Hair transplants and alopecia areata

[gillenator]

Hey Gill.

Quick question.

I have been told by several people that our testosterone levels decrease as we age.

By age 65 we dont have enough to convert to DHT that could damage the remaining hair follicles.

What are your thoughts on that?

Yes, that is true in men and for most, the decrease in production starts after roughly age 30. But it is not a drastic reduction generally speaking and I am not aware of any clinical studies that correlate the decreases in testosterone with a corresponding decrease in the levels of DHT.

We do know that the overabundance of DHT deposits in the liver, bone marrow, and our scalps.

The real dilemma is that most of us men that have MPB lose the majority of what we are destined to lose by the age of 65, meaning, any decrease in loss may not be visually significant to benefit from.

[drybone]

Thats Gill

Good answer

[gillenator]

PW,

I have heard from some guys that experienced shedding from dutasteride with several of these men stopping the use because of this.

Yet everyone responds differently from these various hairloss meds. So stick with what seems to work for you under the supervision of a licensed physician of course.

Some guys experience this type of shedding from the "initial use" of some of these hair loss meds as well.

Every now and then I read about some who start these meds immediately after surgery and experience a massive shedding and/or their regrowth is negatively impacted.

So some docs want their male patients to be on finasteride well ahead of their procedures not only to see how they respond but also to note any initial shedding that can be induced by finasteride, minoxidil, and the like.

And I also recommend that anyone experiencing a substantial shedding cycle to wait for it to subside before having their procedure.

[gillenator]

PW,

I should have also mentioned that I have heard from several men and women over the years who experienced this type of "patchy hair loss pattern" from using minoxidil.

AA is a different type of hair loss and not much is understood about its cause and effect as well as treating it.

I wish you the best of resolve my friend.

[PatientlyWaiting]

Thanks.

That's strange. The AA on my head did started at 22 years old, when I first started using Kirkland's minoxidil. I had actually suspected minoxidil started it, but didn't want to bring that up because I thought it was crazy.

However, I also have a patch in the back of my head, as well as tiny spots across my mustache area, and one patch in my beard area. Also, for as long as i've had leg hair, which was at 13-14 years old that it started growing, i've always had Alopecia Areata on my legs, if it's not AA, then IDK what it is but my legs barely have hair, and it only has a few patches of hair. They've always been like that. Through high school, like gym class, i've always been asked why my hair is like that. I had no idea why. But seeing me getting AA on my head and face, now I think it has always just been AA that I was probably born with, and got worse with environment, stress, diet, etc.

[gillenator]

If it were me, I would not be using any minoxidil product. You might notice some positive changes after discontinuing it for at least one year.

But AA is complex as we have discussed and only a licensed physician experienced with this can be of the best help.

My brother had it only in the scalp, not the body. IMHO, there are several forms of AA which can also affect the body regions. Some may diagnose it as AU (alopecia universallys) which is hair loss affecting the entire body. But I doubt that you have that.

[PatientlyWaiting]

But then if I drop minoxidil, all hairs that were regrown or thickened by minoxidil would fall wouldn't they? So let's say my AA grows back after stopping Rogaine, but then MPB will progress?

Hey Gillenator I know you're not an HT doctor or actually do surgeries, but looking at my hairloss, roughly how many grafts would I need to get cosmetically good results on the hairline? They were taken right now. Obviously i'd need to speak to whatever doctor i'll go with, but i'm asking for a rough estimate. Also, i'm planning on staying on medication after the hypothetical HT, to keep as many native hairs as possible.

No flash and flash.

[gillenator]

Well that's the trade-off. If you stop minoxidil, the open spots from AA may fill back in and they may not. You will only know by trying it.

On the other hand, yes, the progression of MPB will cause you to lose the cosmetic gains from the minoxidil.

There are no hard and fast answers. I would not have the procedure quite yet until you can somehow get stabilization from the AA.

Now to answer your last question on graft count, it really will depend on where the commencement of your new hairline would start. Obviously the higher it is situated above the frontallys area, the less grafts will be needed.

And the density level will also have a big impact on the potential overall graft count. Building a new hairline from nothing takes a large amount of single hair grafts as well.

Either way, even with a conservative placed hairline, you are looking at 3,000 grafts or more to start because of the many single hair grafts involved/required.