My Qualms and my Hair Loss

[lucldh]

I am 28 year old male from India. Barring the hair on head, I consider myself a messy hairy guy with hair almost everywhere on my body - what an irony!! I feel that I have thick hair on my beard and chest. See the photos in my profile: Hair Restoration Social Network ? Community for and by Hair Loss Patients.

 

Hereditary hair loss is on my maternal side only, not on paternal side. My grandfather at 85 has full dark head of hair and my father at 61 has too. Since the time I have gained my conscious, I have seen my maternal grandfather with almost no hair anywhere on his head. As described by Dr. Bernstein at the bottom of this link Male Hair Loss Classification: Hair Loss in Men | Bernstein Medical, he may have been a victim of Diffused Unpatterned Baldness (I am getting nightmares since the time I have learned about this altogether shitty pattern of baldness in which there will no safe donor area). I have 3 maternal uncles - first (around 60 years old) is very similar to maternal grandfather in his balding pattern and can be safely considered N7, second (around 57 years old) has somewhat thick edges but not very dense and is also N7, and third (around 54 years old) has dark edges and is N6.

 

If Histogen's Hair Stimulating COmplex becomes available at this stage, I think that it may be at least stop my hair loss and may also avert it to some extent. I may not even require an HT altogether.

 

 

Can someone please answer my following questions:

 

1. Is my hair loss attributable to factors other than genetics?

 

2. Should I even consider an HT or will Scalp Micro Pigmentation be my only option?

 

3. Even if I consider HT, will my existing hair on scalp be affected by HT due to shock loss? Will I lose few or lot of them due to shock (I don't want to land in a situation where the gains will be offset by losses)?

 

4. Does the technique of a surgeon help keep native hair during HT? If yes, can someone suggest surgeons who specialize in HT while causing minimum damage to native hair due to shock loss?

 

5. How many grafts will I require to have a decent coverage?

 

6. Do I have an above average, average or below average donor characteristics such as donor density, donor thickness, donor laxity, etc.?

 

7. What is Norwood Level - 5, 6 or 7?

 

8. Since I am a diffused thinner as of now, should I consider FUT over FUE because more grafts are available via FUT?

 

9. Who is the best doctor in India who can evaluate my hair characteristics honestly in terms of donor laxity, donor density, donor miniaturization, etc.?

 

 

 

Even I assume that I am not a victim of Diffused Unpatterned Baldness and that around 8000 grafts can be extracted using FUT from safe donor area on back of my head), I have chartered the following HT plan:

 

1. Use FUT of around 4000 grafts to cover present balding area - 2000 grafts for front and mid scalp, 1000 grafts on upper crown adjoining mid scalp and 1000 grafts on lower crown adjoining back of head.

 

2. After 9 months, use FUE of around 2000 body hair grafts to provide density to upper and lower crowns.

 

3. Some 5-6 years down the line, use FUT again of around 3000-4000 grafts to cover present balding area - 2000 grafts for front and mid scalp, 1000 grafts on upper crown adjoining mid scalp and 1000 grafts on lower crown adjoining back of head.

 

4. I will still have around 2000-3000 beard grafts (my beard I feel is very dense) for new balding areas/ repair work that may emerge in future.

 

 

I badly need the advice of forum members and doctors. I am having nightmares as I am learning more and more about my baldness pattern. Sometimes, I also dream about my hair loss getting bad and my hair loss is the first thing that comes to my mind when I get up in the morning. I either need hair on my head or a divine intervention that helps me stop thinking about my hair!!! My hair loss seems to have halted many of my ambitious career plans as I am not able to think beyond that. Bad that.

[Blake Bloxham]

Hi Luc,

 

Let me see what I can do to address some of your concerns.

 

First, and foremost, I do believe the BEST thing you can do right now is consult with a knowledgeable hair loss physician. The doctor will be able to examine your scalp and provide the most helpful and accurate answers to your questions. While I will do my best to answer everything here, you really should be evaluated by a physician.

 

Second, Histogen is still working on starting Phase IIb clinical trials and won't likely be available for at least several years (probably 2017-ish in Asia if all goes to plan). Hair loss is a progressive condition, and most recommend stabilizing with preventive measures today and not delaying treatment in the hopes of new, undeveloped technology.

 

1. It is very difficult to state exactly what is causing your hair loss based upon images alone. Frankly, it looks like your balding in a typical "male pattern hair loss" fashion, which means it is most likely attributed to androgenic alopecia. As you're probably aware, androgenic alopecia is a combination of your genetics and hormones. You will need a physician to evaluate you to determine the cause with certainty.

 

2. If you do suffer from DUPA, hair transplantation is less certain. However, it doesn't appear (based upon those images alone) that you're suffering from diffused unpatterned alopecia. It is far more likely that it is androgenic alopecia, which means you may be a candidate for hair transplant surgery. However, and I'm sure you'll grow tired of this phrase by the time my post is done, this needs to be evaluated by a hair transplant surgeon. Truly, only he/she can tell you for sure.

 

3. Shock loss in the recipient region is more prevalent when the surrounding hairs are weakened by hormone-driven alopecia. Many physicians recommend using finasteride perioperatively (around the time of the procedure) to prevent his, but it can result in permanent "shock loss" in these hairs.

 

4. See above. I would discuss using finasteride perioperatively with your physician.

 

5. Very difficult to say based upon the images alone. It will depend on your hair characteristics, goals, adherence to preventive medications, etc, etc.

 

6. Is your hair shaved shorter on the sides? The back portion of the donor region appears dense, but it looks like the sides are purposely cut shorter (which is why I thought it was the haircut and not DUPA). Otherwise, you seem to have adequate density, and transplanting dark, wavy hair against a darker skin tone usually helps create a more dense appearance. Difficult to assess the laxity from images.

 

7. The Norwood scale (in my opinion) more accurately defines where you're likely "heading" opposed to describing your current hair loss pattern. It does appear as if you may progress to a NW VI eventually.

 

8. Your candidacy for strip versus FUE can really only be determined by a hair transplant surgeon.

 

9. In India, we recommend Dr. Madhu and Dr. Radha.

 

10. Normally, body hair transplantation is only recommended after the traditional donor region is exhausted. Also, most advise waiting a full 12 months before undergoing a second hair transplant procedure. However, I would definitely discuss this plan during a consultation.

[lucldh]

Hi Luc,

 

Let me see what I can do to address some of your concerns.

 

First, and foremost, I do believe the BEST thing you can do right now is consult with a knowledgeable hair loss physician. The doctor will be able to examine your scalp and provide the most helpful and accurate answers to your questions. While I will do my best to answer everything here, you really should be evaluated by a physician.

 

Second, Histogen is still working on starting Phase IIb clinical trials and won't likely be available for at least several years (probably 2017-ish in Asia if all goes to plan). Hair loss is a progressive condition, and most recommend stabilizing with preventive measures today and not delaying treatment in the hopes of new, undeveloped technology.

 

1. It is very difficult to state exactly what is causing your hair loss based upon images alone. Frankly, it looks like your balding in a typical "male pattern hair loss" fashion, which means it is most likely attributed to androgenic alopecia. As you're probably aware, androgenic alopecia is a combination of your genetics and hormones. You will need a physician to evaluate you to determine the cause with certainty.

 

2. If you do suffer from DUPA, hair transplantation is less certain. However, it doesn't appear (based upon those images alone) that you're suffering from diffused unpatterned alopecia. It is far more likely that it is androgenic alopecia, which means you may be a candidate for hair transplant surgery. However, and I'm sure you'll grow tired of this phrase by the time my post is done, this needs to be evaluated by a hair transplant surgeon. Truly, only he/she can tell you for sure.

 

3. Shock loss in the recipient region is more prevalent when the surrounding hairs are weakened by hormone-driven alopecia. Many physicians recommend using finasteride perioperatively (around the time of the procedure) to prevent his, but it can result in permanent "shock loss" in these hairs.

 

4. See above. I would discuss using finasteride perioperatively with your physician.

 

5. Very difficult to say based upon the images alone. It will depend on your hair characteristics, goals, adherence to preventive medications, etc, etc.

 

6. Is your hair shaved shorter on the sides? The back portion of the donor region appears dense, but it looks like the sides are purposely cut shorter (which is why I thought it was the haircut and not DUPA). Otherwise, you seem to have adequate density, and transplanting dark, wavy hair against a darker skin tone usually helps create a more dense appearance. Difficult to assess the laxity from images.

 

7. The Norwood scale (in my opinion) more accurately defines where you're likely "heading" opposed to describing your current hair loss pattern. It does appear as if you may progress to a NW VI eventually.

 

8. Your candidacy for strip versus FUE can really only be determined by a hair transplant surgeon.

 

9. In India, we recommend Dr. Madhu and Dr. Radha.

 

10. Normally, body hair transplantation is only recommended after the traditional donor region is exhausted. Also, most advise waiting a full 12 months before undergoing a second hair transplant procedure. However, I would definitely discuss this plan during a consultation.

 

 

Thanks Blake for sharing your knowledge. I found it informative. I will visit physicians first - both FUT and FUE. Dr. Bhatti is near where I live. Have you seen patients posting here about their hair characteristics reviewed by Dr. Bhatti - I mean to ask whether he has recent state of the art infrastructure to carry out comprehensive analysis of hair characteristics?

Also, the sides were not purposely cut shorter - guard 1.5 clipper was used along all the sides including back; however, the pics of left and right profiles were taken with FLASH on but the pic from back of the head was taken with FLASH off.

Edited November 5, 2013 by lucldh

[lucldh]

Any one have any idea? Does Dr. Bhatti have essential equipment to evaulate hair characteristics of donor area?

[Blake Bloxham]

Luc,

 

The flash could definitely have something to do with differing appearance in the images.

 

I also think Dr. Bhatti likely has the tools to evaluate your scalp (as it's really just magnification). However, I do still think consultations with Dr. Radha and/or Madhu would be helpful as well!

 

Good luck.