Hair Restoration Blog

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.

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 21 year old boy and I started losing my hairs an year ago .I was preparing for my exams and i had some sort of food poisoning thing which affected my health adversely and I couldn’t had a proper diet for two months which resulted in a dull patch of baldness over my scalp.. I consulted with my local doctor and he suggested me minoxidil with some diet supplements(BIOVET-biotin and EMVIT-amino acids ,follic acid and some other vitamins).Now the hair fall is minimal but then too I suffer intense hair fall sometimes . I also took propecia after consulting with a doctor but it aggravated my situation and it catalyzed the hair fall instead. I was suggested that the hair fall will be temporary. I was scared so i discontinued the medicine.I took the medicine for 10 days specifically. Baldness is inherent in my family. What should Ii do?  Please guide me regarding the various hair treatments.  I dont wish to use propecia as I am scared about after mariage issues involved the medicine Hoping for your response as soon as possible.

Thanking You

A:

If you have a strong family history of hair loss, you may be heading in that direction already.  Vitamins for hair loss could be needed in case you are diagnosed with having vitamin deficiency.  However, a person with a balanced diet should not lose hair because of lack of vitamins.

Propecia, or finasteride, is by far the most effective medication for treatment of baldness or prevention of further hair loss.  You may experience some increase in hair shedding in the first few weeks to months, but that should not discourage you.  Hair growth with Propecia won’t be seen before six months from the time you start the medications.

You need to establish a good relationship with a good hair transplant doctor to properly diagnose your hair loss condition.  If you are diagnosed to have male pattern baldness or typical men hair loss you need to start taking hair loss medications and eventually get a hair transplant if need be.

As for “after marriage issues,” I believe you might be referring to the report of side effects associated to the use of finasteride. It has been reported that only 1 out of 100 patients (or less than 2%) have experienced some form of sexual side effect (erectile dysfunction, less desire to have sex, problems with ejaculation such as a decrease in the amount of semen released). The side effects have usually been temporary with continued treatment or disappeared when treatment is stopped.  It is a safe and proven product and should not be disregarded as a way to treat hair loss.

Q:

Dear Mr. Mohebi,

I would like to ask you a question concerning possible side effects that finasteride (Propecia) may cause. I read on the manufacturers instructions that broken tablets must not be handled by women who are or may become pregnant. Can finasteride cause damage to pregnant women health or to the health of the developing fetus? Here I’d like to know also if finasteride can be found in body liquids such as men’s saliva, sweat or sperm? In such case is there any risk that a pregnant woman is exposed to finasteride? Are there any recommendations concerning taking or not propecia before planned or during wife’s pregnancy?

Could you please comment on this?
Thanks in advance.

Best regards,

A:

This is a common question that many of my young patients ask me.  Finasteride (Propecia) blocks the conversion of testosterone to dihydroxytestostrone (DHT).  DHT does not have any known role in adult men development, but it is crucial in development of a male fetus and child external genitalia (their penis).  We at our Los Angeles, California hair transplant clinics don’t recommend taking finasteride for hair loss prevention and treatment before adulthood while maturation of external genitalia is not completed.  Pregnant women should not take finasteride because of its effect on the external genitalia of their male unborn baby.

The pharmaceutical company (Merck) recommends that pregnant women or any women who might have a chance of being pregnant should not be exposed to finasteride.  They should not even be cutting pills that might increase the chance of inhaling small particles of finasteride.  You are right about finasteride being present in body secretion such as semen and saliva.  However, the amount of the medication is so small that it is considered negligible or safe for pregnant women.  So the research shows that it is safe for pregnant women to be exposed to the secretions of a man whom takes finasteride.  That is why we do not recommend men to stop taking finasteride if their wife becomes pregnant.  There has been no evidence of any risk to a male baby from secretion of finasteride through the father’s saliva, sweat or sperm.

Q:
Well I am only 18 yrs old from India and I have got a hair problem. usually when I was young I didn’t care much about my hair, but now I have  found that I have  lost my hair and they r falling very rapidly.

Well my diet is also not too good as I am very lean…..now I am getting very worried about my .They have not completely gone…. but volume or (say) quantity of hair has reduced very much from all over the head and the effect can be seen more on the crown area I don’t use much shampoo and usually I didn’t use to use oil but have started now.

My father is too bald so please help me that what should I do …so that I can restore my hair back……

A:
Your hair loss is most likely genetic and you might be experiencing the early stages of male pattern baldness.  Although malnutrition may cause some types of hair loss, it won’t happen until your are severely deficient of some particular elements.

Having said that, it is a good idea to see your doctor to confirm the diagnosis of the hair loss, especially if your hair loss does not follow a typical male pattern like what you can probably see in other male members of your family.  Men hair loss in its male pattern type is seen in men between their early 20s and will deteriorate for many years.  There are many hair loss products out in the market, but none of those are really proven to work except a few medications that are FDA approved such as minoxidil and finasteride.

My recommendation is not to start using hair loss medications before your diagnosis of male patterned baldness is confirmed by a doctor.  Hair transplant might be an option for you in the future so it is good to start your relationship with a hair transplant surgeon now.

There is just another study on a potential new medication that could be used for treatment of hair loss. Currently, there are only two FDA approved medications for male patterned baldness or typical men hair loss in United States. The two medications that we have extensively discussed on this web site are finasteride (Propecia) and minoxidil (Rogaine).

The article “Effect of Cuscuta reflexa Roxb on androgen-induced alopecia” was published in the Journal of cosmetic dermatology September 2008. The research is done in India and the authors discuss the significance of hair loss in men and the effect of androgenetic alopecia on millions of men and women. They classify typical men hair loss as androgen-driven disorder. They used Cuscuta feflexa Roxb for hair growth activity in androgen-induced alopecia.

The authors of the article used petroleum ether extract of C. reflexa for its hair growth-promoting activity on albino mice. They induced male patterned alopecia in mice by testosterone administration for 20 days. The inhibition of baldness by simultaneous administration of the extract was evaluated using follicular density, anagen/telogen ratio, and microscopic observation of skin sections. To investigate the mechanism of observed activity, in vitro experiments were performed to study the effect of extract and its major component on activity of 5alpha-reductase enzyme.

The researchers announced that petroleum ether extract of C. reflexa exhibited promising hair growth-promoting activity as reflected from follicular density, anagen-telogen ratio, and skin sections. Inhibition of 5alpha-reductase activity by extract and isolate suggest that the extract reversed androgen-induced alopecia by inhibiting conversion of testosterone to dihydrotestosterone. They concluded that the petroleum ether extract of C. reflexa and its isolate is useful in treatment of androgen-induced alopecia by inhibiting the enzyme 5alpha-reductase.

This hair loss research needs more research on human volunteers on a long period of time before it can be considered as a balding treatment. There must also be more research done on the application of the product on human in terms of medication side effects and its comparison with currently available medications for treatment of hair loss.

We at US Hair Restoration continue to follow on the most advanced investigations and researches on hair loss treatment. We keep our patients and the readers of hair restoration blog updated with the new information and medical technology to improve the quality of our hair restoration treatments at our Los Angeles hair restoration clinics.

Q:
I am 24 with a strong family history of hair loss in the male members at and around early 20s. Recently, I started seeing hair in my sink and on the bed that is much lighter my regular hair. Is it normal? Am I balding and can I use a hair transplant to prevent further hair loss.
A:
Male patterned hair loss is characterized with miniaturization of hair shafts before complete losing them. In genetically prone men to male pattern baldness, hairs of an affected area gradually become thinner and thinner, before they ultimately become nonexistent.

Miniaturization hair shafts make them look thinner, because of the smaller size and then the smaller amount of darker pigments that could be seen.

It seems that you started with hair loss phenomenon and you only need to get it diagnosed by a good hair specialist who can also get you started on medication treatment if need be. A miniaturization study can give you some ideas of where you are heading before starting with the medications.