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Hair Restoration Answers

If I Am Starting to Thin, Should I Have A Hair Transplant Or Try Medication First?

Q: My hair is starting to thin in the front, but it is not yet bald. I have been going back and forth about whether to get a hair transplant or use Propecia. I’m not sure what my first step should be. What do you think? — N.K. ~ Pleasantville, N.Y.

A: In general, patients who are thinning, but not actually bald, should begin with combined medical therapy (finasteride and minoxidil) for at least a year prior to considering surgery. In many cases, with this regiment, surgery can postponed or even avoided completely. Unfortunately, some patients cannot tolerate finasteride or choose not to take it due to concern about potential side effects. Minoxidil, although useful, does not significantly alter the long-term course of hair loss when used alone.

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Hair Restoration Answers

Can Resistance Training Accelerate Hair Loss?

Q: I have read several articles on the internet which suggest that resistance training can accelerate male pattern baldness. Is there any truth in this? — B.F., Altherton, CA

A: Anything that raises androgen levels in your body can potentially accelerate hair loss. That said, I suggest to exercise as you normally would. As long as you don’t take drugs to enhance your workout, the effects should be minimal.

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Hair Restoration Answers

Why Am I Still Losing Hair (Shedding) After 6 Months on Minoxidil And Finasteride?

Q: I have been using an increased dosage of Propecia now for around 8 months and Rogaine for about 6 months. I know that shedding can be expected for the first 3-6 months, but I believe I am now beyond that timeframe. Have you seen cases in which these products merely exacerbate hair loss without the expected regrowth? — N.E., Travilah, Maryland

A: It is a bit long to still see shedding, but from my experience, either the medications are working (and you are still in the shedding phase) or you are not responding to them. I have not seen minoxidil or finasteride worsen hair loss. My advice would be to continue the same course for at least a year before re-evaluating their use.

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Hair Restoration Answers

What is the Incidence of Hair Loss in Adults?

Q: How common is hair loss in adult men and women? — N.F., Bronxville, NY

A: The incidence of androgenetic alopecia (common baldness) is quite high for both men and women. By age 50, 50% of men and 30% of women are affected. By age 70, that increases to 80% of men and 60% of women. Fortunately, in spite of significant thinning, women often preserve their hairline and have a diffuse pattern, so there hair loss can be camouflaged for many years.

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Hair Restoration Answers

What is Lichen planopilaris?

Q: What is Lichen planopilaris? — G.S., Pleasantville, NY

A: Lichen planopilaris (LPP) is a distinct variant of cicatricial (scarring) alopecia, a group of uncommon disorders which destroy the hair follicles and replace them with scar tissue. LPP is considered to have an autoimmune cause. In this condition, the body’s immune system attacks the hair follicles causing scarring and permanent hair loss. Clinically, LPP is characterized by the increased spacing of full thickness terminal hairs (due to follicular destruction) with associated redness around the follicles, scaling and areas of scarred scalp. Read more ».

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Hair Restoration Answers

Does Sebum Cause Hair Loss By Blocking Pores On Scalp?

Q: I have been on finasteride for about 7 months. After my latest haircut I can see that my scalp is shiny. I read that is from sebum buildup and it can cause a layer that clogs the growth of hair. I was wondering if this is true and, if so, how can it be treated? — T.C., Philadelphia, PA

A: It is not true. Hair loss is caused by the miniaturizing effects of DHT on the hair follicle, not by blocked pores.

For more on this topic, view our pages on the causes of hair loss in men or the causes of hair loss in women.

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Hair Restoration Answers

Hair Loss and Replacement for Dummies

Q: Why did you write another book on hair loss? — K.L., Greenville NY

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.

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