A question about the hair bulk measurement tool - surely it’s dependent on the person measuring having exactly the same length hair every time a measurement is taken otherwise it’s going to produce inaccurate results?
I mean, great if you know your hairdresser can cut your hair the same length perfectly each time you want to do a measurement but realistically that’s not going to happen unless you use clippers which most of us don’t want to do.
Or does it not work this way? Am I missing something?
If not, then I’d think that a camera would be a better way of judging hair loss.
For the bulk analysis, you need to have an adequate length of hair (maybe 2 inches in length) so that the hairs can be bundled up and the bulk can be measured. Any adequate hair length will work the same, even if it is 3 feet long, because the measurement is made at about one to one and a half inches from the scalp. Think of a person bundling up a long pony tail. If you have more hair, the bulk of the pony tail will be much greater. As the measurement is limited to a point about one inch from the scalp, the longer hair will not impact the measurement.
We take a baseline measurement at the same coordinates of the scalp each and every time you return (12 months). If you cut your hair with clippers with a buzzcut style, you cannot do a bulk measurement. If you have gel or other products on your hair it will give a higher bulk reading, so we ask that there are no hair products on your hair when you come in for the analysis.
If your hair is very short, then we can always use a miniaturization study, looking at hair diameters at a microscopic level. Bulk measurement is doing it at a macroscopic level. These are all our attempts to measure an objective (not subjective) value of your hair status. The subjective measurement can be a simple before after picture of your head/face. The picture can be highly variable depending on lighting and angles. At NHI, we try to keep the angles and the lighting and the camera model, lenses, aperture, and external flash location as constant as possible.
Hi DR Rassman. Thank you for providing this very informative blog.
I’ve wondering about this and trying to find the answer on the internet for ages - sometimes when I rub my head in the morning I see some slightly thinner hair than my normal healthy looking ones. I went to the derm and did a miniaturisation test and had less than 10% miniaturisation. The derm said I am not balding, however when I see these slightly thinner hairs I get worried…
So I guess my question is do these slightly thinner hairs (intermediate?) grow on a non balding scalp? They grow just as long as my normal hair and are same thickness throughout the strand.
If you have less than 10% miniaturization and your dermatologist told you that you are not balding, I would stop worrying. Non-balding people shed about 100 to even 200 hairs a day. Perhaps you’re seeing hairs going through various growth cycles?
If there is any doubt, then have a bulk measurement of your hair done, which will show beyond any doubt if you are thinning or balding. If you have miniaturized hairs, those hairs will not grow at the rate or to the length of normal, non-miniaturized hairs.
How can you tell the difference between male pattern baldness and general thinning as you age? I am almost 35 and have no discernible signs of MPB other than a mature hairline (which appeared when I was about 19). However, I am convinced my hair is thinner than it used to be.
Simple answer: There is a pattern to MPB. That is why they call it male “pattern” baldness and this is the classic male genetic hair loss.
There are other diseases that cause general thinning, including diffuse unpatterned alopecia (DUPA), senile alopecia, etc. You can have that diagnosis made for sure by comparing the bulk in different parts of your scalp. A knowledgeable doctor will add value in examining you.
A few months back you had mentioned an upcoming trip to Europe. You also said that you planned to meet with Gho to discuss his technique or whatever. I am just following up to see if the visit ever materialized? Many people would appreciate a blog update on that situation. ALSO- many people would like you to be the first doctor to offer HST in the United States!
I was just wondering if I sent you a few pics of my hairline do you think you could give me an answer to if I’m going bald or not?
We do not diagnose people on BaldingBlog, as that would be a poor practice of medicine. If you want to send in your pictures for me to post and comment on, feel free. If you want a virtual consultation, you can send good photos, I will look at them, and then established a dialogue with you over the phone.
In general, hairline pictures do not tell me much with respect to predicting the balding process. It’s kind of like sending a picture of your hand and asking me if you will have arthritis later on in life. I am not a fortune teller (or misfortune teller).
About four weeks after getting a large hair transplant I had a bit of a major shock to my business which caused a good deal of panic. A lot of adrenalin rushes, flight/fright, etc., off and on for a few weeks. Pretty constant. The worst has passed, but I am wondering if these adrenalin surges hurt my new implanted grafts’ growth chances. I know it is a vasoconstrictor, but assume that the grafts were secure and alive after 10 days or so.
I don’t have a definitive answer, but I would guess that your emotional stress would have no significant impact on your hair transplants particularly since it occurred a month after your surgery. It’s going to be a case of wait and see.
I am a 20-year-old student who started taking Propecia about a month ago. Since then, I’ve broken out in hives about once every two weeks. The breakout lasts for about 3 days.
I have three questions for you:
- Do you think that this is an allergic reaction to Propecia?
- If I am indeed allergic to Propecia, do you think that it will be less effective?
- I have experienced a noticeable increase in shedding since starting Propecia. The Internet tells me that this could be a good sign, but we both know there’s a lot of misinformation out there.
Again, thanks for the great blog.
First of all, if you are breaking out in hives I would see a doctor. This is not a place to get a medical diagnosis or treatment. Any medications can cause a reaction or side effects, but I do not know anything about your medical history or health or habits to even guess why you are breaking out in these two week intervals. Are you doing something different every two weeks?
In general, patients do not shed after taking Propecia. Patients lose hair with or without the medication from natural genetic causes. The “increased shedding” people refer to is very abstract and hard to quantify. This is one of the main reasons you need to see a doctor before you start Propecia and have some form of documentation of where you are starting from (such as a picture of your hair, miniaturization study, or even a bulk measurement). Without anything objective to compare to, it is just anyone’s guess.
Finally, I would guess there are people who are allergic to Propecia, but I have not met anyone face to face at my medical practice who have these allergies people write about on the Internet.
As if the heartache of divorce wasn’t hardship enough, it appears that women enduring marital break-up may also have to deal with hair loss.
New research reveals that, genetics aside, the next strongest predictor of midline (central) hair loss among women is their marital status, with the loss of a spouse (through either divorce or death) raising the risk for thinning hair above that of married or single women.
The study looked at sets of identical twins and determined that excessive alcohol and smoking increased the risk, in both men and women. The study also revealed that sun exposure is also believed to be a factor in hair loss, as those exercising outdoors or didn’t regularly wear hats (sun protection) saw increased thinning. One of the keys the article focuses on is divorce, which can bring about a lot of stress… and it isn’t surprising that stress can lead to hair loss. Overall, it’s interesting stuff and worth a read.