Thank you for your question.
You submitted a question with two photos and you state in your question that you’ve been
losing hair and the two photos you submitted, one is from January of this year and the next
photo is several months later. And you’re asking about the presence of hair thinning
and you also mentioned that your eyebrows have also been thinning.
Well, I can certainly give you some guidance as to how to proceed given this concern. A
little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island
for over 20 years. I’m also the founder of TrichoStem™ Hair Regeneration Centers,
a system we developed in our practice which we use to non-surgically treat male and female
pattern hair loss with over 99% success using a treatment that involves the use of platelet-rich
plasma (PRP) and acellular matrix. That being said, I would like to give you just some overall
perspective as to how we evaluate hair loss in our practice.
First of all, it’s important to establish the diagnosis. In our practice, the majority
of patients who come to us reflect essentially what is the majority basis for hair loss in
the general population which is 95% of hair loss is genetic pattern hair loss, male and
female pattern hair loss. Now when we evaluate a patient, we ask about age of onset, the
rate of progression. We look at family history, we look at the age of onset within the family
and then we do a proper evaluation with a microscopic evaluation standardized photography.
Now, one of the things that I am concerned about with this history is that you mentioned
that your eyebrows are also thinning. Generally speaking, for male pattern hair loss, we don’t
expect to have concurrent eyebrow thinning. So if there is any possible alternate diagnosis,
something that is inflammatory or of the scarring nature, you should be seen by a dermatologist
to at least establish that you don’t have any other cause for hair loss.
Assuming that you still have male pattern hair loss, I can suggest to you the different
options that we present to our patients. First is the pharmaceutical option. Pharmaceutical
option includes the use of topical minoxidil or the brand name Rogaine as well as the use
of oral medication called finasteride also brand name Propecia. Now these drugs have
their benefits and their limitations. It is not unusual for someone to start their journey
in treating their hair loss with buying Rogaine or minoxidil. It’s applied topically and
it does help a little bit but doesn’t stop progression.
When it comes to finasteride, the challenge is that you have to take a pill daily and
studies have shown that a lot of men do not continuously take these pills daily. By the
second year, majority of people stopped taking them. Now there are exceptions. We have patients
in our practice who I have been prescribing finasteride since the introduction in 1997.
So there are people who can take the pill daily. The challenge we are dealing with now
is that there are concerns about long-term sexual side-effects that are associated with
these drugs. Although from the medical community, that question still remains open.
That being said, we developed a treatment in our practice based on the wound healing
technology we were using when we were doing hair transplants called Hair Regeneration.
Briefly, it’s a combination of acellular matrix that is used for wound healing combined
with platelet-rich plasma and other factors that we developed over time in a way so that
we can get 99% success in terms of stopping progression of hair loss, reactivating hair
that has not been growing as well as inducing the shedding of thinning hairs and the growth
of thicker hair. This works for both men and women, as I stated 99% of the time. And with
more than 5 years of data, we have seen long-term benefit well beyond 5 years. We still treat
everybody as individuals and we follow people very closely.
So the take home message is that if you want to do something about your hair loss, do something
sooner rather than later. The limitation of any treatment whether it’s pharmaceutical
or surgical as well as non-surgical like Hair Regeneration is where you’re at, how fast
you’re progressing and the presence of hair follicles. We are treating people as young
as 17-years-old and in their late teens who are coming to us with their parents or with
someone who can establish for us and sometimes we take biopsies to further establish. But
the onset of hair loss can be relatively young. And so, the earlier we catch someone, the
better it is.
So that being said, I would recommend that you meet with a physician, figure out what
the cause of your hair loss is. Although your photos reflect more of a diffuse pattern which
is consistent with genetic pattern and statistically, it is more likely to be genetic pattern, it’s
very important to still have a proper evaluation and get the right diagnosis and then learn
about your options based on that diagnosis.
So I hope that was helpful, I wish you the best of luck and thank you for your question.