Posts Tagged: Densitometer

What Type of Hair Loss in Women is Suitable for Hair Transplant?

August 10th, 2009

Q: What type of female hair loss is suitable for a hair transplant?

A: A smaller percent of women with genetic hair loss are good candidates for a hair transplant as compared to men. The reason is that hair loss in women tends to be diffuse (i.e. there is thinning all over). In this situation, there is no stable donor area to use for the hair restoration.

Women with hair loss localized to the front and/or top of their scalp and good hair on the back and sides, can be excellent candidates for hair restoration, but it is important for the doctor to determine this by measuring the hair density in the donor area. This can be performed in the office using an instrument called a video-densitometer.

Conditions other than genetic thinning can be treated with hair transplantation, such as traction alopeica and hair loss from surgical scars, but some conditions, such as alopecia areata, do not respond well. It is important to have a dermatologist make sure that the condition is treatable by surgery before considering a hair transplant.

Reminder: Bernstein Medical – Center for Hair Restoration will be holding a Women’s Hair Loss Open House at our facility in Midtown Manhattan, New York City on Wednesday, August 12th, 2009 (4-6pm). You can register to attend the open house by following this link. We look forward to seeing you there!

Topic: Women

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Posted by Robert M. Bernstein M.D. at 9:38 am

Can Female be Candidate for Follicular Unit Hair Transplant?

February 1st, 2008

Q: I am female and thinning can I be a candidate for a Follicular Unit Hair Transplant?

A: If it turns out that you have female pattern hair loss, you may be a candidate a hair transplant, but would need to be evaluated by a doctor who specializes in surgical hair restoration.

In the evaluation, you should have your degree of hair loss assessed and donor supply measured, using an instrument called a densitometer, to be certain that you have enough permanent donor hair to meet your desired goals. For more information about hair loss in women, please see the Diagnosis of Hair Loss in Women page of the Bernstein Medical – Center for Hair Restoration website.

If you are thinking about your hair loss and would like to be evaluated, go to the physician evaluation page of the Bernstein Medical – Center for Hair Restoration website.

Topic: Women

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Posted by Robert M. Bernstein M.D. at 7:22 am

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

Why Should Hair Transplant Doctor Measure Miniaturization in Donor Area Before Transplant?

November 17th, 2006

Q: Why should a doctor measure miniaturization in the donor area before recommending a hair transplant?

A: Normally, the donor area contains hairs of very uniform diameter (called terminal hairs). In androgenetic hair loss, the action of DHT causes some of these terminal hairs to decrease in diameter and in length until they eventually disappear (a process referred to as “miniaturization”). These changes are seen initially as thinning and eventually lead to complete baldness in the involved areas.

These changes affect the areas that normally bald in genetic hair loss, namely the front and top of the scalp and the crown. However, miniaturization can also affect the donor or permanent regions of the scalp (where the hair is taken from during a hair transplant). If the donor area shows thinning, particularly when a person is young, then a hair transplant will not be successful because the transplanted hair would continue to thin in the new area and eventually disappear. It is important to realize that just because hair is transplanted to another area, that doesn’t make it permanent – it must have been permanent in the area of the scalp it initially came from.

Unfortunately, in its early stages, miniaturization cannot be seen with the naked eye. To detect early miniaturization a doctor must use a densitometer, or an equivalent instrument, that magnifies the surface of the scalp at least 20-30 times. This enables the doctor to see early changes in the diameter of the hairs that are characteristic of miniaturization. If hairs of varying diameter are noted (besides the very fine vellous hairs that normally occur in the scalp), it means that the hair is being affected by DHT and the donor area is not truly permanent.

In this situation, a person should not be scheduled for hair transplantation. If the densitometry reading is not clear, i.e. the changes are subtle and the doctor is not sure, then the decision to have surgery should be postponed. By waiting a few years, it will be easier to tell if the donor area is stable. Having surgery when the donor area is miniaturizing can be a major problem for a patient, since not only will the transplanted hair eventually disappear, but the scar(s) in the donor may eventually become visible. This problem will occur with both follicular unit transplantation (FUT) and follicular unit extraction (FUE).

Topic: Donor Area

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Posted by Robert M. Bernstein M.D. at 7:43 am

Which Contributes More to Hair Loss: Stress or Genetics?

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 even more, which led to more hair loss. It is thinner up front and it is thin on top. I have heard of some hair docs mapping your head for miniaturization, do you do this too?

A: Yes. The presence of miniaturization (decreased hair diameter) in the areas of thinning allows us to distinguish between hair loss due to heredity (i.e. androgenetic alopecia) in which hair progressively decreases in diameter under the influence of DHT and other causes such as stress where there is no miniaturization. The degree of miniaturization can be assessed using a hand-held instrument called a densitometer.

The pattern of hair loss and the family history are also important in the diagnosis.

Stress more commonly produces telogen effluvium, a generalized shedding that is not associated with miniaturization and is often reversible without treatment.

Topic: Hair Loss

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Posted by Robert M. Bernstein M.D. at 11:22 am



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