15 Year Old Female with High Hairline

Im fifteen years old with a weird high hairline. It is goes into an ‘n’ shape like my hairline is receding. I’ve been made fun so much and I need to find a surgery quick!

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There is never a ‘quick’ answer for a 15 year old. If you are like my daughter was in her teens, yesterday is never soon enough, but if you have a high hairline, it can be treated (see previous blog answer on this subject in High Hairlines in Women). If you bring your parents in to a competent plastic surgeon’s office or a hair specialist like me, we can discuss what can and should be done to deal with your concerns. At the same time, a specialist’s opinion is valuable in itself.

Am I a Female Hair Transplant Candidate?

I have MPB running rampant in my family. I am a 42 yr old female who is experiencing diffuse shedding mostly in the summer months. It seems to let up after that. I have noticed an overall change in texture from when I was in my 20’s & 30’s and also it’s not as thick (# of hairs total) by maybe 25% or so.

I heard females weren’t as good of candidates as men since the thinning is diffuse therefore hair taken from a donor site might also thin eventually. That said, what female would be a good candidate for transplantation if any? I’m not a supporter of any drug. Your comments & info?

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Humans as a general rule, have asynchronous hair loss (not tied to seasonality) but that rule could vary for you. Hair transplants in women should be confined to women who have a healthy donor area (enough to supply the need), localized hair thinning or loss, or those that have hair loss from other causes such as traction alopecia (common in black women who had their hair pulled very tight when they were children), hair loss from cosmetic surgery, etc…

You need to have a doctor who is ethical and can judge the value of a hair transplant for you. I generally do not recommend hair transplants for about 80% of women because they do not fulfill the above criteria. What is important to me is that if I recommend a transplant, then I would want the patient to be happy and meet realistic expectations. It is the doctor’s responsibility to set those expectations properly.

Transplants Growing In (with Photos)

A picture is worth 1000 words, and this nice patient of mine agreed to share his 4 month growth with everyone on this site. His business colleagues watch him daily and with the gradual growth of the transplanted hair, nobody has noticed anything unusual over these past 4 months. In the coming months, the hair will continue to grow and thicken, but because I’ve received quite a few emails asking what a transplant looks like as it grows in, I wanted to show this patient.

The “before” photo on the left was taken in May, and his “after” photo on the right was taken in September. He had 2,189 grafts transplanted. Please remember, this is only 4 months after the procedure and some of the hair has grown while other areas look like he is balding. Slowly over the next few months, the open areas will fill in continuing the gradual transition from a bald front to a non-balding frontal view. While it is growing in, if notice at all, it will look like the patient is losing hair, but day by day and week by week, the patient will be looking less thin. After 8 months, one can expect 80% of the growth and in 12 months, this patient will have over 90% of the results visible.

For more information about the post-op timeline, please see Post-Op Course in Follicular Unit Transplantation.



Crown Transplants or Propecia?

Here is an example of a patient of ours who refused to take Propecia, but had 2,027 grafts transplanted in 2001. He had a remarkable change from the transplant, even filling in some of the upper part of the crown. At his recent visit a few days ago, I suggested again, that he try Propecia before undergoing a hair transplant, even though his results from the single procedure he had was remarkable. Much of the original hair in the upper crown that he had a few years ago, fell out. But even if the transplants still saved the day, he may have avoided the loss with Propecia.

Why would I suggest Propecia rather than transplants? First, I tell my patients that I make my living doing transplants, so if I recommend the drug approach rather than a transplant, I must be thinking of something other than the money I might make from the transplant. The answer should be obvious to the readers. I care about what is best for the patient. The drug, in many patients, will postpone or make transplants unnecessary. If this man succeeds at regrowing hair in the crown with Propecia, he will avoid surgery, saving money and donor hair for some time down the road when/if he might need it. A doctor should always put his patient’s interest first and foremost and if this young man was my son, that is what I would recommend for him. If the drug does not work, then a transplant is a reasonable option. He should wait for 8 months before facing that decision again. He was very appreciative.

Below: His “before” photo in 2001 is on the left, and “after” photo in 2005 is on the right.



Prednisone and Hair Loss in Women, Follow Up

Hi,
I am currently on prednisone and have been taking 40 mg for many months now on 30mg. I was told by my doctor that my hair loss, since July, is due to the meds. But, it is stated here in the site that this drug only impacts men w/hair loss and women. Please clarify this for me. Is there a small percentage that lose hair on this drug ?? I may be on it for a few more months and need to know this. Also if I am correct , if it’s the drug than once off it than hair would grow back and be back fully in a yr or so ??
thanks

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Steroids, as you said, do precipitate hair loss in men. Women also have some male hormones, so I would suspect that there could be some association with hair loss in your situation. The reality is that you need them for medical purposes. Women rarely have permanent hair loss and usually reverse once the offending problem that created it is gone. That goes for stress, cancer drugs, and other types of processes that precipitate hair loss in women.

Another Steroids and Hair Loss

I took a steroid and my hair is falling out. I stopped it in about a month, but it is still falling out. I have been on Propecia for a few years so I thought that would protect me. What will happen to me? Have I messed up my hair?

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You probably precipitated what we call a telogen effluvium, which can be caused by steroid use. Once this begins there is nothing that will reverse it until it goes its course. I always tell my patients that although Propecia may protect you somewhat, it is not a sure thing when you take steroids. I would strongly suggest that you continue with the Propecia. As the hair loss may take months to go its course, stay on the Propecia and wait it out. See your hair doctor as well, so that good baselines can be taken to compare with what will evolve over time. By having measurements to compare, at least you will know when the process has stopped, when it reverses, and what to expect. Advise your friends not to do what you did, so that you can help someone else avoid the problem you had.

Another Hair Loss Following Pregnancy

I have experenced hair loss after each one of my pregnecies. I have three kids,while I was pregnant my hair was fine. I have seeked medical advise, I was told stop having kids. Can you tell me if hair loss after pegnancy will ever correct itself, in other words will it grow back?

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Some doctor’s amaze me with ridiculous comments like, “Stop having kids”. Hair loss with pregnancy is common and most women who experience it, like you, will see the process reverse within the first year after birth of the child. Have as many kids as you want. The hair loss, unfortulately, may recur with each pregnancy on a non-permanent basis, unless you have genetic female balding.

I answered a similar question about a week ago, found here.

Hair Obsession

i have had a full head of thin, wavy hair most of my life, and am now 53 years old. I had some loss many years ago from using alcohol based mousse, and had one transplant(okay). Recently, I had some hair color (nasty alcohol based stuff from Walgreen’s)in my hair for Halloween 2004. Anyway, I left it in for a day(extremely stupid), and then had several weeks of an itchy scalp in December, which I treated with tea tree/jojoba oil. I noticed some hair loss in January, had 1000 grafts put in and now I just had another ” greater loss” bout in July and August of this year, which I am extremely unhappy about. I now have a minor tingling on the left side of my frontal area, and I am extremely parnoid I am losing more. I am using tea tree oil shampoo/conditioner. I went to back to the doctors who did my transplants, who told me I would look worse if I had not been given the 1000 grafts, which I have a hard time seeing where they are.(as some were supposed to be put in the area that has receded!)I asked to possibly get my old hairline back, and the doctor said that only celebrities and media people only wanted a “1”, and now me. They offered to put in another 1000 grafts for $4/graft, but I want an effective job this time, asI do not have unlimited donor area. The more I think about it, the more I am insulted. The doctor said I had no infection/disease in the scalp. I want more work, but done right. PLEASE, PLEASE ADVISE.

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You are hair obsessed. Please don’t take this comment the wrong way, but you are probably causing your own problems because of this obsession. I too would be insulted if the doctor who precipitated reactive hair loss with the second transplant (that is what it sounds like), told me that I needed another one at a discounted price to solve the failure of the last transplant (which was supposed to solve your problem). Sounds more like a huckster is playing you for your hair obsession and selling you hair like you needed a new car.

On this blog, I often say that you need to have a good doctor make an assessment of what is really happening to you. This is a buyer beware field and it is easy to sell hair to a hair obsessed person like you. I am not saying that you did not need a hair transplant, but it sounds like you were not clearly informed of what you were buying into. I often take a stand against transplants when I am not convinced that hair transplants will address the problem. I am rarely wrong but some of the patients who I turn down just go to another doctor who might be enthusiastic to take his money. Talk to a good doctor, not a huckster and find out what happened and what is going on with your hair problem.

Lowest Donor Density?

What is the lowest donor density a person can have in their late twenties, in order to have a successful transplant?

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There is no simple answer to this question on donor density. First, I would want to make sure that the person should not have Diffuse Unpatterned Alopecia, which would reflect a depletee donor area in a young man (1-2% of the male population). Then, the size of the balding area (the area of the demand) and the eventual pattern of balding that would have to be maintained must be balanced in a well defined master plan with a worse case scenario put together. A good doctor can make a judgment on the value of the donor density.

Propecia Allergy?

I have been taking Propecia for about two years. It has always worked fine until roughly six months ago when certain side effects began to appear. My lips were swelling quite frequently and I would get hives on my body. I was able to combat this with a daily dose of claritan. I am worried though that these effects could be dangerous to my body, even though the hives never appear while taking claritan and the lip swelling is only a few times a month at most. Also, I was curious to know if there is any correlation to these side effects and the ineffectiveness of propecia. I have noticed an increase in hairloss over the past six months, but still nowhere near as bad as before I went on the drug. Any light you could shed on this matter would be great. Also, I thought I would add that I have experienced no sexual side effects.

Thanks

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You need to have a good dermatologist take a look at you. Although some of the symptoms are reflective of a drug allergy, you may also have some other medical problem. Don’t play doctor. There is an old adage: a person who treats themself has a fool for a doctor. Adhere to good common sense and have a professional look at you.