*Warning* Long post Ahead!! Turn back now!! (Sorry, too late...)
I'm 52 and have had two micro-follicular procedures back in '02/03 to restore my hairline/front/middle section (I was about a 5). Still super-happy with my results, in fact it has been this long since I have frequented any of the hair sites!
I want to thank this site and several others that were a huge help to me back then. But I have since learned a few things which might help someone who is contemplating surgery (or trying to avoid it).
Like I said, I'm a former HT patient and generally happy camper. But a few months ago it seemed like my hair was starting to thin again. I first started noticing it between shampoos and at the hairstylist. The thinning seemed to be occurring all over, even in the transplanted areas which I had thought were fairly permanent. (Yikes!) I called my doc and he said it is fairly normal for follicles to miniaturize somewhat with age. (Double Yikes!) But this didn't make sense, my hair density had been good and stable for 5+ years previous to this--- why now???
I started thinking about what I was doing differently now compared with say, a year ago. My regimen and diet were much the same...same old store-brand shampoos as before (basically whatever was on sale...). No major stress in my life, no medical conditions, nothing I could point to. The only thing I could think of is that occasionally during the day, I would rub my scalp with my fingertips. Just one of those unconscious twittery things one does while watching one's team play or preparing one's tax return. Over time, I guess I was doing this with more frequency. And that's also about the time I started seeing more and more of my scalp.
But how?? How can this be? It wasn't like I was pulling my hair out or anything! I mean, you always hear about how beneficial scalp massage is, right? But then I thought back to high school, to the time when I was visited by a bad case of zit-i-titis. I tried EVERYTHING, and NOTHING seemed to help. HORRORS! Finally, on the advice of a friend I tried changing my habits: I washed my face same as always, but then didn't touch it for the rest of the day. It was hard to do at first but, VOILA!! Zits beat a hasty retreat! The simple reason is, by touching the skin with my fingertips I was spreading bacteria everywhere. (And apparently, making them quite angry!)
And when I stopped, so did they.
Okay, but what does this have to do with hair loss? Well, in my case I only knew that I was rubbing my scalp more often than I used to, and that my hair was thinning again (like it used to). So I figured I would stop rubbing or playing with my scalp, and see what happened. And voila! My hair stopped thinning and started filling in again!
I think I know why now, it's pretty simple. And it's not that scalp massage is a bad thing. It is just that our male scalps normally excrete sebum to lubricate the scalp (witness the Simonize finish on a bald scalp). This is a good thing, but the sebum is also a carrier for our evil arch-enemy Mr. DHT. And if you have an oily scalp (like yours truly), a stray fingertip spreading that stuff around is NOT a good idea! Case in point: A good friend of mine, who I have known since high school, has always had this habit of rubbing the top of his head. He is completely bald now, and maybe it's just a coincidence. Or is it?
So, what to do? In my case, I stopped rubbing! And to control the oil, I actually use a moisturizing shampoo now. Why? It's counter-intuitive, but because my scalp is being moisturized, it produces a lot less oil now than when it was trying to counter the stripping action of the "normal" shampoo. I noticed the same thing with sunblock. My derm told me I need to put sunblock on every day to protect myself. I hated the idea of putting something greasy on my face, which gets pretty oily by itself. But a funny thing happened. Within a week or so of using the sunblock daily, my face stopped being oily. I guess it figured out there was enough moisture there already, and didn't need to manufacture any extra. Well, I applied the same logic to my shampoo and I am liking the results.
My regimen is simple, it comes down to controlling the sebum/DHT situation:
Use any decent brand of moisturizing shampoo (currently Costco/Kirkland)
Use wide-tooth comb, OK to use light scalp pressure (on clean scalp only)
Wash comb regularly (look for sebum buildup): Old toothbrush/409 works well
Try not to touch or rub scalp between shampoos
I also take 1/4 Proscar daily, NO topicals.
I know it may sound odd and pretty simplistic, but this regimen works for me, and may for you. Besides, what do you have to lose? (Oh, that's right..)
Happy growing! hairmeister