Q: Does donor area hair thin with age? – T.W. A: Hair taken from the donor zone is considered to be permanent and should resist changes related to androgenetic alopecia also known as genetic patterned baldness. In other words, it will not be lost. Through the natural aging process, hair diameters may decrease over time […]
Dr. Bernstein was featured in a wide-ranging interview published in the New York City-based, Japanese language magazine NY Japion. Among the topics discussed were the differences between FUT and FUE hair transplants, updates on robotic hair transplant technology, the type of procedure most beneficial for Asian patients, criteria that determine candidacy for a hair transplant, and more.
Q: What is the problem with transplanting the crown too early? — P.L., Newark, NJ
A: If a person’s hair loss continues –- which is almost always the case -– the crown will expand and leave the transplanted area isolated, i.e. looking like a pony-tail. The surgeon can perform additional hair transplant procedures to re-connect the transplanted area to the fringe, but this is a large area that can require a lot of hair, and it is often impossible to determine when a person is young if the donor supply will be adequate. View the full post to see a photo of a patient who had an early hair transplant to his crown.
The 2015 hair restoration practice census, published by the International Society of Hair Restoration Surgery (ISHRS), showed that hair transplantation is an increasingly popular treatment for hair loss.
The biennial survey found that 397,048 procedures were performed in 2014, an estimated increase of 28% over the previous survey, published in 2012. Three prior surveys found increases of up to 12%, so the rate of surgical hair restoration seems to be accelerating.
Q: Hi. I am 52 years old and wish to know if Propecia will work for my age. I have started losing some hair a couple of years ago and it’s thinning out. Thank you very much for your help. — K.E., Boca Raton, FL
A: Propecia (Finasteride 1 mg) can hold on to hair at any age, but works best to re-grow hair in those who are younger. Occasionally we see patients in their 50s re-grow some hair with Propecia, but this is the exception rather than the rule.
Dr. Bernstein was interviewed by Dana Tyler, host of the television program “Eye on New York” on CBS, for the show that aired on April 17th. The wide-ranging interview was the feature in a 9-minute segment on hair transplantation and hair loss. Read further for a partial transcript of the interview.
Q: What happens to hair diameter when you age? — K.L., Greenville NY
A: From infancy to puberty, hair gets progressively thicker. From adulthood to old age the hair becomes thinner again and this is exacerbated by the effects of DTH in susceptible persons. The later process is called androgenetic alopecia (common baldness) and is characterized by miniaturization – the progressive decrease in hair diameter and lengths as a result of DHT.
However, even without the effects of DHT, hair gradually thins over time in many people.
Asylum.com reporter Brett Smiley interviewed Dr. Bernstein to get his take on hair loss and the balding pattern known as a “power alley”:
“Power alley is an accurate term for that type of balding,” says Dr. Robert M. Bernstein, a clinical professor of dermatology at Columbia University and world-renowned hair-transplant surgeon. “It’s Norwood Class III balding, which is the most common type.”
Q: I know that Propecia works in only about half of patients. Are younger people more likely to be helped by this medication? — V.C. Greenpoint, Brooklyn
A: The main studies by Merck looked at men between the ages of 18 and 41. The five year data (which, in my view, is most important) showed that 48% of men had an increase in hair growth and 42% had no change over baseline. Thus a full 90% held on to their hair or had more over a 5-year period. This compares very favorably to the placebo group where 75% lost hair over the 5-year period.
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? — E.Z., Darien, CT
A: The difference is genetic with the inheritance coming from either side of the family.
Q: I am 22 and want to go for hair transplantation. I want hair restoration surgery now because I have a concern about my donor area that it might diminish if I postponed my transplantation. Could this be the case? — T.J., Westchester County, N.Y.
A: The logic is not correct. Having a hair transplant at an early age does not protect the donor supply.
If your donor area diminishes over time, then the transplanted grafts will fall out as well. Hair does not become permanent just because is moved in a hair transplant. It is never any better than the hair in the area where it came from.
The longer you wait – i.e. the older you are when a hair transplant is performed – the more information we will have about the stability of your donor area and this will allow for optimal planning of the hair restoration.
“Dermatologic Clinics” is a hard-cover quarterly peer review publication with comprehensive, state-of-the-art information by experts in the field of dermatology. In a 2005 issue entitled “Advanced Cosmetic Surgery”, Dr. Bernstein is lead author of the article: “Follicular Unit Transplantation: 2005.”
This valuable contribution to the field of surgical hair restoration explores techniques and best practices of the surgical procedure known as Follicular Unit Transplantation that Dr. Bernstein pioneered and is now considered the state-of-the-art in hair transplant surgery.