Answers to frequently asked questions about hair loss.

Hair Restoration Answers

Going Bald. Do You Perform a Test for LPP (Lichen Planopilaris)?

Posted by Robert M. Bernstein M.D. on April 2nd, 2014

Q: Hi Dr. Bernstein, I am a 30 year old man with a balding crown. I’m 99.9% sure its male pattern baldness (I’m currently on Propecia and Rogaine). I recently read about how people going bald are getting tested for LPP (lichen planopilaris). Do you perform this test?

A: Lichen Planopilaris (believed to be a type of autoimmune disease) occurs more frequently in women than in men and more commonly in African-Americans than in Caucasians. The variation that could be confused with androgenic alopecia in men is central centrifugal cicatricial alopecia (or CCCA). While definitive testing would involve a scalp biopsy, this is rarely necessary as the doctor can easily tell by just examining you with the naked eye using magnification (densitometry).

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What is the Incidence of Hair Loss in Adults?

Posted by Robert M. Bernstein M.D. on April 5th, 2013

Q: How common is hair loss in adult men and women?

A: The incidence of androgenetic alopecia (common baldness) is quite high for both men and women. By age 50, 50% of men and 30% of women are affected. By age 70, that increases to 80% of men and 60% of women. Fortunately, in spite of significant thinning, women often preserve their hairline and have a diffuse pattern, so there hair loss can be camouflaged for many years.

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What is Lichen planopilaris?

Posted by Robert M. Bernstein M.D. on January 22nd, 2013

Q: What is Lichen planopilaris?

A: Lichen planopilaris (LPP) is a distinct variant of cicatricial (scarring) alopecia, a group of uncommon disorders which destroy the hair follicles and replace them with scar tissue. LPP is considered to have an autoimmune cause. In this condition, the body’s immune system attacks the hair follicles causing scarring and permanent hair loss. Clinically, LPP is characterized by the increased spacing of full thickness terminal hairs (due to follicular destruction) with associated redness around the follicles, scaling and areas of scarred scalp. Read more ».

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What is the Origin of the Term DUPA?

Posted by Robert M. Bernstein M.D. on January 18th, 2013

The terms DPA and DUPA were first described by O’tar Norwood in his seminal 1975 publication: Male Pattern Baldness: Classification and Incidence.

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What Is Saw Palmetto And Does It Prevent Hair Loss?

Posted by Robert M. Bernstein M.D. on August 15th, 2011

Q: What is Saw Palmetto? — R.P., White Plains, NY

A: Saw Palmetto is a dwarf palm plant native to North America. The active ingredients can be found in the plant’s brown-black berries. It is proposed that it blocks the enzyme 5-alpha-reductase that converts testosterone to dihydrotestosterone (DHT). There is little scientific evidence that Saw Palmetto is actually effective for hair loss.

Read about the causes of hair loss in men

Read about the causes of hair loss in women

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Does Sebum Cause Hair Loss By Blocking Pores On Scalp?

Posted by Robert M. Bernstein M.D. on November 29th, 2010

Q: I have been on finasteride for about 7 months. After my latest haircut I can see that my scalp is shiny. I read that is from sebum buildup and it can cause a layer that clogs the growth of hair. I was wondering if this is true and, if so, how can it be treated? — T.C., Philadelphia, PA

A: It is not true. Hair loss is caused by the miniaturizing effects of DHT on the hair follicle, not by blocked pores.

For more on this topic, view our pages on the causes of hair loss in men or the causes of hair loss in women.

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What Happens To Hair Diameter As You Age?

Posted by Robert M. Bernstein M.D. on June 10th, 2010

Q: What happens to hair diameter when you age?

A: From infancy to puberty, hair gets progressively thicker. From adulthood to old age the hair becomes thinner again and this is exacerbated by the effects of DTH in susceptible persons. The later process is called androgenetic alopecia (common baldness) and is characterized by miniaturization – the progressive decrease in hair diameter and lengths as a result of DHT.

However, even without the effects of DHT, hair gradually thins over time in many people.

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Is Hair Thicker In The Summer?

Posted by Robert M. Bernstein M.D. on June 3rd, 2010

Q: It seems like my hair is thicker in the summer. Can this be true?

A: Hair will increase in diameter when there is more humidity, as it absorbs moisture, and will actually be thicker in the more humid summer environment.

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What Color Hair Is The Thickest Or Most Dense?

Posted by Robert M. Bernstein M.D. on May 26th, 2010

Q: What color hair is the thickest? I thought it was brown, followed by red then blonde? But I am also reading that red is the thickest but redheads have the fewest hairs.

A: In very general terms, the darker the hair, the thicker it is and the lower the density (hairs per area). For example, Asians have the darkest hair, the highest hair diameter and the lowest density. Scandinavian blonds have very high hair density and the fine (diameter) hair. But there are many exceptions, African Americans have black hair, but it is usually very fine and of low density. I have seen red heads in all categories.

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Before Hair Loss Evaluation, Should One Fast or Change Diet?

Posted by Robert M. Bernstein M.D. on January 23rd, 2009

Q: I am a 47 year old woman with thinning on the top of my scalp for three years. I think I want to go for a comprehensive evaluation for hair loss and know that the doctor may want to take blood tests to help find out the cause of my hair loss. I am […]

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Is Hair Loss Determined by Age or Family History?

Posted by Robert M. Bernstein M.D. on November 15th, 2008

Q: Why do some people have a full head of hair into their seventies or eighties and others start to go bald in their late teens or early twenties? A: The difference is genetic with the inheritance coming from either side of the family. Although a person will have the genes his/her whole life, a […]

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Does Body Hair Indicate Future Hair Loss?

Posted by Robert M. Bernstein M.D. on April 14th, 2008

Q: I have a quite a bit of hair on my chest, back and legs. Is that an indicator of future baldness? A: Although bald people joke around that they wish the hair on their body (and ears) was on their head, body hair is not an early sign of baldness.

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Can Hair Loss be Caused by Weight Lifting and Increase in Testosterone Levels?

Posted by Robert M. Bernstein M.D. on April 7th, 2008

Q: My son, 25 years old, is seeing hair loss around the hairline. According to your website, he is probably a stage II. He may have a little hair loss at the vertex; right now it is hard to tell. He is very muscular and loves weight lifting, but no drug enhancement. Is there a […]

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What does Hair Transplant Evaluation or Hair Loss Evaluation Cost?

Posted by Robert M. Bernstein M.D. on April 2nd, 2008

Q: Didn’t you do free consults in the past? A: Yes. It had been in response to the policy of the larger chains. Patients coming to our practice are evaluated by a board certified dermatologist, trained in diagnosing the causes of your hair loss with expertise in both medical and surgical management. Our consults are […]

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Why Different Hair Loss Evaluation Fees for Diffuse Thinning Versus Patterned Hair Loss?

Posted by Robert M. Bernstein M.D. on January 21st, 2008

Q: Why is the consult fee more for diffuse thinning than for a regular visit? A: Diffuse hair loss, more common in women, can be the result of a number of underlying medical conditions and therefore it usually requires an extended medical evaluation. If you are a male or female with obvious diffuse thinning from […]

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Do You Use Digital Imaging to Forecast Hair Transplant Results?

Posted by Robert M. Bernstein M.D. on November 25th, 2007

Q: Do you use computer type imaging to create the best way to insure you (or any hair transplant surgeon) have the same goal or target “picture” of the particular patient’s restoration as that particular patient has as his “picture?” A: I prefer not to do imaging since it tends to oversell the hair restoration […]

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Can Stress Cause Diffuse Unpatterned Hair Loss (DUPA)?

Posted by Robert M. Bernstein M.D. on October 30th, 2007

Q: Can stress produce diffuse unpatterned hair loss (DUPA), or was it bound to happen anyway? A: Both DPA (diffuse patterned hair loss) and DUPA (diffuse unpatterned hair loss) are genetic conditions, unrelated to stress and would have happened anyway. These types of hair loss are characterized by a high percentage of mininiaturized hair in […]

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Can Stress Cause Hair Loss or is that a Myth?

Posted by Robert M. Bernstein M.D. on September 6th, 2007

Q: I’ve been dealing with daily mental stress for the past few months. I’ve notice that during that time, I’ve experience a lot of frontal hair loss and thinning. I thought stress was a myth for causing hair loss. A: Stress may cause temporary shedding, but it generally does not affect the long-term course of […]

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Dr. Bernstein's Hair Loss: Why No Hair Transplant?

Posted by Robert M. Bernstein M.D. on June 10th, 2007

Q: Dr. Bernstein, why have you not had a hair transplant? I’m sure this question gets asked a lot. Thanks. A: Yes, all the time. My donor area is very thin (so I am not a good candidate) and I have gotten used to being bald. It has been years.

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Hair Loss Causes: What is Miniaturization and What is Effect of DHT on Hairs?

Posted by Robert M. Bernstein M.D. on May 8th, 2007

Q: I have read that in the evaluation of a patient for hair restoration surgery some doctors use a densitometer to measure miniaturization – the decrease in size of hair diameters. I read that miniaturization is a sign of genetic hair loss, but when there is miniaturization of greater than 20% in the donor area, […]

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Dr. Bernstein's Hair Loss: Would You Consider a Hair Transplant if You Were a Better Candidate?

Posted by Robert M. Bernstein M.D. on April 20th, 2007

Q: Dr. Bernstein, I saw you on TV where you explained why you haven’t had a hair transplant. If you had better donor hair and you could do the surgery on yourself, then would you consider having a hair transplant? A: Yes.

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Will Hair Cut Affect Hair Growth?

Posted by Robert M. Bernstein M.D. on April 9th, 2007

Q: Will cutting my hair short – skin level – adversely affect it? A: Hair shafts are not alive (only the follicle is) so cutting the hair will not affect its growth.

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Can My Hair be Thinning Without Shedding?

Posted by Robert M. Bernstein M.D. on April 2nd, 2007

Q: I seem to be thinning, but I never shed hair as such in the shower. I cannot see my hair falling out. Can it be androgenetic hair loss? A: In androgenetic hair loss one rarely sees hair falling out in mass, but rather the thinning is due to the hair decreasing in diameter and […]

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Can One Treat Early Hair Loss with Laser Comb and At What Age Should One Start?

Posted by Robert M. Bernstein M.D. on March 9th, 2007

Q: If I’m 20 years old and haven’t lost any hair yet, should I start using a laser comb now? A: One should not treat hair loss until it actually occurs. That said, once there is clear evidence that if a person is thinning, non-surgical treatments are best started early to prevent further hair loss. […]

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How Do You Treat Hair Loss from Pseudopelade or Scarring Hair Loss on the Scalp?

Posted by Robert M. Bernstein M.D. on February 20th, 2007

Q: I am suffering from Pseudopelade for four years now. I have lost a lot of hair & there are big bald patches on the top of my scalp that are difficult to hide. Is there any hair transplant surgery or follicle transplant surgery possible in my case, or anything else I can do? A: […]

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Can Hair Transplant Treat Hair Loss from Traction Alopecia?

Posted by Robert M. Bernstein M.D. on January 8th, 2007

Q: I am a Caucasian female that has experienced hair loss on the sides of my head from the height of the eyebrow to the ear due to traction. The hair loss has been present since my teen years. My job requires me to wear my hair up most of the time. Although I don’t […]

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What are Styling Tips for Thinning Hair?

Posted by Robert M. Bernstein M.D. on November 20th, 2006

Q: I am a 45 year old women and I am beginning to thin on the top of my scalp. I don’t want to use medications and I don’t think that I am quite ready for surgery. Is there anything else I can do? A: There are a number of things that you can do […]

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What is a "Bar Code Hair Style"?

Posted by Robert M. Bernstein M.D. on November 20th, 2006

Q: I was at a party the other day and some women were talking about their boyfriend’s hair. I heard one refer to her ex-boyfriend as having a “bar code.” What is that? A: A “bar code” is slang term used in Japan for a comb over.

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Can You Describe Your Hair Transplant Consultation and What Should One Expect from a Consultation at Bernstein Medical?

Posted by Robert M. Bernstein M.D. on November 9th, 2006

Q: I have been to a number of consults and each time I felt the doctor was rushed and had already in his head what he though I wanted even before I had a chance to speak. At another consult, the person was really attentive, but it turned out he wasn’t even the doctor. If […]

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Can Hair Transplant Thicken Thinning Hair in Person with Early Hair Loss?

Posted by Robert M. Bernstein M.D. on November 2nd, 2006

Q: I am 22 and losing my hair all across the top of my head. How can I thicken my hair to its level a few years previously? A: If medication, such as finasteride, is successful it can thicken hair by increasing the diameter of the existing hair shafts. Although the cosmetic benefits can be […]

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Can Hair Transplant Treat Diffuse Hair Loss in Women?

Posted by Robert M. Bernstein M.D. on October 27th, 2006

Q: My hair loss resembles the grade I female hair loss scale, but none of the male hair loss patterns. It has been relatively stable for the past five years and only recently has it begun to progress further. I began both Propecia and regain two months ago, but the hair loss still continues at […]

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How Do You Treat Diffuse Hair Loss in Donor Area?

Posted by Robert M. Bernstein M.D. on October 9th, 2006

Q: I underwent hair transplant surgery several years ago and was pleased with the results. However, over the last 2-3 years I’ve lost hair in the donor area with subsequent loss of hair in the transplanted area. Is this type of hair loss especially difficult to treat? What accounts for hair loss from the back […]

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Can Hair Transplant Treat Chronic Telogen Effluvium?

Posted by Robert M. Bernstein M.D. on October 2nd, 2006

Q: I am a 36 year old female who has been diagnosed with Chronic Telogen Effluvium. Although I do not have any bald spots yet my hair is much thinner on both of my temples as well as in the back of my head. Is a hair transplant an option for me or am I […]

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Which Contributes More to Hair Loss: Stress or Genetics?

Posted by Robert M. Bernstein M.D. on September 26th, 2006

Q: Can stress accelerate hair loss? I am 25 and there is balding on my dad’s side of the family. I never had any thinning or hair loss till this year. I guess you can say I’ve been under a lot of stress. When I did notice shortly after my 25th birthday I started stressing […]

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Is Asymmetrical Hair Loss from Telogen Effluvium or Androgenetic Alopecia?

Posted by Robert M. Bernstein M.D. on September 12th, 2006

Q: Over the past three months, my hair seems to be thinning more on one side. Is it common in male pattern hair loss for it to be more on one side? I had a lot of stress about three months ago and have heard that this could be the cause. Is this possible? Should […]

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What Causes Patch of Hair Loss in Women?

Posted by Robert M. Bernstein M.D. on September 7th, 2006

Q: I am a 34 year woman with a patch of hair loss by my temple. I went to the salon to have my hair done and to my surprise my hairdresser told me that I have Alopecia? First time I heard of it, my G.P is not very concerned about it but having read […]

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Is Hair Loss in Men Caused by Elevated Testosterone Levels?

Posted by Robert M. Bernstein M.D. on August 25th, 2006

Q: I was told that if men have a lot of testosterone that that’s when they lose hair. Is this true? A: Although androgenetic hair loss is dependent upon normal levels of testosterone, it is not due to increased testosterone. It is caused by a sensitivity of the follicles to normal levels of testosterone. So […]

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How Does Densitometer Help Diagnose Hair Loss?

Posted by Robert M. Bernstein M.D. on August 17th, 2006

Q: Dr. Bernstein, I was reading about a densitometer on your website. What is it and what is it actually used for? A: The hair densitometer was introduced to hair restoration surgeons by Dr. Rassman in 1993. It is a small, portable, instrument that has a magnifying lens and an opening of 10mm2. To use […]

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Can Hair Loss be Caused by Thyroid Problems or Fluctuations in Levels of Hormones Produced by Thyroid?

Posted by Robert M. Bernstein M.D. on August 14th, 2006

Q: One of the things that I have noticed as a person who has needed to take thyroid medication for a long, long time, is that when my thyroid gets a little bit out of balance – when I’m not getting quite enough, I begin to notice is that my hair starts falling out. What […]

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What Causes Common Hair Loss or Baldness?

Posted by Robert M. Bernstein M.D. on July 26th, 2006

Q: I know that I am going to be bald because my father is bald and I am losing my hair just like him. What actually causes this kind of hair loss? A: Although there are many different causes, the overwhelming number of people that have hair loss have what is referred to as “patterned […]

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Do You Recommend Hair Transplant for Hair Thinning Over Entire Scalp?

Posted by Robert M. Bernstein M.D. on November 25th, 2005

Q: I am 19 years old and seem to be thinning all over, including the sides. My father has all of his hair but my grandfather is totally bald. Should I have a hair transplant now or wait until I am older? A: Most likely you have a type of androgenetic alopecia called Diffuse Unpatterned […]

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What is Recommended Treatment of Early Hair Loss?

Posted by Robert M. Bernstein M.D. on July 1st, 2005

Q: I am 27 years old and have a Class 3 degree of hair loss. Should I should do a hair transplant or consider non-surgical methods of hair restoration? A: At age 27 with early hair loss, you should consider non-surgical options first. Propecia is the most important medication, but you need to be on […]

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Can Hair Loss Be Caused By Braids and Extensions?

Posted by Robert M. Bernstein M.D. on June 23rd, 2005

Q: Over the years, I have worn my hair in braids and extensions. My hair is not growing at my hairline and temples. Can the braids be the cause and can this be treated with a hair transplant? A: The name for hair loss is this area is called alopecia marginalis. It is almost invariably […]

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Should One Consider Hair Transplant with Early Hair Loss in Crown and Donor Area?

Posted by Robert M. Bernstein M.D. on May 18th, 2005

Q: I’m currently 24 years old. Ever since turning 20, my hair on top began to thin little by little. I have noticeable thinning on the top part of my scalp and on my crown, but have no recession at the temples. My hairline looks amazingly young and hair on the donor areas seems quite […]

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Should I Have Hair Transplant Surgery After Meeting with "Medical Consultant"?

Posted by Robert M. Bernstein M.D. on May 10th, 2005

Q: What are “Senior Medical Consultants”? A: These are non-medical personnel who wear white coats to give the impression that they have formal medical training. They are actually salespersons and they should immediately identify themselves as such. Although non-medical personnel can help to answer general questions, they should not be examining you and making specific […]

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Can Hair Transplant Repair Bald Areas Caused by Alopecia Areata?

Posted by Robert M. Bernstein M.D. on May 6th, 2005

Q: Can a hair transplant into bald areas caused by alopecia areata ever be successful? A: Alopecia areata is an autoimmune disease in which the body attacks its own hair follicles. It generally appears as round patches of smooth bald areas scattered in the scalp or beard. Less commonly, it can involve the entire scalp […]

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In Early Hair Loss, Can Scalp Tingling and Hair Thinning be Related?

Posted by Robert M. Bernstein M.D. on January 17th, 2005

Q: I am twenty and think that I am starting to thin. I am also experiencing a slight tingling in my scalp. Are these related? A: Most likely. Early androgenetic alopecia can be associated with a slight tingling or slight tenderness of the scalp. You should see a dermatologist for evaluation and, if you have […]

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