Regular Clinic Hours
Monday - Friday: 9:00am - 5:00pm
Tuesday: 9:00am - 6:30pm
Saturday: 10:00am - 3:00pm
Fax: 408 996 0300
1471 Saratoga Ave., #200
San Jose, CA 95129
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Hair Loss Evaluation
Hair Loss Frequently Asked Questions
Hair is far more complex than it appears on the surface. We all know that it not only plays a vital role in the appearance of both men and women, but it also helps to transmit sensory information as well as create gender identification.
Hair has two distinct structures – first, the follicle itself, which resides in the skin, and second, the shaft, which is what is visible above the scalp.
The hair shaft is made of a hard protein called keratin and is made in three layers. This protein is actually dead, so the hair that you see is not a living structure.
Hair Growth Cycle
Hair on the scalp grows about .3 to .4 mm/day or about 6 inches per year. Unlike other mammals, human hair growth and shedding is random and not seasonal or cyclical. At any given time, a random number of hairs will be in one of three stages of growth and shedding: anagen, catagen, and telogen.
Anagen is the active phase of the hair. The cells in the root of the hair are dividing rapidly. A new hair is formed and pushes the club hair (a hair that has stopped growing or is no longer in the anagen phase) up the follicle and eventually out.
During this phase the hair grows about 1 cm every 28 days. Scalp hair stays in this active phase of growth for two to six years.
Some people have difficulty growing their hair beyond a certain length because they have a short active phase of growth. On the other hand, people with very long hair have a long active phase of growth. The hair on the arms, legs, eyelashes, and eyebrows have a very short active growth phase of about 30 to 45 days, explaining why they are so much shorter than scalp hair.
The catagen phase is a transitional stage and about 3% of all hairs are in this phase at any time. This phase lasts for about two to three weeks. Growth stops and the outer root sheath shrinks and attaches to the root of the hair. This is the formation of what is known as a club hair.
Telogen is the resting phase and usually accounts for 6% to 8% of all hairs. This phase lasts for about 100 days for hairs on the scalp and longer for hairs on the eyebrow, eyelash, arm, and leg. During this phase, the hair follicle is completely at rest and the club hair is completely formed. Pulling out a hair in this phase will reveal a solid, hard, dry, white material at the root. About 25 to 100 telogen hairs are shed normally each day
Hair loss is a big worry to many people, both male and female. If you have a worrying amount of hair in the basin after shampooing, you may think you are on the way to baldness. But this is not usually the case. The 50–100 hairs that everyone loses each day often become tangled with the rest of the hair, but are washed out when we shampoo. So we see what seems like a lot of hair in the basin after shampooing, but in reality these hairs have been shed earlier.
Norwood Hair loss Classification
NW2 – Receding Hairline
NW3 – Generalised Frontal Thinning
NW4 – Frontal area and Crown Balding
NW5 – Top of Scalp and Crown Balding
NW6 – Extensive Hair Loss
NW7 – Severe Hair Loss
ALOPECIA in women
Over 13% of pre-menopausal women report androgenic alopecia. However, this incidence increases more in women already in menopause.
The Ludwig Scale – for female alopecia
Causes Of hair loss
There are many causes of hair loss, but the main 4 that account for almost all types are
- Androgenetic Alopecia – known as Male pattern Baldness (MPB) – 92% of cases
- Telogen Effluvium – upto 3%
- Alopecia Areata – 1% to 2%
- Scaring Alopecia – 1% to 2%
Male Pattern Baldness (MPB)
Androgenetic alopecia or common male pattern baldness (MPB) accounts for more than 95% of hair loss in men. By the age of thirty-five two-thirds of men will experience some degree of appreciable hair loss, and by the age of fifty approximately 85% of men have significantly thinning hair. Approximately twenty five percent of men who suffer with male pattern baldness begin the painful process before they reach the age of twenty-one.
Contrary to societal belief, most men who suffer from male pattern baldness are extremely unhappy with their situation and would do anything to change it. Hair loss affects every aspect of the hair loss sufferer’s life. It affects interpersonal relationships as well as the professional lives of those suffering. It is not uncommon for men to change their career paths because of their hair loss.
MPB , is caused by the effect of the male hormones, called androgens, on genetically predisposed .
hair follicles (passed down the family tree). For those who are prone to hair loss, within these genetically programmed hair follicles the male hormone ‘testosterone’ is converted into the androgen ‘Dihydrotestosterone’, or ‘DHT’, by an enzyme called 5-alpha reductase. It is the effect of this DHT that inhibits the growth of new hair cells, which in turn leads to male hair loss and in many cases, eventual baldness
Common beliefs about hair loss – true or false?
Some hairstyles can cause hair loss
Styles that put tension on the hairs – such as tight ponytails, plaits or corn-rows – can cause hair loss. Winding hair tightly onto rollers (particularly heated rollers) can have the same damaging effect.
Hair extensions can cause hair loss
If not done properly. If the hair extensions are too tight, they can pull on the hairs and cause bald patches (which in severe cases could be permanent).
Brushing the hair 100 times a day will stimulate the circulation and prevent hair loss
Vigorous brushing is more likely to injure the hairs and make the problem worse.
Frequent shampooing makes hair fall out
Shampooing simply gets rid of the hairs that have already fallen out.
Blow-drying and heated brushes can worsen hair loss
The reason is that extreme heat damages the proteins in the hairs, making them fragile and liable to break off. Brushing the hair during blow-drying causes more damage. Careless use of heated brushes or heated hair straighteners can even burn the scalp, so that the hair follicles are permanently damaged in that area.
Protein-containing conditioners and shampoos nourish the hair and help it to grow
Protein-containing conditioners only temporarily fill in defects on the surface of the hair shaft, making it smoother and thicker.
Hair dyes, perms and hairsprays worsen hair loss
Hair dyes, perms and hairsprays do not affect thinning hair. Perms and hairsprays can help to disguise the problem.
If your father has a full head of hair, you will not go bald
A tendency to baldness is inherited and probably involves a combination of genes. So you are not automatically in the clear even if your father has a full head of hair. It is not true, as sometimes claimed, that only genes from the mother’s side are involved.
Stress can cause hair loss
Scientists have now identified some chemicals that are produced in the body during periods of stress, which can affect hair growth (Journal of Investigative Dermatology 2004;123:455–7).
It is normal to lose hair from our early 30s
A person aged 20–30 years typically has 615 hair follicles per square centimetre. The number falls to 485 by 50 years of age and to 435 at 80–90 years of age. Also each hair is thinner. So, with ageing, hair becomes both finer and sparser.
Hair Loss FAQ
- What are the reasons for male pattern balding?
Male pattern balding, or Androgenetic Alopecia to give it its medical name, is genetic and can be inherited from either parent. This condition makes some hair follicles susceptible to a hormone called dihydrotestosterone (DHT) which occurs naturally in our bodies. DHT molecules chemically bond with special receptor sites on hair follicle cells, causing the susceptible follicles to weaken or “miniaturize” and gradually produce thinner, finer hairs. Eventually, the affected follicles stop producing hairs altogether and die. When this happens the hair is lost forever. There is no cure for hair loss in men but there are solutions. Read more about hair loss and treatment options.
- Can you predict hair loss?
One cannot precisely predict hair loss. The best indicator is to make a comparison with an older male relative such as a father or maternal grandfather. Having said this, the gene for baldness may well skip generations and/or individuals in the same family.
- What is Androgenic Alopecia?
Simply put, androgenic alopecia is the common form of baldness that affects the majority of men and women. The incidence is thought to be higher in men than in women. This condition occurs in roughly 70% of men and 40% of women at some point in their lives.
Androgenic alopecia is a genetically determined condition. Only two drugs are approved today for the treatment of androgenic alopecia: minoxidil and finasteride, also known as Propecia. The prognosis for androgenic alopecia continues to remain unknown. Some patients even reach the point of losing all the hair on their scalp, whilst other patients mysteriously regain it. The women that suffer from this ailment most likely present a decrease in the hair’s density around the scalp, and not so much as a total absence of it, as it more often occurs in men.
- What are the causes of alopecia?
This genetically determined disorder is progressive by gradually converting mature hair into immature hair – velus. Patients have a mature hair reduction ratio: velus, which is normally 2:1. Following the miniaturisation of the hair follicles, only the fibrous tracts remain in their place. Patients with this disorder typically show a pattern of hair loss.
- Why Am I Losing My Hair?
There are a number of causes of hair loss. Androgenetic Alopecia (AA) is the most common cause of hair loss. It is genetic and can be inherited from the mother or father. In AA, DHT (a testosterone derivative) attacks hair follicles, resulting in miniaturization and alopecia.
Hair loss is progressive throughout our lifetimes. In certain areas of the head, the cells around hair shafts have more 5-alpha reductase (the enzyme that makes DHT). As a result, these areas have more DHT and generally demonstrate greater loss.
Hair transplants, sometimes called hair grafts, can give you years back on your appearance. Male Pattern Baldness or Female Hair Loss needn’t be a concern any longer. Using modern hair transplant and non-surgical solutions, we’ve created beautiful heads of hair for our male and female clients.
- I See Hair in the Shower Every Day. Is That Normal?
There are 100,000 hairs on the average head of hair. Hair cycles between growth and resting phases. In the normal head, 100-150 hairs enter a resting phase and fall out every day. The vast majority will begin to grow back in three to four months. This should not create anxiety as it is a normal function and not normally noticeable. In fact, your grafts will also cycle like all normal hair.
Hair loss medication alone may help your thinning hair, but our experts can help you make the decision that is right for your particular hair loss pattern.
- Does a Transplant Prevent Hair Loss?
No, a transplant will not prevent further loss. We consider this when planning a surgery. You can decrease the rate at which you lose hair by taking non-surgical hair loss treatment such as medication or laser therapy.
- How Do I know if I am a Good Candidate for a Hair Transplant Procedure?
Most men and women in good general health are candidates for hair transplantation. In order to accurately determine your suitability (based upon degree of hair loss and hair type), a complimentary private consultation is recommended.
During a consultation you will receive a thorough examination of your scalp and hair to determine donor density, scalp laxity and the requirements for restoration. Your suitability for a transplant procedure also takes into account your individual hair characteristics including colour, texture, and curl to develop the right hair restoration treatment plan.
- What causes hair loss in women?
Female hair loss is a distinctly different entity from male pattern hair loss which has a known cause and usually follows a predicable path. Though some women experience hair loss that resembles male patterned loss, others experience diffuse loss that involves the entirety of the scalp. Such individuals are not candidates for surgical hair restoration in that they do not possess an uninvolved area of hair from which to obtain hair for transfer.
Other causes for hair loss in women range from medical conditions associated with hair loss such as anaemia, hypothyroidism and connective tissue diseases to adverse reactions to medications or deleterious effects of certain grooming practices e.g. tight braiding of the hair which causes traction alopecia.
- Who is a Candidate for a Hair Restoration Procedure?
There are many factors in assessing an individual’s candidacy for hair restoration and so the answer to this question can only be determined in a private consultation with a hair expert well versed in the surgical and non-surgical management of hair loss.
Not everyone with hair loss is a candidate for hair transplantation though the vast majority of men and a smaller but significant majority of women are good candidates.
A consultation will include thorough examination to analyse your type and degree of hair loss. At the conclusion of this complimentary consultation advice will be provided outlining medical and surgical options.
* All patients are actual patients of our practice who have provided consent to display online. Readers should understand that results do vary and not all individuals achieve the results depicted here.
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