Hair Restoration Blog

I visited a 30 year old patiet for a hair loss consultation a while back who believed he lost his hair due to having too much sex.  The fact is that most patients attempt to find a reason for rapid loss of hair in the early stages.  Thas is often the same age that they are most active sexualy.  The combination of the two may convince them that they may have lost their hair due to having too much sex in those years.

These people are not the only balding peole who try to find an environmental situation and blame it for their genetic balding problem.  Many people blame their partner, bad relations, stressful situations and other significant events in their lives for their hair loss.  The reality is that gene, sex and time are the only major contributors to male or female patterned hair loss and environmental factors only may accelerate the presentation of the hair loss.  Normal people without balding gene may lose hair for different reason, namely stressful conditions, but the hair always grow back when stressor is gone.   This is not the case for people who have the gene of hair loss that may never grow their back what they lost after losing it due to stressors.

Q:

Hey Doctor Mohebi,

I was wondering, I’m thinking about getting a hair transplant, but I’m afraid of telling my future wife and female friends that I’ve had a hair restoration. I know men may not care that much, but if I’m dating someone and eventually I tell them I’ve gotten a hair transplant, I fear that they may get turned off.

I kind of look at it like plastic surgery. I know when I meet women who has undergone a nose job, I kind of feel strange about it and think maybe that person was not happy with their looks.
To be honest, it  turns me off.

So, my question is: from your experience with patients, do they keep it a secret from others or do they not mind telling people?

A:

Today, we have capabilities we did not have 50 years ago. As a young soccer lover, I used to have the disadvantage of wearing glasses.  It was very difficult for me to stay competitive in succer team without wearing my glasses.  Every now and then, I use contact lenses to be able to put aside my glasses. I am planning to get a LASIK procedure for that as well.

If I undergo a LASIK procedure, does it make me an insecure person. Not at all. I call it using all your resources to look your best.

We do have technology that we did not have 10 years ago. I say: why not use it? A lot of people are doing it, and nobody cares if these peoples’ hair is native hair or transplanted. The point: they are not bald any more and they can be as competitive as their non bald rivals in life.

One time, I met a very beautiful woman at a party and I ended up having a conversation with her.  When I told her I do hair transplants, she told me a story about someone who proposed to her and she rejected him. She said the man was bald. But I’m not saying because he was bald that he got rejected, but because he did not do anything about it. I know the argument can be made that what the woman did is sad and superficial but, hey, looks do play a part in initial courtship, whether we would like to admit it or not. And it was her prerogative to make that decision.

My point is: Be yourself and do whatever makes your heart happy. No matter what you do with your life, there are going to be people who may not like it. It should not influence your decisions.

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.

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.

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.

Q:

I am a 26 year old female and felt like the world was mine, and then this happened and now I would rather hide, so I understand about feeling like a freak. But I think we all have to remember that we have nothing to be ashamed of This disease is more widespread than we think and people are more understanding than we give them credit for. We can all still live long and happy, if a little self consciously. Since getting AU, I have heard of so many people who have friends or family with this disease - there are a lot of us, and we are still lovable, attractive, successful and admired. We may look different but if we can overcome the self-imposed stigma of it, I think it will just serve to make us stronger.

Speaking as a woman, let’s give our daughters, sisters and mothers a good example for self-respect, and show them how to be fearless, how to overcome obstacles and show them that women are more than long shiny hair and a media approved image.

I know I am young and have not yet suffered with this disease as long as any of you, so it is likely easier for me to say these things. I just hope to remain this optimistic and not let it get the better of me. We are all more than our hair. And if being bald and shapely or hairy and fat is the choice, I choose to keep my body healthy on the inside instead of just looking it on the outside.

Thanks to all of you, I wish you all the best and just remember, you are more than your hair and do not accept feeling like a freak! Remember the people that love you when you are at home and hairless for all to see, what they see in you is what you truly are, not the you that has to wear a wig so people don’t stare or the one who has come to hate the wind.

A:

I like your attitude.  Treatment of Alopecia Universalis (AU) could be difficult or impossible in some cases.  You have to come to my office and talk to some of my patients who think the world has come to an end because they are losing their hair.

This is what I always say to my patients: It is important to try to look your best. If you have the option to change your appearance for the better, do it as much as possible, but for the part that you cannot change, accept it.  Learn to use it to your advantage and learn to love it.

I am a 26 year old female and felt like the world was mine, and then this happened and now I would rather hide, so I understand about feeling like a freak. But I think we all have to remember that we have nothing to be ashamed of This disease is more widespread than we think and people are more understanding than we give them credit for. We can all still live long and happy, if a little self consciously. Since getting AU, I have heard of so many people who have friends or family with this disease - there are a lot of us, and we are still lovable, attractive, successful and admired. We may look different but if we can overcome the self-imposed stigma of it, I think it will just serve to make us stronger.

Speaking as a woman, let’s give our daughters, sisters and mothers a good example for self-respect, and show them how to be fearless, how to overcome obstacles and show them that women are more than long shiny hair and a media approved image.

I know I am young and have not yet suffered with this disease as long as any of you, so it is likely easier for me to say these things. I just hope to remain this optimistic and not let it get the better of me. We are all more than our hair. And if being bald and shapely or hairy and fat is the choice, I choose to keep my body healthy on the inside instead of just looking it on the outside.

Thanks to all of you, I wish you all the best and just remember, you are more than your hair and do not accept feeling like a freak! Remember the people that love you when you are at home and hairless for all to see, what they see in you is what you truly are, not the you that has to wear a wig so people don’t stare or the one who has come to hate the wind.

A:

I like your attitude.  Treatment of Alopecia Universalis (AU) could be difficult or impossible in some cases.  You have to come to my office and talk to some of my patients who think the world has come to an end because they are losing their hair.

This is what I always say to my patients: It is important to try to look your best.  If you have the option to change your appearance for the better, do it as much as possible, but for the part that you cannot change, accept it.  Learn to use it to your advantage and learn to love it.

Trichotillomania (TTM) [Greek: tricho (hair), till (to pull), and mania], also called trich, is hair loss due to an impulse control disorder distinguished by the repeated urge to pull out hair of scalp, body, eyelashes, eyebrows, facial hair, nose hair or pubic hair.  Trichotillomania may result in noticeable bald spots or hairless patches.

Trichotillomania is more common during the first two decades of life with female predominance; however it could be seen in both sexes and all ages. Trichotillomania may resemble a habit, an addiction, a tic disorder or an obsessive-compulsive disorder. Trichotillomania often begins during the individual’s teenage years, but may happen at any age. Depression or stress can trigger the trich. Due to social implications, the disorder is often unreported and it is difficult to predict accurately prevalence of Trichotillomania.  It is stated that 2.5 million people in the U.S. may have TTM, with a 1% prevalence rate.

Patients with trichotillomania may live relatively normal lives.  TTM may not be known by the patients and in fact most patients deny any manipulation of the hair.  An additional psychological effect can be low self-esteem, often associated with being rejected by peers and the fear of socializing due to appearance and negative attention they may receive.  Trichotillomania can be effectively treated by habit reversal training along with a variety of psychiatric medications based on the underlying disorder.

I have recently seen a male patient with male patterned baldness in our Los Angeles hair transplant clinic who has previously undergone a hair transplant surgery in another hair transplant clinic about a year before with over 500 grafts on his crown area.  The result of the surgery that should have been completed at the time of our consult was very disappointing both to the patient and to us.  I performed a microscopic evaluation of the scalp in both the frontal and crown area.  I noticed broken hair at both frontal native hair area and crown area, which was evidence of manipulation of the hair.

Patient denied any hair pulling, but had disclosed having experienced a nervous breakdown recently.  However, he did not deny that he had been too conscious about newly implanted hair follicles after his hair transplant that might have forced him pulling most of his transplanted hair grafts.

I recommended a psychological evaluation and treatment of any underlying disorder and we decided to re-evaluate him in a few months after his psychological treatment.  I won’t recommend a hair transplant until he shows no evidence of trichotillomania for a considerable period of time.  I have previously treated a patient who has had hair loss due to trichotillomania at childhood with hair transplant, but was treated completely with no evidence of pulling hair for a long period of time.

I am in the Detroit airport on my way back to Los Angeles from the 16^th annual meeting of international society of hair restoration surgery (ISHRS) that was held in the beautiful city of Montreal in Canada last week. This five day meeting was filled with a variety of presentation on the clinical and basic science aspects of hair transplant surgery and medical hair restoration.

I gave a lecture on psycho-social impacts of hair restoration on men on the first day of the meeting. The lecture has been prepared based on my other article on Psychology of Hair Transplant that was previously presented and published on the Hair Transplant Forum International on April, 2008. In the current presentation on psycho social impacts of hair transplantation, I explored some other social and psychological aspect that hair transplant patients experience after their hair restoration procedures based on experience we had with our Los Angeles hair transplant patients and what we found in our research last year with New Hair Institute (NHI).

Several other interesting studies were presented on the aesthetic planning and designing of the hair line and frame of the face with hair transplantation. There were many articles on the hair transplant surgery techniques that could be used for optimization of the final appearance of a hair transplant.

Few articles were presented on hair stem cell research and hair multiplication. However based on the presented evidences, there were no signs of an upcoming solution for hair multiplication or hair cloning any time soon.

One article discussed an innovative method of hair graft harvesting that can produce more hair from an existing follicular unit. The result of this study, although interesting was very controversial among the experts and the author could not release the study details on the methodology to elucidate this matter.

I will publish the highlights of this meeting on the website of US Hair Restoration soon.

Alopecia areata

Alopecia areata is an autoimmune condition and causes patchy hair loss in any area in body. The bald areas of the skin usually look normal with no gross evidence of irritation or inflammation. A genetic association could be found in some cases and it could also be linked to other autoimmune disorders. Alopecia areata is usually a self limiting disease, but could be treated by a dermatologist with injection of steroid or with topical medications if necessary. See my article on alopecia areata “Treatment of Alopecia Areata - Treat or Not Treat”

Traction alopecia

Traction alopecia is very common cause of hair loss in children. This condition that is particularly seen among girls happens mostly due to the fragility and weakness of hair follicle in children. Tight ponytail is the common cause of traction alopecia that can cause hair loss at sides and frontline in most cases. Traction alopecia could present with elevation of hair line as an initial sign. Treatment of traction alopecia of children is by cutting hair short and by eliminating the physical assault. Recovery is generally spontaneous, and may take a few months. In some cases of prolonged traction alopecia, damage to the hair follicles could be permanent and hair transplant might be necessary.

Tinea Capitis

Tinea Capitis is a fungal infection of scalp that affects head and neck hair. Approximately 3 to 8 percent of American children are affected. Many of these children are never diagnosed. Tinea Capitis is more common in children between 2 to 8 years of age and like other fungal diseases can be transferred through direct contact or contaminated comb, brush, towel and cloth. Fungus attacks hair shaft and decrease its integrity and makes it fragile. Again a good dermatologist should be involved for treatment of this condition, which may need systemic antifungal medications.

Trichotillomania

Trichotyllomania is one of the other common causes of hair loss in children. It is a compulsive disorder that the patient has a constant urge to pull his or her hair. It is not limited to scalp hair and could be seen in any hair bearing area. Parents are not aware of this condition in many cases and treatment is through psychotherapy and behavioral therapy. Most cases resolve completely after treatment of the compulsive disorder.

Telogen Effluvium

Telogen Effluvium could be seen in adults and children. Many factors like sever infection, big surgery, trauma, fever, and emotional distress will cause this condition through converting the growth phase of hair follicle into resting phase. The hair in resting phase starts to shed. This hair loss is typically self limiting and recovers spontaneously without treatment especially in children. Diagnosis of this condition is often through excluding other causes of hair loss. Complete recovery is expected within 4 to 6 months.