Q: I fInd that I am losing a
lot of my hair whenever I comb or wash it. I’m considering having a
hair transplant but I’m concerned about undergoing such an invasive
procedure. What do you think? I am 78.
A: Baldness in older men is extremely common. With increasing age, the hair follicles become more sensitive to
testosterone and this causes them to shrink.
Genes govern the degree to which you go bald and at what age, but by their late 70s most men have lost a lot of hair.
There are a couple of treatments you could try before resorting to a
transplant. Finasteride tablets block the action of testosterone, which
allows the hair follicles to grow back to normal size.
It doesn’t work for everyone but around two thirds of users have some hair regrowth and in most patients hair stops thinning.
They take about four months to start working and up to two years for
full hair growth. They also stop working the moment you stop taking
them.
Side effects are uncommon, but can include loss of sex drive. another
option is minoxidil lotion, which you need to rub on your scalp every
day. Again, this takes about four months to work.
Neither treatment is available on the nHs and you will need a private prescription from your doctor for finasteride tablets.
Hair transplant surgery usually involves transferring plugs of scalp
skin with the hair follicles from the back of the head to the balding
areas. The more hair that is transplanted the better the result but
this can be difficult if you hair is already thin at the back.
It is also expensive. More importantly, there are risks, especially for
an elderly gentleman. If you do decide to go ahead, see your GP first
to check that you are fit enough to undergo this type of surgery.
Q: I’ve been diagnosed with
spinal stenosis, which I understand will probably mean surgery. What
are the risks and complications, how serious is the operation and is
the condition going to recur? I also have scoliosis.
A: In spInal stenosis, there is
narrowing of the spaces between the structures of the spine – either
the gaps between the bones (vertebrae) or between the vertebrae and the
spinal cord. This can lead to pressure on the nerves as they leave the
spinal cord, causing pain which can be severe.
Any part of the spine can be affected but symptoms usually occur in the
buttocks and legs. Other symptoms include numbness, pins and needles
and muscle weakness.
The most common cause of spinal stenosis is arthritis in the joints
between the vertebrae, as well as thinning of the intervertebral discs.
It can also be linked with structural deformities, such as scoliosis,
which is an abnormal curve in the spine. Treatment depends on the
underlying cause.
In some cases, exercise and physiotherapy, together with pain relieving medication, is all that is required.
However, the only way of easing the pressure on the nerves is by
removing extra bone to give more space for the nerves. The risks and
benefits of the surgery vary.
There is always a slight chance of permanent damage to either the
nerves or the spinal cord. In older people suffering from severe
arthritis, surgery may be too dangerous but in younger people it can be
very successful.
Your surgeon should be able to advise you.
If you have a question for Dr
Rosemary, write to her, in confidence, at The Northern & Shell
Building, 10 Lower Thames Street, London EC3R 6EN, or e-mail
health@express.co.uk Dr Rosemary’s reply will appear in this column.
She regrets that she cannot enter
into personal correspondence and that, due to the volume of letters,
she cannot reply to everyone
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