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 thick. Am I in the early stages of male patterned baldness? I cannot place myself in the Norwood scale since my thinning doesn’t seem to follow the classic pattern. I just started on Propecia. Should I be considering a hair transplant?
A: From the description, it sounds like you have typical Diffuse Patterned Hair Loss or Diffuse Patterned Alopecia (DPA).
Please see: The Classification of Hair Loss in Men for more information.
In this condition, the top of the scalp thins evenly, the donor area remains stable, and the hairline is preserved for a considerable period of time.
Propecia would be the best treatment at the outset. When the hair loss becomes more significant, patients with DPA are generally good candidates for surgical hair restoration.
It is important, however, that your donor area is checked for miniaturization to be sure that it is stable before a hair transplant is considered.
Topic: Hair Loss
Tags: Classification of Hair Loss in Men / Crown / Diffuse Patterned Alopecia (DPA) / Early Hair Loss / Hair Loss in the Temples / Hair Thinning / Hairline / Miniaturization / Norwood Hair Loss Classification / Propecia
Posted by
Robert M. Bernstein M.D. at
2:13 pm
May 16th, 2005
Q: I am taking a baby aspirin to prevent heart disease and I heard that I should stop this medication before my hair transplant. How long should I stop for?
A: You should discontinue the aspirin 10 days prior to your hair restoration procedure.
Other NSAIDs (non-steroidal anti-inflammatory drugs) need only be stopped 3 days before the hair transplant.
Both aspirin and other NSAIDs can be resumed three days after surgery.
Reference: Otley CC: Preoperative evaluation and management in dermatologic surgery. J Am Acad Dermatol 2006; 54:119-27.
Topic: Drugs & Medications
Tags: Aspirin / Non-steroidal Anti-inflammatory Drugs (NSAIDs)
Posted by
Robert M. Bernstein M.D. at
12:37 pm
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 recommendations about your surgical procedure. That is the job of your doctor.
When a physician evaluates you and makes recommendations, he or she is responsible for informing you of the risks as well as the potential benefits of your surgery, and is ultimately responsible for your care. They will also have the knowledge to provide you with a balanced view regarding your surgery as well as other treatment options. This is the practice of medicine!
A “consultant” who is being paid to convince people to have a transplant, but who is not actually performing the surgery, does not bear this responsibility and may have a natural tendency to over-sell the procedure. Beware!
Topic: Consultation
Tags: Medical Consultants / Non-medical Personnel / Physician Evaluation
Posted by
Robert M. Bernstein M.D. at
1:37 pm
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 (alopecia totalis) or all facial and body hair (alopecia universalis). Unless the condition is well localized and totally stable, hair transplantation is not likely to be effective because the transplanted hair would be subject to the same problem.
We prefer that one have no new lesions for a minimum of two years before considering surgical hair restoration, although this does not insure that the procedure will be successful.
You may find more information on this relatively common condition at the National Alopecia Areata Foundation. For more information, visit these websites: www.alopeciaareata.com or www.naaf.org.
Topic: Medical Conditions
Tags: Alopecia Areata / Alopecia Totalis / Alopecia Universalis / Autoimmune Disease / National Alopecia Areata Foundation / Round Patches of Bald Areas
Posted by
Robert M. Bernstein M.D. at
12:38 pm