Bernstein Medical Center for Hair Restoration - Bald Patch

Bald Patch

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Losing one’s hair can be an uncomfortable topic of conversation for any adult, but, given the importance many women place on their appearance, hair loss in women is an especially taboo subject of conversation. Whether it is a bald patch, diffuse thinning, balding from a medical condition, or scarring from an accident, hair loss can be upsetting or even traumatic for many women.

The good news is that hair restoration pioneers like Dr. Bernstein are bringing the treatment of women’s hair loss out of the cosmetics bag and into the modern era of hair restoration. What a better way of squashing the taboo once and for all than for Dr. Bernstein to appear on national television and confront the issue head-on. Dr. Mehmet Oz invited Dr. Bernstein to appear on his show, the Dr. Oz Show, to discuss the causes and diagnosis of hair loss in women.

As seen in the image above, Dr. Bernstein used a densitometer to evaluate the hair loss of a female member of the audience. The device enables a physician to determine the amount of miniaturization, or genetic thinning, present in the patient’s scalp. Dr. Bernstein also commented on the treatment of hair loss with low level laser therapy (LaserComb).

Dr. Oz and Dr. Bernstein are colleagues at The New York Presbyterian Hospital of Columbia University. They first appeared together on the Oprah Winfrey Show where Dr. Bernstein explained his new hair transplant techniques to Oprah.

See before and after hair transplant photos of some of our female patients.

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Q: I just started to lose my hair but it’s just in one spot, like a circle on the left side of my head. Do you ever do a hair transplant just into a bald spot and not the whole head? — D.F., Esher, U.K.

A: It is possible to have a hair restoration procedure into a single bald spot. However, it would be most beneficial to first determine the cause of the condition.

Bald spots caused by alopecia areata (an autoimmune disease) are best treated with injections of steroids into the scalp, rather than with a hair transplant. In fact, the transplanted hair can be rejected in patients with this condition.

Traumatic scars (i.e. from an accident) can be treated with follicular unit hair transplantation as the hair grows quite well in scar tissue, as long as the scar is not thickened (hypertrophic).

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Q: Can the laser comb grow hair back in bald areas of scalp?

A: The HairMax LaserComb only works in areas where there is still some hair.

It will not bring back hair that has been lost. You need hair transplantation to do this. The laser comb works by thickening fine, miniaturized hair.

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Q: I am suffering from Pseudopelade for four years now. I have lost a lot of hair & there are big bald patches on the top of my scalp that are difficult to hide. Is there any hair transplant surgery or follicle transplant surgery possible in my case, or anything else I can do? — T.L., Boston, MA

A: In general, hair transplantation does not work for Pseudopelade (a localized area of scarring hair loss on the top of the scalp) since the condition is recipient dominant rather than donor dominant.

With a donor dominant condition, such as androgenetic hair loss, the tendency to have the condition, or be resistant to it, is located in the hair follicle and moves with the hair follicle when the follicle is transplanted to a new area. Therefore, in androgenetic alopecia, healthy permanent hair taken from the donor area in the back of the scalp will continue to grow in the a new location in the balding part of the scalp.

In a recipient dominant condition, such as Pseudopelade, the problem is in the skin, so if you perform a hair transplant into an affected area of skin, the transplanted hair will become affected by the same process and be lost.

The disease process can often be slowed down with anti-inflammatory agents, such as corticosteriods, applied or injected locally and the bald area can be camouflaged with cosmetics specially made for use on the scalp. See the Cosmetic Camouflage Products page on the Bernstein Medical – Center for Hair Restoration website.

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Q: I am a 34 year woman with a patch of hair loss by my temple. I went to the salon to have my hair done and to my surprise my hairdresser told me that I have Alopecia? First time I’d heard of it, my G.P is not very concerned about it but having read so much about it on this site I am becoming a bit concerned. The rest of my hair is healthy any suggestions and diagnosis? — M.V., Williamsburg, Brooklyn

A: “Alopecia” is just a generic term for any kind of hair loss.

It sounds like you have a specific condition called alopecia areata. Alopecia areata is an autoimmune disease that presents with the sudden appearance of well localized bald spot(s) on the scalp or other parts of the body. The underlying skin is always normal.

The treatment is injections with cortisone. Hair transplant surgery is not indicated for this condition.

You should see a dermatologist to confirm the diagnosis and treat.

Other diagnoses to consider are triangular alopecia (which would have been present since childhood) and traction alopecia (that is cased by constant tugging on the hair).

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Q: I have a scar on the top of my head the size of a quarter from an old injury. I would like hair to grow back on the bald spot. Can a hair transplant re-grow hair on the spot and not have any scar on my head at all? – E.D., Oceanside, N.Y.

A: Traumatic scars are readily treated with follicular unit hair transplantation. The hair generally grows quite well in scar tissue as long as the scar is not thickened (hypertrophic). Several sessions are usually required. Although the hair restoration can make the bald area undetectable, the underlying scar tissue will still be there.

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Q: I have a bald patch on my scalp diagnosed as DLE, can this be corrected with a hair transplant? – V.Q., Scarsdale, N.Y.

A: DLE or discoid lupus erythematosus is a type of autoimmune disease where the body produces an inflammatory reaction to components of the skin, causing it to scar and lose hair.

The skin in the area of hair loss generally has a smooth appearance with tiny empty hair follicles, redness, and altered pigmentation. These skin changes help to differentiate it from the more common condition alopecia areata where the underlying skin appears normal.

The diagnosis of DLE can be confirmed by biopsy. Because DLE may exhibit a property called Koebnerization, where direct trauma can make the lesions enlarge, surgical hair restoration risks making the condition worse and is, therefore, not indicated.

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Hair loss has a variety of causes. Diagnosis and treatment is best determined by a board-certified dermatologist. We offer both in-person and online photo consults.

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