that we are, in fact, dealing with female pattern alopecia in your mom’s case when I answer your question. However, I just want to say, in an effort to be thorough, that you mom should be checked out by a Dermatologist to rule out other causes of alopecia in women. And this might include blood tests and a scalp biopsy as well as a thorough medical history. So assuming your mom is suffering from female pattern alopecia, what could have gone wrong? Or did anything go wrong? I have found that it is quite common for women to have extreme “shock loss” following an initial hair transplant procedure, so I always advise them of this and the fact they are very likely to require an additional procedure or procedures to achieve reasonable cosmetic density.Now since “shock loss”generally affects hair that is destined to fall out anyway, the procedure did not “cause” the hair loss, but it certainly did speed it up. Assuming your mom has sufficient donor hair available an additional procedure or procedures should help your mom achieve reasonable cosmetic density. Soassuming that all the grafts transplanted did grow, my only concern would be that these issues were not discussed in advance in a frank and professional manner. Doctors can’t always tell you what you what to hear, but we can make very sure that we tell you the absolute truth.

Gregory Pistone, MD
Member, International Alliance of Hair Restoration Surgeons