Dr. Robert M. Bernstein was interviewed by Fox and Friends over the weekend. He discussed hair loss, hair transplant surgery, propecia hair loss medication, hair plugs, and more.
Watch the full video here:
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Q: Why did you write another book on hair loss?
A: Hair Loss and Replacement for Dummies is the first book that we have written that is specifically geared for the lay public. Besides hair restoration, it covers a wide range of topics including: the diagnosis and treatment of medical conditions that can cause hair loss, tips on hair care, information on hair systems, and a number of other topics not stressed in our other books.
Our prior books, The Patient’s Guide to Hair Restoration and The Guide to Hair Restoration focused on medical treatments and surgical hair restoration. Although very easy to understand, they are most helpful for someone that already has a basic understanding of hair loss or that had a consultation.
Q: Why do some people have a full head of hair into their seventies or eighties and others start to go bald in their late teens or early twenties?
A: The difference is genetic with the inheritance coming from either side of the family.
Although a person will have the genes his/her whole life, a gene’s expression (also called phenotype) can be quite variable. The factors that cause this variability is still unknown.
Q: I have a quite a bit of hair on my chest, back and legs. Is that an indicator of future baldness?
A: Although bald people joke around that they wish the hair on their body (and ears) was on their head, body hair is not an early sign of baldness.
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.
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Disclaimer: The purpose of the Hair Transplant Blog is to provide the public with general information on hair restoration. Information provided on this site should not be used for medical diagnosis and/or treatment.
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