Why am I losing my hair and is there anything I can do about it? By the time patients come to see a hair transplant surgeon, they have already lost a substantial amount of hair.

The first question most of them ask is the title of this post “Why am I losing my hair and is there anything I can do about it?” To this simple question there is a complicated answer which starts with understanding hair follicles and how they produce hair. The first thing to understand is that all hair follicles are not the same.

For instance your beard hair did not come about until the onset of puberty. So clearly in some way, those follicles are different from your scalp hair. Similarly your eyebrow hair and eyelash hair only grow to a certain length. The genetic variation in the hair follicle Is responsible for these differences. While the end result may be hair from these follicles it is obvious that the genetic coding in each follicle is different. The reason that you have lost hair is embedded in the genetic code of those hair follicles. They were preprogrammed to go away or to put it technically die an early death, a process known in medical lingo as senescence. Therefore unless you can change the genetic code there is no reason to believe that there was anything you could have done to prevent the hair loss.

Hair loss, to some extent, is hereditary but that is not the complete answer. Just because your father had a complete head of hair till he was 70 does not mean that you will or vice versa. That if he lost all his hair, you will too.

— In next week’s blog, I address the question of what can be done to prevent hair loss.