Hair Loss and Replacement Questions and Answers
- What causes hair loss? In both men and women, the most common cause is generally genetic. However, there are hormonal causes as well, such as thyroid imbalances or excess testosterone, which causes an increase in DHT (dihydrotestosterone). Many men on steroids have increases in DHT, and this causes permanent hair loss. In men, the most common type of hair loss is called Male Pattern Baldness(MPB), and in women, Female Pattern Baldness (FPB).
- What options are there for hair loss in men? If they have MPB, they can try minoxadil 5% (Rogaine) foam or solution. This will keep one from losing more hair and may increase the hair diameter. Fenasteride, an oral medication, prevents conversion of testosterone to DHT. Often both are used together to reduce hair loss. The other option is a hair transplant.
- For women, hormones should be checked. If normal, they can try minoxadil also. For FPB, hair transplants are often the best choice. FPB is generally central baldness on the scalp, and the hairline is not receding as in men.
- Why and how does a hair transplant work? Hair is removed from the back of the scalp where it is genetically coded not to fall out, and micro-grafted to the front or top where it is needed. In its new location, it will grow like normal hair.
- What are the current types of hair transplant procedures? The old method is taking a strip of scalp from the back of the scalp and cutting it up into grafts. The new way is to use FUE (follicular unit extraction) as small micro-grafts. This way there are no sutures or visible scars in the back of the scalp.
- What is NeoGraft? An automated FUE technique, allowing more accuracy and more grafts.
- The most important factors? The skill and experience of those performing the grafts. The hairline must be designed naturally and the grafts must be placed in the proper direction for a totally natural result.
- Expectations? Grafted hair starts growing at 3 months. Full density is at 1 1/2 years. Generally it is permanent.
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Ronald Finger, MD, FACS