Hair loss. White bulb versus black?

Question

Derm thinks I have AGA with maybe TE. No biopsy was done. He said it wouldn’t change outcome and didn’t have great things to say about any options out there.I seem to lose the normal amount of hair 80-100 hairs per day. But I would say half of those hairs have white the other black bulbs? What does it mean if you are losing hairs in the ANAGEN phase? And is the only option still rogaine & spirolactone? I heard about this scalp tattoo is it worth the money? And can it damage scalp?

Jeff Rapaport, MD · Answer

You need  to visit a hair loss expert. They will do a good examination ,history, possibly dermoscopy ,biopsy and blood work. The above with a biopsy proceeded horizontally  from two different sites with antigen & telogen counts as well as telogen & vellus counts should be able to determine your diagnosis.PRP hair md.com

Parsa Mohebi, MD, FISHRS · Answer

The amount of hair you report losing is in the normal range but based on you having said the Derm doc thinks you have "AGA with maybe TE", that would indicate a greater than normal amount of hair loss. Best I can say is that you need to see a hair restoration physician to help you sort this out.  A good history including family history of hair loss, along with a microscopic evaluation, will likely give you a clearer picture. And, if indicated, a biopsy could be done. With regard to your question concerning medication for hair loss, there are 2 meds that are FDA approved for hair loss....finasteride and Rogaine.  During your visit those options can be discussed if you truly have AGA.  Lastly, your question about "scalp tattoo", we do offer scalp micropigmentation (SMP) to certain patients that do not wish to undergo a hair transplant just yet but want to give the illusion that there is still hair in between your native hair.

Jeff Donovan, MD, PhD · Answer

I would need to see your scalp up close and know all your story to say what is going on. AGA and TE are very different and change outcome. It is pretty unlikely you are losing hair in anagen but if you were,  biopsy is mandatory. Most people get so confused over the hairs they are shedding. 99.99 % of the time they are telogen hairs. Options for treatment depend on your exact diagnosis. It sounds like you may or may not have confirmed that.

William Rassman, MD (retired) · Answer

Hair loss does cause hair to fall out and at times you can see the bulbs of these hairs and other times not.  Some men do not undergo hair transplants when they see hair thinning and do Scalp Micropigmentation to address thinning. Some men just shave their head and take the plunge to always keep their head shaved and have the Scalp Micropigmentation provide the look of a full head of shaved hair.

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Hair loss. White bulb versus black?

Answers (4)

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