August 26, 2018
We will occasionally request blood tests in women suffering from hair loss if the diagnosis is unclear. One of the tests we do is a testosterone (T) level as elevated levels of testosterone can be associated with hair loss and we want to rule out this possibility. Many times, however, the test result will reveal that the level is actually low. The question that arises is whether or not anything should be done about this. Dr. Nakatsui usually requests that the patient discuss this with her family physician to see if testosterone supplementation is reasonable. Over the years, some of the patients who went on supplementation have reported to us that their hair loss actually improved!
Should a woman with low T go on supplementation?
Whether or not to go on supplementation depends on a number of factors. Firstly, does the patient have any other symptoms of low testosterone, such as insomnia, fatigue, depressed mood, hot flashes, and vaginal dryness? If so, perhaps a case could be made to go on supplementation.
The other issue is that of side effects as one of the possible side effects is increased facial hair. Is the patient willing to deal with this?
The last question is whether or not supplementation will actually improve the hair loss. (more…)
August 26, 2018
For many years, we have used finasteride (Propecia) for male pattern hair loss and for many men, it has worked very well. However, in those men who are non-responders, another option may be dutasteride, a cousin to finasteride. Whereas finasteride is approved by the FDA for hair loss, dutasteride is not but has been used off-label for several years.
Both of these medications are 5-alpha-reductase inhibitors, which help improve hair loss by preventing the formation of dihydrotestosterone (DHT). The difference between them is that finasteride (FIN) inhibits 5-alpha reductase type 2, whereas dutasteride (DUT) inhibits 5-alpha reductase type 2 and type 1.
Which is stronger?
DUT is more potent and decreases DHT to a greater extent than FIN (90% versus 70%). However, the flip side is that side effects are potentially greater so many patients are reluctant to go on this medication for this reason. (more…)
July 12, 2018
Hair transplant surgeries have become one of the most popular cosmetic procedures for men and a large number of women. Much of what happens before, during, and after a hair transplant surgery is uncertain for many curious people. Here is what the typical process for hair restoration surgeries look like from consultation to 1 year after the surgery with Dr. Nakatsui.
Complimentary Comprehensive Consultation
A prospective patient will come in to our clinic for a complimentary consultation with Dr. Nakatsui. During this consultation, Dr. Nakatsui will obtain a thorough history of the individual. When did the hair loss begin, what types of treatments they have tried in the past, and what is their family history for hair loss are among a few of the typical questions asked.
Dr. Nakatsui then performs a thorough examination of the scalp to determine if there are any other medical factors that may contribute to the hair loss such as Alopecia Areata or Lichen Planopilaris. These are conditions in which the body attacks its own hair and because of that, hair transplantation into these areas is not recommended. Dr. Nakatsui then assesses the patient’s situation and expectations and determines if the individual is a good candidate for hair restoration surgery. (more…)