Be Better Guys

If you’re like 50% of men (and 1 in 4 women), pattern or hereditary hair loss has a role in your life. Many men (myself included) have embraced the shaved pate as an alternative to bald spots and curious hair line patterns. But there are alternatives that some might consider, if they had good information on the topic. Enter cosmetic surgeon Dr. Robert Leonard, Founder and Chief Surgeon of Leonard Hair Transplant Associates. Dr. Leonard took a few minutes to enlighten Brian of Be Better Guys about the realities of hair loss, hair restoration, and what you can choose to do about it.

BBG: As an African American male who’s shown signs of pattern baldness since my late 20s, I began shaving my hair bald once the hair loss reached the point of no return. Culturally speaking, that was a viable option for me, but I can’t say that I explored all of the options available. Is it too late for me to begin using Rogaine or some other form of treatment?

Dr. Leonard: Absolutely not. Male pattern hair loss is a progressive process. Through treatment it can be stabilized and then assessed to see what regrowth should be expected. If you’re 60% bald, having a full head of hair might not be realistic. But no, it’s not too late. You should come see me!

BBG: I’d assumed I was past the point of non-surgical remedies. Can you give me three myths about balding? What’s the truth about hair loss?

Dr. Leonard: a.) One myth is that stress causes hair loss. This isn’t true.There’s no correlation to stress and hair loss.

b.)  Another myth is that wearing a hat (baseball, helmet, etc.) all the time will make you go bald. Again, this is not true.  In my office this is a common scenario: a young guy will come in with his mother for a consultation, and she pulls me aside and says “Tell him that wearing his baseball cap all the time is causing his baldness.” The truth is, wearing a cap does not cause hair loss, but if the guy is wearing the hat all the time, it may be a sign he’s embarrassed about the hair loss and may need emotional support in addition to treatment. The first thing I’ll tell him is that he’s not alone – 50% of men suffer from hereditary hair loss. Then I give him his treatment options and we move forward.

c.       Finally, another myth is that hair loss comes only from the mother’s side of the family. In fact, it comes from both sides of the family. The effects are additive—if people on both sides are genetically inclined to balding, your chances of going bald increase.

What’s the truth about hair loss? Genetics cause hair loss. There are some other conditions, such as alopecia areata, that cause hair loss. Scarring can also cause hair loss. But for the majority of people (roughly 98% of men), genetics will dictate hair loss.

The hormone in our systems called di-hydrotestosterone (DHT) is the major cause of male pattern hair loss. DHT is the breakdown product of the male hormone testosterone. For those who are genetically predisposed, DHT will shorten the hair growth cycle, causing the follicle to diminish in size and pigmentation. Hence, you become balder. But this also allows for some non-surgical treatment options.

BBG: So much is made of having a “healthy head of hair.”  What constitutes a healthy head of hair?

Dr. Leonard: The main thing is a healthy scalp. People say you can’t shampoo every day, that it will make your hair fall out. The hair shaft is in the follicle, the health of the scalp directly impacts the ability of the hair shaft to grow. Keeping a clean head of hair and scalp will ensure a healthy head of hair. This means washing your hair daily.

BBG: What impact, if any, does lifestyle have on hair loss? Are there tell-tale things to avoid?

Dr. Leonard: None of your lifestyle choices will cause baldness—drinking, smoking, etc. However, traction alopecia (for women) is a problem, specifically for African American women. Long-term braiding destroys the follicle and the hair will not grow. The only thing that will help this condition is transplantation.

BBG: It seems as if the science surrounding hair growth taken off in the past several years. Why is that?

Dr. Leonard: I’ve been in the field since 1986. When I first started, hair cloning was supposed to be the next big thing: we would clone your own hair and transplant as needed. That still hasn’t come to reality as of yet. But several other treatments have and are effective.

Today, Rogaine, Propecia, laser therapy and hair transplantation are the only treatments that work on male pattern hair loss.  Today’s hair transplantation techniques delivery natural looking results. Hair and skin from the back of the head is moved to areas that are thin or bald – and these hairs will then grow hair for the rest of a person’s life.

BBG: Ok, Dr. Leonard, riddle me this: if Rogaine (and other treatments) is so effective, why don’t more people use it? Objectively speaking, is it fear of side effects, doubts of efficacy, etc?

Dr. Leonard: One-half of all men have male pattern hair loss, but men are very private about it. They don’t want anyone to think they care about their hair. Lack of consumer education is the biggest problem, so as a hair restoration surgeon, education is passion of mine. I advise people on the options, but I’m honest about the impact and the commitment needed. Part of it is that you have to use the treatment products long term (at least 4 months) before results are shown, and patients need to learn how to properly apply the products for optimal results – Unscented Men’s Rogaine Foam should be applied twice a day every day directly to the scalp (visit RogaineDirect.com for more information). Also, make sure you have realistic expectations.  Start by seeing a specialist (you can find one at ishrs.org) to learn which options are best for you.