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Frequently Asked Questions About Hair Loss

Hair loss usually starts with a question. Why is this happening? Can I stop it? Will I need a hair transplant? Should I be thinking about FUE, FUT, medication or PRP with ACell? And eventually it comes down to the question that really matters. What can I actually do about it?

Leonard Hair Transplant Associates helps men and women throughout New England find that answer. Led by our experienced Chief Hair Restoration Surgeon Dr. Matthew Lopresti, our practice offers FUE and FUT hair transplant surgery along with non surgical treatments including finasteride, minoxidil and PRP with ACell. Hair loss comes with enough uncertainty. The answers shouldn’t. Below, we tackle the questions people ask us every day and help you understand what may make sense for the hair you still have and the hair you want back.

What Causes Hair Loss?

Hair loss can be caused by genetics, hormones, autoimmune conditions, illness, stress, medications, nutritional issues, childbirth, rapid weight loss, physical tension on the hair and other medical conditions. The most common cause of progressive hair loss in men and women is androgenetic alopecia, also known as genetic pattern hair loss.

Genetics

Genetic hair loss happens when certain hair follicles inherit a sensitivity to hormones such as DHT. Over time, those follicles can gradually miniaturize, producing hairs that become finer, shorter and less visible.

Your DNA may have started the conversation. That doesn’t mean Mom or Dad gets all the blame.

Other Causes

Hair loss and excessive shedding can also be associated with:

Rapid or significant weight loss can sometimes trigger telogen effluvium, a form of excessive shedding that occurs when more hair follicles than usual enter the resting and shedding phase. With the increased use of GLP-1 weight-loss medications, this has become an increasingly common hair loss question.

Some forms of hair loss may be temporary and improve when the underlying trigger resolves. Others can be progressive or permanent.

What Are Common Myths About Hair Loss?

Hair loss comes with plenty of myths, and some of them have been passed around almost as long as the genetics themselves.

The good news is that hair loss isn’t a choice between believing the myths and accepting defeat. Evidence based treatment options may include finasteride, minoxidil, PRP with ACell and FUE or FUT hair transplant surgery, depending on the cause and extent of your hair loss.

You don’t need another miracle promising you the hair you had ten years ago. You need to know why you’re losing it, what can realistically be done about it and which treatments actually deserve your time and money.

What Are the Different Types of Hair Loss?

The main types of hair loss include genetic pattern hair loss, autoimmune hair loss, traction hair loss, temporary shedding and scarring hair loss.

They may all look like thinning or shedding in the mirror, but what is happening beneath the surface can be very different. Genetics, inflammation, autoimmune activity, physical tension and changes in the normal hair growth cycle can all affect hair follicles differently.

That’s why understanding the type of hair loss comes before deciding how to treat it. Two people can be losing hair for completely different reasons, and the right treatment starts with knowing the difference.

Androgenetic Alopecia

Androgenetic alopecia, also known as male pattern baldness or female pattern hair loss, is the most common form of progressive genetic hair loss. Family history is one of the biggest clues. If thinning or baldness runs on either side of your family, genetics may have given your hair follicles a greater sensitivity to hormones such as DHT.

Men commonly notice a receding frontal hairline, thinning at the temples or loss of density through the crown. Women more often notice a widening part or diffuse thinning across the top of the scalp.

The important word is progressive. Genetics usually doesn’t take your hair overnight. Sensitive follicles gradually miniaturize, producing finer and shorter hairs one growth cycle at a time. Your family history may tell us where the story started. What your follicles are doing today helps tell us where it may be going.

Alopecia Areata

Alopecia areata is an autoimmune condition that causes sudden, often patchy hair loss when the immune system mistakenly attacks hair follicles. Hair may regrow on its own, but the course can be unpredictable. Some people experience one episode, while others may have recurring or more extensive hair loss.

This isn’t the same biology as genetic male or female pattern hair loss. It may look like hair loss in the mirror, but under the skin, it’s a very different conversation.

Alopecia Universalis

Alopecia universalis is an autoimmune condition that can cause complete whole body hair loss from head to toe. It is an advanced form of alopecia areata in which the immune system attacks hair follicles, potentially causing loss of scalp hair, eyebrows, eyelashes, facial hair and body hair.

This is very different from genetic male or female pattern hair loss. When someone is experiencing widespread or whole body hair loss, identifying the underlying condition comes before talking about hair restoration.

Traction Alopecia

Traction alopecia is hair loss caused by repeated tension or pulling on the hair follicles, and hairline recession is often one of the first places it becomes noticeable. Tight ponytails, braids, buns, extensions and weaves can repeatedly pull on the same follicles, especially around the front and sides of the hairline.

Early on, reducing the tension may allow affected follicles to recover and hair to regrow. But years of tight ponytails or other high tension hairstyles can lead to chronic inflammation, follicle damage and eventually permanent hair loss.

Your ponytail may look innocent. Your hairline knows how tight you’ve been pulling it.

Telogen Effluvium

Telogen effluvium is a form of excessive hair shedding that happens when more hair follicles than normal shift from the growing phase into the resting and shedding phase. The tricky part is timing. The shedding often doesn’t appear until a few months after whatever triggered it.

Three questions we hear all the time involve GLP-1 weight loss, childbirth and seasonal shedding. Rapid or significant weight loss, including weight loss while using GLP-1 medications, can trigger telogen effluvium. So can the major hormonal and physical changes that happen during and after pregnancy. Seasonal changes in shedding can also occur, although that is not necessarily the same thing as classic telogen effluvium.

Other triggers can include illness, high fever, surgery, severe stress and nutritional deficiencies. In many cases, telogen effluvium is temporary once the underlying trigger has resolved.

Hair has a surprisingly good memory. What you’re seeing in the shower today may be the biological receipt for something your body went through months ago.

Scarring Alopecias

Scarring alopecias are hair loss conditions in which inflammation damages and can permanently destroy hair follicles. Warning signs may include spotty or patchy hair loss along with redness, itching, burning, tenderness or other irritation of the scalp.

This is very different from typical genetic pattern hair loss. If we see patchy hair loss or signs of scalp inflammation or irritation, we may recommend that you see a dermatologist to determine what is happening before considering hair restoration treatment.

A thinning follicle may still give you something to work with. A follicle destroyed by inflammation and replaced by scar tissue is a very different conversation.

Is Hair Loss Inherited from Your Mother or Father?

Hair loss can be inherited from your mother’s side, your father’s side or both. So before blaming Mom and Grandpa for everything happening on top of your head, take a look at Dad’s side of the family too.

Androgenetic alopecia, or male and female pattern hair loss, is influenced by multiple genes. That’s why one brother can have a full head of hair while another starts thinning in his 20s. Genetics apparently didn’t get the memo about treating siblings equally.

If genetic hair loss runs in your family, hormones such as DHT can cause susceptible follicles to gradually miniaturize, producing finer and shorter hairs over time. Genetics may load the deck, but your family photos can’t tell you exactly how your own hair loss will play out.

Why Do Men and Women Lose Their Hair?

Genetics is the most common cause of progressive hair loss in men and women, known as androgenetic alopecia or pattern hair loss. If your follicles inherited a sensitivity to hormones such as DHT, they can gradually miniaturize and produce shorter, finer hairs over time. Genetics handed you the cards. Your follicles are simply playing the hand.

But genetics doesn’t get all the credit. Stress, illness, hormonal changes, childbirth, certain medications, nutritional issues, autoimmune conditions and other medical causes can also trigger thinning or shedding. Hair may look simple sitting on top of your head. The biology underneath it is anything but.

And that’s the part that matters. Seeing more scalp tells you something is changing. It doesn’t tell you why. Before you start buying shampoos, supplements or whatever miracle your phone decided to advertise to you this week, figure out what you’re actually dealing with.

How Does DHT Cause Hair Loss?

DHT causes genetic hair loss by attacking hair follicles that are genetically sensitive to it, causing them to slowly shrink in a process called follicular miniaturization. As the follicle gets smaller, the hair it produces becomes thinner, shorter and harder to see.

Your body makes DHT, or dihydrotestosterone, when an enzyme called 5 alpha reductase converts testosterone into it. That’s completely normal. The interesting part is that some hair follicles inherit androgen receptors that make them more sensitive to this hormone than others.

When DHT binds to those receptors, it can shorten the follicle’s normal hair growth cycle. A thick, healthy terminal hair can become a thinner hair. Then a finer one. Then a tiny, wispy one. Eventually, the follicle may stop producing visible hair altogether. The follicle doesn’t simply disappear overnight. It gets worse at growing hair one cycle at a time.

This is why finasteride can be an important non-surgical hair loss treatment for the right patient. Finasteride blocks 5 alpha reductase, which means less testosterone gets converted into DHT. Less DHT means less pressure on genetically sensitive follicles and a better chance of slowing continued miniaturization.

You don’t always have to wait for a follicle to stop producing visible hair before doing something about it. Sometimes the smartest move is helping protect it while it’s still in the game.

Does Wearing a Hat or Helmet Cause Hair Loss?

No. Wearing a hat, baseball cap or helmet does not normally cause hair loss, baldness or male and female pattern hair loss. Your favorite hat is off the hook.

The most common form of hair loss is androgenetic alopecia, or genetic pattern hair loss. It happens at the hair follicle level and is influenced by genetics and hormones such as DHT. Wearing something on top of your head does not cause DHT to attack your follicles, suffocate your scalp or stop your hair from growing. Hair follicles receive oxygen and nutrients through the blood supply beneath your skin, not from the air above your head.

There is one exception worth understanding. A very tight hat, helmet or headwear that repeatedly pulls on the hair could potentially contribute to hair breakage or traction alopecia. That is caused by repeated tension on the hair and is very different from genetic hair loss.

So wear the hat. Wear the helmet. Just don’t blame either one for something your DNA may have started years ago.

Do Women and Men Lose Their Hair for the Same Reason?

Yes. Men and women can lose hair for many of the same reasons, including genetics, hormones, stress, illness, medications and changes in the normal hair growth cycle. But genetic hair loss often tells a different story.

Men with androgenetic alopecia commonly see recession in the frontal area and thinning through the crown. Women with female pattern hair loss more often see diffuse thinning and a widening part. Same biology. Different blueprint.

Hair loss may look different on everyone. The important part is knowing what’s driving yours.

How Much Hair Loss Per Day Is Considered Normal?

Losing around 50 to 100 hairs a day is generally considered normal. Your hair is constantly cycling through growing, resting and shedding phases, so seeing some hair in the shower, on your pillow or in your brush doesn’t automatically mean you’re going bald.

What matters more is whether something has changed. More hair in the shower. A wider part. Less density. More scalp showing in photographs. Those changes can be more important than trying to count every hair that went down the drain.

Your scalp contains tens of thousands of follicles, all operating on their own biological schedules. A little shedding is biology. A noticeable change in your hair may be something worth understanding.

How Is Male Pattern Baldness Treated?

Male pattern baldness can be treated with medications such as finasteride and minoxidil, PRP with ACell and, when appropriate, FUE or FUT hair transplant surgery. The right treatment depends on how much hair you’ve lost, how much you still have and where your hair loss may be headed.

Hair Transplant and Hair Loss Treatment FAQs

What Is the Difference Between FUE and FUT Hair Transplants?

FUE and FUT are two different ways of harvesting donor hair for a hair transplant. With FUE, individual follicular units are removed one at a time. With FUT, a narrow strip of donor tissue is removed and the follicular units are then prepared for transplantation.

The technical difference matters, but what probably matters more to you is choosing the approach that fits your hair, your goals and the way you want to look years from now. You may prefer FUE because it avoids a linear donor scar. You may be better suited for FUT because it can make sense based on your donor supply or the amount of hair you want to move. There is no single “better” procedure for everyone.

Dr. Matthew Lopresti personally performs both FUE and FUT hair transplant surgery at Leonard Hair Transplant Associates. The goal is not to steer you toward one technique. It is to help you understand which option gives you the best path forward with the hair you have.

How Do I Know If I Am a Good Candidate for a Hair Transplant?

For many people, the answer depends less on how much hair they have lost and more on what they still have to work with. Your donor hair, pattern of hair loss, age and the possibility of future thinning all help determine whether FUE or FUT hair transplant surgery makes sense for you.

That’s why looking at someone else’s before and after photos can only tell you so much. Their hair isn’t your hair. Their donor supply isn’t yours. And what worked for them may not be the right plan for you.

At Leonard Hair Transplant Associates, Dr. Matthew Lopresti looks at the hair you have today while thinking about the hair you may still have years from now. If a hair transplant makes sense, he’ll show you what may realistically be possible. If it doesn’t, he’ll tell you that too and discuss other options that may be better for you.

How Many Grafts Will I Need for a Hair Transplant?

There is no single graft number that is right for everyone. The number of grafts you may need depends on your pattern of hair loss, donor hair, the area being restored, your hair characteristics and the possibility of future hair loss. But the biggest number isn’t always the best plan. Your donor hair is limited, and once it is used, you don’t get it back.

Dr. Lopresti looks beyond how many grafts can be transplanted in one procedure and considers how those grafts can be used effectively while preserving donor hair for the future. A successful hair transplant isn’t a contest to see who can transplant the most grafts. It’s about putting the right number of grafts in the right places, creating a natural-looking result and making decisions today that still make sense if your hair loss continues tomorrow.

Will a hair transplant leave a scar?

Any hair transplant will leave some degree of scarring. FUE typically leaves small, scattered scars in the donor area, while FUT leaves a linear scar that can usually be concealed by surrounding hair. Neither technique is truly scarless.

The right choice is not about which procedure has the better sales pitch. It is about which one makes the most sense for you. Dr. Lopresti personally performs both FUE and FUT, so the procedure fits the patient, not the other way around.

Does a Hair Transplant Hurt?

We know this may be one of your biggest concerns when considering a hair transplant. Your scalp is numbed with local anesthesia, and once you are numb, you typically will not feel the procedure itself. We pay close attention to your comfort throughout the day, so if you need anything, just let us know.

After surgery, most patients find that Extra Strength Tylenol is all they need for any discomfort. If you need something more, additional medication can be prescribed. Our goal is to make the entire experience much easier and more comfortable than you may be expecting.

Who Performs Hair Transplant Surgery at Leonard Hair Transplant Associates?

FUE and FUT hair transplant surgery is personally performed by Chief Hair Restoration Surgeon Dr. Matthew Lopresti. He evaluates your hair loss, donor hair and goals and develops a plan around what makes sense for you, not simply how many grafts can be transplanted.

Because a successful hair transplant shouldn’t look like you had a hair transplant. It should look like you on a really good hair day, without having to think about it.

Where Does Dr. Matthew Lopresti Perform Hair Transplant Surgery?

FUE and FUT hair transplant surgery is performed by Dr. Lopresti at Leonard Hair Transplant Associates in Newton, Massachusetts and Warwick, Rhode Island.

But where you live doesn’t have to decide where you go for your hair transplant. Patients come to us from throughout Massachusetts, Rhode Island and New England, as well as from other parts of the country and the world. If you’re coming from farther away, you can start with a virtual consultation before making any travel plans. Our team can then help you understand what to expect, how to plan your visit and when you can head home after surgery.

Can Hair Loss Be Treated Without a Hair Transplant?

Yes. A hair transplant isn’t the only way to fight hair loss, and it may not be the first thing you need. At Leonard Hair Transplant Associates, Dr. Matthew Lopresti may recommend non-surgical treatments such as finasteride, minoxidil or PRP with ACell depending on your hair loss and goals.

Sometimes the smartest move isn’t replacing the hair you’ve lost. It’s getting ahead of hair loss while you still have more hair to protect.

How Long Does It Take to See Results After a Hair Transplant?

New growth typically begins around five to six months after surgery, with more noticeable changes developing around nine to twelve months. Your final result can take approximately 16 to 18 months.

It takes patience, but there’s something different about watching your hair improve instead of watching it disappear. The change is gradual. So is the moment you realize you’re not thinking about your hair as much anymore.

How Do I Choose a Hair Transplant Surgeon?

Choose a hair transplant surgeon by looking at their training, experience, before and after results, professional credentials and whether they personally perform the type of hair transplant being recommended. Just as important, ask whether the surgeon offers more than one surgical technique. If every patient gets the same answer, you may want to ask why.

Then use some common sense. Do you gel with the surgeon? Do you trust what they’re telling you? Is the office clean, professional and the kind of place where you would feel comfortable having surgery? How does the staff treat you? Does the recommendation make sense, or does the consultation feel more like a sales pitch? Credentials can tell you a lot. Your gut can tell you something too.

Dr. Matthew Lopresti is a Fellow of the International Society of Hair Restoration Surgery (FISHRS) and a Diplomate of the American Board of Hair Restoration Surgery (ABHRS). He personally performs both FUE and FUT at Leonard Hair Transplant Associates, allowing the procedure to fit the patient instead of asking every patient to fit the procedure.

And remember the old saying: you probably wouldn’t buy the cheapest parachute. Hair transplant surgery shouldn’t be a race to find the lowest price either. You’re making a permanent decision with a limited supply of donor hair. Choose the surgeon, the plan and the place you trust, not simply the price you like best.

Contact Leonard Hair Transplant Associates

If you’re noticing more hair in the shower, a receding hairline, a widening part, thinning through the crown or simply less hair than you used to have, you don’t need to wait until it gets worse to find out what’s happening.

At Leonard Hair Transplant Associates, we focus on one thing. Hair loss. Led by Chief Hair Restoration Surgeon Dr. Matthew Lopresti, our team helps men and women understand why they’re losing hair and what may actually be worth doing about it. Depending on your hair loss, options may include finasteride, minoxidil, PRP with ACell, FUE or FUT hair transplant surgery.

You can’t go back and save the hair you’ve already lost. But you can decide what you do with the hair you still have. Schedule a complimentary consultation at one of our Massachusetts, Rhode Island or New Hampshire locations and let’s figure out what makes sense for yours.