Hair loss is a universal condition, affecting all ages, races, genders and nationalities. It’s estimated that “androgenetic alopecia,” or male and female pattern baldness affects 35 million men and 21 million women in the United States alone. This section examines how race, age and gender affect hair loss.
In physiological terms, human beings are all composed of the same bones, muscles, and everything else down to the cellular level. But there are specific differences.
Hair, in all of its variations, is one area in which human beings display their differences. Hair follicles can widely vary in terms of color, length, shape, thickness, strength and various other factors.
There are many ethnic groups to consider. But we will focus on the special considerations of Asians, Blacks (of African descent) and Caucasians.
Asian people typically have very straight hair. Their scalps contain fewer hairs per square centimeter, they actually have a lower hair density than that of Caucasian hair follicles. But because the individual hair follicles of East Asians are thicker, this gives the look and impression of greater hair density.
For these reasons, hair restoration techniques for East Asians, much like other races, must be sensitive to a variety of anatomic and cultural differences. For instance, East Asian females often have an increased likelihood of developing “diffuse alopecia,” or hair that thins evenly over the entire head than Caucasian females.
Even though it’s not a definite requirement, it’s very helpful for Asian patients to seek out doctors with experience in Asian hair.
Another consideration for East Asians considering hair restoration surgery is the increased chance of developing keloid scars. A keloid is a thick, irregularly shaped and elevated scar with uncontrolled growth that results from excess fibrous skin tissue. East Asians typically have a greater likelihood of keloid development than Caucasians, but less than that of people of African descent. Therefore, before undergoing surgery, East Asians may want to consider being medically evaluated for keloids.
People of African descent usually possess naturally curly hair. This curly hair gives the visual impression of increased hair density for a given amount of hair, which is beneficial in hair restoration surgery.
The hair follicles beneath the skin of people of African decent also typically curve more than Caucasians. This can make harvesting the donor hairs, without severing or transecting the hair follicles beneath the scalp, more difficult. A hair restoration physician needs to be very aware of this difference and adjust to its requirements.
As in the case of East Asians, people of African descent possess some unique hair and skin characteristics. Some of these medical conditions are more common in black skin than in white skin. This may increase the risk for post-surgical complications.
Those of African descent have a higher chance of developing keloid scarring when injured. This in turn leads to a greater chance of noticeable donor scars. Keloids aren’t a widespread problem. But those with a history of them are carefully evaluated in regard to their existing scars. The evaluation usually involves a small "test procedure" to determine if there’s a normal healing rate.
Another issue is that of postoperative skin discoloration. With darker skin, there’s often a greater risk of both increased and decreased skin color after injury or surgery. These risks can be determined by the patient’s medical and family history.
Ingrown hairs are also a more common problem in darker skin. If a patient has a history of ingrown hairs or other minor skin infections, this may signal a higher risk for ingrown hairs post-hair restoration surgery. Again, this risk can be determined by a small test procedure.
Caucasians (white people) may have a wide range of hair and skin types. However, if someone has dense and or coarse hair, as well as skin color similar to their hair color, they will generally achieve the best results for a given amount of restored hair.
Learn more about aging and gender hair loss
Follicular unit extraction is a minimally invasive procedure for performing follicular unit hair transplantation. However, unlike the predominant follicular unit transplant procedure, in which a strip of donor tissue is removed and dissected under magnification, the FUE procedure uses a small punch to extract each follicular unit one by one.
Both the strip excision and FUE procedures create 1, 2, 3, and 4 hair follicular unit grafts that are then transplanted into the balding area in the same manner. The primary difference between these two procedures is the technique used to harvest the follicular unit grafts.
The common strip excision method of performing follicular unit hair transplantation involves surgically excising a thin horizontal strip of bald resistant skin from the donor area.
Strip Excision Procedure
This donor area is then sutured together. These sutures (either stitches or staples) are then typically removed about ten days after surgery. Some physicians use dissolvable sutures so that no removal is needed.
Once this linear incision is fully healed the patient is left with a thin horizontal scar in the back of the head. This scar is typically hard to detect since the surrounding hair conceals it, even when the hair is cut short.
To view a video of an actual strip excision surgery.
With the Follicular Unit Extraction or FUE procedure 1, 2, 3, and 4 hair follicular unit grafts are carefully extracted one at a time using a tiny punch of one millimeter or less. Often the surgeon requires the patient to buzz cut a portion of their donor area so that they are able to see the patient’s scalp.
The follicular units are extracted by placing the punch around a single follicular unit and cutting a small circle through the skin around that follicular unit. The follicular unit is then gently pulled up and away from the loose tissue underneath the skin.
The small hole left behind after the follicle is extracted then heals over the following week. Normally this small round incision contracts as it heals making the resulting round scar smaller than the size of the 1mm punch that made the incision. The FUE patient ultimately ends up with hundreds of small round white scars, which are normally not detectable once the patient’s hair grows out.View a video of an actual FUE surgery.
Advocates for the relatively new FUE procedure claim that this procedure produces less noticeable scarring and no tightness or numbness in the donor area since no donor tissue has been pulled together and sutured. Many patients and physicians find the claim that FUE produces less visible scarring to be debatable.
Some physicians and patients also have concerns about the relatively new FUE procedure, such as the lack of formal studies regarding the percentage of follicles that may or may not be transected during the sight unseen extraction process.
In addition, since the physician must personally extract all follicles, one by one, the FUE procedure is very physician dependent and thus very expensive. The FUE procedure also requires considerably more time in surgery to move a given amount of hair to the balding area.
The standard strip excision procedure has the advantage of utilizing a collaborative team to carefully create the grafts once the donor tissue is removed in a strip. This collaborative approach enables a well trained staff to do sessions of 2,000 to 3,000 all follicular unit grafts in a single day. This team approach enables a patient to get a much larger number of grafts/hairs in one sitting at a much lower cost per hair than with the FUE procedure.
However, some believe that despite being relatively costly the FUE procedure may be appropriate for patients who have very limited elasticity in their donor area or who only need a small number of grafts.
For many balding men and women worldwide, credible hair loss concealers like DermMatch are an important part of their daily routine. By utilizing concealers, individuals with thinning hair are able to increase the appearance of follicular density and recreate a thicker, fuller head of hair all with a single topical application.
Like any other hair loss treatment, concealers must be reviewed, clinically tested, and proven before receiving any endorsement from this website community. However, after reviewing both the product and patient testimonials on our open hair loss forum, one thing is clear: DermMatch is a dependable, hair loss concealer that has been proven effective by the overall patient community.
Unlike other "sprinkle," "spray," or "lotion" concealers, DermMatch utilizes a patented "EZ Grip, EZ Reach" applicator to evenly distribute a hard-packed powder formula over a hair loss sufferer’s scalp. In addition to "matching" the patient’s scalp to their natural hair color (minimizing the contrast between scalp and hair, and truly concealing baldness), the DermMatch powder formula coats, thickens, and volumizes existing hair.
Because DermMatch minimizes the appearance of hair loss by matching scalp to hair tone, the product is available in 8 different shades, and creates an integrated, natural look for all hair colors and types. Furthermore, if consumers require a highly specialized color, DermMatch shades can be mixed to truly mimic the appearance of any complex hair tone. Additionally, because of the ease of the "EZ Grip, EZ Reach" applicator, DermMatch is particularly useful for recreating or matching shortly cropped hair, mimicking natural hairlines, and diminishing the appearance of previous hair transplant surgery scars.
In addition to simple application and a natural appearance, DermMatch is extremely resilient, and can withstand excessive sweating, wind stress, and even full water submersion. According to the makers of DermMatch, the product’s all natural ingredients, including emollients, botanicals, and other organic elements, coat the hair and scalp, and protect from unwanted and unexpected stessors. By adding this level of protection, DermMatch will resist the running, flaking, and smudging associated with other, less effective concealers. Furthermore, because DermMatch does not contain any unsafe dyes or colorants, it will not dry/irritate the scalp or affect any new or existing hair growth.
According to the makers of DermMatch, the product is useful for all hair loss sufferers (both male and female), and provides aesthetically pleasing results in patients with up to 80% decreases in hair density. Furthermore, DermMatch can be used with other proven hair loss treatments like Propecia (finasteride), Rogaine (minoxidil), and surgical hair transplantation. Because of its efficacy, usability, and popularity with hair loss sufferers, DermMatch is highly recommended to any individual seeking a quality concealer.
For step by step instructions on how to apply DermMatch to thinning areas including photos and an in-depth discussion with other hair loss sufferers, visit the discussion topic "DermMatch (Pictures)". To see what other members and DermMatch consumers are saying, you are encouraged to use the "search" feature of our hair restoration discussion forum.
An Active Ingredient in Several Topical Hair Loss TreatmentsAzelaic acid is a naturally occurring substance found in whole grains that contains a mild antibiotic designed to “clean” skin. It is also said to be a potential inhibitor of 5-alpha-reductase in human skin. A reduction of this enzyme may reduce the amount DHT (dihydrotestosterone) in the body and therefore, have a similar effect to finasteride; the active ingredient in FDA approved oral hair loss solution Propecia (finasteride). In theory, applying azelaic acid to the scalp may prevent or eliminate the binding of DHT to the hair follicle receptor, preventing hair loss and potentially stimulating hair regrowth. Azelaic acid can be found in many prescription acne medication and topical hair loss products like Xandrox and Provillus.
Combining azelaic acid with FDA approved hair regrowth solution minoxidil in a single topical product in theory, may prove to be a more powerful hair loss treatment for androgenic alopecia than minoxidil alone. This is why some conjecture that Xandrox may be a more effective treatment than Rogaine (minoxidil).
Azelaic acid has not been clinically proven effective as a standalone treatment for treating genetic female hair loss and male pattern baldness. It has also been known to irritate the scalp when applied topically. Though there is a low percentage, azelaic acid may interact with other medications. Be sure to consult your physician before using azelaic acid while on other medications.
While hair restoration surgery is now a proven treatment for restoring hair where it has been lost, Hair loss medication such as Rogaine (minoxidil) and Propecia (finasteride), have made real contributions toward stopping and even reversing hair loss.
During the late 70’s and early 80’s it was discovered that minoxidil, used as a heart medication, had hair growing side effects. Minoxidil was tested for use as a topical scalp treatment for hair loss and proved to inhibit hair loss in many test subjects.
It has proven to be effective to some degree in slowing the hair loss process. For a minority of people it can even grow back lost hairs in the crown area (back of the head). However, Rogaine (minoxidil) does not slow or reverse the balding process in the frontal hairline area.
Rogaine is typically applied topically on the scalp twice a day, morning and evening. But once usage is discontinued the hair loss which had been inhibited will resume and the hair that was saved will be lost.
Rogaine originally required a prescription, but in 1995, it became available in 2% strength Rogaine over-the-counter. Today, men and women can buy 5% strength lotion over-the-counter as Rogaine or as generic minoxidil.
To date Rogaine (minoxidil) and Propecia (finasteride)are the only hair loss medications with FDA approval. Propecia’s active ingredient, finasteride, was originally used to treat enlarged prostate glands. It was discovered that, like minoxidil, it had the “side effect” of stopping male pattern baldness and for some even regrowing hair.
Propecia is taken as a pill once daily and acts to inhibit the body’s ability to create dyhydrotestosterone or “DHT”. DHT acts as the active ingredient or catalyst in the balding process.
The 90’s brought great advances in hair restoration, both surgical and non surgical. Now most people can realistically halt and reverse their hair loss with truly natural results.
In 1988 minoxidil, Rogaine, became the first hair loss medication to be approved by the FDA for the treatment of hair loss.
In 1998 the FDA approved Propecia for the treatment of hair loss. Propecia (finasteride) should NOT be taken by woman or children for any reason.
Hair loss suffers often don’t want to admit that going bald bothers them. But there's nothing wrong or vain about being concerned with hair loss.No matter what people say, having hair or not does matter. We are judged by our appearance. And hair loss, also known as alopecia, is generally seen as a sign of weakness and aging.
"At first I just didn't feel comfortable admitting that I wanted my hair back."– Dean, restored his hair with Propecia and hair restoration surgery.
Hair loss Statistics – Hair loss affects about 35 million men and 21 million women in the United States alone.40% of men have noticeable hair loss by age 35 and 65% by age 60.
First you need to understand why hair loss occurs. In Cause of Thinning Hair and Baldness you'll learn that your hair loss has little or nothing to do with shampooing, hats, or any other practices. Alopecia is largely genetic.
It's also important to deal with the psychological and emotional effects of hair loss. In the Psychology of hair loss these personal issues and how society views hair loss are uncovered.
Regardless of our differences, hair loss can affect anyone. However,there are a variety of gender and racial differences to consider.Age is also a prime factor. In Race, Age and Hair Loss these differences are explored.
Hair loss is not a new phenomenon, as our Ancient Hair Loss "Cures" section reveals. Whether it's Julius Caesar using wreaths to hide his thinning, or French King Louis XIV's elaborate 15-20 pound wigs -- history's filled with interesting tales of balding cover-ups. This section also explores the reality behind many Hair Loss Myths and “cures”, from electro-shock treatments to headstands.
Alopecia areata (sometimes referred to as“spot baldness”) is a medical condition that typically results in patchy hairloss or bald spots on the scalp, beard, arms and legs. Though the exact cause of alopecia areata is unknown, it is thought to be an autoimmune disorder causing the body’s immune system to attack its own hair follicles, resulting in hair loss.
Roughly 2% of the world’s population suffers from alopecia areata and approximately 5% of these have a family history of "alopecia", the medical term for hair loss.
Alopecia areata is normally diagnosed through the observation of symptoms. However, occasionally a scalp biopsy or blood tests may be performed.
There is no cure for alopecia areata and current treatments, while sometimes effective, offer limited success. Current treatments for alopecia areata include; steroid injections, topical corticosteroids (steroid hormonesnaturally produced in the adrenal cortex of vertebrates), topical immunotherapy, Rogaine(minoxidil) and ultraviolet light therapy.
Although permanent hair loss is a possibility, the course of the disease is unpredictable and varies from patient to patient. The good news is that, even without treatment and after many years,the hair follicles do remain viable and ready to resume normal hair production if and when they receive the appropriate signal. Hair regrowth may, and often does, occur in time.
Patients suffering from alopecia areata are rarely considered good candidates for hair transplant surgery because donor hair grafts harvested from the “safe” zone at the rear and sides of the scalp are still vulnerable to the effects of the body’s immune system once transplanted to the recipient sites. However, if the affected area is small, has remained unchanged for an extended period of time and if there is no sign of inflammation below the scalp, hair transplantation may be an option. This would require a thorough consultation with a skilled and experienced hair restoration surgeon and the patient would need to fully understand and accept the risks of such a procedure.
Depending upon the severity of the condition, hair loss concealers like Toppik, Nanogen and DermMatch may help disguise bald patches. In more severe cases, a hair replacement system or full wig may be necessary.
Aswith all forms of hair loss, patients suffering from alopecia areata may experience emotional and psychological trauma. It’s important to reach out to family and friends, join an alopecia support group and/or seek the services of a mental health professional if you are experiencing intense, prolonged and overwhelming psychological effects.