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Q: I am a 21 yrs old male having serious hair loss over the last few years. I also have very little facial hair. Since Propecia is a DHT blocker can it inhibit beard growth? — E.M., Astoria, N.Y.

A: As you suggest, it would be reasonable to assume that since DHT stimulates beard growth, blocking DHT (with finasteride) would tend to inhibit its growth. In practice, this does not seem to be the case, i.e. we don’t find that Propecia has any effect on facial hair. The reason is not clear.

It is interesting to note that testosterone stimulates growth of axillary and pubic hair, but not scalp hair. Scalp hair growth is not androgen dependent, only scalp hair loss is.

DHT stimulates terminal hair growth of the beard, trunk and limbs, external ears and nostrils. Of course, it also is responsible for the bitemporal reshaping of hairline as one passes into adulthood and causes male patterned baldness (androgenetic alopecia).

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Q: Can you use beard hair for a hair transplant using Follicular Unit Extraction? — A.C., San Francisco, CA

A:It is possible to use beard hair for a hair transplant, but there are three main differences between harvesting from the donor area and harvesting from the beard that should be taken into account. These are: 1) scarring 2) ease of extraction and 3) hair quality. Let’s explore these differences in turn.

First, in FUE, although there is no linear scar, there are small white round scars from where the hair is harvested. Normally these marks are hidden in the donor area and are not visible, even if the hair is clipped very short. However, if the scalp is shaven, these marks will become visible. When the beard is used as the donor source for the hair transplant, the patient must continue to wear a beard after the restoration, even if it is tightly cropped, or the faint white marks will show. The tiny round scars from FUE will generally be visible on a clean shaven face. As each person heals differently, we would perform a test before doing the actual procedure to make sure the marks from the extraction are not noticeable at the length that the person wants to wear his beard.

Second, FUE performed on beard hair differs from extraction from the scalp because of the greater laxity — or looseness — of facial skin. This makes extraction with minimal transection more difficult in some cases. A test prior to the hair transplant is particularly important in beard FUE so that the ease of extraction may be determined in advance.

Third, beard hair is coarser than scalp hair. Although the hair seems to take on some of the characteristics of the original hair in the transplanted area, the transformation is not complete. This makes beard hair an imperfect substitute for scalp hair.

A solution to the problem is to transplant beard hair behind the hairline for volume and scalp donor hair at the hairline for naturalness.

Read about FUE Hair Transplants

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