Female with Miniturazation and MPB

[worriedgirl]

I am new to forum. I saw a very reputable doctor yesterday in Los Angeles. I have receding at my temples so I went in to inquire about a HT to those areas. Upon inspection, he indicates that I have about 30% or so miniturazation in the donor area. I'm very scared and am now thinking "am I going to go completely bald"? I have more questions. Has anyone with similiar problem had a HT that can offer me some insight. He says he can do the HT but can offer no guarantee on how long it would last.

 

Also, how long to miniturazized hairs last and how fast does it progress? Is it normal for a woman at age 46 to have hair miniturazation. These are questions I forgot to ask the doctor.

 

Any help is appreciated.

[worriedgirl]

I am new to forum. I saw a very reputable doctor yesterday in Los Angeles. I have receding at my temples so I went in to inquire about a HT to those areas. Upon inspection, he indicates that I have about 30% or so miniturazation in the donor area. I'm very scared and am now thinking "am I going to go completely bald"? I have more questions. Has anyone with similiar problem had a HT that can offer me some insight. He says he can do the HT but can offer no guarantee on how long it would last.

 

Also, how long to miniturazized hairs last and how fast does it progress? Is it normal for a woman at age 46 to have hair miniturazation. These are questions I forgot to ask the doctor.

 

Any help is appreciated.

[thanatopsis_awry]

Hey, sorry to hear of your plight.

 

Which doctor did you go to?

[Bill - Seemiller]

worriedgirl,

 

With hair miniaturization in the donor area, you may not be a candidate for a hair transplant, or at least, there really is no "safe zone" and increases the risk of loss of at least some of the transplanted hair.

 

Have you been diagnosed with male pattern baldness (hence the title of this thread)? If you have thinning in areas of your scalp all over your head, you may (also?) have diffuse alopecia which may or may not be genetically related. Be sure to consult with a dermatologist or hair restoration specialist to rule out all other non-genetic causes of your hair loss.

 

Some typical causes of diffuse alopecia are hormonal changes, certain medications, thyroid conditions, iron deficiency, etc.

 

If a hair is miniaturizing, it will most likely whither away and eventually die. The length of time will depend upon the hair growth cycle for those hairs. It could take months or even years depending on what genetics have dictated or depending upon whether or not you are using any hair loss treatments such as Rogaine.

 

I hope this helps.

 

Bill

[Guest HLBD]

worriedgirl,

 

I am sorry to hear about your issues with hair loss.

 

Are you sure that you were diagnosed with MPB? A 30% miniaturization is pretty high and more congruent with FPB (Female Pattern Baldness). It's common in MPB for a man to experience little or no thinning in the donor area until either later in life, or they may never significantly thin in this area. With FPB the patient thins all over the scalp. It is also conceivable that you may have a combination of MPB and FPB. You must be very knowledgeable about hair loss, it seems. There are a lot of doctors that will write-off any hairloss as genetic, or MPB/FBP due to hair loss and the patients gender - they are not always correct in doing so.

 

As Bill mentioned, you may also have other contributing factors: a nutritional deficiency (iron deficiency is the most common nutritional problem in the developed world), changes in body chemistry (caused either naturally, or due to medication), stress can contribute to hair loss as can other poor nutrition and poor hair care (over use of perms and dyes) - it is believed, however, that these are more likely to agitate the hair loss situation than to be the actual cause.

 

Rogaine tends to be more effective in women. I think it may be worth a try. Ask your doc about it and other causes and agitations as mentioned to be sure that you are getting the treatment.

 

I hope your situation gets better soon!

 

HLBD

[Dr. Michael Beehner]

Dear "Worried Girl,"

30% is a fairly high percentage of miniaturization to be present in the occipital donor area, usually the best hair on most women's heads who have female pattern alopecia. Most of the time I wouldn't transplant a woman with that high of a percentage, simply because it also portends that a lot of the other hairs will probably be following in the same footsteps of miniaturization a life-cycle or two away from now. The good news is that hereditary female pattern hair loss is a very SLOW process for most women, and almost never occurs as rapidly as its counterpart in males.

The most curious part of your history is the fact that you described being thin in the temple areas only. Usually a woman with 30% miniaturization in the donor area will have an even higher percentage of miniaturization in the top recipient area behind the hairline, and yet you didn't seem to complain about that at all. What degree of miniaturization did your doctor find in the top recipient area? Even if the hair on top was the same and no worse than the back, that degree of miniaturization would still be easy to see through and I would expect that would have been your main complaint ir at least mentioned along with the other temple problem.

Regarding the decision as to whether you should be transplanted or not, you certainly could, but your expectations would have to be lowered and realistic, especially concerning the number of years of your life you may get to enjoy this additional hair you gain by transplantation. For some women entering a critical period of their lives from a social or career standpoint, even 10-15 years of having increased density of hair could be valuable to them and worth it. I have been fooled in a few cases in which I initially didn't want to transplant a particular woman, she insisted on going ahead despite my low expectations for her, and she went on to do well over at least a 5-10 year period up to the present (and still doing well). In some others I can think of, it seemed like a high percentage of the hairs from the donor area, even the seemingly strong appearing ones, when they emerged in the recipient area one life-cycle later (after going through the normal "shock" reaction all transplanted follicles undergo), an even higher percentage of them grew out "wispy" and the overall experience was not a forward step for the patient. Theoretically, one additional step that could be taken would be to "cherry pick" only the follicular units that contain at least one strong "terminal" hair and only use them, putting aside the severely miniaturized ones, as the injury to the scalp of the recipient incision is almost not worth the tradeoff for placing a hair that is unlikely to add to the cosmetic appearance and theoretically could hurt the chances for the good follicles to grow. I have transplanted hundreds of women and must confess not having used this method yet. As per the other suggestions you received, Rogaine will certainly slow down the hair loss process if taken faithfully. The comments about other medical diagnoses is important for completeness and can be ruled out with a couple of simple blood tests and a good history, but I must emphasize that they are very rare in most of our clinical hair practices.

The bottom line is this: if your expectations are not too high and are realistic and your hair surgeon feels that a positive result is possible, then you have a chance of being reasonably happy with your result for quite a few years.

Mike Beehner, M.D.

[worriedgirl]

Thanks everyone for your help. To Dr Beehner: My doctor did say that he thought I might be happy for ten years or so and that he would place the terminal hairs and the front of my temples and then feather in the more miniturized hairs as he goes back. Of course, he could not guarantee any results.

 

I want to add that I've had the "triangle" at both sides of my temples for many years and they have very slowly progressed. I do have a very full head of hair at this time (and hopefully in the future as well). I have started using Rogaine and am taking an herbal DHT blocker. Don't know if it will help, but I'm willing to try anything.

 

I wish I could determine what started this for me. My mother and both sisters have extremely fine and thin hair. I was blessed with extremely thick hair and am dumbfounded as to why this is happening.

 

Anyhow, I have a second Dr. appt with Dr. Kabaker on Monday for a second opinion. I very scared to go...not sure if I want to hear more bad news. I hope to make a decision after that appt.

[Dr. Michael Beehner]

Worried girl:

The way you describe your "full head of hair" presently, it sounds like you might not be too bad off, and maybe that area that was examined in the donor area that showed 30% miniaturization wasn't representative of most of the areas. I am fairly certain you don't have 30% miniaturization on top from your description of your hair.

On another note, you will be in excellent hands with Dr. Kabaker. He's one of the best. One of my old patients from 10 years ago moved to San Francisco and had his last two procedures with Dr. K and was very pleased with the results and how nice of a guy he is.

Regarding miniaturized hairs, each life cycle (usually 5-6 years in a woman) they become skinnier in diameter and will grow to a shorter length until they finally disappear. This whole process is very slow over many years in a woman, but it is generally somewhat progressive over many years so there is an actual change. It also varies from one woman to another, just as in males. Stay on the Rogaine faithfully. I highly doubt any "DHT blockers" work in a female, as that isn't the hormonal mechanism behind female pattern hair loss. As long as you've had a thyroid test (TSH is the best one) and an iron level (Ferritin level) at some time in the past 5 years or so, you are covered on that front. If your periods have been normal and you had normal fertility, then the hormonal blood tests usually aren't necessary. Good luck.

Mike Beehner, M.D.

[worriedgirl]

Thanks Dr. Beehner. I just posted on another site about the Rogaine. You've answered my question here. I'm using all over my head since my appt last week. I will update after my visit with Dr. Kabaker.

[worriedgirl]

I saw Dr. Kabaker today. He told me "not to worry" which made me feel much better. He told me that although he wasn't "impressed" by the donor hair in the back of my head that he felt that the top and sides of my head were thicker and he would most likely take from the sides anyway for my temple area.

 

At any rate, I have decided that I am going to sit on this information for a while before making any decisions. I'm lucky to still have a full head of hair and no one notices my problem areas except for me. I'm weighing the benefits (of just pleasing myself) as opposed to any possible damage that might occur from doing an HT.

 

I'm a woman though....and I might change my mind.

[Bill - Seemiller]

I'm a woman though....and I might change my mind.

 

And you are certainly entitled to do so

 

But taking your time to consider all the information and your options is important and must better than making an emotional decision.

 

Keep us posted on your decision and best wishes!

 

Bill