hair loss

Finasteride, is a 5-alpha reductase inhibitor that prevents the conversion of testosterone to dihydrotestosterone (DHT). In the 5-mg dose, it has been used for the treatment of non-cancerous prostate tumors and in the 1-mg dose has been prescribed both as a prevention and treatment for early onset male pattern baldness. However, some caution was taken when a study conducted in 2003 by the National Cancer Institute suggested that while Finasteride 5mg (Proscar) might be responsible for a 25% reduction in the overall incidence of prostate cancer, it might also be responsible for an increase of 25.5% in high-grade, aggressive tumors detected in these patients when compared to the placebo group. This random study was conducted on a group of 18,000 men.

The 2003 study, however, did not conclude whether the increased incidence of high-grade tumors was caused by finasteride or if finasteride, in fact, aided in the detection of pre-existing high grade aggressive cells.

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I’m 28 years old and my hair loss seems to be isolated to the top top of my head. My hairline is still very thick and has not receded as far as I can tell. After reading information online it seems that having a hair
transplant just for the crown at my age is a bit controversial. Do you think it is possible to have a successful hair transplant just in the crown of my head without complications?I am on Propecia for a year now and everything seems to be stable.
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The crown can be a difficult area to transplant and create problems as you age. If you have a defined bald spot with distinct borders a transplant could be considered. If however, you are just thinning in the crown you should not transplant. When transplanting a thinning crown and the hairs are miniaturized you will experience shock loss in the area. Read the Story

My 15 year old son has been losing hair in the shower and when he combs his hair. He feels his hair is thinning and is worried about it. We are also very concerned because he had surgery on his head when he was an infant which left a very large scar and also left his skill asymmetrical which has always been covered by hair. We are interested in finding a physician to help his hair loss and see if it is possible to have hair transplanted onto his scar. Does it sound like he would be able to have a hair transplant? What could be causing his hair loss at such a young age? Please help we need a Christmas miracle.

Your son’s situation is quite complex and needs to be carefully analyzed. Although he may be an excellent candidate for surgical hair restoration, surgical intervention can lead to a variety of problems later in life if he develops a more extensive balding pattern than what is being predicted at this time.

First off, follicular-unit grafts seem to grow quite well in many scars. Follicular-unit restoration has proven to be a very successful technique for camouflaging the adverse cosmetic appearance of scalp and facial scars. I tend to favor a much more conservative approach when placing grafts in scar tissue. Scar tissue has a significantly reduced blood supply compared to intact skin. A compromised blood supply can adversely affect healing and graft regrowth. Read the Story

My 17 year old  daughter was in a car accident about 4 months ago. Thankfully she is  recovering well with no permanent injuries, however during  the accident  her head hit the dashboard of the car causing tremendous  bruising. About 2 weeks after the accident all of the hair in that area  just began falling out. the hair has not returned. Could there have been  some permanent damage to the hair follicles so that the hair will not grow  back and if it does not grow back will a hair transplant work to replace  the lost hair?

The cause of the hair loss is what we call ‘anagen effluvium’ assuming that there is no severe scar tissue in the area of hair loss.  This means that the trauma caused an acute lack of blood supply (oxygen) to the hair follicles, causing them to shed hair.  Normally, we would expect all the hair to regrow.  If it does not all regrow, this would suggest that there have been some scarring under the skin that resulted in permanent follicles damage.  It would be best to wait at least 6 months to see if there is good hair regrowth, in which case a transplant would be unnecessary.  If there is no growth at that time, a transplant should be considered.

Jerry Cooley, MD
Member, International  Alliance of Hair Restoration Surgeons

Hello, can dandruff cause hair loss? I have been dealing with dandruff and scalp irritation for several years and I seem to be losing more and more hair. Please let me know what I should do.

Dandruff does not directly cause hair loss. However, dandruff can cause the scalp to become itchy and irritated. If your response to this itchiness is to excessively rub and scratch your scalp, this could be causing you to lose hair. Most dandruff is formed as a result of an increase in production of dead skin cells which clump together to form the whitish flakes. While still debatable, most researchers believe this increased cell turnover on the scalp is caused by a fungal colonization. Therefore, it stands to reason that a good shampoo with anti-fungal properties will help alleviate the problem. I usually recommend Nizoral, a shampoo containing ketoconazole. Read the Story

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 the Story