Hair Restoration Blog

To add to our growing selection of Video Testimonials online, here is the story of one of our female patients “thrilled with the results” of her hair restoration. Her end results are instantly recognizable when compared to her before photos and the confidence restored to her was well worth more than anything else gained. With no need to hide or cover her hair loss with different hairstyles, this patient can now freely live her life without cares of wind and styling that was always needed to be accounted for before.

** To see before and after pictures of this patient, please feel free to visit her Photo Gallery. **

Q:

Good Afternoon Dr. Mohebi,

My body trainer recently recommended that I go on a medication for body building purposes.  The medication that I am planning on taking is ANAVAR (an anabolic steroid), so I just wanted run it by you to make sure it would be OK to take it along with the Propecia I am currently taking.

I appreciate all you help, Thanks!

A:

Anavar (oxandrolone) is a weak androgen and is considered an anabolic steroid.  It is indicated as adjunctive therapy to enhance weight gain after weight loss due to an extensive surgery, infectious disease, trauma and so on.  Anavar has also been prescribed to some patients who for no reason fail to gain weight despite of proper nutrition and work out schedules.   It may also be used to maintain normal weight or to prevent the catabolism due to prolonged administration of corticosteroids.

There have been some online reports of hair loss with Anavar’s use and some exagerated hair loss reports in patients who take both Propecia (finasteride) and Anavar (oxandrolone) in conjunction. Although my personal searches in medical publications have never revealed any studies supporting this information, reports can be found online by its claimed users.

My general recommendation is, unless there is a strong medical indication for its use, those people with any evidence of male patterned baldness should stay away from anabolic steroids.  Although you may find some anabolic steroids over the counter, your family doctor should always be involved and aware of any anabolic steroids that you take as part of your body enhancing plan.

Every now and then I see patients in my office that have no sign of baldness whatsoever, yet they are extremely concerned about losing their hair.  Some of these patients have even previously received hair transplants from other clinics.  Body Dysmorphic Disorder (BDD) or body dysmorphia is a type of mental illness in which a patient is always preoccupied with his or her appearance and cannot stop thinking about one or several problems in their face or body.  This problem may be an exaggerated preexisting problem or it may be totally imaginary.

People with BDD often have significant anxiety and do not want to be seen by anyone if possible because they think their appearance seems too shameful.   BDD could be seen in both men and women and it is estimated that 1–2% of the world’s population meet all the diagnostic criteria for body dysmorphic disorder (Psychological Medicine, vol 36, p 877).

People with BDD are intensely obsessed over their appearance and their body image, often for many hours a day or even to the point that it affects their life or work. They may ask for several cosmetic procedures in an attempt to improve their perceived image, however they are never satisfied and their perceived image cannot ever be met. If the doctor seeing this patient cannot diagnose the problem and agree to pursue with a cosmetic procedure, he or she will also tend to be blamed for some (or at times all) of the problems that they imagine they have.

Diagnosis of BDD

1. Preoccupation with an imagined or slight defect in appearance. If a slight physical anomaly is present, the person’s concern is markedly excessive.
2. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
3. The preoccupation is not better accounted for by another mental disorder (e.g., dissatisfaction with body shape and size in Anorexia Nervosa)

In research carried out by Dr. Katharine Philips, involving over 500 patients with BDD, percentages of patients concerned with the most common problem locations of their bodies were recorded and hair problems were reported in as high as 56% of patients as the second most common problem (after skin) that these patients express having.

Treatment of BDD

Treatment of body dysmorphic syndrome involves cognitive-behavior therapy which includes education about BDD and its treatment, and specific treatments to deal with faulty thoughts.  In some patients, medications may be needed as well.

Q:

hey doctor:

is it true i can lose hair by wearing a baseball cap a lot of the time? if that’s the case, then i guess baseball players are good candidates for hair transplants! =P. but really, is there any truth to that? I read that it doesn’t have an effect on a person’s hair, but i wanted to verify with an actually hair loss doctor.

A:

We can lose hair due to environmental trauma to the hair shaft and, consequently, to the hair follicles. The name of this condition is traction alopecia; it can be seen when people braid their hair very tightly. One type of traction alopecia is called turban alopecia, for people who wear turbans on their head for long periods of time and when they wear it tightly. Baseball caps are regularly used by people, and I have not seen it in those people who wear them. However, you can guess that a tight cap of any kind may mimic the turban effect and may cause traction alopecia in which hair follicles are being pulled over time, which destroy them eventually.

Q:

Hiya Doc,

I’ve read in a book on hair loss that mentioned, in certain circumstances, hair loss can be caused by emotional or mental stress. I’ve started to lose a bit of hair, but I’m really hoping it’s only temporary, as I don’t think I have genetic hair loss because my two older brothers seem to be doing OK.

How common is it for hair loss to be caused by emotional distress?

Thanks,

A:

Many hair loss patients who come to me for their initial hair loss evaluation associate the beginning of their hair loss to some stressful event in their lives. Many say they notice hair loss when they moved to another city or different country, got divorced or had significant problems at work or in their personal lives. Usually, they are right as these types of evens can accelerate hair loss.

However, hair loss would not happen to these same people if they were not genetically predisposed to balding. In other words, at age 30 and after, we may have the hair loss gene which is supposed to cause balding. At age 30 or after, if we are involved in a stressful situation, an emotional traumatic event, or major surgical procedure, it can accelerate the hair loss process. So the loss expected to be seen in 10 years could come around sooner.

Stress, trauma, or major surgeries may cause hair loss in people who are not supposed to lose hair, but the condition is temporary and the lost hair will grow back after the passing of the stressful condition, or treatment of the medical condition.

In these cases, patients have a condition called telogen effluvium in which, due to stress, a significant number of hair follicles go to sleep. Remember: patients do not lose those follicles permanently and the follicles can produce new hairs in just a few weeks.

My recommendation for you is to see a hair specialist and get your hair miniaturization mapped by microscope; this way the doctor can tell you whether or not you are experiencing an early stage of patterned baldness or that you have lost your hair due to stress.

If your baldness has just begun, medication may help you. If you are experiencing telogen effluvium without being predisposed to pattern baldness, you only need to wait and your hair will grow back in a couple of weeks.

Q:

I started the Propecia at the beginning of March (8 months ago), prior to the procedure last March. Should I still be on it?

A:

It is great to hear from you and I am glad you are happy with the result of your hair transplant. The final result of your hair may still get better up until one full year after your surgery if you allow your hair on the transplanted area to grow longer.

Finasteride was mostly prescribed for prevention of shock loss after hair transplant or losing native hair on the balding areas after a hair transplant. You have significant miniaturization on the front, top and crown area (90%-100%), which makes your preexisting hair on balding areas prone to further hair loss. Now that you had your transplanted hair grown, you can decide to stop Propecia. By doing that, you may risk losing your own hair on the balding area further (transplanted hair does not need Propecia for its growth) or you can continue taking the medication to increase the longevity of your preexisting hair on those areas.

One time, a friend told me he was at a diversity conference and there was a man who came up to the podium to speak. He asked the audience, “what is the first thing you notice about me?” Someone yelled out, “BALDIE!” And subsequent laughter ensued (being an African American, it turned out he was hoping someone would say, “you’re black”).

Although the remark was taken as a joke, it’s unfortunate many people in our society notice physical appearances before anything else. There’s no shame whatsoever in losing one’s hair. The reality is that it’s not that person’s fault. It’s their genetic coding.

For those losing hair, there’s a socially acceptable solution: A hair transplant. Hair transplants have done wonders for all types of people, from big-name actors to prominent television sports anchors. It boosts self-confidence, makes a person feel less conspicuous in social settings, and may even increase the chance of a person landing a first date or better someone’s job prospects.

Hair transplants at US Hair Restoration are all-natural. Take a look at our hair transplant before and after photo gallery.  In a way, a hair restoration can restore your youth and help you feel at ease around people you’re meeting for the first time, making the experience of life better and more rewarding.

Much like narrowing a gap between teeth by getting braces, or correcting one’s near-sightedness by lasik eye surgery, a hair restoration can be a wonderful option for those who believe they may benefit from it.

Q:

Dear Dr. Mohebi,

Thank you for taking the time to see me on Saturday! Your correspondence providing a summary of our discussion was very comprehensive and is much appreciated!

Since our meeting on Saturday, I have done some research and would like to trouble you with a few more questions:

1) Is Alopecia the correct term to describe my hair loss pattern?

2) Would you consider cortizon shot treatment for me?

3) Would you consider laser therapy?

4) If I were to use monoxidil, does it have to be 2% or a higher percentage would yield more and faster hair growth?

5) you recommended a complete medical evaluation, could you please recommend someone that you trust?

I wish to thank you again for all your time and patience!

Best regards,

A:

Hi,

Here are your answers in the order you asked:

1) Is Alopecia the correct term to describe my hair loss pattern?

Alopecia is a general term that means hair loss. We have many different patterns of hair loss or alopecia, like male pattern or female patterned alopecia or alopecia cicatricial. Your pattern is similar to a male pattern because you lost your hair on the frontal area while you kept your hair on the donor area intact, which is why you might be a good candidate for a hair transplant procedure considering that your medical evaluation is negative for any medically treatable cause of hair loss.

2) Would you consider cortizon shot treatment for me?

No, steroid shots are sometimes used for Alopecia Areata (AA), which is an autoimmune disorder. Alopeica Areata is a hair loss condition with patchy hair loss spots. Your condition does not seem to be Alopecia Areata.

3) Would you consider laser therapy?

I do not recommend laser therapy for hair loss in the form of laser comb or laser machines because of the lack of solid medical evidence that support their effectiveness at this time.

4) If I were to use Monoxidil, does it have to be 2% or a higher percentage would yield more and faster hair growth?

You can start with 2% and then you need to be re-evaluated in six to 12 months and a treatment plan might need to be adjusted at that time.

5) you recommended a complete medical evaluation, could you please recommend someone that you trust?

Any good internist or endocrinologist could follow through with the lab works that you need.  Our letter includes the list of medical conditions that should be considered and lab works to rule out those women like you who have hair loss. You can share my letter with any good internist or endocrinologist and he or she should be able to follow through with your lab result and treat any treatable conditions that could possibly be found.

Have a great day,

Earlier this year, in an L.A. Times story, business columnist David Lazarus said he had visited a hair transplant center’s open house and noticed a lot of men in attendance. A lot more than he expected. He spoke to the director of the business and found out that, these days, a lot of the men looking for hair transplants are hoping to increase their job prospects by having a full head of hair.

Some studies have shown that people who are more attractive, or are not overweight, or are younger, tend to have an edge on the job market. They get paid more, are more likely to get promoted, and are likely to be treated better. Although this finding may be saddening, it unfortunately may be somewhat of a reality.

Considering this finding, there are balding men in our society who believe they can increase their job prospects by having a full head of hair. It may simply turn out to be a psychological edge, or a self-image booster, for these men to perform well during their interviews.

Nevertheless, what seems more important is the manner in which a job seeker presents himself to his prospective employer. The answers he gives, his attitude, eye contact, and overall vibe. But, it seems, to some people, it wouldn’t hurt to have a full head of hair.  Plus, due to the current state of the economy, hair transplant costs are at an all-time low for high-quality hair restorations.

Over the last few decades, different therapies which effect wound repair have been proposed. The connection between wound healing and hair growth was already proposed by Dr. Catsarelis at the University of Pennsylvania through the WNT pathway (some molecular process that controls would healing and hair growth). Now, we review the emerging fields of gene and stem cell therapy in hair restoration and wound healing.

Gene therapy, initially developed for treatment of congenital defects, is a new option for enhancing wound repair. In order to accelerate wound closure, genes encoded for growth factors or cytokines showed the greatest potential.

The majority of gene delivery systems are based on viral transfection (intentionally contaminating the host cells with a particular virus that insert the desired gene to the target cells), naked DNA application, high pressure injection, or liposomal vectors, etc. Embryonic and adult stem cells have a prolonged self-renewal capacity with the ability to differentiate into various tissue types. A variety of sources, such as bone marrow, peripheral blood, umbilical cord blood, adipose tissue, skin and hair follicles, have been utilized to isolate stem cells to accelerate the healing response of acute and chronic wounds.

Recently, the combination of gene and stem cell therapy has emerged as a promising approach for treatment of chronic and acute wounds. This is good news for prospective hair loss patients: the idea that similar gene therapy techniques can be used to affect the baldness gene by switching the hair loss gene off and on.

This new study was done by Branski et al. at the Department of Surgery, The University of Texas Medical Branch and Shriners Hospitals for Children.