Q: How common is hair loss in adult men and women? — N.F., Bronxville, NY
A: The incidence of androgenetic alopecia (common baldness) is quite high for both men and women. By age 50, 50% of men and 30% of women are affected. By age 70, that increases to 80% of men and 60% of women. Fortunately, in spite of significant thinning, women often preserve their hairline and have a diffuse pattern, so their hair loss can be camouflaged for many years.
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Researchers at the University of Pennsylvania, who were investigating the biological causes of androgenetic alopecia or common genetic hair loss, have discovered that levels of a certain inhibitor protein, called Prostaglandin D2 (PD2), are elevated in bald areas on the scalp. This discovery could be an important breakthrough in developing a medical hair loss treatment that regulates the production of the protein, or one that blocks it from attaching to its receptor protein.
Prostaglandins are a family of proteins that have a wide range of functions, including controlling cell growth and constricting and dilating muscle tissue. According to an article in ScienceDaily, the researchers had previously found evidence that something was inhibiting hair growth, but they did not expect to find prostaglandins involved in the miniaturization of hair follicles:
In men with androgenetic alopecia, Prostaglandin D2 was found to be three times higher in bald scalp tissue versus areas of the scalp with hair. Additionally, when hair follicles in a laboratory culture were treated with PD2, the hairs were significantly shorter than non-treated ones. A derivative of PD2, called 15-dPGJ2, was found to completely inhibit hair growth.
The receptor protein that is active with both prostaglandins, called GPR44, may hold the key to limiting the effects of PD2 and, therefore, in regulating hair loss in both men and women. While the study looked only at men, the GPR44 receptor protein exists in women as well. So, theoretically, a topical hair loss treatment may be developed that would prevent or limit thinning or hair loss in both sexes.
Posted byDr. Robert M. Bernstein, pioneer of the follicular unit transplantation and follicular unit extraction hair transplant procedures, was selected as one of New York metropolitan area’s top physicians.
New York, NY — Robert M. Bernstein, M.D., F.A.A.D., world-renowned pioneer of the Follicular Unit Transplantation and Follicular Unit Extraction hair transplant techniques and founder of Bernstein Medical – Center for Hair Restoration, was included in New York Magazine’s Best Doctors issue for the twelfth consecutive year.
Dr. Bernstein, a Clinical Professor of Dermatology at Columbia University in New York, said that he is honored to be recognized again for the Best Doctors issue. He said, “My inclusion in the Best Doctors issue for the twelfth year in a row is a testament to the hard work and dedication of my staff, our consistently high quality of care, and our passion for treating patients who are struggling with hair loss.”
The New York Magazine Best Doctors issue is an annual compilation of physicians that is based on a peer-review survey conducted by Castle Connolly Medical Ltd., a research company that publishes Top Doctors: New York Metro Area. Each year, medical professionals in the New York metropolitan area nominate their choice of the best doctors in a field. The physicians make their recommendations based on several criteria including: professional qualifications, reputation, skill in diagnosis, and skill in providing treatment for patients.
Dr. Bernstein, a New York native, is a true innovator in the field of hair restoration. His medical publications on follicular unit transplantation (FUT) and follicular unit extraction (FUE) have revolutionized hair transplantation and provide the foundation for techniques in use by hair transplant surgeons across five continents. His medical practice has been solely devoted to the treatment of hair loss since 1995 and he has provided hair loss treatments and hair restoration surgery at his state-of-the-art hair restoration facility in New York City since 2005. The Bernstein Medical – Center for Hair Restoration, located in midtown Manhattan, is dedicated to the diagnosis and treatment of hair loss in men and women and specializes in both restorative and corrective hair transplants.
Dr. Bernstein has appeared on a wide variety of notable media programs and publications. Some of these include: The Oprah Winfrey Show, The Dr. Oz Show, The Today Show, Good Morning America, ABC News, CBS News, Fox News, National Public Radio, New York Times, Men’s Health Magazine, GQ Magazine, Univision, Telemundo, “O” the Oprah Magazine, and more. He is co-author of Hair Loss & Replacement for Dummies and The Patient’s Guide to Hair Restoration.
Posted byQ: I have been on finasteride for about 7 months. After my latest haircut I can see that my scalp is shiny. I read that is from sebum buildup and it can cause a layer that clogs the growth of hair. I was wondering if this is true and, if so, how can it be treated? — T.C., Philadelphia, PA
A: It is not true. Hair loss is caused by the miniaturizing effects of DHT on the hair follicle, not by blocked pores.
For more on this topic, view our pages on the causes of hair loss in men or the causes of hair loss in women.
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Men’s Health has published a new spotlight, called “Hair Health.” The multi-article spotlight is featured on the magazine’s website homepage and covers a wide variety of topics related to men’s hair loss and hair transplant surgery. Dr. Bernstein was asked to contribute to the series of articles, including an “expert advice” feature which answers five commonly-asked questions about hair loss myths.
The centerpiece articles in the spotlight include the article, “Scalped,” which details the best treatments for hair loss in men, and, “Keep Plugging Away,” about best-practices on finding a great doctor who can treat your hair loss.
In “Scalped,” Dr. Bernstein speaks to the urgency of halting your hair loss using Propecia and Rogaine, while he cautions younger patients on the side effects of the drug Dutasteride:
“Start [Propecia and Rogaine] as soon as your hair begins to thin for the best results.”
[…]
“The reproductive side effects [of Dutasteride] — decreased libido and ejaculation disorders — may be persistent, so I don’t usually recommend this medication for younger patients.”
On hair transplantation, Dr. Bernstein says:
“Hair transplants are most appropriate for people who have not responded to medical treatments.”
“Keep Plugging Away,” centers on hair transplant surgery and the repair of hair transplants that used out-dated, large, “pluggy” hair grafts. Dr. Bernstein – the hair transplant physician most responsible for the new pioneering techniques of follicular unit transplantation and follicular unit extraction – had this to say about hair transplant repair:
“Reversing the unnatural appearance of older plugs is more involved than using the right technique in the first place,” he says. “But in most cases, it can be accomplished with excellent results.”
Visit the “Hair Health” feature online at MensHealth.com.
Posted byDr. Robert M. Bernstein, founder of Bernstein Medical – Center for Hair Restoration, was selected by Castle Connolly as one of the New York metropolitan area’s top physicians through a peer-review survey of medical professionals.
New York, NY — Robert M. Bernstein, M.D., F.A.A.D., world-renowned pioneer of the hair transplant techniques, Follicular Unit Transplantation and Follicular Unit Extraction, and founder of Bernstein Medical – Center for Hair Restoration in Manhattan, has been included in New York Magazine’s “Best Doctors” issue for the eleventh consecutive year.
Dr. Bernstein, a Clinical Professor of Dermatology at Columbia University in New York, said he was honored to be chosen by his peers for the magazine’s special annual issue. He said, “It is a privilege to be involved in the care of treating patients struggling with hair loss and an honor to be recognized by my peers for contributions that I have made to the rapidly evolving field of surgical hair restoration.”
Dr. Bernstein has performed hair transplant surgery at his state-of-the-art Center for Hair Restoration in New York City since 1995. The practice is solely devoted to the diagnosis and treatment of hair loss in men and women and specializes in both restorative and corrective hair transplants.
The list of physicians in the Best Doctors issue is based on an annual peer-review survey conducted by Castle Connolly Medical Ltd., a research company that publishes Top Doctors: New York Metro Area. Each year, Castle Connolly distributes 12,000 nomination forms to medical professionals in New York metropolitan area. These medical industry peers are asked to nominate their choice of best doctors in a particular field and to take into account not only professional qualifications and reputation, but also skill in diagnosing and treating patients.
Dr. Bernstein has appeared on such notable programs and channels as The Oprah Winfrey Show, The Dr. Oz Show, The Howard Stern Show, The Today Show, Good Morning America, ABC News, Fox News, Discovery Channel, and National Public Radio. He also appeared in New York Magazine’s special issue Best Beauty Docs in New York, where he was included for his pioneering work in Follicular Unit Transplantation and Follicular Unit Extraction. He is co-author of Hair Loss & Replacement for Dummies: The Patient’s Guide to Hair Restoration, and numerous medical publications.
Posted byQ: Why is hair loss in women harder to treat with hair transplants than hair loss in men?
A: The majority of women present with diffuse hair loss (i.e. thinning all over) rather than the patterned hair loss seen in men (where the hair loss is localized to the front and top of the scalp).
Diffuse thinning presents two problems for a potential hair transplant candidate.
The first is that there is no permanent area where the hair can be taken from. If hair is taken from an area that is thinning, the transplanted hair will continue to thin after the procedure, since moving it doesn’t make it more permanent.
The second problem is that since the areas to be transplanted are thin, rather than completely bald, the existing hair in the area of the hair transplant is at some risk to shedding as a result of the procedure.
When women have a more defined pattern (i.e. more localized thinning on the front part of the scalp with a stable back and sides), they can make excellent candidates for surgery. This pattern occurs in about 20% of women. A small percentage of men have diffuse thinning and are, therefore, poor candidates for a hair restoration surgery as well.
Posted byQ: Have there been any studies showing the difference between men and women in their response to laser treatments for hair loss?
A: In the International Journal of Cosmetic Surgery and Aesthetic Dermatology (Vol. 5, Number 2; 2003), a study on low level laser therapy (LLLT) was conducted which indicated that there was a 55% increase of growth (hair count) in the temporal area as well as 64% in the vertex of the female subjects who were treated with LLLT for hair loss. The study also indicated a 74% increase in the hair counts of the male subjects in the temporal area and 120% in the vertex region. These results would initially indicate that LLLT works better in men than in women, but there were four times as many men in this study so the results might be different in a larger test group.
However, even in this notably smaller female group, the tensile strength of the hair increased dramatically over the tensile strength observed in the male subjects after treatment. This would indicate that, at least in this study, there was not only an increased hair count in women, but the tensile strength of that hair was greatly improved as well. This would be initially indicative that LLLT may be found to be more beneficial to women than to men.
It is important to note that this study was published in 2003. Further studies need to be conducted to confirm the initial results and to further elucidate the possible mechanisms of low level laser light therapy in both men and women with alopecia. As important, long term data needs to be accumulated to show the continued efficacy of this treatment. It had been our clinical experience that LLLT is not as effective as one would assume from the results of the initial studies.
Visit the page on Laser Therapy for more information, or read more answers to questions about laser therapy.
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Hair Transplant Surgeons Author Hair Loss for Dummies Book
An authoritative guide explaining the causes of hair loss and the newest ways to treat it.
New York, NY (PRWEB) December 1, 2008
Renowned hair restoration surgeons Robert M. Bernstein, M.D., F.A.A.D., and Dr. William Rassman, have co-authored the first authoritative, but user-friendly guide, to help both men and women understand hair loss, its prevention, and their medical and hair transplant options. The book, published by John Wiley & Sons, Inc., is set for a December 3 publication date. Titled Hair Loss & Replacement for Dummies, the book follows in the tradition of the other informative books in the popular For Dummies series.
Dr. Bernstein is the author of numerous medical publications on hair restoration, which can be found at www.bernsteinmedical.com.
Those who follow the current trends in hair restoration and hair transplant procedures know Dr. Bernstein for his pioneering work in the development of the Follicular Unit Transplantation procedure which has revolutionized the treatment of hair loss. Recently awarded a certificate of achievement from Columbia University, he has been named one of New York Magazine’s “The Best Doctors in New York” for the ninth consecutive year.
“Dr. Rassman and I felt it was necessary to write this book because we wanted to dispel many of the myths about hair loss and give men and women basic, easily understandable information about their hair loss,” Dr. Bernstein explained. “We feel that this book will provide men and women suffering from common baldness and other types of alopecia with the tools necessary to make informed decisions about their condition. There are a lot of options when it comes to the treatment of hair loss and we want to make certain that consumers are making the decisions that are the best fit for them as individuals – whether it is medical therapy or a hair transplant.”
In addition to providing readers with information about the latest trends in hair loss medications and hair transplants, the book also aims to caution against potentially harmful products that are currently on the market for treating hair loss. Finally, the text also gives tips for maintaining a healthy head of hair: from washing and drying correctly, to caring for children’s hair.
About Dr. Bernstein
Dr. Bernstein is Clinical Professor of Dermatology at the College of Physicians and Surgeons of Columbia University in New York. He achieved worldwide recognition for pioneering Follicular Unit Hair Transplantation. He is founder of Bernstein Medical – Center for Hair Restoration in Manhattan which is devoted to the treatment of hair loss using his state-of-the-art hair restoration techniques.
Dr. Bernstein has been chosen as one of “America’s Top Doctors,” by Castle Connolly Medical and New York Magazine’s “The Best Doctors in New York” for nine consecutive years. He has been selected to be among New York Magazine’s “Best Beauty Docs in New York” for his pioneering work in Follicular Unit Transplantation and Follicular Unit Extraction and is the most widely published author on these subjects. He is the founder of Bernstein Medical -Center for Hair Restoration in New York City (www.BernsteinMedical.com).
About John Wiley & Sons, Inc. /For Dummies Series
John Wiley & Sons, Inc. was founded in 1807 during the Jefferson presidency. In the early years, Wiley was best known for publishing the works of Washington Irving, Edgar Allan Poe, Herman Melville, and other 19th-century American literary giants. By the turn of the century, the company was established as a leading publisher of scientific and technical information.
In recent years, Wiley has focused its efforts on delivering its deep reservoir of “must-have” content to global communities of interest, forming collaborative relationships with such significant partners as Dow Jones/Wall Street Journal, CNBC and PricewaterhouseCoopers, among others. In 2001, Wiley acquired Hungry Minds, Inc., including the latter company’s wildly popular For Dummies series of books. Cleverly written, packaged and marketed, all For Dummies books utilize a lighthearted approach and down-to-earth style (often including cartoons and humorous icons) to dispel fears, inspire confidence and educate the public. For more information on John Wiley & Sons, Inc., visit wiley.com.
For further reading see the Hair Loss & Replacement for Dummies summary, the transcript of an interview with Dr. Bernstein about the book, or purchase the book at Amazon.com.
Posted byQ: I’m 52 years old and have been taking Propecia (finasteride) for two years. It seems to maintain the status quo with no apparent regrowth. I am considering adding a dose of Avodart (dutasteride) once a week in conjunction with the daily Propecia. My question is twofold: (1) Since dutasteride blocks production of both enzymes (type I and II) that produce DHT from testosterone, is it redundant to take the finasteride that only blocks the type I enzyme? — Y.B., Orlando, Florida
A: It is redundant to take both.
However, you may not be taking the optimal dose of dutasteride which seems to be at least 0.5mg a day for hair loss.
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NY Japion — a weekly newspaper in the Japanese language, published in the New York tri-state area, and distributed for free in the Japanese community — has featured Robert M. Bernstein, MD, in their series on hair loss in men and women. In the series, TV producer, Hideo Nakamura, who is bald himself, goes on a mission on behalf of fellow bald men. His column hopes to help others with hair loss to have a more fulfilled, fun life and to raise their self-esteem.
Nakamura interviewed Dr. Bernstein for this weekly series that began in October 2006. In issues No. 1 and 2, Dr. Bernstein explained the basic mechanism of balding for both men and women which are quite different in its causes, balding types, and progression of hair loss. The NY Japion’s readers were all very surprised by the fact that balding for men is actually related to genes on both the mother’s side as well as the father’s side of the family. Dr. Bernstein also shared his unique theory of why Japan’s Samurai had the uniformed bald look.
The column discussed post-op care after hair restoration surgery and explained the drug Propecia, a men’s oral hair growth treatment, minoxidil and some cosmetic hair products.
Reporter Nakamura was also examined by Dr. Bernstein and with the patient’s permission was allowed to observe a hair transplant surgery. Issues No. 3, 4, 5 are about the surgical hair restoration procedure known as Follicular Unit Hair Transplantation (FUT), a method that Dr. Bernstein helped to pioneer. By using the patient’s own hair, FUT can give totally natural looking results. The patient’s own hair starts growing where there was no hair before.
You can download a PDF version of the original series (in Japanese) at the link below:
Q: I was told that if men have a lot of testosterone that that’s when they lose hair. Is this true? — Y.B., Lake Forest, Illinois
A: Although androgenetic hair loss is dependent upon normal levels of testosterone, it is not due to increased testosterone. It is caused by a sensitivity of the follicles to normal levels of testosterone.
So someone that is bald doesn’t have extra levels of male hormones and is not necessarily over-sexed.
Posted byQ: Dr. Bernstein, a lot of older women are taking testosterone to restore libido, but are they going to experience hair loss as a consequence?
A: They can. In women there is a delicate balance between the androgens, i.e. testosterone and estrogens. Estrogen is protective to some degree against hair loss in women, which is why most women don’t experience such severe hair loss as do men.
When a woman takes testosterone supplements it upsets that balance and can cause hair loss. However, hair loss in post-menopausal women is usually due to age related changes. Typically, the hair decreases in size in a genetically determined progression that seems not to be directly related to changes in the levels of hormones.
For more information, please see the Causes of Hair Loss in Women page on the Bernstein Medical – Center for Hair Restoration website.
Posted byQ: Why do some people have a full head of hair into their seventies or eighties and others start to go bald in their late teens or early twenties?
A: The cause is genetic and this poly-genetic trait can be inherited from the mother’s side, the father’s side, or both.
There is an old wives’ tale that it is inherited only from the mother’s parents. Although the inheritance can come from either side, it is actually greater from the mother’s side – but only slightly.
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