Advice needed! Traction alopecia at age 21!!!

[Big_foot]

I got a great amount of hair loss at age 15. As you may know the followers of the "Sikh" faith require their hair to be tied tightly in a bun which causes stress to the front of the head. My dermatologist dignosed it and got a lab test done to confirm it to being alopecia areta and belived that the hair will regrow within 2-5 years. At age 16 I had cut my hair to lose the strain on the hair.

 

I am now 21 years old. The hair hasn't grown back. I belive I have traction alopecia and the Dr. made a mistake, maybe because this might be a rare case for her. I know alopecia areta are round patches spread over the head and that it is a autoimune disease. I have hair loss only in the front and front sides of my head and I have thick hair on top and on the back of my head (I have no hair line) and some thinning in the front. At age 21 the thinning in the front seems to have progresed slightly. I wish to undergo a hair transplant and I am guessing 3,000 to 4,000 grafts (estimating) should be enough to give me a hairline that I want by the Fue method.

 

My questions are

 

1. I've been told that at age 21 years old I'm too young because when my androgentic alopecia kicks in, I will have odd looking gaps. I am not concerned if this (androgentic balding) happens at age 40 or 50. If my full hair last me till age 40 without gaps I am happy.

 

2. Do DR.s diagnose the type of hair loss before the HT because I know having an HT on alopecia areta will cause the hair follicules to fall out.

 

3. Does traction alopecia progress over the years or is it basically the weak and damaged follicules from the excessive pulling finally falling out and causing a thinning look in the front?

 

Thanks in advance!

[Bill - Seemiller]

Big_Foot,

 

Welcome to our forum community.

 

Traction alopecia doesn't progress like androgenic alopecia does. Traction alopecia however, can get worse if you continue to put hair follicles under stress by pulling them. Thus, if you do have traction alopecia and are considering a hair transplant, be sure not to stop any activity or styling that's putting your hair under unnecessary durress.

 

All quality hair transplant surgeons will evaluate your scalp, determine the type of hair loss you're experiencing and then recommend a strategic short and long term hair restoration plan that best fits your situation. I agree that 21 years old is pretty young, but depending on your situation, hair transplant surgery may not be completely out of the question. Know however, that in the event you also experience male pattern baldness, that you may require subsequent procedures to prevent your hair from appearing unnatural or awkard looking.

 

I hope this helps.

 

Bill

[Big_foot]

Mr. Bill first of all I would like to thank you very much for replying I also want to tell you that I followed your story and pictures on this forum. I was shocked to see the pictures of when you were younger with a full set of hair and older with the hair loss. Your hair was very very thick and nobody could guess that androgenetic hair loss would kick in so soon Now I know hairloss is unpredictable! Anyways getting back to my story, people don't releaize that I am a 21 year old with traction alopecia. I'm given odd looks and mocked about my comb over hairstyle. My girlfriend has left me and I don't have the courage to ask any other girl out because I feel like an alien. I can sense rejection waiting to happen. Although my male friends who don't suffer from any type of hair loss have been very suportive to me and they have recommended me going through with the HT. I always thought us "males" were the only ones who placed looks as the number 1 priority in the opposite sex but I guess I was wrong. Hopefully after I undergo this HT, I will be as hairy as big foot on my head of course Hey btw can you suggest any good HT Dr. around NY that use the FUE method? I've heard Dr. Feller is one of the best?

[Dr. Bernardino Arocha]

Big_foot,

 

Bill has offered some good information. Dr. Feller certainly is a fine surgeon option available for those in the New York area,the others are: http://www.hairtransplantnetwo...list.asp?StateAbr=NY .I was completing my answer to your questions, when your reply to Bill beat my posting it.

 

Thanks for your interesting questions. It is a bit complicated to discern without the benefit of a physical examination. Alopecia Areata can manifest in different presentations: 1. The common annular 'coin' lesion(s): 2. Diffuse pattern hair loss; and lastly 3. Ophiasis, which occurs with a band-like hair loss pattern involving the temporal (sides) and occipital (back) areas. Traction alopecia resulting from the hair styling used by male followers of the Sikh faith can look a lot like the Ophiasis type pattern Alopecia Areata. Did your Dermatologist perform a scalp biopsy? That would have confirmed the diagnosis if there was a doubt.

Both conditions can produce hair loss in a similar pattern, hence a scalp biopsy can shed light helping to differentiate the two and also rule out any activity if in fact you had Ophiasis type Alopecia Areata. If there is no disease activity presently, or if it was due to Traction Alopecia then you might indeed be a candidate for hair transplantation. I don't think that being 21 years per se precludes surgical treatment, even if you are predisposed to Male Pattern hair loss, as long as sound hair restoration principles are fallowed and you are deemed a suitable surgical candidate.

[Big_foot]

Thank you very much Dr. Bernard Arocha for replying! She did have a scalp biopsy done but I don't remember (I was 15 at that time) what she confirmed it for. I have my report infront of me. Here it is typed up....

 

ANATOMIC SITE

 

Left Temple in scalp

 

CLINICAL INFORMATION

 

Centralized Laboratory services specimen labled "Numbers"

 

"15 year old sikh with progressive alopecia along frontal and temporal hairline; 3-4 months duration; traction alopecia (patient wears a bun) vs. ophiasis type alopecia areata."

 

DESCRIPTION OF FINDINGS BY EXAMINATION GROSSLY

 

The specimen is received in formalin and consists of a punch of biopsy of skin measuring 0.3 X 0.3 X 0.4 cm. The specimen is submitted in toto in one cassette to be sectioned.

 

DESCRIPTION OF FINDINGS BY EXAMINATION HISTOPATHOLOGICALLY

 

There is a decreased number of follicles in anagen in this specimen from scalp and those are thinned and shortned.

 

Diagnosis

 

LEFT TEMPLE IN SCALP-COMMON (ANDROGENTIC) BALDNESS, PROBABLE

 

Note: A PA stain adds no additional information. Step sections have been examined.

[Big_foot]

Here is a side photo

[Big_foot]

Here is another side photo.

[Big_foot]

Can anybody help and tell me what this report means?

[hair_girl]

I am a 20 year old female with the same exact problem. I've seen a doctor who told me that I indeed have traction alopecia. I see that everyone provided information about men but I really need assistance. I have tried every pill and topical treatment possible. Unlike big_foot I started losing my hair at around 10 from braids. My mother never tended to it so it has gotten worse. I was also told I am too young for a transplant but I have been without hair for so many years I feel there is no other hope. I have a super thin hairline and clean temporal on each side. My temporal have very little hair on them and in some areas they are smooth. I have never in my life been able to pull my hair back in a ponytail. I tried as a young child but I was just teased or taunted so I never tried again. I need help and I am willing to go anywhere to get it. If anyone has any advice it would be greatly appreciated. Thanks

[Bill - Seemiller]

hair_girl,

 

Welcome to our community.

 

Traction alopecia is entirely different from genetic hair loss. Since traction alopecia occurs by accidental pulling of the hair roots via braiding, tight ponytales or headbands, often the "cure" is to cease any and all activities that pull your hair.

 

In many cases, hair lost via hair pulling will return on it's own over a period of several months. Rogaine (minoxidil) may be able to assist to jump start hair growth.

 

If the area of loss has scarring from excessive pulling, the loss may be permanent.

 

In my opinion, you may want to consult with a dermatologist who can evaluate your scalp and offer a professional opinion.

 

Best wishes,

 

Bill