Bernstein Medical Center for Hair Restoration - Body Hair

Body Hair

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Q: Dr. Bernstein, can you please comment on leg and body hair transplants? — J.R., Ridgewood, NJ

A: I’ve tried the technique in the past but have been dissatisfied with the results. Scalp hair, unlike the rest of the body, has multiple hairs rising out of each follicle. With leg and body hair, you have only one hair per follicle, not follicular units of multiple hairs. Leg hair is also very fine. It might thicken up a little bit after it is transplanted, but not enough to be clinically useful. In men you want full thickness hair, so fine hair can make it look like it is miniaturizing, as it does when you’re losing it.

Body hair has been successful in softening hairlines, but most people have enough scalp hair to due this, since it often requires very little if properly placed. Another issue is that because leg hair emerges from the skin on a very acute angle, more wounding of the skin occurs as each hair is individually extracted and this leaves marks.

Body hair, from the chest or back, does hold better potential for success than leg hair, particularly if it is plentiful, but it still is extracted one hair at a time and can leave significant scarring when done in large numbers.

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After trading anecdotes with fellow hair loss physicians about how finasteride can reduce body hair in some patients, Sharon A. Keene, M.D. took the next logical step and asked whether finasteride might have a negative effect on patients who have body hair transplant (BHT) procedures.

In a review of scientific literature on whether finasteride effects body hair growth, Dr. Keene finds that current research is inconclusive.

Finasteride, the drug in the hair loss medication Propecia, works by blocking the 5-alpha-reductase type 2 enzyme (5-AR Type 2) which is needed by the body to covert testosterone to DHT. DHT causes common baldness, by making hair follicles shrink and eventually die.

In looking at DHT’s effect on body hair growth, current research strongly suggests that it does play a key role. Males born with a deficiency of 5-AR Type 2, and thus no DHT, have reduced, or absent, body hair growth (and no loss of scalp hair).

It would seem logical then, that when finasteride is used to re-grow hair on the scalp, it would also inhibit the growth of hair on the body. However, the genetic variation among people is too great to determine exactly how much of an influence it plays.

With this uncertainty of DHT’s effects on body hair, it is impossible to say, without further study, if finasteride would have the same effect on body hairs which are transplanted to the scalp. In Dr. Keene’s conclusion, she suggests:

A patient on finasteride for at least a year who undergoes BHT is probably safe to continue it, as remaining body hairs are apparently not sensitive to the effects of this drug.

You can read the full discussion and review of current research in the January/February 2011 issue of Hair Transplant Forum International, the official newsletter of the International Society of Hair Restoration Surgery (ISHRS).

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Q: I heard that it is possible to transplant body hair to the scalp. Does it leave any scarring? — V.P., Cherry Hill, NJ

A: Unfortunately, it does leave scarring. And since the hair is generally of poor quality, it is usually not worth the trade-off. Below is the typical scarring seen in a BHT procedure. Click the image for a larger version:

Body Hair Transplant - Scarring

Scarring with body hair transplant
(note circular white scars on the person’s chest)

Read more about Body Hair Transplants

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Q: I’m concerned that finasteride might result in unwanted body hair on the arms, back, etc. Is there any truth to this? My thinking is that since finasteride blocks the enzyme 5 alpha-reductase which converts testosterone to its more active form, DHT (dihydrotestosterone), is it possible that it might actually have some effectiveness in ameliorating unwanted hair? — P.P., Stamford, CT

A: Yes, finasteride does have some ability to decrease body hair, since growth of body hair is stimulated by DHT. However, the effects of finasteride are mild and not observed by everyone, so if you have unwanted body hair you will probably need some other means to remove it such as waxing, laser hair removal or electrolysis. The important thing is that finasteride doesn’t increase body hair.

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Q: I am currently 28. I have been taking Propecia for 6 years and recently began to grow sparse chest hair for the first time in my life. Is the Propecia causing these effects? — H.L., Gowanus, Brooklyn, NY

A: DHT causes male pattern baldness and stimulates the growth of body hair. The use of Finasteride, a DHT blocker, will permit scalp hair to grown and inhibit the growth of body hair, not stimulate it.

However, the effects on body hair are quite small, so your natural tendency to grow chest hair over time is probably not being blocked by the treatment.

Read more about propecia and the effects and effectiveness of the medication.

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Q: One of the things that I have noticed as a person who has needed to take thyroid medication for a long, long time, is that when my thyroid gets a little bit out of balance – when I’m not getting quite enough, I begin to notice is that my hair starts falling out. What about the role of thyroid for hair loss? — T.K., Mineola, NY

A: Both increases and decreases in thyroid levels can cause hair loss and changes in the levels of thyroid hormone can change the consistency of one’s hair. Elevated hormone levels cause scalp hair to be fine and soft, with diffuse thinning being relatively characteristic.

When thyroid hormone levels are low, the hair becomes dry, coarse, and brittle. Hair loss can be either patchy or diffuse (involving the entire scalp).

Low levels of thyroid hormone are associated with the loss of the outer 1/3 of the eyebrows and a decrease in body hair. When changes in thyroid hormone levels are abrupt, there can be dramatic shedding (telogen effluvium).

The most important thing to do if you have thyroid disease is to try to keep the levels within a normal range and keep them as steady as possible. If you are taking thyroid medications, try to use them on a regular basis, because alterations of ones in hair can be caused by large fluctuations in the levels, as much as by the absolute values.

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