Scientific studies have shown that hair loss can create
loss of self-esteem and even affect job performance.

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Hair loss is a problem for men and women. Scientific studies have shown that hair loss can reduce self-esteem and affect job performance. People feel less attractive when they are experiencing hair loss and it can have a significant effect on relations with the opposite sex. The most common cause of hair loss in men and women is pattern baldness or androgenic alopecia. It usually occurs in gradual and predictable patterns – a receding hairline and bald spots in men and thinning hair along the crown of the scalp in women.  

Many people still believe the myth that hair loss only comes down from the mother’s side of the family. The truth is that hair loss can come from either side of the family. It may follow a very predictable pattern from your mother or father or a combination from both sides. Occasionally a young patient will come to us with extensive baldness when there is no family history of early baldness from either parents’ side.

It is helpful to think of hereditary Pattern Hair Loss as a random shuffling of the genetic cards. The genetic ‘hand’ you are dealt will determine when your hair loss appears and how quickly it progresses. There has been some work on gene therapy for hair loss but there are no effective treatments on the horizon.

At the Cooley Hair Center, we rely on the family history and the patient’s own history of hair loss as a guide to estimate what a patient can expect in the future. It is just an estimate as there is no way to accurately predict at this point in time how bald someone may become. In general, the more family members with extensive baldness and the earlier in life someone’s hair loss appears, the more extensive it will become.

Types of Hair Loss

Scarring alopecia

Scarring alopecia is a reference that can be confusing and misleading. It means that hair follicles are absent from microscopic scarring within the scalp. In non-scarring alopecia, even though hair shafts have been lost, the hair follicles are still present within the skin. In scarring alopecia, inflammation or trauma has resulted in the actual destruction of hair follicles and may or may not be associated with visible scars on the scalp’s surface.

Types of scarring alopecia include lupus, lichen planopilaris, Frontal Fibrosing Alopecia, Central Centrifugal Cicatricial Alopecia (CCCA), and scarring from accidents, burns, or radiation treatment for cancer. Discoid Lupus results in scarring and bald spots within the scalp and must be treated with steroids to prevent further hair loss. Patients are not candidates for a hair transplant unless the condition has been inactive for a long time.

Lichen planopilaris is also an autoimmune condition in which the pattern of hair loss is a little different than lupus. There is usually redness, itching, and a characteristic scaling around the base of the hair shaft. Steroids are also the mainstay of treatment but a transplant may be considered if the condition has resolved.

However, the disease’s chance to reactivate must be considered because if this occurs, the transplanted hair will also be lost. When active, these conditions are not amenable to hair transplantation. Hair transplantation may be considered when they have been dormant for an extended period. 

Frontal fibrosing alopecia is an increasingly common form of scarring alopecia that attacks the frontal hairline. The initial approach is to treat the inflammation with topical and/or oral medications. Hair transplantation may be considered if it has been under control for some time.


Trichotillomania is a condition where the patient compulsively pulls out their own hair. Sometimes they are unaware of it and will deny that this is occurring. If the condition goes on long enough, permanent bald spots may occur. If this occurs and the condition has been quiet for a long time, the patient may be a candidate for hair transplantation to fill in these bald spots. Of course, if the condition comes back, the patient may also lose the transplanted hair.

Telogen effluvium

Telogen effluvium is a common condition where the person experiences rapid shedding of hair. The hair grows in stages, which is known as the hair cycle. The growing phase (anagen) lasts for about three years, followed by a resting phase (telogen) which lasts for 3 to 4 months, after which the hair shaft is shed, and a new growing cycle begins. Usually, the hairs are in different stages of the cycle and only a small amount of hair is shed every day.

However, certain trigger factors can send the hair from the growing phase into the resting phase, followed by shedding 3 to 4 months later. These trigger factors include stress, hormone changes, medication side effects, vitamin deficiencies, etc. Usually, pattern hair loss appears and progresses slowly while telogen effluvium appears suddenly. A dermatologist can usually tell the difference but if not, a biopsy of the scalp may be performed. The treatment for telogen effluvium is to correct the underlying cause and the normal hair cycle will naturally be reestablished.

Get your self-confidence back

When you have surgical hair restoration at Cooley Hair Center, you will see not only new hair but renewed self-confidence and higher self-esteem. It is an investment in yourself!

It is an investment in yourself!
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Alopecia areata

Alopecia areata is an immune system condition that causes patchy hair loss and creates smooth bald spots on the scalp. Rarely will this progress involve the entire scalp (alopecia totalis) or even the entire body in which all hair is absent (alopecia universalis).

Steroids (topical, injected, or systemic) are the mainstay of treatment and are generally effective. For patients with extensive alopecia areata (totalis or universalis), exciting new treatments are available for this condition at the Cooley Hair Center. Patients with alopecia areata are generally not candidates for hair transplantation.


Wearing excessively tight hairstyles that pull hair away from the scalp and cause the hair strands to fall out can also result in hair loss. This type of condition is called traction alopecia. Hairstyles like pigtails, braids, and cornrows are the most common causes of this type of hair loss. Often, the hair regrows after you change your hairstyle. 

However, traction alopecia may lead to thinning hair or bald spots unless the hairstyle is changed. African-American women often experience this type of hair loss near the temples or along the hairline.

Central Centrifugal Cicatricial Alopecia (CCCA)

Central Centrifugal Cicatricial Alopecia is relatively common among African-American women and Dr. Cooley has extensive experience treating this condition.

It may begin as a small round area on the top of the scalp and gradually progress outwards with an enlarging bald spot.

It is usually accompanied by dry skin, redness, burning, and itching. Some have theorized that this condition is due to various styling practices such as perms and relaxers. However, this has never been proven.

Hair loss treatment for CCCA entails injecting steroids and topical steroids, and the patient is encouraged to minimize harsh relaxers.

Dr. Cooley encourages patients to consider letting their hair grow naturally or to use relaxers as little as possible.

At the Cooley Hair Center, we consider a woman with this condition a good candidate for hair transplantation. If the CCCA is under control with no symptoms or hair loss for a significant period of time.

After undergoing a hair transplant, Dr. Cooley has patients use topical steroids once or twice a week or indefinitely to ensure that the CCCA does not flare up.

If it does, Dr. Cooley immediately treats the patient with injected steroids to prevent hair loss. 

At the Cooley Hair Center, you have a chance to restore hair growth and confidence. Schedule a consultation with Dr. Cooley today. 

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