Hair Transplant in Black Woman

/by William Rassman, M.D./2 /,

I am a black woman age 27. Seven years ago I had thick black hair. I used chemical products on my hair and got my hair styled by various hair dressers. Fine bumps developed in the back of my head, I attended a doctor and I was told that there were keloids. About a year after I conceive and gave birth to my only daughter that was in 1999. I relaxed my hair again and this time I am not sure if it is as a result of the keloid but my hair started thinning at the front and it is getting worse. I try to keep my hair up to hide the bald spots and this has affected my self esteem some what. Can this problem be rectified. Can my hair grow back or can I have hair transplant to make it look normal again?

This is a very complex problem that would require an examination of your scalp. Without seeing you, I would be loathe to suggest what to do. See a good dermatologist first, then see if he/she recommends another expert. Bald areas in the scalp are easily treated provided that there are no disease contra-indications for transplantation. Keloids and a variety of diseases that cause Alopecia need to be evaluated.

Bald Spots in African American Women

/by William Rassman, M.D./18 /, ,

I and my daughter have severe bald spots. My other daughter has a bald spot also. Not as severe as ours. My daughter is devasted. I think she can be saved from what I am experiencing. I personally feel that there is something in our system. No other family members have this disorder. We have been unsuccessful in locating a doctor who is familiar with Black Hair care or disorders. Can you help us. I now wear a wig. My daughters do various things from sew-ins to wigs. If you provide address I will mail pictures. Thank you.

If there are spots of hair loss in you and your daughters, you should start off by seeing a dermatologist. There are genetic conditions that fit the description of what you are talking about. Please see a good dermatologist.

Itchy Scalp

/by William Rassman, M.D./2 /,

I am a 27 year old African American woman. A few months ago I saw some bald spots in the middle of my head. I thought it was the wigs and hair weave I used to wear, but later on the bald spots started to spread down to the front of my hair line. When my hair itches I used to bang my head with my hand so that I could stop the iching. I don’t know what to do with this situation. I want to cut my hair off and start all over re-growing my hair. What do you think is best for me to do?

If you have not yet seen a physician, I suggest that you get a thorough examination to rule out any underlying medical conditions, which could be causing the balding. The physician would also be able to determine how best to treat the itching.

Hair Loss in the African American Man

/by William Rassman, M.D./3 /,

I am 33 years old African American and am very concerned about my hairloss. I am probably between a Type 3 Vertex and Type 4 hair loss pattern. My crown is very thin and my hairline is getting thinner by the day. I tried Propecia for 10 months and did not see any substantial differences. I stopped using Propecia because of the uncertanity of future complications.

My hair on the sides and back are very strong, but I am concerned about how a transplant would look. I have seen some guys that have that pluggy look, which looks bad. Can you give me some advise on what the best step would be.

A man of your age who is still at a Class 3 Vertex or Class 4 pattern, is usually not going to get very bald. In the African American, this is more typically the case, but it would be best to get a complete history of your family to be sure that your ancestors did not have advanced cases of hair loss. My concern would be that Class 4 patterns sometimes do lead to Class 5 or even to a Class 6 pattern. That is why I like trying to prevent progressive hair loss with a DHT blocker like Propecia which will probably stop or slow the progression. Stopping the progression is as important as fixing your problem correctly.

African Americans’ are the best candidates for transplant. The characteristics of very curly hair make the frontal work look awesome and the hair just covers better. It is always a pleasure to show off the results. Here are some examples from our website, newhair.com:

African American Female, Age 52

/by William Rassman, M.D./2 /,

I am an African American female age 52. I have very long sister locks and they are beautiful. trouble is, I had a hysterectomy last summer and noticed that my hair is balding on the sides. I went to a dermatologist who said it was my locks pulling, but I clearly had to get him straight and tell him that I never had braids in that spot, only a hair line that never was long enough to incorporate into the dreads. I am a professional person and am always in the public eye. I am now wearing scarves to cover the sides. I would like to know what I can do. I did notice that before I had surgery, my scalp was itching badly on the sides and the hair at the follicle became crusty at the base, as if it was dead. Any help would be appreciated

You should be seen by an expert. With a good history like yours, I would worry about a series of localized skin conditions that should be ruled out by a good dermatologist. As you are convinced (and have convinced me) that this is not traction alopecia, then a transplant might be a good solution provided that your dermatologist has determined that there are no skin conditions that would kill off the transplants. Transplants are undetectable in most African American hair types.

Alopecia in African-American Women

/by William Rassman, M.D./1 /,

I am a 22 year old African American female. I very curly, short, and extremely dry frizzy hair. Due to experimenting with different hairstyles I have managed to pull out some of my hair from the root and now I have bald spots all over my head, which i have fortunately managed to hide with my other hair. I have tried many produts to see if I could regain the hair lost in these particular areas, but nothing has worked thus far. My hair is also particularly thin around my forhead and basicly non-existent around the temples/edges of my head. I want my hair to be longer, thicker, more healthy all while still looking natural and not too “fake” What would be the best hair procedure for me to opt in my particular case and what are the estimated costs for this/these procedure(s)?

Note: Just so that you know the extent of my hair damage. It is so bad that I have had to resort to wearing hair weaves, wigs, and other hair pieces.

I would want to see you before rendering an opinion. Your history is one I hear with great frequency, but the cause of the hair loss needs to be determined before making any plan to fix it. Different diagnoses would include traction alopecia and a variety of autoimmune alopecias. You need to be careful with wigs, because they can induce traction alopecia, compounding your problem. If you are in the California or New York areas, you can meet with an NHI affliated doctor. If not, visit ISHRS.org to find a doctor specializing hair restoration in your area. Or you can find a local qualified Dermatologist to get the diagnosis you need.

Hair Loss in Young African American Man

/by William Rassman, M.D./2 /, ,

Dr. Rassman;

As hard as this may seem to believe (especially for me), I am a 20 year old African American male who started losing my frontal hairline at the young age of 18. I am a sophmore in college and only started losing hair a few months after my first year. I am foolishly hoping that there is some other unknown cause to my early hairloss besides MPB (i.e.-I wore tight cornrow braids for a year, have heavy dandruff, and am also a heavy marijuana smoker) but I know this is unlikely. I have not had any tests done. I am wondering what my best options are considering that I am a college student with low income. I do not want to only stop hairloss, I really need to re-grow the hair I already lost. I am well into a Norwood class type III and have been for about a year now. I also cannot shave my head completely bald because of dark spots on my scalp and the weird shape of my dome. My situation is devastating due to my age and lack of money. I feel that NHI is really the most sincere and genuine hair transplant program and would be the most truthful and accurate with any advice they could offer. Thank you in advance for your time, patience, and assistance.

Robbed of Youth

Returning lost hair may be impractical for genetic hair loss. If you had your hair in tight braids when you were young, what you may be experiencing is some impact of traction alopecia modified by the genetic process. Whatever the cause, you do need to be examined by a competent doctor to make a diagnosis. The drug Propecia can return hair that has been lost, usually not as much in the front as elsewhere on the scalp. This is a prescription item, so again you need to be seen by a good doctor. A good Dermatologist should be able to do this. We have offices in California and and an affliated office in New York, so if you can get to one of our offices, we would be happy to examine you. Otherwise, look for a doctor in your area at ISHRS.org. You are too young for transplants, so be sure that no one does a hair transplant on you and stay away from anyone that pressures you to do surgery.

Hair Loss and Chemotherapy

/by William Rassman, M.D./0 /,

I am African American, and was diagnosed with cancer a year ago (Hodgkin’s). I was told that Chemo would definitely leave me bald. I was one of the lucky ones that did not go completly bald, but my hair sheded a lot leaving it fragile and very very thin. Now that I am cancer free (praise God), I would like to know if there is anything I can do to grow my hair back. I also have anemia, something I’ve had all my life (not cancer related). I have not had Any chemicals on my hair in about seventeen months. Can I use perms again?

Thank you for your response in advance, for this is a very touchy and hard to speak on subject with the oncologist, I think they feel my concerns are vain.

Unfortunately, some doctors are still in the middle ages when it comes to hair loss, but your oncologist should not be in that situation. Curing cancer is very important and getting back to normal is just as important. Chemotherapy may cause hair loss and sometimes it takes a couple of years for the hair to return to normal. You should be extra-gentle with the hair while you are waiting it out and not use chemicals that might damage the hair while it is fragile. Hair thickeners do not cause much of a problem. If your African hair allows the use of thickeners, you can increase the fullness of each hair shaft with their use. Your hair situation may be still the result of other elements that followed your treatment. Anemia is known to contribute to hair loss as is thyroid problems so a good evaluation of these other systems are important. Hormone assessment is also important, particularly if you are female. If you are a male, Propecia may have value.

Take the time to get you doctor to sit down with you and review every factor that may contribute to hair loss in your case, based upon his/her experience. I am sure that he/she sees this problem often so do not be shy or embarrassed about talking about it.

African-American Female Hair Loss

/by William Rassman, M.D./1 /, ,

Here’s an email I just received today…

Dear Dr. Rassman,

I am an African- American female, aged 62, with pattern baldness around my hairline. I would like to know if the “new hair” will grow and how will any chemicals, ie. straightners, dyes, etc. might affect the transplanted hair. I would also like to know where and how I can schedule an appointment for consultation ASAP. I have been using Rogaine but I am still compelled to wear wigs to look my best…HELP! I am VERY interested in getting this procedure and I have the blessing of my husband of 40 years!

I have done work on many African American females. As you may know, frontal balding is common amongst African American females largely because of the combined effect of pigtails that were used for styling in their youthful days as well as the abuses with chemicals, ie. straightners and dyes. First, a good examination needs to be done to separate the effects of chemicals and pigtail styling (if appropriate) to the female genetic hair loss. Then, a complete examination needs to be done to make sure that other medical conditions are not the cause of the hair loss such as thyroid disease, hormone imbalances, anemia, etc. There are a series of blood tests that can rule this out.

My recommendation is to make an appointment first (if you wish to see me, ask for me by calling 800-NEW-HAIR). The consultation is free.

Thanks for the good question.

Keloid Question

/by William Rassman, M.D./1 /,

An African American woman writes…

I am interested in the restoration process to my temples. Having black skin I am concerned with forming keloid scars in the visible frontal and back area. Does this happen? I noticed pictures of African Americans however they may be some of the lucky ones who don’t form big scars. Can you give me some more information on this?

There also didn’t seem to be any info on other possible pitfalls to take into consideration?

Thank you for your email. If you are a known keloid former, then a test of the scalp may be the safest way to determine if you would form a keloid. Such a test might be performed with a very small incision in the area where the hair would come from and a few needle ‘pokes’ in the area where the transplants were to be placed. If you have no history of Keloids, and have had scars in the past that did not produce Keloids, then it would be reasonable to assume that you would not form a Keloid in a hair transplant area.

As a black woman interested in hair transplants, please make sure that you are evaluated by a good, ethical and competent doctor. With regard to Keloids of the scalp in association with a hair transplant, they are very, very rare even in black skinned people.