Split ends reflect drying and trauma over time. The longer hair ends are the oldest part of the hair shaft and that is why we see the greatest damage at the ends. The trauma is caused by sunlight, blow driers, hot rollers, rubbing too hard, hacking it with dull scissors, back brushing, using a metal comb with fine tines, perming, bleaching or coloring, putting rubber bands around the hair and the use of various hair sprays. The use of good shampoos and conditioners help keep the hair in better shape. Once the cuticle cracks or breaks and the cortex is damaged, only a good hair cut (which removes the damaged hair) will allow you to get the healthy hair look you want. These pictures show the complexity of a hair shaft, with many layers, each of which can be damaged permanently if you don’t take good care of your hair. Look to the right side of the photo and see a still intact hair shaft so you can see if someone had a hair cut and used a good shear to cut this hair a bit shorter, the end will be clean and not irregular.
College-aged rugby players taking creatine monohydrate supplementation for three weeks had their Testosterone and DHT measured. The results of these tests indicated a rise in DHT levels when using this supplement in their diet. A rise in DHT levels can accelerate, at least in theory, the hair loss seen in genetically balding patients.
https://www.ncbi.nlm.nih.gov/m/pubmed/19741313/
The following is taken from MSN Lifestyle:
- HOW HAIR TURNS GREY
Hair grows in a follicle, a bulb-like tube on your scalp. The average head has 100,000 to 150,000 follicles, each operating independently from the others. Hair in its basic, unpigmented state is white. It gets its color from melanin, a pigment that also determines skin color. Two types of melanin, eumelanin (dark brown or black) and phaeo-melanin (reddish yellow), combine to make all the hair colors. One hypothesis for why hair goes grey is that aging slows or stops the hair from accessing the melanin, so it comes out grey, silver, or white instead.
- GREYING IS CAUSED BY HEREDITY
When you’re born, your genes are already hardwired for when and how your hair will turn grey. This includes premature greying—people who grey before age 30 usually do so because it runs in the family. For most of us, greying starts in middle age. Dermatologists go by the 50/50/50 rule of thumb: by age 50, half the population will have at least 50 percent grey hair—although a worldwide survey showed that number was much lower, with only 6 to 23 percent of people half grey by age 50.
- RACE IS ALSO A FACTOR
In a related matter, race also determines when you’re likely to grey. In general, Caucasians gray in their mid-30s, Asians in their late-30s, and African Americans in their 40s.
- PLUCKING ONE GREY HAIR WILL NOT CAUSE THREE TO GROW IN ITS PLACE
This old wives’ tale is a myth. Each follicle can contain only one hair, and plucking it won’t make it able to produce multiple hairs. Furthermore, what you do to one follicle has no effect on the ones around it. That said, excessive plucking isn’t a good idea—it can damage the follicles and even stop hair production in that area altogether.
- STRESS PROBABLY PLAYS A ROLE IN GREYING
When President Obama went grey his first term in office, was it stress, age, or a combination of both? Scientists aren’t sure. While some researchers say that your genes alone are responsible for grey hair, others say that there seems to be a connection between greying and stress, just no direct link to prove it. In 2011, a study by Nobel Prize winner Robert Lefkowitz discovered that long-term productions of the body’s fight or flight response—the instinctive ability to mobilize energy in response to a threatening situation—can damage your DNA and cause premature aging, including greying hair.
- TRAUMA WON’T MAKE YOU GO GREY OVERNIGHT
Another myth is that a major shock will cause your hair to suddenly turn grey. This is sometimes called the Marie Antoinette Syndrome because the French queen’s hair supposedly turned white the night before she was beheaded. But hair, once grown, doesn’t change color, so waking up with a head of white hair isn’t going to happen. Although there is a very rare condition where all of the colored hairs can fall out, leaving only white hairs behind, the simpler answer is that Marie Antoinette probably just took off her wig.
- SMOKING MAY CAUSE YOU TO PREMATURELY GREY
Multiple studies have linked smoking with premature aging, which includes early greying. In 2013, a study found that there is a significant relationship between smoking and grey hair in people under 30. In fact, “smokers were two and half times more prone to develop PHG” or premature hair greying.
- BODY HAIR ALSO TURNS GREY
All your body hair—chest, nose, pubic, etc.—can turn grey. Body hair tends to grey at a different rate than the hair on your head, which is why some men can have grey beards and brown hair, or vice versa. By the way, dyeing grey pubic hair is a thing.
- SOMEDAY, RESEARCH MAY LEAD TO A GREY HAIR CURE
Scientists in Europe discovered a breakthrough with vitiligo, a disease where skin loses pigment and develops white patches. Like hair, vitiligo is caused by “massive oxidative stress via accumulation of hydrogen peroxide,” causing the skin to bleach itself from the inside out. Researchers have successfully treated the discolored skin and eyelashes of vitiligo patients, which has led some to predict a potential cure for grey hair. But while the idea sounds promising, history is full of tonics and creams claiming to cure grey hair. As far as we know, none of them have worked yet.
https://www.foxnews.com/health/2015/12/08/fda-clears-cold-cap-to-save-hair-during-breast-cancer-chemo.html
A number of times we wrote about the use of the Cold Cap for people who have cancer and did not want to lose their hair during chemotherapy. The stories I followed included a relative of mine who was able to hold on to 80% of her hair under chemotherapy for breast cancer. Another patient held on to his hair with chemotherapy for lung cancer. The value of this technology is absolutely clear and now the FDA has formally cleared the technology for clinical use. It was interesting to hear the stories from some of the patients I followed. Their doctors were somewhat resistant to this technology but because the patients insisted on it, they allow its use in their Chemotherapy Centers. Keeping ones hair during chemotherapy gives dignity to many such patients and helps reduce the stigma associated with these horrible diseases.
There seems to be an impact when obese men have children. The same may apply to women as well, but the study that is referenced here (December 3, 2015 The Scientist by Karen Zusi) states “Obese men have information that can be transferred to children that could potentially affect their eating behavior. And this information can be changed if obese men lose weight,” said Barrès. “Our study doesn’t show what is transmitted to children, but it is likely that something is transmitted and it will change brain development and behavior.”
The study is a “provocative start to asking some really interesting questions,” said Tracy Bale, a neuroscientist at the University of Pennsylvania who studies stress-related epigenetics in mice. “The big picture here is fascinating. It does support the very important potential role of the environment to influence epigenetic marks in dads’ germ cells.”
The concept of a nocebo (a psychogenic effect of a drug) has been discussed in the various studies which focus on the sexual side effects of the drug Propecia (finasteride). The significant ‘hype’ on the internet, has driven many people to the conclusions that if they take this drug, they will become impotent. As doctors, we must discuss potential and known side effects of any drug we prescribe, but what happens following the disclosures, the patients read the internet and find many, many panicky young men who report sexual impotence from taking the drug. Is it real? We don’t know but what we do know is that many studies from other countries have not shown the high sexual side effects reported in the United States. So is this a Nocebo effect resulting from panicky people who read bulletin boards and web sites which focus on this issue.
Dr. Robert Haber, a very respected hair transplant surgeon from Ohio, started to test the concept of a nocebo effect and the general side effects on sex drive and sexual performance using patients who came into his office. This is an early report of his initial findings.
“While I also doubt the existence of PFS, about a year ago I started asking my finasteride patients to complete an anonymous sexual dysfunction survey. For years I frankly addressed the topic at every visit, and my impression was that the incidence of sexual dysfunction in my patients was similar to the 1-2% reported in the studies. I wondered if a more objective survey would reveal anything different. Many of you may recall that I suggested we all gather this data in our offices, but there was little interest.
I have data now on over 500 patients, and much to my surprise, the overall incidence of sexual dysfunction in my finasteride patients is 25%. When I started seeing this number develop, I started giving a similar survey to all male patients not on finasteride as well. I have a much smaller sample size thus far, but the overall incidence of sexual dysfunction in my non-finasteride patients is 24%!
So I think that when we trust our direct face to face questioning of our patients regarding sexual dysfunction, [we should ask our selves if the patients are fooling themselves] that they are being honest. Apparently, sexual dysfunction is very common overall, so its not at all surprising that patients with this problem will try to blame something, and when there is a target like finasteride, both physician “experts” and lawyers will capitalize on the opportunity.”
Hi,
I am curious. I have been taking Finasteride (1mg) for about six months now. I am a female of 46 years old.
I see that most of the comments are from men and that is why I am wondering if women can experience similar symptoms. I have already suffered from anxiety and panic attacks in the distant past but since six months they have come back and are much worse than ever before. I feel anxious all the time, I am not sleeping and I have panic attacks daily. I am wondering if it is the meds doing that? Could another woman tell me if this could be a possible reason for my extreme symptoms please. It is the only thing I can think of at this time. I am very upset and feel just awful every day. Those attacks are limiting my life and making feel so depressed. I had them under control before but cannot control them today! I am almost hoping it could be the Finasteride I am taking because I have read all the comments on this forum and many people have experienced the same as me. I appreciate any guidance. Thank you.
Marianne
First and foremost you need to go back to your doctor and discuss these issues.
Finasteride is NOT to be taken by women.
Hi Doc, I read on a website that a doctor is offering FUE surgery at $0.50 that is 50 cents a graft in Pakistan. What do you think?
Your guess is as good as mine. I really can’t validate this claim.
There was a sarcastic remark made about the Taliban and how it may relate to prices. Apparently it offended a few readers. We apologize for the insensitivity to those who were sensitive to the comments.
Had, what I feel was very successful strip surgery graft to frontal area at beginning of year. Full natural hairline . In light of this, pursued transplant to crown at different center (for geographical/practical reasons) Was disappointed that rather than 1,500 or so grafts promised only 900 were done. Reason given was lack of scalp laxity. Multi unit hair grafts were used for a total of 4,500 hairs. Crown area is question was about 14 sq in (35 sq cm) My hair is somewhat coarse, not particularly fine. I’m not fair skinned. Was interested in your opinion as to what your best guess would be in terms of final density.
I am not here to “guess”. You have specific numbers and it is merely about doing the math.
It is worrisome how 900 grafts will total 4500 hairs. This equals 5 hairs per graft. This is highly suspicious since most people have an average of 2 hairs per graft.
Your 900 grafts in a 35 sq cm equals 26 grafts per sq cm. If you really have 4500 hairs in a 35 sq cm that would be 129 hairs per sq cm.
An average non balding scalp may have 100 grafts (200 hairs) per sq cm.
If you had a successful surgery with one doctor and had a disappointing experience with the second doctor, maybe you should follow up with the first doctor.
Recently, I’ve been worrying about my hair as I’m seeing more hairs fall out in the shower. The issue is that at least have these hairs are short (1 inch or less), thin and tapered at the end, not the root. My hair on my head in general does not look or feel any thinner but the amount of these types of hairs falling out is concerning me. Are these types of hairs an early symptom of balding? Thanks.
Male pattern balding (MPB) is a genetic trait. The hair loss is apparent from a certain “pattern” that develops. The morphology of hair may be an sign of hair loss as miniaturized hair is smaller in its diameter. However ALL of us (even those who are not balding) have miniaturized hair. It is part of the cycle of hair.
I am an African American woman and have braided hair…is it safe to use Rogaine on my scalp???
If you are losing hair, it would be advisable to find the cause for the hair loss before seeking treatment. Rogaine is a medication to grow hair. It does not matter if you are African American, a woman, or have braided hair. If you are concerned about hair loss, treatment options, or side effects associated with medications, please see a doctor.
Will Hair Grow Back When I Lose it From Stress and Diet Problems?
Sometimes yes and sometimes no is the answer. For those individuals who have genetic hair loss, these stress factors tend to accelerate a normal hair loss process which does not reverse once accelerated. In some people, a telogen effluvium starts which is reversible and in a few, this type of problem can be cyclical when hair loss and stress are related in non-genetic balding.
This is a note I sent to a patient I saw today.
You have had previous hair transplants done by a Los Angeles doctor who has since lost his license. You received 3400 grafts in the front of your head. You were very frightened about the prospect of being bald at that age of 23. Now you are 31 years old and started Propecia 4 months ago. You want to know the status of your balding situation.
Today’s we used the HAIRCHECK instrument on your head. Measurements indicated that you hair bulk in the frontal 3 inches of your scalp exceeds the hair bulk of the donor area by 30%. Comparing the crown and the back of your head, the measurements were comparable.
This tells me two things:
- You are not presently balding
- Your hair transplant done years ago was done on a young man that probably was not balding but driven to have a hair transplant out of fear of balding. Frankly, you were taken advantage of for the money. I am ashamed that doctors in this field would take advantage of your youth and naivety.You agreed with me that in hindsight, you were driven by fear, not balding
The good news is that you should stop the Propecia and if you are ever concerned again about balding (which I believe will be unlikely for your future), please come back and let me retest you with the HAIRCHECK instrument.
As a side note: I would agree to (1) help him file a complaint with the medical board if the doctor was still licensed in California and (2) I would put him in touch with a lawyer to facilitate a malpractice action against the doctor and act as an expert witness on his behalf.
A young woman wrote this a while back and this week, just four days before these pictures were taken, we moved her hairline back to her 15 year old concave hairline. This is the same hairline that my wife had done here over a year ago. This rounded frontal presentation is a classic female look.
Surgical Complications in Hair Transplantation: A series of 533 Procedures
- Sandro Salanitri, MD1, 5, , ,
- Antonio José Gonçalves, PhD2,
- Américo Helene Jr., PhD3, 5,
- Flavia Helena Junqueira Lopes4
Background
Surgical complications in hair transplantation can sometimes be a serious matter. Most of the published literature on this issue deals with individual case reports rather than larger series of patients.
Objective
The authors analyze complications in 425 consecutive patients undergoing 533 hair transplantations.
Methods
Patients with androgenetic alopecia (407 men and 17 women), cicatricial alopecia (9 men and 8 women), and malformations (1 man and 3 women) with a mean age of 36.9 years (standard deviation, 10.4 yrs) underwent hair transplantation between 1995 and 2006 and were followed up postoperatively for at least 1 year. Data on surgical complications were retrospectively analyzed.
Results
The overall complication rate in our series was 4.7%, including enlarged scar (1.2%), folliculitis (1.0%), necrosis in the donor area (0.8%), keloids (0.4%), bleeding (0.2%), hiccups (0.2%), infection (0.2%), and pyogenic granuloma (0.2%). The frequency of enlarged scar increased proportionally according to the number of surgical procedures.
Conclusions
The hair transplantation complication rate in this series was 4.7%. Good communication between patient and surgeon, a complete clinical and laboratory assessment of the patient, accurate surgical technique, specific equipment, a trained surgical team, and careful postoperative attention to the patient are crucial for successful hair transplantation and for decreasing complication rates.)
- DISCLOSURES
- The authors have no disclosures with respect to the contents of this article.
- Reprint requests: Sandro Salanitri, MD, Santa Casa São Paulo, Rua Cesário Motta Júnior, 112– Vila Buarque, São Paulo, SP 01221-020, Brazil
- 1
- Dr. Salanitri is from the Department of Surgery
- 2
- Dr. Gonçalves is Chief, Head and Neck Surgery Division, Department of Surgery
- 3
- Dr. Helene is Chief, Plastic Surgery Division, Department of Surgery.
- 4
- Ms. Lopes is a medical student at Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
- 5
- Drs. Salanitri and Helene are members of the Brazilian Society of Plastic Surgery.
Copyright © 2009 American Society for Aesthetic Plastic Surgery, Inc. Published by Mosby, Inc. All rights reserved.
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