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Am I a candidate for a hair transplant - am I balding?
Hello. I am a 33-year-old man. My father is not bald but has a high hairline. I too have
a high hairline. However, I recently have been told my hair appears to be thinning on
my crown area. I am not sure if it indeed is or if it's simply too much hair product
put into my hair. Attached is a picture. My grandfather was bald and I am just concerned
it might increase. If it's indeed a problem, how can I gauge it and would hair transplant
fix it? Thanks
Thank you for your question!
You're 33 years old and you asked are you candidate for transplant and are you balding.
And you provided for us some information about your family history. So, these are two separate
questions but let's start with the question are you balding and are you losing hair.
Although you sent only one photo, it is relatively clear in that photo that the crown to the
central area of your scalp appears to be thin. It is possible that hair products like gel
can make hair look a bit thinner because of the clumping that will happen but at the same
time, it is not unusual for someone in their early 30s to start losing hair. there is a
general rule of thumb that we use in our general hair restoration world and it is basically
the rule of decades specifically for male pattern hair loss. So in the 20s, only 20%
of men are losing hair. In their 30s, 30% and it increases with every decade.
So you have an opportunity to make some decisions on how to manage your hair loss. Something
that we cannot predict is the rate of the progression. Male pattern hair loss is bewildering
and there are all kinds of rumors about how to predict your own future such as using the
rule of the maternal uncle as being the person to determine your hair loss. That is actually
not true. It's actually a set of genes that are variably expressed. Within the same siblings
can have different patterns of hair loss.
Assuming that you are also aware, besides looking at your pictures but also what you
feel that you are thinning, you have some options as what to do and you don't necessarily
need to go straight to hair transplantation. So let's understand about the options.
For male pattern hair loss specifically in the United States, there are two drugs which
are FDA approved specifically for hair loss. One is minoxidil such as the trade name Rogaine,
which is a topical which can improve hair that is thinning. It doesn't reverse the hair
loss but appears to thicken some hairs as well as prolong the growth cycle of your hairs
so that when if you have hair around, it gets thicker. The other drug is finasteride which
goes by the trade name Propecia. It is a drug that inhibits and enzyme called 5-alpha reductase
which is responsible for the conversion of testosterone to dihydrotestosterone. This
is based on the understanding that hair follicles have this androgen receptors and the sensitivity
of those receptors to dihydrotestosterone.
Now there is a lot that we don't know about the behavior of the hair follicle and that
what makes the hair loss treatment process so limited in so many ways. For several decades,
universities and private companies have been working in identifying the keys and signals
responsible for hair growth. And I think that some of things that people are realizing is
that what may have been a puzzle what people think years ago was a thousand pieces is actually
closer to a million pieces. So there's a lot of research going on and every two years,
you hear something new that is found in the university and we stay on top of that information.
But unfortunately, the dream of hair cloning or growing hair in the lab that it can be
transplanted in terms of the clinical world, we're not close to being there yet.
In my practice, we have a great opportunity to develop a process called Hair Regeneration.
This happens to be a serendipitous discovery where a material called extracellular matrix
was used to help improve the healing of a transplant area as well as to improve the
growth of the transplant follicles and at the same time, it appeared to thicken thin
hair. so we developed an injection method where we're able to treat hair loss or thinning
using this extracellular matrix and platelet-rich plasma which is your own blood which spun
and concentrated the areas called platelets and plasma to maximize the effects of extracellular
matrix.
This has changed tremendously on how we manage our patients who have hair loss. So you have
options. A few years ago, we would say that they should start with medical treatment and
they would make an informed decision. Currently, there has been a lot of concerns about the
*** side-effects of finasteride so a lot of younger men who are coming to us in their
20s and 30s are just not interested in taking finasteride. Ironically, we have men in their
50s and 60s who have been taking finasteride since it first came out and they have had
no side-effects and they are very happy. So it's important to get an informed decision.
Many of our patients like yourself who are in their 30s and who come to us with thinning
hair and who don't want to take finasteride and are balancing the options of choosing
transplant ultimately choose hair regeneration as their preferred options. There a couple
of reasons for that. One is that it's an injection, it's not like a transplant surgery. So surgery
versus injection, it's a pretty decision to make. But also there's an understanding, although
you get a transplant, that hair transplant is only the permanent hairs or the hairs that
don't thin are transplanted to areas that are thinning. Hair transplantation does not
stop progression of hair thinning. So we see men who have come to us who have had multiple
hair transplants and they've lost their existing hairs and are left with only their transplant
and that's what people identity, the transplant look or the pluggy look. And it keeps a lot
of people from even considering a hair transplantation.
So what we're doing is we're using this Hair Regeneration technology, we've been treating
people with thinning hair. and with 2-3 years of data behind us, we are not needing to repeat
this injection. There are the occasional patients that we repeat the injection on but we see
very carefully. We follow them with microscopy as well as with the digital photography to
watch their progression after we do the injection. So if you were to come to our practice, then
we would probably guide to consider hair regeneration and avoiding transplantation. By saving the
hairs, you are able to thicken those thin hairs that will fill a lot more effectively
that any hair transplant can. We can't duplicate with transplantation what nature creates naturally.
So this wonderful extracellular matrix technology has helped us reverse hair thinning and thickening
hair with the hair regeneration. So in your position, I will not choose a transplantation
and learn about the medical options as well as the option for hair regeneration. So I
hope that was helpful and thank you for your question!