What kind of baldness is this?

[Baldy234]

Hey all, first time poster.

Recently let my hair grow out the past four or so months and only discovered I have lost a truly monumental amount of hair from the sides and nape area.

The top is destroyed fair enough but the only thing that was keeping me sane was the fact that I could someday remedy this with a HT, considering the amount of donor hair I thought I had.

I had planned on visiting Dr. Devroye in Belgium in the future as lots of people seemed delighted with him.

Don't know how I have failed to notice this before now but there you go.

I have posted pics of sides and back. It's hard to tell how far this baldness had infiltrated upwards because the hair started to get so thick I couldn't see as much scalp as in the pics ive attached.

Funny thing is you'd never know about the hair loss when my hair is brushed down as normal... For now anyway.

Am I a bad candidate for a HT now I guess I guess I'd like to know?

What type of baldness do I even have?

Sorry about the length of post and thanks in advance..

I just don't know where I stand now. This is just horrible.

 

PS.. Will post pics

Edited September 3, 2015 by Baldy234

[Spanker]

Retrograde alopecia probably. Pics aren't great. You should consult a doc in person.

[Baldy234]

sorry i just posted up the rest there.. had a bit of trouble

[gillenator]

I agree that there appears to be some thinning from the neckline going upwards.

 

Any doctor that is experienced in performing microscopic examinations for miniaturization and diffusion can evaluate your scalp, especially the donor zone to see if your donor is affected by DHT.

 

Baldy, does any of the older men on either side of your family history have donor zone thinning or hair loss in the donor area?

[Baldy234]

Hi gillenator,

Thank you for your reply.

Funny enough, I began scouting my family members the last few day after noticing this. Haha

My dad, mid sixties, has no indication of this thinning around the sides or back, just same pattern of baldness on top as myself.

 

My older brother, 40, has show signs of thinning at sides and nape alright, doesn't seem as bad as mine though at all, unless I notice it more cause my hair is grown out. his hair cut is shorter than mine. He actually has pretty good coverage on top apart from a slight bald spot on the crown.

 

I did notice the other day that my mum has patchy hair at the sides, similar to mine.

Think she has thinning at the nape too.

Overall, I think my loss at present is a lot more severe than hers, giving the age difference.

Only noticed this as we were out walking and got caught in a shower. Her hair was soaking.

When her hair is dry, it otherwise looks quite thick, full and totally no signs of hair loss.

 

Can't comment on her dad as he died before my time but going on pics if him, he had a full head of hair.

 

It's as though I got dads baldness on top and mums patchy hair loss everywhere else.

Double whammy

[Dr Blake Bloxham]

Hi Baldy,

 

Thanks for sharing these images.

 

This is a tough one. I was fairly certain this was just androgenic alopecia ("male pattern baldness") until I got to the pictures of the donor area and nape (neck). You can have some upward thinning in the nape area with androgenic alopecia. Like Spanker said above, however, this could also be a sign of something called "retrograde alopecia." This can impact some of the fringes of the "safe donor area" (though this is a bit of a moving target in-and-of-itself) and make hair transplantation less certain. What's more, it also appears like you may have some thinning in your donor regions on the side of the scalp. However, it was difficult to tell based solely on those images.

 

Thinning in the nape and the sides of the donor region would make me think of a few things. Namely, diffuse unpatterned alopecia. But, it could be a few other types of alopecia as well.

 

Regardless, some of these may disqualify you from hair transplant surgery. Because of this, you should really see a hair loss doctor for a thorough evaluation IN PERSON! This may also include a biopsy of the scalp to get a definite diagnosis of what's going on. I don't think most would advise seeking any sort of surgical treatment until you figure out precisely what's going on.

 

Please, keep us updated. Feel free to ask any additional questions as well.

[Carolinapride800]

Hi Baldy,

 

Thanks for sharing these images.

 

This is a tough one. I was fairly certain this was just androgenic alopecia ("male pattern baldness") until I got to the pictures of the donor area and nape (neck). You can have some upward thinning in the nape area with androgenic alopecia. Like Spanker said above, however, this could also be a sign of something called "retrograde alopecia." This can impact some of the fringes of the "safe donor area" (though this is a bit of a moving target in-and-of-itself) and make hair transplantation less certain. What's more, it also appears like you may have some thinning in your donor regions on the side of the scalp. However, it was difficult to tell based solely on those images.

 

Thinning in the nape and the sides of the donor region would make me think of a few things. Namely, diffuse unpatterned alopecia. But, it could be a few other types of alopecia as well.

 

Regardless, some of these may disqualify you from hair transplant surgery. Because of this, you should really see a hair loss doctor for a thorough evaluation IN PERSON! This may also include a biopsy of the scalp to get a definite diagnosis of what's going on. I don't think most would advise seeking any sort of surgical treatment until you figure out precisely what's going on.

 

Please, keep us updated. Feel free to ask any additional questions as well.

 

I'm new here, but a bit confused....are you a licensed physician? Unlike all the others here identifying themselves as surgeons or doctors, I can't find any information or a readily available cv. Forgive me if this question has been asked before.

[Dr Blake Bloxham]

Carolina,

 

Yes sir, I am!

 

I think your confusion may be the difference between a recommended/Coalition physician, and a doctor with a general member profile. I was one of the moderators and editors of this community before graduating medical school and training with one of our Coalition doctors. I'm now partnered with him, and I'm hoping to be considered for official recommendation sometime in the future.

 

Hope this clears things up.

[Carolinapride800]

Carolina,

 

Yes sir, I am!

 

I think your confusion may be the difference between a recommended/Coalition physician, and a doctor with a general member profile. I was one of the moderators and editors of this community before graduating medical school and training with one of our Coalition doctors. I'm now partnered with him, and I'm hoping to be considered for official recommendation sometime in the future.

 

Hope this clears things up.

 

Well in what state are you licensed? Where did you complete your internship(which every state uniformly requires for a medical license)? Use of of the terms surgeon/physician/doctor is a gray area and varies state to state, but your use of terms in your profile certainly implies that you are a licensed physician. I hope that's the case but a search of the New York State database doesn't turn up any records(of course maybe I just overlooked it). Using the term 'doctor' is a little different and varies from state to state- there is probably nothing wrong with someone that hasn't completed an official allopathic or osteopathic intern year from calling themselves a doctor(physician and possibly surgeon are much different stories), but every state I'm familiar with does have some guidelines on what you can and can't say and present to the public. In New York State the term 'physician' is very much a legal term without a gray area.

 

 

It's not an issue of whether or not you are a coalition/recommended member on this forum...that's not an issue of legal import at any level. While I'm coming on here to obviously research different ht providers and I understand that hair transplantation is a unique field and physicians from many different specialties have skill in it(for example one of the names I've been given is of an internist with a great rep), being able to accurately research the different providers FORMAL(meaning official acgme or osteopathic program) training and qualifications is important as well.

 

If you don't have any formal training after school, I would be extremely surprised if your use of terminology here in this forum isn't a violation of ny medical board laws. If you aren't a physician this probably relevant to you, but it may be relevant to the physician who employs or partners with you and he/she is under the authority of such boards if medicine.

[Dr Blake Bloxham]

Carolina,

 

I agree. This is all very important.

 

-Medical school: A.T. Still University -- Kirksville College; graduated 2014 with Sigma Sigma Phi honors

 

-Post graduate training: Dually accredited AOA/ACGME (osteopathic/allopathic) general internal medicine training in PA; 2014 - 2015

 

-Current state licenses:

 

 

I'm also not sure which database you checked. There is only one in NY. Here's a screenshot of my profile:

 

 

I had a license in PA prior to this as well. I hope this clears any issues up. However, I feel like it's detracting from the OP's question, so this will be my last response on the topic. You're free to send me a private message if you'd like to discuss further.

[Carolinapride800]

So your entire formal training consists of an intern IM year in PA? Seriously?

 

I'm not a surgeon(well then again you aren't either), but surgeons have told me they were still trying to find their head from their ass even up until their pgy-4 year.

 

The idea that a grad from a little year ago with only one an intern year completed(ie virtually no useful formal medical training) is presenting yourself this way is troubling. Perhaps one doesn't need much formal training to work in this particular niche field, but from your posting history it certainly doesn't seem that you have been very open in disclosing your traditional qualifications.

 

 

Also note that while nys(and some other states) may allow a person for now to obtain a medical license with only a year of training, it's certainly not a guarantee(some would say it's unlikely) that this policy will continue ten or fifteen years from now. In fact, in many states we are already seeing more reasonable requirements added to initial licensing and renewal. This is coming in the form of granting residents an initial license after their intern year but then requiring them to check whether they are still in a training program for the purposes of renewal. This trend is very clear, and it's hard to imagine that ten or fifteen years from now it will be easy to renew a license year after year if ones entire real medical training consists of what yours appears to be.

 

You seem like a very young guy, and you are obviously passionate about hair loss treatment. But given your age I find it hard to believe it wouldn't have been in your best interests to stay in medicine and actually completing a bare-bones minimum amount of training(such as actually starting residency and not just leaving medicine after an intern year). It's just two extra years, and even if you never 'use' primary care or IM training, you would be in a much more secure place going forward. I'd shudder to think of what would happen if some complication develops with a patient(even if it's not due to your lack of training) and you are being deposed by opposing counsel- "doctor, where did you complete your residency"...."doctor how many years of residency did you do"...."doctor are you board eligible in any area of medicine".....it would be a potentially disastrous situation for you, and trust me opposing counsel would go forums like this and see where you are using the terms you do('surgeon') and would roast you alive. Even if you happen to be great at what you do- traditional qualifications and such do matter in such situations. Even if you have it set up at your workplace where you are actually a supertech of sorts, the lawyers are still going to crucify you. Do not pass go, do not collect 200 dollars.

 

Note that if you didn't drop out of medicine and are still in the process of completing a training program(in IM, family med, whatever) then none of this applies. But it seems like it would be difficult for you to do all that stuff and this ht stuff at same time.

 

But your life is your life, and everyone makes their own decisions. I'm a practicing physician(one that actually completed a residency) and I know these things so I of course would only choose someone who has a good clinical reputation AND the minimum standard qualifications and training to go along with it. But I wonder how many potential hair transplant patients here aren't as sophisticated on such matters and don't know that your level of training is virtually zero and nowhere close to normal or reasonable in 2015.....If they don't, hopefully they will read this and discover it. If they still say "I'm ok with listening to this guy speak on such matters even though he never even started a residency after his intern year", well that's fine too and it's their choice. But I think patients and members of this forum should at least know.

[Melvin- Admin]

So your entire formal training consists of an intern IM year in PA? Seriously?

 

I'm not a surgeon(well then again you aren't either), but surgeons have told me they were still trying to find their head from their ass even up until their pgy-4 year.

 

The idea that a grad from a little year ago with only one an intern year completed(ie virtually no useful formal medical training) is presenting yourself this way is troubling. Perhaps one doesn't need much formal training to work in this particular niche field, but from your posting history it certainly doesn't seem that you have been very open in disclosing your traditional qualifications.

 

 

Also note that while nys(and some other states) may allow a person for now to obtain a medical license with only a year of training, it's certainly not a guarantee(some would say it's unlikely) that this policy will continue ten or fifteen years from now. In fact, in many states we are already seeing more reasonable requirements added to initial licensing and renewal. This is coming in the form of granting residents an initial license after their intern year but then requiring them to check whether they are still in a training program for the purposes of renewal. This trend is very clear, and it's hard to imagine that ten or fifteen years from now it will be easy to renew a license year after year if ones entire real medical training consists of what yours appears to be.

 

You seem like a very young guy, and you are obviously passionate about hair loss treatment. But given your age I find it hard to believe it wouldn't have been in your best interests to stay in medicine and actually completing a bare-bones minimum amount of training(such as actually starting residency and not just leaving medicine after an intern year). It's just two extra years, and even if you never 'use' primary care or IM training, you would be in a much more secure place going forward. I'd shudder to think of what would happen if some complication develops with a patient(even if it's not due to your lack of training) and you are being deposed by opposing counsel- "doctor, where did you complete your residency"...."doctor how many years of residency did you do"...."doctor are you board eligible in any area of medicine".....it would be a potentially disastrous situation for you, and trust me opposing counsel would go forums like this and see where you are using the terms you do('surgeon') and would roast you alive. Even if you happen to be great at what you do- traditional qualifications and such do matter in such situations. Even if you have it set up at your workplace where you are actually a supertech of sorts, the lawyers are still going to crucify you. Do not pass go, do not collect 200 dollars.

 

Note that if you didn't drop out of medicine and are still in the process of completing a training program(in IM, family med, whatever) then none of this applies. But it seems like it would be difficult for you to do all that stuff and this ht stuff at same time.

 

But your life is your life, and everyone makes their own decisions. I'm a practicing physician(one that actually completed a residency) and I know these things so I of course would only choose someone who has a good clinical reputation AND the minimum standard qualifications and training to go along with it. But I wonder how many potential hair transplant patients here aren't as sophisticated on such matters and don't know that your level of training is virtually zero and nowhere close to normal or reasonable in 2015.....If they don't, hopefully they will read this and discover it. If they still say "I'm ok with listening to this guy speak on such matters even though he never even started a residency after his intern year", well that's fine too and it's their choice. But I think patients and members of this forum should at least know.

 

This does detract from the OP's question but fascinating, I've never thought to even ask any hair restoration doctor how much formal training they have, I guess I just assume every doctor has completed a certain amount of years in residency. It does concern me what if something bad happens, I guess as hair loss sufferers the first thing we think of is results the last thing in our minds is health complications.

[Carolinapride800]

This does detract from the OP's question but fascinating, I've never thought to even ask any hair restoration doctor how much formal training they have, I guess I just assume every doctor has completed a certain amount of years in residency. It does concern me what if something bad happens, I guess as hair loss sufferers the first thing we think of is results the last thing in our minds is health complications.

 

Well, I'm not really taking a stance on whether patients *should* care a lot about whether the 'surgeon' doing the procedure is a traditionally trained surgeon or plastic surgeon, ent, a dermatologist, an internist, etc. simply because I don't know enough about the procedure to know how involved it is. That's part of my learning process in coming here before I take the plunge.

 

But it seems that many people do view restorative hair procedures under the medical/surgical realm, and since that is the case I think it's fair for potential consumers to at least know a general idea what everyone's training is. Whether they choose to care about such is another matter I have no opinion on.

 

But if this is a medical procedure/minor surgery, I certainly wouldn't feel good about letting someone with little to no formal medical training(and someone who only completed an intern year in medicine, probably not even as a categorical, certainly qualifies as that) be the point person for it.

 

But to each their own....

[secondtryuser]

While it is perfectly legitimate (and indeed advisable) for any patient to question their doctor's credentials, I find the way Carolinapride800 has done this to be rude and disrespectful. Ever heard of that adage, 'it's not what you say, it's how you say it'?

 

Blake is not your doctor and while politely asking is ok the way you've done it is inappropriate. Learn some manners.

 

Blake - that you responded so calmly suggests you'll have great pillow talk....I guess you're in the right job!

[Carolinapride800]

While it is perfectly legitimate (and indeed advisable) for any patient to question their doctor's credentials, I find the way Carolinapride800 has done this to be rude and disrespectful. Ever heard of that adage, 'it's not what you say, it's how you say it'?

 

Blake is not your doctor and while politely asking is ok the way you've done it is inappropriate. Learn some manners.

 

Blake - that you responded so calmly suggests you'll have great pillow talk....I guess you're in the right job!

 

You are right that he isn't my doctor, but it is MY OPINION as an actual medical professional that he hasn't been forthcoming with his credentials to any degree. As i said patients can take the information(that he hasn't even started a residency in any field) however they want. But they should be aware of it.....

 

I think with older patients who aren't familiar with health care there may be a little confusion on what is standard in practice and training. 70 years ago there were occasional med school grads who only did a year(or two) of post-med school training and then practiced in a meaningful capacity in primary care. Because of this, med school was structured different and students did receive useful training that would get them closer to practice ready(if they only did an intern year). But those days are long long gone, and it's widely acknowledged now that one doesn't "learn to be a doctor" in medical school today. What happens is you learn how to be ready to begin internship, residency, and then possibly fellowship in some fields. Those are the periods in training today where one learns how to practice medicine. So when someone leaves medicine before they even start the training where one learns to be a doctor, I would view that as very relevant information if they insist on passing themselves off as a medical professional of sorts(even considering this is a unique field)

[secondtryuser]

You are right that he isn't my doctor, but it is MY OPINION as an actual medical professional that he hasn't been forthcoming with his credentials to any degree. As i said patients can take the information(that he hasn't even started a residency in any field) however they want. But they should be aware of it.....

 

I think with older patients who aren't familiar with health care there may be a little confusion on what is standard in practice and training. 70 years ago there were occasional med school grads who only did a year(or two) of post-med school training and then practiced in a meaningful capacity in primary care. Because of this, med school was structured different and students did receive useful training that would get them closer to practice ready(if they only did an intern year). But those days are long long gone, and it's widely acknowledged now that one doesn't "learn to be a doctor" in medical school today. What happens is you learn how to be ready to begin internship, residency, and then possibly fellowship in some fields. Those are the periods in training today where one learns how to practice medicine. So when someone leaves medicine before they even start the training where one learns to be a doctor, I would view that as very relevant information if they insist on passing themselves off as a medical professional of sorts(even considering this is a unique field)

 

 

Well you completely missed my point. I stated quite clearly that it was your tone that was disrespectful and rude. I'll restate it: learn some manners.

[spyk777]

I am surprised how one can get a license after an intern year (PGY1) alone in the US. Is he not an osteopathic doctor? I feel the credentials of a physician are relevant to disclose, but to be weighted in the eye of the beholder. The post did have an assertive tone rather than blatant rude.

[Carolinapride800]

I am surprised how one can get a license after an intern year (PGY1) alone in the US. Is he not an osteopathic doctor? I feel the credentials of a physician are relevant to disclose, but to be weighted in the eye of the beholder. The post did have an assertive tone rather than blatant rude.

 

In some states(apparently ny is one) it is still possible to obtain a medical license after just an intern year. As I said though, this is changing and some states that use to grant a license for people after one year if internship are now changing this and making sure that for renewal applications the person is still in a training program. There are some advantages for the teaching institution for their pgy2-4 residents to have a medical license, so my guess is state board of medicines will continue to work with teaching hospitals to allow for licensure. But make no mistake, the fact that one technically can in some cases obtain a medical license after their intern year in no way means that doing a residency is considered optional to practice medicine in any real sense.

 

Yes it does appear that the poster is an osteopathic grad as the institution he listed is a DO school. DO schools tend to be far less competitive to enter than allopathic schools and some of the clinical rotations are....ummm, less than stellar. Just because a lot of DO schools don't have a major teaching hospital associated with them and have to send their students to various community hospitals where the experience isn't the same. That said, since medical school is NOT where one learns to be a doctor anyways this is generally not a big deal in the long run. I would have expressed the same bewilderment had he graduated from a well thought of allopathic med school and left before starting residency.

 

The only area(besides working in hair transplantation as in this case I guess?) where you see people without any real medical training using their title in some way working with patients is the medical marijuana industry. In California, for example, patients who want a medical marijuana card have to get something from a 'doctor'. I've heard of people who either could not get a residency after internship or were thrown out of their residency after internship signing up for this and basically offering to write people a medical marijuana card. Obviously anyone who sees patients in any capacity without any real medical training is never going to be able to get on insurance panels or get hospital privileges, but i suppose in medical marijuana and certain aspects of hair restoration work these things(hospital privileges and being on insurance panels) are not important.

 

Just from what I've seen so far in the early stages of looking for a possible provider, pretty much everyone has a background consistent with that of the typical physician in their field. Whether they were trained as a dermatologist, ent, general surgery and then plastics, integrated plastics, general surgery and then just an interest and learning informally, etc.....that's why it caught my eye.

 

I'm sure if my aunt(who is a hairdresser) worked in the HT industry long enough with other people doing them, she could probably gain the skill set neccessary to do them. But given the number of providers out there who have an appropriate background AND lots of real world experience in this niche field, why would I pick her? And to be blunt, completing one year of an internship year(probably in a community hospital system rather than a large academic medical center) of medicine would be only *slightly more* medical training than my aunt the hairdresser.

[Carolinapride800]

Well you completely missed my point. I stated quite clearly that it was your tone that was disrespectful and rude. I'll restate it: learn some manners.

 

And my argument would be that someone giving advice to a mostly non-medical forum has a moral and ethical obligation to properly disclose their background and training appropriately. If I was blunt in pointing this out, it was done so there wouldn't be any grey area for non-medical types reading the forum. For me, speaking clearly and assertively on matters like this is more important than dancing around the issue.

[TakingThePlunge]

Carolinapride800,

 

While you're certainly entitled to your opinion, your behavior in this discussion is inappropriate. First and foremost, you've hijacked this discussion. I don't know how much experience you have participating in discussion forums but taking a thread off-topic is considered bad form.

 

Next, your overall tone has me questioning your motives. Do you have a bone to pick with Dr. Bloxham? Perhaps you're a competitor or have some other agenda to discredit him?

 

I'll tell you what, since he has laid out all the details of his credentials, why don't you start a new discussion and do the same. Provide the community with your name, image and a detailed account of your training and experience. Perhaps then your opinions will carry some weight.

 

In the meantime, let's stop derailing this disucssion.

[Carolinapride800]

Carolinapride800,

 

While you're certainly entitled to your opinion, your behavior in this discussion is inappropriate. First and foremost, you've hijacked this discussion. I don't know how much experience you have participating in discussion forums but taking a thread off-topic is considered bad form.

 

Next, your overall tone has me questioning your motives. Do you have a bone to pick with Dr. Bloxham? Perhaps you're a competitor or have some other agenda to discredit him?

 

I'll tell you what, since he has laid out all the details of his credentials, why don't you start a new discussion and do the same. Provide the community with your name, image and a detailed account of your training and experience. Perhaps then your opinions will carry some weight.

 

In the meantime, let's stop derailing this disucssion.

 

I am not in hair transplantation or anything similar. So no, not a competitor. As for me 'having a bone to pick with him', I have already stated that that the way he is presenting himself is not ethical and very misleading. My only intention in this discussion was to make sure other consumers are aware that he doesn't have any significant medical training to speak of. Whether or not that matters to them is not my concern; but they should know. And hopefully now with this thread they will.

 

I'll also point out that I haven't given my 'opinion' on much of anything here. And to the extent I have done so, I have prefaced it as such. For example, I stated I wouldn't have such a procedure from someone without any significant medical training. The first part is my own preference/opinion; the second part(his level of formal training) is not an opinion. It is what it is, and there doesn't seem to be any confusion or disagreement about what his level of training is(pretty much nonexistent).

 

As to your last point, why would I go over my credentials? I've already stated that I am not in hair restoration. If I was in hair restoration and was giving opinions and advice on the matter(as Blake is), then of course my credentials would be relevant. That's a pretty obvious distinction.

[TakingThePlunge]

Obviously your "opinion" differs from that of the State of New York where Dr. Bloxham is licensed to practice medicine.

 

This is the last word on this topic that will be written on this thread. I will delete any further comment as I have asked you to stop hijacking this discussion from its intended purpose.

 

Until you identify yourself, there is no reason to believe you are who you say you are and thus, your input is suspect.

[PupDaddy]

Thank you, David, for shutting down this obvious troll.