Posts Tagged: Densitometry

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.


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

Are Fewer Women Candidates for Hair Transplant?

June 25th, 2007

Q: I heard that a smaller per cent of women are candidates for hair transplants compared to men. Is this true?

A: Yes, that is true. Women more commonly have diffuse hair loss where the thinning is all over the scalp. This means that the donor area (the back and sides of the scalp) are thinning as well.

If the donor area is not stable, then there is no point in doing a hair transplant, since the transplanted hair will continue to fall out. Remember, the transplanted hair is no better than the area where is comes from.

On the other hand, women with stable donor areas can be great candidates for surgical hair restoration. The stability of the donor area can be assessed using a procedure called densitometry and should be part of the hair loss evaluation when you see your physician.


Posted by Robert M. Bernstein M.D. at 1:05 pm

How do You Treat Early Hair Loss in Women?

June 25th, 2007

Q: I am a 33 year old women and am just starting to thin on the top of my scalp behind my frontal hairline. What should I do? Should I have a hair transplant?

A: There are a number of things that you should consider that can be effective in early hair loss. These include minoxidil (Rogaine), laser therapy, and using cosmetics specifically made to make the hair appear fuller. Lightening or streaking the hair, as well as parting the hair off to the side, will also make the hair appear fuller.

If a surgical hair restoration is performed too early and there is still a lot of existing hair in the area, the hair transplant may actually accelerate hair loss. Surgery should not be performed prematurely.

Also, it is important that the doctor check the stability of the donor area, using densitometry, to make sure that the procedure is even possible. For those women who are good candidates, and if it is done at the appropriate time, a follicular unit hair transplant is a great procedure that can produce really natural results.


Posted by Robert M. Bernstein M.D. at 12:56 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.


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

Can Hair Transplant Treat Hair Loss from Traction Alopecia?

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 wear it nearly as tight, I seem to continue to lose my hair in the front and on the top of my head. My hair also used to be very thick as a child and is now quite thin. I’m not sure if this is normal or something else is going on, but I am definitely interested in a hair transplant.

A: It sounds like you are experiencing continued traction alopecia. Unless the underlying cause is corrected (the traction), you can expect to continue to lose your hair. People that have traction alopecia can have thinning even from mild pulling that might not be a problem for others. Once you stop the pulling, it can take up to two years for the hair to return, although there may be permanent hair loss.

Surgical hair restoration is the treatment of choice for permanent hair loss from traction. If you have significant thinning on the sides, you may not be a candidate for hair transplantation since in this procedure we often need to harvest hair from the permanent area in the sides of the scalp as well as the back.

An additional problem (that you allude to) is that you may have underlying female pattern hair loss. This would further complicate the surgical treatment.

A careful examination (including densitometry) can sort these problems out and allow for more specific recommendations.


Posted by Robert M. Bernstein M.D. at 11:48 am



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