Posts Tagged: Androgenetic Alopecia

Is Genetic Test for Hair Loss Worthwhile?

October 14th, 2009

Q: Is it worth getting the genetic test for balding?

A: You’re referring to Hair DX (hairdx.com), which costs about $150 and came to market in January of 2008 as the first test for androgenetic alopecia, aka male pattern baldness.

The test screens for variations in the androgen receptor gene on the X chromosome, the gene that is associated with male pattern hair loss. The purpose of the test is to identify persons at increased risk of developing hair loss before it is clinically apparent – so that medical intervention can be started early, when it is most effective.

It is important to realize that, at this point, there is just an association with this gene and hair loss; the cause and effect has not been proven and the association is not anywhere near 100%. A danger is that patients may overreact to the relatively incomplete information that the test provides. It is best to have the test performed under a doctor’s supervision, so that it can be put in the context of other information that the physician gleans through a careful history, physical and a densitometry hair evaluation. As of this posting, genetic testing for hair loss is not permitted in New York State.

Topic: Genetics

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Posted by Robert M. Bernstein M.D. at 7:30 am

Is Latisse a Viable Hair Loss Treatment?

July 28th, 2009

Q: I read that Latisse, the medication recently approved to grow eyelashes, can be used to grow hair in other places. Is this true?

A: Yes. We are currently looking at the use of Latisse (Lumigan, Bimatoprost) to grow eyebrow hair and we suspect that it will be useful in stimulating the growth of scalp hair as well. However, there are additional issues when using it to treat male or female pattern hair loss. These include:

  1. The potential for side effects from systemic absorption, since androgenetic alopecia usually covers an area much larger than eyebrows or eyelashes.
  2. The cost of Latisse used in large quantities can be prohibitive.
  3. Long-term results (the ability of Lumigan to keep stimulating hair growth over time is not currently known).

For more on this topic, please visit the Latisse page on the Bernstein Medical – Center for Hair Restoration website.

Topic: Latisse

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Posted by Robert M. Bernstein M.D. at 9:50 am

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

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. We charge $350 for this evaluation.

If you are a male or female with obvious diffuse thinning from androgenetic alopecia (common baldness), or if you have patterned hair loss where the diagnosis is straightforward, the fee is $125.

Topic: Fees

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Posted by Robert M. Bernstein M.D. at 10:28 am

Does Propecia Hair Loss Medication Effect Beard Growth?

July 6th, 2007

Q: I am a 21 yrs old male having serious hair loss over the last few years. I also have very little facial hair. Since Propecia is a DHT blocker can it inhibit beard growth?

A: As you suggest, it would be reasonable to assume that since DHT stimulates beard growth, blocking DHT (with finasteride) would tend to inhibit its growth. In practice, this does not seem to be the case, i.e. we don’t find that Propecia has any affect on facial hair. The reason is not clear.

It is interesting to note that testosterone stimulates growth of axillary and pubic hair, but not scalp hair. Scalp hair growth is not androgen dependent, only scalp hair loss is.

DHT stimulates terminal hair growth of the beard, trunk and limbs, external ears and nostrils. Of course, it also is responsible for the bitemporal reshaping of hairline as one passes into adulthood and causes male patterned baldness (androgenetic alopecia).

Topic: Drugs & Medications

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Posted by Robert M. Bernstein M.D. at 12:48 pm

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

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, a person may not be a good candidate for hair transplants. Is this correct and does 20% miniaturization mean that 20% of the population of terminal hairs have become fine vellus-like hairs or that there is a 20% decrease in the actual diameter of each of the terminal hairs?

A: Miniaturization is the decrease in hair shaft length and diameter that results from the action of DHT on healthy, full thickness terminal hairs. The hairs eventually become so small that they resemble the fine, vellus hair normally present in small numbers on the scalp and body. Miniaturized hairs have little cosmetic value. Eventually miniaturized hairs will totally disappear. Twenty percent miniaturization refers to the observation, under densitometry, that 20% of the hairs in an area show some degree of decreased diameter.

In the evaluation of candidates for hair transplantation, we use the 20% as a rough guide to include all hairs that are not full thickness terminal hairs. Of course we are most interested in the presence of intermediate diameter hairs – i.e. those whose diameters are somewhere between terminal and vellus and are clearly the result of DHT. I don’t know if one can tell the difference on densitometry between vellus hairs, fully miniaturized hairs and senile alopecia. The partially miniaturized population is most revealing.

Miniaturization in the recipient scalp (i.e. the balding areas on the front top and crown that we perform hair transplants into) is present in everyone with androgenetic hair loss. Miniaturization in the donor area, however, is less common (in men). It means that the donor area is not stable and will not be permanent. Men with more than 20% of the hair in the donor area showing miniaturization are generally not good candidates for hair transplant surgery.

Topic: Hair Loss

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Posted by Robert M. Bernstein M.D. at 6:21 am



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