Is it possible to not be eligable for a HT?

[mark25]

I once read a post on here (can't find it now, tried searching for it to no avail) where someone had paid about $20,000 over various HT's and eventually got to Dr. Wong who told him that he has some rare kind of DHT resistance and all transplanted follicles would fall out (as has happened in his case).

 

Anyone have more info on this? And would top-notch doctors check for this before operating? Is it possible to know before an operation?

[RCWest]

Some unlucky men have donor hair that thins along with their normal Norwood pattern thinning. I've seen this in the more advanced cases of baldness, not usually in someone at NW4 or lower. Most recommended physicians will check for this.

[Dr. Michael Beehner]

The condition you are referring to is known as the acronym, "D.U.P.A." It stands for "diffuse unpatterned alopecia." It usually is easy to tell on close inspection of a consultation patient's scalp, but we always double-check with magnification, usually around 30x power. The density is very low and often there are a significant percentage of "miniaturized" hairs also, which do not have many more life cycles to live before they disappear.

There are a number of reasons they make poor transplant candidates: The first is that, as they thin, the donor scar (or even the FUE white dots) will become more and more obvious and detectable.

Another reason is that it is hard to move that much hair. I have had a couple of men over the years, usually in their early 30's, in which case things were evolving much more slowly, and we did discuss a very limited plan of "cherry picking" a number of hairs from the rear donor wall and using them to frame the face in a limited area at the front-center. I obviously pointed out the positives and the negatives, and both men elected not to go forward with it.

One strategy that can work to help these men for a few years is to use a camouflage agent such as Dermmatch or Toppik. I am not aware that finasteride helps to reverse this condition.

Two other situations in which a person would not be a candidate for hair transplantation are the following:

a) Person with an auto-immune condition which would result in lymphocyte cells from the disease process attacking the newly transplanted follicles and not letting them survive. The two commonest conditions we encounter in this regard are Lichen Planopilaris and Alopecia Areata. Lupus is another such condition. Sometimes, after a couple of years have gone by and the process has stabilized, they can be transplanted, but the patient has to be warned that it is possible that the original condition could reactivate and attack the transplanted follicles and result in their permanent loss. If a hair surgeon does elect to later transplant one of these patients, either a biopsy (to make sure the disease is inactive) or a small area of "test grafts" is a good idea before embarking on a big session.

b) The person who has only so much donor hair available, and after explaining to the patient what the most that can be done is, the patient states that would not satisfy him. You never want an unhappy patient or one whose expectations are unrealistic, given the reality of the patient's situation.

Mike Beehner, M.D.

[Al - Moderator]

I keep saying the donor area is not permanent hair like the Drs want you to believe. This area does thin out in some people and it happens long before they reach "old" age. I posted some new pictures on my profile to show what I mean.

[mark25]

I keep saying the donor area is not permanent hair like the Drs want you to believe. This area does thin out in some people and it happens long before they reach "old" age. I posted some new pictures on my profile to show what I mean.

Did they thin out slowly for you, or very quickly? Also I saw the pictures are from 2009...has it gotten worse since then?

 

Also, which doctor did you go to? Are they not able to check whether or not a follicle is genetically programmed not to fall out?

[RCWest]

I keep saying the donor area is not permanent hair like the Drs want you to believe. This area does thin out in some people and it happens long before they reach "old" age. I posted some new pictures on my profile to show what I mean.

 

This is very true! This is why everyone is recommended to wait and see where things are heading before embarking on a hair transplant.