Hair Loss and Its Causes

What is the normal cycle of hair growth and loss?

The normal cycle of hair growth lasts for 2 to 3 years. Each hair grows approximately 1 centimeter per month during this phase. About 90 percent of the hair on your scalp is growing at any one time. About 10 percent of the hair on your scalp, at any one time, is in a resting phase. After 3 to 4 months, the resting hair falls out and new hair starts to grow in its place.

It is normal to shed some hair each day as part of this cycle. However, some people may experience excessive (more than normal) hair loss. Hair loss of this type can affect men, women and children.

What causes excessive hair loss?

A number of things can cause excessive hair loss. For example, about 3 or 4 months after an illness or a major surgery, you may suddenly lose a large amount of hair. This hair loss is related to the stress of the illness and is temporary.

Hormonal problems may cause hair loss. If your thyroid gland is overactive or underactive, your hair may fall out. This hair loss usually can be helped by treatment thyroid disease. Hair loss may occur if male or female hormones, known as androgens and estrogens, are out of balance. Correcting the hormone imbalance may stop your hair loss.

Many women notice hair loss about 3 months after they've had a baby. This loss is also related to hormones. During pregnancy, high levels of certain hormones cause the body to keep hair that would normally fall out. When the hormones return to pre-pregnancy levels, that hair falls out and the normal cycle of growth and loss starts again.

Some medicines can cause hair loss. This type of hair loss improves when you stop taking the medicine. Medicines that can cause hair loss include blood thinners (also called anticoagulants), medicines used for gout, high blood pressure or heart problems, vitamin A (if too much is taken), birth control pills and antidepressants.

Certain infections can cause hair loss. Fungal infections of the scalp can cause hair loss in children. The infection is easily treated with antifungal medicines.

Finally, hair loss may occur as part of an underlying disease, such as lupus or diabetes. Since hair loss may be an early sign of a disease, it is important to find the cause so that it can be treated.

Can certain hairstyles or treatments cause hair loss?

Yes. If you wear pigtails or cornrows or use tight hair rollers, the pull on your hair can cause a type of hair loss called traction alopecia (say: “al-oh-pee-sha”). If the pulling is stopped before scarring of the scalp develops, your hair will grow back normally. However, scarring can cause permanent hair loss. Hot oil hair treatments or chemicals used in permanents (also called "perms") may cause inflammation (swelling) of the hair follicle, which can result in scarring and hair loss.

What is common baldness?

"Common baldness" usually means male-pattern baldness, or permanent-pattern baldness. It is also called androgenetic alopecia. Male-pattern baldness is the most common cause of hair loss in men. Men who have this type of hair loss usually have inherited the trait. Men who start losing their hair at an early age tend to develop more extensive baldness. In male-pattern baldness, hair loss typically results in a receding hair line and baldness on the top of the head.

Women may develop female-pattern baldness. In this form of hair loss, the hair can become thin over the entire scalp.

Can my doctor do something to stop hair loss?

Perhaps. Your doctor will probably ask you some questions about your diet, any medicines you're taking, whether you've had a recent illness and how you take care of your hair. If you're a woman, your doctor may ask questions about your menstrual cycle, pregnancies and menopause. Your doctor may want to do a physical exam to look for other causes of hair loss. Finally, blood tests or a biopsy (taking a small sample of cells to examine under a microscope) of your scalp may be needed.

Is there any treatment for hair loss?

Depending on your type of hair loss, treatments are available. If a medicine is causing your hair loss, your doctor may be able to prescribe a different medicine. Recognizing and treating an infection may help stop the hair loss. Correcting a hormone imbalance may prevent further hair loss.

Medicines may also help slow or prevent the development of common baldness. One medicine, minoxidil (brand name: Rogaine), is available without a prescription. It is applied to the scalp. Both men and women can use it. Another medicine, finasteride, is available with a prescription. It comes in pills and is only for men. It may take up to 6 months before you can tell if one of these medicines is working.

If adequate treatment is not available for your type of hair loss, you may consider trying different hairstyles or wigs, hairpieces, hair weaves or artificial hair replacement.

Hair transplantation is a surgical technique that involves moving individual hair follicles from one part of the body (the donor site) to bald or balding parts (the recipient site). It is primarily used to treat male pattern baldness, whereby grafts containing hair follicles that are genetically resistant to balding are transplanted to bald scalp. However, it is also used to restore eyelashes, eyebrows, beard hair, chest hair, and pubic hair and to fill in scars caused by accidents or surgery such as face-lifts and previous hair transplants. Hair transplantation differs from skin grafting in that grafts contain almost all of the epidermis and dermis surrounding the hair follicle, and many tiny grafts are transplanted rather than a single strip of skin.

Since hair naturally grows in follicles that contain groupings of 1 to 4 hairs, today’s most advanced techniques transplant these naturally occurring 1–4 hair "follicular units" in their natural groupings. Thus modern hair transplantation can achieve a natural appearance by mimicking nature hair for hair. This hair transplant procedure is called Follicular Unit Transplantation (FUT). Donor hair can be harvested in two very different ways;

1. Strip Harvesting - a strip of scalp is removed under local anesthesia, the wound is then sutured back together and this piece of scalp tissue is then cut in to small pieces of tissue called grafts which are then transplanted back in to the thinning area of the patients head. This method will leave a linear scar in the donor area, which should be covered by a patients hair (if long). The recovery period is around 2 weeks and will require the stitches to be removed by medical personnel.

2. Follicular Unit Extraction or FUE Harvesting - individual follicles of hair are removed under local anesthesia; this micro removal uses tiny punches of between 0.6mm and 1.25mm in diameter. Each follicle is then reinserted back in to the scalp in the thinning area using a micro blade. Because individual follicles are removed, only small, punctate scars remain and any post-surgical pain is minimized. As no suture removal is required, recovery from FUE is within 7 days.

دکتر فرهاد هوشیدری - کاشت موی طبیعی ، جراحی زیبایی ، پاک کردن تاتو در یک جلسه ، لیزر پوست و موهای زائد

Hair Loss in Men

دکتر فرهاد هوشیدری - کاشت موی طبیعی ، جراحی زیبایی ، پاک کردن تاتو در یک جلسه ، لیزر پوست و موهای زائد

Hair Loss in Women

The Procedure

Example of a graft transplantation to cover the scar of a Hidradenitis suppurativa operation on the back of the head.

At an initial consultation, the surgeon analyzes the patient's scalp, discusses his preferences and expectations, and advises him/her on the best approach (e.g. single vs. multiple sessions) and what results might reasonably be expected.

For several days prior to surgery the patient refrains from using any medicines which might result in intraoperative bleeding and resultant poor "take" of the grafts. Alcohol and smoking can contribute to poor graft survival. Post operative antibiotics are commonly prescribed to prevent wound or graft infections.


Transplant operations are performed on an outpatient basis, with mild sedation (optional) and injected local anesthesia, which typically last about six hours. The scalp is shampooed and then treated with an antibacterial agent prior to the donor scalp being harvested.

In the usual follicular unit procedure, the surgeon harvests a strip of skin from the posterior scalp, in an area of good hair growth. The excised strip is about 1–1.5 x 15–30 cm in size. While closing the resulting wound, assistants begin to dissect individual follicular unit grafts from the strip. Working with binocular Stereo-microscopes, they carefully remove excess fibrous and fatty tissue while trying to avoid damage to the follicular cells that will be used for grafting. The latest method of closure is called 'Trichophytic closure' which results in much finer scars at the donor area.

دکتر فرهاد هوشیدری - کاشت موی طبیعی ، جراحی زیبایی ، پاک کردن تاتو در یک جلسه ، لیزر پوست و موهای زائد

FUE harvesting negates the need for large areas of scalp tissue to be harvested and can give very natural results with little or no scarring.

The surgeon then uses very small micro blades or fine needles to puncture the sites for receiving the grafts, placing them in a predetermined density and pattern, and angling the wounds in a consistent fashion to promote a realistic hair pattern. The technicians generally do the final part of the procedure, inserting the individual grafts in place.

Post-operative care

Advances in wound care allow for semi-permeable dressings, which allow seepage of blood and tissue fluid, to be applied and changed at least daily. The vulnerable recipient area must be shielded from the sun, and shampooing is started two days after the surgery. Some surgeons will have the patient shampoo the day after surgery. Shampooing is important to prevent scabs from occurring around the hair shaft. Scabs adhere to the hair shaft and increase the risk of losing newly transplanted hair follicles during the first 7 to 10 days post-op.

During the first ten days, virtually all of the transplanted hairs, inevitably traumatized by their relocation, will fall out ("shock loss"). After two to three months new hair will begin to grow from the moved follicles. The patient's hair will grow normally, and continue to thicken through the next six to nine months. Any subsequent hair loss is likely to be only from untreated areas. Some patients elect to use medications to retard such loss, while others plan a subsequent transplant procedure to deal with this eventuality.

Modern techniques

There are several different techniques available for the harvesting of hair follicles, each with their own advantages and disadvantages. Regardless of which donor harvesting technique is employed, proper extraction of the hair follicle is paramount to ensure the viability of the transplanted hair and avoid transection, the cutting of the hair shaft from the hair follicle. Hair follicles grow at a slight angle to the skin's surface, which means that regardless of technique transplant tissue must be removed with a corresponding angle and not perpendicular to the surface.

There are two main ways in which donor grafts are extracted today: strip excision harvesting and follicular unit extraction.

Strip harvesting is the most common technique for removing hair and follicles from a donor site, most commonly the area at the back and sides of the scalp. A single-, double-, or triple-bladed scalpel is used to remove strips of hair-bearing tissue from the donor site. Each incision is planned so that intact hair follicles are removed. Once removed, the strip is dissected into follicular units, which are small, naturally formed groupings of hair follicles.

Follicular Unit Extraction (FUE) takes place in a single long session or multiple small sessions. FUE is considered to be more time consuming, depending on the operator's skill, and there are restrictions on patient candidacy. The advantages of this technique over the conventional strip harvest are that it does not leave a linear scar, and the procedure produces little or no postoperative pain and discomfort. There are some disadvantages such as increased surgical times and higher cost to the patient. Clients are selected for FUE based on a fox test. There is however some debate about the usefulness of this in screening clients for FUE.


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Am I a Candidate for a Hair Transplant?

If you've noticed you're thinning on top, chances are you've already experienced a significant amount of hair loss. Hair transplant surgery may be an excellent choice for people who've tried other hair restoration options in the past with limited success or who are simply looking for noticeable, natural looking and permanent results.

Candidacy for hair transplantation can only be determined by a physician. During your consultation, a Hair Club Medical GroupTM doctor will determine the extent of your hair loss and the amount of hair available in the donor region. If you are a good candidate, the physician will make a recommendation on the number of grafts and sessions as well as what coverage you will be able to achieve.

Most men experience typical male pattern baldness. This means they experience either a receding hairline, hair loss at the crown or top of the head, or both. However, even men with significant levels of hair loss usually have healthy hair at the sides and back of their head. This hair is genetically programmed to grow, regardless of whether the individual is experiencing hair loss elsewhere. It is for this reason that most men in the early- to mid-stages of hair loss are generally good transplant candidates - with the caveat that it all depends on what your expectations are for coverage and density.

Due to the diffuse nature of women's hair loss (hair thins across the entire scalp), relatively few women are considered good candidates for hair transplants. Transplanting hair due to diffuse hair loss creates a possibility of transplanting hair that you may eventually lose. Scar repairs, traction alopecia and follicles that are damaged by Trichotillomania (chronic hair pulling) are exceptions, since transplants for these types of hair loss can often help significantly.

If you think it's time to do something about your hair loss, then you could be a candidate for one of our hair restoration solutions, including hair transplant surgery.


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 Eyebrow Transplantation

Eyebrows play a very important role in the beauty of the face and in one's own self-confidence. On the other hand, the task of eyebrows in establishing communication with the others and in expression of feelings is undeniable. However, the main duty of the eyebrows is to protect the eyes against the downward flow of sweat (or any type of fluid) from the forehead, and against the rays of sunshine. Losing eyebrows causes a lot of stress in the individual and very often, these individuals refer to a doctor after a short time for medical treatment or hair transplantation.

The phase of hair growth in the eyebrows is short and therefore, they do not grow much and do not get too long. For this reason, in case of any harm to this area, it will take a long time for the hair to grow again. This means that the capability of healing would be much less and its pace more slowly. Losing eyebrows can have various reasons, which are as follows:

1- Any damage by a blow or stroke like car accident, burning, chemicals, electric shock, etc.

2- Skin local diseases like skin lupus and Alopecia Areata

3- Birth defect

4- For beauty and design, women often pluck regularly their eyebrows to give them a better shape. However, as the eyebrows are not easy to repair and the speed of the hair growth in this area is low, plucking eyebrows in the long term harms the roots and they become thinner and scarce, until they get lost forever. In fact, this is the most prevalent reason for the hair transplantation in women.

5- Trichotillomania: to remove the eyebrows by pulling them compulsively because of a psychological illness or as a bad habit.

6-Losing eyebrows in the process of other treatments like chemotherapy, radiotherapy, removing a tumor in the eyebrow, or in an operation

7- General diseases like hormonal problems. In this case, first all of the probabilities should be considered, examined, and treated if possible, because otherwise even after hair transplantation, the hair loss may continue.

دکتر فرهاد هوشیدری - کاشت موی طبیعی ، جراحی زیبایی ، پاک کردن تاتو در یک جلسه ، لیزر پوست و موهای زائد

If the individual suffers from Trichotillomania, hair transplantation does not work. First, the person should be treated by a psychologist and after being cured, the transplantation can be carried out. Sometimes transplantation is done for an aesthetic reason according to the taste of the individual. They may want to have their eyebrows higher or want to have sharper eyebrow curves. Sometimes the eyebrows are for example naturally thin and the individual wants to make them look thicker. Taking the present boundaries and restrictions in the hair transplantation into consideration, in both above-mentioned cases, it is advisable not to undergo any hair transplantation. The best candidates for the hair transplantation are those who have either no eyebrows or have lost part of their eyebrows and want to replant them on the same spot.

دکتر فرهاد هوشیدری - کاشت موی طبیعی ، جراحی زیبایی ، پاک کردن تاتو در یک جلسه ، لیزر پوست و موهای زائد دکتر فرهاد هوشیدری - کاشت موی طبیعی ، جراحی زیبایی ، پاک کردن تاتو در یک جلسه ، لیزر پوست و موهای زائد

Beard and Moustache Transplantation

Bart and moustache are considered signs of masculinity in the men, and their existence has a great role in the attractiveness of a man's face and his self-confidence. Losing beard and moustache would cause severe stress in men and usually they refer to a doctor after a short period for medical treatment or transplantation. Losing beard and moustache may have various reasons, which are as follows:

1- Any damage by a blow or stroke like car accident, burning, chemicals, electric shock, etc.

2- Alopecia Areata DLE, systematic diseases like hormonal problems and local illnesses like...

3- Birth defect

4- Trichotillomania: to remove the beard and moustache by pulling them compulsively because of a psychological illness or as a bad habit.

5- Losing beard and moustache in the process of other treatments like chemotherapy, radiotherapy, removing a tumor in the eyebrow, or in an operation

In the consultation session, the doctor should consider and examine all the reasons that are responsible for the hair loss in this area, and they should be treated and cured if possible, because otherwise even after hair transplantation, the hair loss may continue.

If the individual suffers from Trichotillomania, hair transplantation does not work and the person should be treated first by a psychologist. It is also worthy of mentioning that beard and moustache transplantation in case of Alopecia Areata (local baldness), in which small and big circles in the beard and moustache growth area are cleared completely, would be of no use and in fact is forbidden.

For the time being, there are some problems in the beard and moustache transplantation procedures that are as follows:

1- The beard and moustache hair do not match completely to the rest of the body hair, so the transplanted hair would differ to some extent in their visible characteristics like color, thickness, etc with the previous ones (of course, this would not be the case in which the individual has no beard or moustache at all) .

دکتر فرهاد هوشیدری - کاشت موی طبیعی ، جراحی زیبایی ، پاک کردن تاتو در یک جلسه ، لیزر پوست و موهای زائد

2- With the existing devices used in beard and moustache transplantation ( which are very tiny and microscopic ), the same density of hair like the one in beard and moustache cannot be recreated and the distance between the transplanted hairs would be more than the normal density. Of course, the degree of the density could be raised in the second and third session of the hair transplantation; nevertheless, this density would never be as high as the normal hair growth in these areas.

3- Since the facial skin in the beard and moustache region is naturally oilier than parts, the possibility that the individual breaks out in infectious pimples after the beard and moustache transplantation is more, and for this reason at times the patient need to take antibiotics for some time. Of course, this would not interact with the planted hairs. The procedures in the beard and moustache transplantation is similar to the other hair transplantations, but here only 1-2 hair follicular units are used and they are reinserted with a micro blade so that the scars are minimized and invisible.

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