Q: Why does a hair transplant grow – why doesn’t the transplanted hair fall out?

A: Hair transplants work because hair removed from the permanent zone in the back and sides of the scalp continues to grow when transplanted to the balding area in the front or top of one’s head. The reason is that the genetic predisposition for hair to fall out resides in the hair follicle itself, rather than in the scalp. This predisposition is an inherited sensitivity to the effects of DHT, which causes affected hair to decrease in diameter and in length and eventually disappear – a process called “miniaturization.” When DHT resistant hair from the back of the scalp is transplanted to the top, it will continue to be resistant to DHT in its new location and grow normally.

Q: There has been a lot of talk circulating on the internet regarding the use of Platelet Rich Plasma (PRP) for the treatment of hair loss. Would you be able to comment on whether or not you think this will turn out to be a viable treatment for male pattern baldness (MPB)?

A: It is a bit too early to tell. My sense is that it will not have any practical long-term benefits for the treatment of hair loss (MPB), since it doesn’t get to the cause of androgenetic hair loss, i.e. DHT. Treatments such as copper-peptide, saw-palmetto, laser therapy, have all been promoted for male pattern hair loss, but have not really turned out to have any significant long-term benefits. Further studies need to be done on PRP to get a better sense of its value in combating hair loss.

Q: Hi! I wanted to ask if after a hair restoration surgery the transplanted hair will eventually fall out? Because the surgery is to restore hair mainly for people with genetic hair loss which results from DHT, won’t the DHT make the new follicles implanted fall out as well? A: Hair loss is due to [...]

Q: Are there DHT blockers that are sold in the pharmacy over the counter? A: The only effective DHT blockers are finasteride (Propecia, Proscar) and dutasteride (Avodart). These medications require a doctor’s prescription and are not sold OTC. Nizoral is a topical shampoo for seborrhea (a type of dandruff) that is sold over the counter, [...]