Female hair loss is one of the focuses of our hair loss clinic in Orange County. I have been asked this women hair loss question over and over about alopecia areata hair loss disorder during pregnancy in our Los Angeles hair transplant and Orange County hair restoration clinics. Here is another hair loss question on alopecia areata during pregnancy. One of my patients from our Los Angeles – Orange County hair transplant said that she was diagnosed with Alopecia and lost pretty much all of her hair during pregnancy. Her son is now 5 months old and her hair has grown back. All but one spot. She said that she could hide the balding spot, but I would love for one day not to have to hide it.
My patient has experienced extensive alopecia areata, but she got her hair back after only a few months. This is a pretty good recovery for a condition that could have lead to a much worse outcome. My suggestion to this patient was to be patient and to hang in there. It is very likely that this patient can grow the rest of her hair back without any hair loss treatment. If her hair loss was due to alopecia areata, a hair transplant cannot help her balding condition. However, she would need to be seen and examined by a hair specialist to confirm the diagnosis of her hair loss condition properly.
Women can see hair loss during or after pregnancy. Women who experience hair loss after pregnancy may lose hair due to a condition called telogen effluvium that should not be mistaken with other hair loss disorders. Telogen effluvium is a common cause of hair loss in women after delivery of a baby or some other conditions.
28.12.08
14.5.08
Hair Loss CCCA(Alopecia)
Hair loss or Alopecia, which means hair loss, is of epidemic proportion for many women of color. Although there have been magazine articles and television segments about alopecia, it continues to be poorly understood by many women. There are many different causes of alopecia that affect women with brown skin. However, there are two types of hair loss that women with curly or tightly coiled hair are plagued with: central centrifugal cicatricial alopecia (Figure 1 and Figure 2)
Alopecia is a devastating condition for all women, despite the cause. All women want to have their own healthy hair. Hair loss effects self-esteem, social interactions and relationships.
Central centrifugal cicatricial alopecia (CCCA) was previously called follicular degeneration syndrome or hot comb alopecia. CCCA is a form of hair loss that has the following features:
* Central (crown) portion of the scalp is were the problem begins
* Centrifugal (circular) pattern is the outward pattern in which this problem progresses
* Cicatricial (scarring) of the hair follicles occurs
* Alopecia (hair loss) is progressive
With CCCA, the hair loss may appear suddenly and progress relentlessly (Figure 3). It occurs in women of all ages, from as young as 20 to as old as 60. The cause of CCCA is unknown but it is felt to be related to repeated and frequent but unnoticed damage to the hair follicles. There may be a hereditary component to CCCA and for Black and some Latina women, a combination of hair care habits and practices may cause or contribute to the condition. Some dermatologists theorize that the following factors may play a role in the cause or CCCA:
* Genetics
* Hot combing (microscopic droplets of hot hair oil drip onto and damage the hair follicles)
* Chemical relaxing (the severe tingling and burning that occurs when the application directions are not followed may produce inflammation and destruction of the hair follicles)
* Tight rollers or curlers used to set the hair (the chronic pulling or traction of the hair may produce inflammation and destruction of the follicles)
* Braids with extensions or weaves to style the hair (the chronic pulling or traction of the hair may produce inflammation and destruction of the follicles)
* Blow drying (excessive heat applied to the scalp and hot oil droplets may destroy the follicles)
* “Oiling or greasing the scalp” (may block the follicles and cause inflammation in the follicles)
Once the hair follicles become damaged or destroyed, scar tissue (cicatrix) forms and hair will never regrow. Therefore, if you suspect that you may have CCCA, it is important to see your dermatologist immediately. An evaluation by the dermatologist will include blood tests to eliminate other causes of hair loss and a scalp biopsy. A scalp biopsy is a simple procedure in which a small area of the scalp is removed after numbing medication is administered. A stitch is then placed to close the areas. When the biopsy is analyzed by the pathologist, features typical of CCCA may be seen: a decrease or absence of hair follicles, scar tissue formation and inflammatory cells surrounding the hair follicles.
Treatment
Since dermatologists do not know the exact cause of CCCA, outlining a treatment is difficult. The first step is to stop any styling practice that may be causing or contributing to the hair loss. Often that means no hot combs, no tightly applied rollers or braids, blow drying or relaxers for a period of time. If the hair follicles have not been damaged beyond repair, you may, for example, be able to resume your hair care practices but with modifications. Your dermatologist can help you determine when—and if—you can resume these styling practices. Taking a break from harsh styling and substituting gentler techniques may allow the inflammation to resolve, the scalp to heal and hair growth to resume.
Your dermatologist may prescribe medications to decrease the inflammation that is seen in the hair follicles of those affected by CCCA. Oral or topical antibiotics are sometimes prescribed because they help to reduce inflammation. Likewise, topical cortisones applied to the scalp or cortisones directly injected into the scalp may also be used to treat or reduce scalp inflammation. Finally, once the inflammation is minimized, your dermatologist may recommend over-the-counter Minoxidil (Rogaine) to stimulate grow of follicles that have not been destroyed.
With severe CCCA (Figure 4), the hair follicles are destroyed and neither topical or injected medications will help the condition. Hair transplantation may be a solution for some women although the severe scarring may make this procedure technically difficult.
Sometimes CCCA is confused with the hereditary form of alopecia, called androgenic alopecia. This form of alopecia is also characterized by thinning in the central portion of the scalp with extension toward the hairline. With androgenic alopecia, the underlying scalp appears normal and the follicles are not scarred. Therefore, there is a greater likelihood that hair will regrow. The over the counter medication, Minoxidil (Rogaine), may help improve the particular condition.
Bottom line
CCCA is a devastating condition for women with brown skin and the best chance of reversing the process and restoring hair is early diagnosis and prevention. Therefore, it is important to see a dermatologist who is knowledgeable in tightly coiled or curly hair at the first sign of hair loss.
Traction Alopecia
Traction alopecia is hair loss that occurs as a result of continuous pulling of the hair. Pulling may occur from hairstyles such as tight cornrows or braids, weaves, ponytails or even hair rollers or curlers. Traction alopecia may also be due to excessive weight from long extensions or locks. Signs that the hair is being pulled too tightly are difficulty moving your forehead or temples, headache, and scalp soreness. Side effects of pulling too hard are breakage of hair strands and hair loss from the follicle. An even more serious side effect of chronically pulling the hair is an inflammation of the follicle and the appearance of small bumps (folliculitis). Inflammation can lead to destruction of the hair follicle and permanent hair loss. Over time, bald spots may develop along the hairline and in the area above the ears. Since the hair loss happens gradually, you may not even notice it until the bald spot develops or your hairline recedes significantly. If traction alopecia continues for a prolonged period of time, the follicles may become destroyed and hair loss permanent.
Treatment
It may seem obvious but it’s time to stop pulling your hair out. To save your hair, you may need to switch hairstyles altogether. However, if your hair loss is minimal and you want to continue to braid your hair or plait your child’s hair, for instance, you can make adjustments, such as wearing looser braids, plaiting the hair loosely and wearing shorter weaves or locks. Women of color often pull tightly on hair to make it look smooth or straighter in a ponytail or bun. A better solution might be to apply a hair gel or a dab of conditioner to the hair to help it to lie flatter and straighter. More manageable hair will look smooth and neat without all that pulling, so wash and deep condition regularly. To camouflage bald spots or a receding hairline you might consider brushing your hair towards the hairline or coloring the scalp with a scalp pencil. You can find scalp pencils at a local beauty supply store; apply as you would an eyebrow pencil, with short strokes in the direction of hair growth.
Once the pulling and tension have been eliminated, if there is active folliculitis, your dermatologist may prescribe an oral or topical antibiotic to reduce the inflammation. In addition, potent cortisone containing creams or cortisone injections may reduce inflammation. If severe scarring is present, hair transplantation may be an effective treatment.
Bottom Line
Traction alopecia can also be a devastating condition for women with brown skin in much the same way as CCCA. Although women may think that they look terrific with tight hair styles, they can and do lead to permanent loss of hair. The key with traction alopecia is simply to avoid tight hair styles. Also, it is important to see a dermatologist at the first sign of hair loss.
Hair loss or Alopecia, which means hair loss, is of epidemic proportion for many women of color. Although there have been magazine articles and television segments about alopecia, it continues to be poorly understood by many women. There are many different causes of alopecia that affect women with brown skin. However, there are two types of hair loss that women with curly or tightly coiled hair are plagued with: central centrifugal cicatricial alopecia (Figure 1 and Figure 2)
Alopecia is a devastating condition for all women, despite the cause. All women want to have their own healthy hair. Hair loss effects self-esteem, social interactions and relationships.
Central centrifugal cicatricial alopecia (CCCA) was previously called follicular degeneration syndrome or hot comb alopecia. CCCA is a form of hair loss that has the following features:
* Central (crown) portion of the scalp is were the problem begins
* Centrifugal (circular) pattern is the outward pattern in which this problem progresses
* Cicatricial (scarring) of the hair follicles occurs
* Alopecia (hair loss) is progressive
With CCCA, the hair loss may appear suddenly and progress relentlessly (Figure 3). It occurs in women of all ages, from as young as 20 to as old as 60. The cause of CCCA is unknown but it is felt to be related to repeated and frequent but unnoticed damage to the hair follicles. There may be a hereditary component to CCCA and for Black and some Latina women, a combination of hair care habits and practices may cause or contribute to the condition. Some dermatologists theorize that the following factors may play a role in the cause or CCCA:
* Genetics
* Hot combing (microscopic droplets of hot hair oil drip onto and damage the hair follicles)
* Chemical relaxing (the severe tingling and burning that occurs when the application directions are not followed may produce inflammation and destruction of the hair follicles)
* Tight rollers or curlers used to set the hair (the chronic pulling or traction of the hair may produce inflammation and destruction of the follicles)
* Braids with extensions or weaves to style the hair (the chronic pulling or traction of the hair may produce inflammation and destruction of the follicles)
* Blow drying (excessive heat applied to the scalp and hot oil droplets may destroy the follicles)
* “Oiling or greasing the scalp” (may block the follicles and cause inflammation in the follicles)
Once the hair follicles become damaged or destroyed, scar tissue (cicatrix) forms and hair will never regrow. Therefore, if you suspect that you may have CCCA, it is important to see your dermatologist immediately. An evaluation by the dermatologist will include blood tests to eliminate other causes of hair loss and a scalp biopsy. A scalp biopsy is a simple procedure in which a small area of the scalp is removed after numbing medication is administered. A stitch is then placed to close the areas. When the biopsy is analyzed by the pathologist, features typical of CCCA may be seen: a decrease or absence of hair follicles, scar tissue formation and inflammatory cells surrounding the hair follicles.
Treatment
Since dermatologists do not know the exact cause of CCCA, outlining a treatment is difficult. The first step is to stop any styling practice that may be causing or contributing to the hair loss. Often that means no hot combs, no tightly applied rollers or braids, blow drying or relaxers for a period of time. If the hair follicles have not been damaged beyond repair, you may, for example, be able to resume your hair care practices but with modifications. Your dermatologist can help you determine when—and if—you can resume these styling practices. Taking a break from harsh styling and substituting gentler techniques may allow the inflammation to resolve, the scalp to heal and hair growth to resume.
Your dermatologist may prescribe medications to decrease the inflammation that is seen in the hair follicles of those affected by CCCA. Oral or topical antibiotics are sometimes prescribed because they help to reduce inflammation. Likewise, topical cortisones applied to the scalp or cortisones directly injected into the scalp may also be used to treat or reduce scalp inflammation. Finally, once the inflammation is minimized, your dermatologist may recommend over-the-counter Minoxidil (Rogaine) to stimulate grow of follicles that have not been destroyed.
With severe CCCA (Figure 4), the hair follicles are destroyed and neither topical or injected medications will help the condition. Hair transplantation may be a solution for some women although the severe scarring may make this procedure technically difficult.
Sometimes CCCA is confused with the hereditary form of alopecia, called androgenic alopecia. This form of alopecia is also characterized by thinning in the central portion of the scalp with extension toward the hairline. With androgenic alopecia, the underlying scalp appears normal and the follicles are not scarred. Therefore, there is a greater likelihood that hair will regrow. The over the counter medication, Minoxidil (Rogaine), may help improve the particular condition.
Bottom line
CCCA is a devastating condition for women with brown skin and the best chance of reversing the process and restoring hair is early diagnosis and prevention. Therefore, it is important to see a dermatologist who is knowledgeable in tightly coiled or curly hair at the first sign of hair loss.
Traction Alopecia
Traction alopecia is hair loss that occurs as a result of continuous pulling of the hair. Pulling may occur from hairstyles such as tight cornrows or braids, weaves, ponytails or even hair rollers or curlers. Traction alopecia may also be due to excessive weight from long extensions or locks. Signs that the hair is being pulled too tightly are difficulty moving your forehead or temples, headache, and scalp soreness. Side effects of pulling too hard are breakage of hair strands and hair loss from the follicle. An even more serious side effect of chronically pulling the hair is an inflammation of the follicle and the appearance of small bumps (folliculitis). Inflammation can lead to destruction of the hair follicle and permanent hair loss. Over time, bald spots may develop along the hairline and in the area above the ears. Since the hair loss happens gradually, you may not even notice it until the bald spot develops or your hairline recedes significantly. If traction alopecia continues for a prolonged period of time, the follicles may become destroyed and hair loss permanent.
Treatment
It may seem obvious but it’s time to stop pulling your hair out. To save your hair, you may need to switch hairstyles altogether. However, if your hair loss is minimal and you want to continue to braid your hair or plait your child’s hair, for instance, you can make adjustments, such as wearing looser braids, plaiting the hair loosely and wearing shorter weaves or locks. Women of color often pull tightly on hair to make it look smooth or straighter in a ponytail or bun. A better solution might be to apply a hair gel or a dab of conditioner to the hair to help it to lie flatter and straighter. More manageable hair will look smooth and neat without all that pulling, so wash and deep condition regularly. To camouflage bald spots or a receding hairline you might consider brushing your hair towards the hairline or coloring the scalp with a scalp pencil. You can find scalp pencils at a local beauty supply store; apply as you would an eyebrow pencil, with short strokes in the direction of hair growth.
Once the pulling and tension have been eliminated, if there is active folliculitis, your dermatologist may prescribe an oral or topical antibiotic to reduce the inflammation. In addition, potent cortisone containing creams or cortisone injections may reduce inflammation. If severe scarring is present, hair transplantation may be an effective treatment.
Bottom Line
Traction alopecia can also be a devastating condition for women with brown skin in much the same way as CCCA. Although women may think that they look terrific with tight hair styles, they can and do lead to permanent loss of hair. The key with traction alopecia is simply to avoid tight hair styles. Also, it is important to see a dermatologist at the first sign of hair loss.
20.4.08
New Port Beach Hair Transplant
Hair Transplant Surgery in Newport Beach County OC
Newport Beach hair transplant centers are generally located at One of the new
11.4.08
Hair Restoration Surgery Donor Scar Repair
Hair restoration with regular strip technique can cause linear scar that could be visible on the back of head if the patient wants to shave his head. Hair transplant scar is not limited to bad hair transplant technique and it might have to do with personal healing process too (some people are generally better healers compare to the others).
The good news is that we have methods to minimize the size of the scars nowadays and if you have bad hair transplant scars from bad transplants in the past, there are several new methods that can help improving the appearance of the donor scar. Hair transplant scar could be improved by repair of linear widened scars with different methods that we perform at our Los Angeles office of US Hair Restoration. Dr. Mohebi is the inventor of Laxometer, a device that measure the laxity of the scalp precisely before hair transplant surgeries. Good measurement of the scalp laxity is one of the best ways to minimize development of donor wound complications and widening of donor scar.
One method is through simply excising the scar. Excision of the donor scar may be helpful for some donor scars. After removing the scar, hair transplant surgeon can close the skin with trichophytic closure method in which a small wedge on one or both sides of the skin edge is removed and skin is closed primarily. Trichophytic closure allows some hair follicles grow new hair into the final scar. Presence of hair helps making hair transplant scar become invisible.
Hair transplant donor coverage could be done by transplanting hair into the scar. Hair could be harvested from other areas using FUE or mini-strip techniques. Again, presence of the hair inside scarred area could trick the discriminating eye and scar become less detectable. Patients may need more that one hair transplant procedure into the donor scar for minimizing the difference between the densities of hair in scar and surrounding areas.
The last method that could be used to camouflage the linear scar is by tattooing the scar. People who plan to keep the hair very short can easily tattoo the scar with the figures of short hairs so it seems that there are some hairs present in the scar area, which can help minimizing the visibility of the scar.
2.4.08
Megasession at US Hair Restoration for women
Although women generally doing need large sessions, mega session hair transplant surgery has been around for almost a decade since Dr. Rassman and others started doing bigger and bigger sessions. Before 1993 all could be done was less than 1000 and occasionally 1500 grafts per each session. Using newer techniques and larger team of experienced technicians, we at US Hair Restoration are currently performing large sessions on a regular basis.
Not all physician teams are equal. If a doctor routinely performs sessions in over 2500 graft size, then it would be safe to assume that this doctor has mastered the skills required for large session. Unfortunately, not all doctors have either the teams or the skills to accomplish the feat on a routine basis. Limiting the size of the session to under 2000 grafts, it may take more surgical sessions to accomplish the same goal as when twice the number is transplanted.
Many factors should come together for a mega session hair transplant surgery. First, the surgical team must be trained in doing large sessions with fast, efficient cutting and placing. The following points must be available for the surgery to be successful. The sessions should not take more than eight to ten hours, for more than that, the grafts that are out of the body awaiting placement produces reduced graft growth. Hair transplant surgeon should keep a larger team of technicians to help reducing the time of surgery.
The surgeon must know the nuances of prolonged anesthesia without increasing the risks to the patient. The patient’s scalp laxity must be very loose so that a wide strip can be taken safely (often these strips measure greater than 2cm in width and 22cm in length). The patient’s density must be high (50% higher than normal densities). Large sessions might carry increased risk of swelling and redness after surgery, but overall are not more risky than smaller sessions, but the above criteria must be bet or the yield would not be there. At US Hair Restoration, we offer megasessions to patients with extensive baldness with good donor quality with excellent results.
2.3.08
Miniaturization and Hair Loss
Miniaturization and Hair Loss
Miniaturization of hair or thinning of hair shafts is a part of the hair loss process. When hair becomes miniaturized, it gets finer over time before falling out. Microscopic evaluation of the scalp and hair can help determine the rate of miniaturization on human hair. Balding in men and women usually is not obvious until significant miniaturization is present.
Mapping of scalp hair miniaturization in a typical
man with hair patterned alopecia (baldness)
The appearance of baldness will not be visible at least 70% of hair is miniaturized. A miniaturization study is part of the hair loss evaluation of a patient and could be used as predictor of future balding in a given area. Significant hair miniaturization is seen in patients who are in the active phase of hair loss and this evaluation could determine a patients’ response to a certain type of medical treatment.
Microscopic evaluation of scalp:
Patient has significant miniaturization
That can predict future hair loss
At US Hair Restoration, mapping of the patient’s scalp hair is done for all patients in order to evaluate patient’s hair before initiating any medical treatment or surgery. Young patients with significant miniaturization are prone to losing their vulnerable hair after a hair transplant surgery due to the stress of surgery on skin and hair follicles. This phenomenon is called shock loss and occurs less in patients with minimal amounts of hair miniaturization.
Patient’s scalp is evaluated by digital microscope:
Miniaturization study is needed before starting medical treatment
If patient has 10 to 20% miniaturized hair, it could be normal and not part of the balding process. Scalp hair goes through two main phases: Growth phage (Anagen) and resting phase (Telogen). The Growth phase in scalp hair of normal people can take between 1 to 6 years, where the resting phase is about 4 to 6 weeks. When we lose one hair to the telogen phase, another hair will grow from its follicle which will be represented by a few tiny hairs showing hair cycling, in the area and not necessarily the balding process.
Presence of over 20 percent hair miniaturization in a general area could be quite normal. It is common indication of active hair loss in the area. Higher numbers of miniaturization could represent active hair loss and progress of balding in the future. If you are a balding man with significant miniaturization, you should take finasteride after mapping your scalp. The effect of medical treatment of baldness is very gradual and may take at least six months for any detectable improvement in miniaturization of hair.
Article from Hair Loss Q&A web log.
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