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Click on any question below to read about hair loss and hair restoration at Dr. Korman's practice:
What causes hair loss?
Numerous medical conditions can cause temporary or permanent hair loss. These include thyroid or other hormonal imbalances, nutritional deficiencies, auto-immune disorders, medication side effects, trauma to the hair or scalp, stress and many others. While Dr. Korman will diagnose and treat any underlying medical conditions, the cause of the problem in the vast majority patients seeking hair restoration is what is known as male pattern hair loss or female pattern hair loss.
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Male Pattern Hair Loss (Androgenic Alopecia)
Male pattern baldness is sometimes referred to as androgenic alopecia. "Alopecia" means "hair-loss" and "androgenic" refers to male sex hormones or "androgens" that are responsible for the progressive miniaturization and loss of hair with age. The hormone testosterone is converted to dihydrotestosterone (DHT) by an enzyme called 5-α reductase and it is now understood that DHT is responsible for beard and body hair growth as well as for scalp hair loss. The medication Propecia (finasteride) prevents androgenic alopecia by blocking 5-α reductase. In general, the horseshoe shaped area of scalp hair starting above the ears and extending to the back of the head is resistant to the effects of DHT and so is not lost with male pattern baldness. The resistance of these hairs to DHT is retained even when they are relocated to other areas of the scalp and it is this property that makes modern hair transplantation possible.
The effect of androgens on the male hairline can begin as early as the teenage years and most men will have experienced some degree of pattern hair loss by the time they reach their fifties. The pattern typically begins as recession of hair in the temple areas and in the crown and can gradually progress until only a thin rim of hair is left around the edge of the scalp. It can be very difficult to predict the ultimate extent and pattern of hair loss for any individual patient.
The progression of male pattern baldness (the Norwood-Hamilton Scale)
Predisposition to male pattern baldness is thought to be largely inherited however the genetic process is complex and poorly understood. It is a myth that the "baldness-gene" is inherited from the maternal grandfather. Other myths include that poor scalp circulation, caps or hats, or shampoos cause baldness (although certain products such as strong relaxants can damage hair).
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Female Pattern Hair Loss
Women are also subject to hair loss and while this can be particularly upsetting and can have a devastating impact on self-esteem, in most cases it can be effectively treated. As noted above, there are numerous medical conditions that can cause hair loss in women and hair loss can be associated with other factors such as recent pregnancy or long-term pulling of the hair in pony-tails or tight braids. Women who experience hair loss should seek professional advice from a hair restoration specialist.
As in men, the most common cause of hair loss in women is inherited androgenic pattern baldness however the pattern is generally different from what is seen in males. While female pattern hair loss can start early, it often begins later than the male variety and is more frequently, but not always, associated with a diffuse thinning effect over the entire scalp sparing the frontal hairline. Many women complain that the part in their hair seems to get wider.
The progression of female pattern baldness (the Ludwig Classification)
While female pattern hair loss is extremely common, many women do not realize that treatment is available and effective and so continue to suffer with the embarrassment and anxiety that frequently accompany thinning hair. Fortunately, more and more women are seeking out advice from hair loss specialists like Dr. Korman and are availing themselves of the excellent treatment options that are available.
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Can hair loss be prevented?
Medical treatment can slow or stop pattern hair loss in a large proportion of patients. Some patients will even experience re-growth of hair. The key to medical prevention of hair loss is to start as soon as possible and preserve your existing hair. Although there are many options to restore hair that has already been lost, Dr. Korman’s philosophy is that problems are almost always easier to prevent than to treat.
The mainstays of modern medical treatment include Propecia and Minoxidil. Propecia blocks the action of 5-α reductase and will stabilize hair loss in approximately 90% of men who take it. The mechanism by which Minoxidil affects hair growth is unclear however it has been shown to be effective in both men and women. Propecia and Minoxidil appear to work synergistically, meaning that greater effect is achieved by using both medications at the same time.
There are numerous other products available that are marketed as hair loss cures. While some of these may have effect, many are unproven and some can even be harmful. You are encouraged to do your homework and realize that if a "miracle" lotion or potion seems too good to be true, it probably is. Dr. Korman will be happy to answer any questions that you have about other hair restoration products.
It is important to remember that if left untreated, male pattern baldness will progress relentlessly. While some patients experience re-growth, the primary goal of medical treatment is to prevent additional hair loss. If there is no change in the appearance of your hair during the treatment period, this should be viewed as a success, not a failure.
For more information about preventing hair loss please refer to the Non-Surgical Hair Restoration section of this website or contact us to make an appointment to discuss your questions with Dr. Korman.
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When should I consider treatment?
The decision to proceed with hair transplantation or other surgery is a major one and the timing must be right for you. It is absolutely critical however, to appreciate that your hair is a non-renewable resource and Dr. Korman strongly encourages that medical treatment to stop ongoing hair loss be initiated at the soonest possible time even if surgical treatment is not currently an option for you.
By the time an area has a thinned appearance, 50% of the hair in that area has already been lost. Halting your hair loss will conserve valuable donor hair and prevent progressive baldness, possibly reducing the extent or even eliminating the need for future surgery.
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What treatments are available?
There are a wide variety of medical and surgical options available. Propecia and Minoxidil are the mainstays of medial treatment and hair transplantation is the backbone of hair replacement techniques.
Please see the Our Services area of this website for more information regarding specific treatments.
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How much will treatment cost?
The cost of treatment depends on the nature and extent of the hair loss and what treatment options are best for you.
Medical treatment such as Propecia and Minoxidil vary in cost from $25-100 per month depending on the combination and format of medications that are used.
Grafting procedures vary widely in cost depending on the area to be transplanted. More advanced procedures such as scalp-plasty or scalp-reduction operations are assessed on a case-by-case basis.
Under some circumstances, elective surgical procedures are deductible from your income as a medical expense. Patients are encouraged to contact their tax professional.
There are several options for financing elective surgical procedures. Examples include:
You are encouraged to contact us to arrange an appointment so that your specific questions can be addressed.
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Where can I learn more?
» Read more about hair transplantation and other surgical and non-surgical hair restoration services provided by Dr. Korman.
» Click here for links to more information about hair restoration surgery.
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