Hair Loss 101: Diagnosis, Treatment & The Future of Restoration with Dr. Achiamah Osei-Tutu
Posted posted on May 13, 2025
On This Week's Episode:
Dr. Achiamah Osei-Tutu—board-certified dermatologist and hair restoration specialist—breaks down the hidden truths behind hair loss and what you really need to know before considering treatment. From scarring alopecia to the future of hair cloning, joins Dr. Anthony Rossi on Give Good Face to explore the medical, emotional, and technical sides of hair restoration.
You’ll learn why accurate diagnosis is everything, how textured hair needs special care, and why hair transplants are far more than just a cosmetic procedure—they’re a true art form.
Guest Bio:
Dr. Achiamah Osei-Tutu, MD is a board-certified dermatologist specializing in hair restoration, aesthetic, medical, and surgical skincare.
After graduating from Binghamton University with a degree in Biology, Dr. Osei-Tutu received her medical degree from Stony Brook University School of Medicine. During medical school, she had the unique honor of being chosen as a Howard Hughes Medical Institute/ National Institutes of Health (NIH) Research Scholar. Dr. Osei-Tutu completed her medicine internship at Mount Sinai Hospital and dermatology residency at the SUNY Health Sciences Center- Brooklyn, where she was selected Chief Resident in her final year.
Although she is well experienced in all aspects of dermatology, she has had extensive additional training in hair loss disorders and hair restoration. She has also been devoted to hair loss education- speaking at hair shows, putting together hair loss educational symposia, and partnering with stylists in New York. She also has a special interest in skin of color and the specific issues that affect melanin-rich skin.
She has authored/coauthored a number of academic publications.
Dr. Osei-Tutu is sensitive to issues of multi-ethnic skin and is committed to providing her patients with personalized care.
Episode Transcript:
DR. ROSSI: I’m Dr. Anthony Rossi, and this is Give Good Face, a podcast focusing on skin care, skin care science, and how to maintain and shape a healthy lifestyle. All right, everyone, welcome back to Give Good Face. Today is a really special episode because I have Dr. Achama Osei-Tutu on. She’s not only my friend, but she was my professor in residency.
DR. OSEI-TUTU: Oh my God.
DR. ROSSI: And you’re giving very professororial vibes right now, which I love. She’s a world-renowned hair transplant surgeon and just an overall amazing human being. I would love to talk to you all about hair today.
DR. OSEI-TUTU: Amazing. I can’t wait. Thank you for inviting me to speak.
DR. ROSSI: Of course. I miss you too.
DR. OSEI-TUTU: It’s the only way we get to see each other.
DR. ROSSI: Exactly. Because Achama’s been all around the world lately. I’ve been following you on Instagram and you’ve been traveling the world teaching, and I’m sure learning a lot as well.
DR. OSEI-TUTU: Best way to gather information and steal people’s things to bring back to patients at home.
DR. ROSSI: So when your doctors go away to conferences, it’s not just for fun.
DR. OSEI-TUTU: No. There’s rarely time for that. It’s an exchange of ideas. We’re learning. We’re teaching techniques. And especially for hair, the field is constantly evolving. Hair transplant is an art form. There’s so much happening both surgically and non-surgically. We’re refining techniques so results look more natural.
DR. ROSSI: We’ve come such a long way, especially with textured hair.
DR. OSEI-TUTU: Yes, absolutely.
DR. ROSSI: My family are hairdressers, so I grew up seeing hair transplants walk through the door. We saw the evolution from plugs to follicular units. And you handle some of the hardest cases, especially scarring alopecia.
DR. OSEI-TUTU: That’s probably what I do the most.
DR. ROSSI: Which is the hardest.
DR. OSEI-TUTU: Very challenging, but fun.
DR. ROSSI: Tell us a little about scarring alopecia.
DR. OSEI-TUTU: When we talk about hair loss, we break it down into scarring and non-scarring. With scarring alopecia, the follicle is completely and irreversibly destroyed. It’s usually due to inflammation. We break it down by the immune cell type attacking the follicle. The one I see most is lymphocytic: central centrifugal cicatricial alopecia (CCCA), most often in women of African descent, and also men. Then there’s lichen planopilaris, which is very itchy. Then frontal fibrosing alopecia, which in Black patients can look like traction alopecia.
DR. ROSSI: It’s important to understand not all hair loss is just “you’re getting older.”
DR. OSEI-TUTU: Exactly. And some people want to hear that because it’s easier to treat. But inflammatory conditions require getting to the root issue. And often patients have more than one thing happening: CCCA plus traction alopecia plus hormonal hair loss. You need to address everything to optimize growth.
DR. ROSSI: Traction is different — it’s pulling hair tight.
DR. OSEI-TUTU: Exactly. Traction comes from styling: braids, weaves, wigs rubbing the hairline. CCCA is autoimmune or auto-inflammatory. Multifactorial. Genetics, styling, scalp organisms, metabolic issues. It’s important for patients of African descent to have a biopsy and diagnosis from a dermatologist. Turkey is popular, but if you transplant on inflammatory scalp disease, the grafts can fail.
DR. ROSSI: Yes — you can waste the trip.
DR. OSEI-TUTU: We also see lichen planopilaris, frontal fibrosing alopecia, lupus. All require proper diagnosis.
DR. ROSSI: Hair loss needs its own visit.
DR. OSEI-TUTU: Absolutely. There’s a full battery of tests we can run. We check labs because vitamin deficiencies, thyroid disease, autoimmune diseases can all show up as hair loss. Sometimes labs are normal, but it’s important to check.
DR. ROSSI: When you don’t find anything, what do you do?
DR. OSEI-TUTU: I talk about everything. Daily habits, stress, lifestyle. We come up with fancy regimens but if you’re not going to take them, they won’t work. I need to know if you avoid medication, if you prefer holistic, if you’ll take vitamins. If someone is overwhelmed, I start slow. If they want everything, we do everything. If they need surgery, we decide when. Stress also matters. Are you even in a place where you can prioritize treatment? Hair requires a motivated doctor and a motivated patient.
DR. ROSSI: And hair is a non-essential organ.
DR. OSEI-TUTU: Exactly. If your body is under stress, hair is sacrificed first. So we must treat the whole person.
DR. ROSSI: What about topicals?
DR. OSEI-TUTU: Minoxidil works. But with curly or coily hair, you must be careful. Over-the-counter minoxidil is in an alcohol base, which can cause breakage in textured hair. You must moisturize well, apply to the scalp not the hair shaft, and monitor breakage. Compounded formulas are fine with proper diagnosis. And yes, you can use it on eyebrows with a brush — carefully.
DR. ROSSI: And you do eyebrow transplants.
DR. OSEI-TUTU: I do. With curly hair, you must be careful because it can grow in all directions. You keep brows short, use gels, sometimes lamination — but be careful because lamination is basically a relaxer. We take donor hair from the finest area of the scalp. Men can use body hair. In big cases, body hair is added for density.
DR. ROSSI: Explain donor dominance.
DR. OSEI-TUTU: You take hair from a DHT-resistant, immune-privileged area like the back of the scalp. But the recipient site can still thin — called recipient site influence. If you don’t maintain medical therapy, you’ll lose the surrounding native hair and be left with only the grafts, which can look odd. Surgery must be paired with long-term therapy.
DR. ROSSI: Especially for medical tourism.
DR. OSEI-TUTU: Yes. If you have no follow-up, you risk wasting your investment and running out of donor. Always get diagnosed here, choose a reputable surgeon anywhere, and have a follow-up plan.
DR. ROSSI: What about finasteride?
DR. OSEI-TUTU: It can cause sexual and mood side effects but they are not common. You weigh risks and benefits. Some patients take it with no issues. If people fear it, we use topical finasteride, oral minoxidil, or inject dutasteride into the scalp. Injectable dutasteride means office visits and cost. It’s all about preference.
DR. ROSSI: And for women?
DR. OSEI-TUTU: Very helpful. Women can have androgen-driven loss too. Spironolactone blocks androgen receptors. Bicalutamide can work even better but it’s a cancer drug so we use it carefully. Postmenopausal women can use finasteride or dutasteride. Premenopausal cannot use them if pregnancy is possible. Mechanisms aren’t fully understood.
DR. ROSSI: We even use spironolactone in breast cancer patients.
DR. OSEI-TUTU: Yes. And bicalutamide can also be used in women after assessing risks.
DR. ROSSI: How do you feel about PRP?
DR. OSEI-TUTU: Great as part of a combination. Rarely as monotherapy unless the patient only wants that. Combo therapy is always best. PRP hurts, but we numb. Numbing hurts too.
DR. ROSSI: And exosomes?
DR. OSEI-TUTU: Controversial. Data on hair is limited. Less than 10 human studies. Plant, cord, placental — variable. Bone marrow–derived had the best data but the company pivoted to COVID. I explain cost, evidence, and frequency. We now have a new device called TricoPat for iontophoresis to deliver actives. It’s about tailoring to the patient.
DR. ROSSI: And telling patients when something won’t work.
DR. OSEI-TUTU: Exactly. You cannot revive a scarred follicle. Sometimes transplant is the only option, and sometimes even transplant won’t work if the disease is active.
DR. ROSSI: And you do Docs for Hair.
DR. OSEI-TUTU: Yes, with Mina. We host a textured hair workshop teaching derms all the techniques that aren’t covered enough: nanofat, PRP, microneedling, SMP, long-hair FUE, strip. Everything. Textured hair deserves expertise.
DR. ROSSI: Hair is way beyond “hair club for men.”
DR. OSEI-TUTU: Absolutely. It’s a great time to be a hair surgeon. New medications targeting new pathways are coming. Hair cloning someday — still far off, but it will be a game changer.
DR. ROSSI: We’ll talk about that next time.
DR. OSEI-TUTU: Yes, we will.
DR. ROSSI: Thank you for being here.
DR. OSEI-TUTU: Thank you.
DR. ROSSI: Thanks for listening to Give Good Face. Subscribe on Apple, Spotify, YouTube, and follow along on social at @DrAnthonyRossi and @RossiDermMD.
Hair Loss 101: Diagnosis, Treatment & The Future of Restoration with Dr. Achiamah Osei-Tutu
On This Week's Episode:
Dr. Achiamah Osei-Tutu—board-certified dermatologist and hair restoration specialist—breaks down the hidden truths behind hair loss and what you really need to know before considering treatment. From scarring alopecia to the future of hair cloning, joins Dr. Anthony Rossi on Give Good Face to explore the medical, emotional, and technical sides of hair restoration.
You’ll learn why accurate diagnosis is everything, how textured hair needs special care, and why hair transplants are far more than just a cosmetic procedure—they’re a true art form.
Guest Bio:
Dr. Achiamah Osei-Tutu, MD is a board-certified dermatologist specializing in hair restoration, aesthetic, medical, and surgical skincare.
After graduating from Binghamton University with a degree in Biology, Dr. Osei-Tutu received her medical degree from Stony Brook University School of Medicine. During medical school, she had the unique honor of being chosen as a Howard Hughes Medical Institute/ National Institutes of Health (NIH) Research Scholar. Dr. Osei-Tutu completed her medicine internship at Mount Sinai Hospital and dermatology residency at the SUNY Health Sciences Center- Brooklyn, where she was selected Chief Resident in her final year.
Although she is well experienced in all aspects of dermatology, she has had extensive additional training in hair loss disorders and hair restoration. She has also been devoted to hair loss education- speaking at hair shows, putting together hair loss educational symposia, and partnering with stylists in New York. She also has a special interest in skin of color and the specific issues that affect melanin-rich skin.
She has authored/coauthored a number of academic publications.
Dr. Osei-Tutu is sensitive to issues of multi-ethnic skin and is committed to providing her patients with personalized care.
Episode Transcript:
DR. ROSSI: I’m Dr. Anthony Rossi, and this is Give Good Face, a podcast focusing on skin care, skin care science, and how to maintain and shape a healthy lifestyle. All right, everyone, welcome back to Give Good Face. Today is a really special episode because I have Dr. Achama Osei-Tutu on. She’s not only my friend, but she was my professor in residency.
DR. OSEI-TUTU: Oh my God.
DR. ROSSI: And you’re giving very professororial vibes right now, which I love. She’s a world-renowned hair transplant surgeon and just an overall amazing human being. I would love to talk to you all about hair today.
DR. OSEI-TUTU: Amazing. I can’t wait. Thank you for inviting me to speak.
DR. ROSSI: Of course. I miss you too.
DR. OSEI-TUTU: It’s the only way we get to see each other.
DR. ROSSI: Exactly. Because Achama’s been all around the world lately. I’ve been following you on Instagram and you’ve been traveling the world teaching, and I’m sure learning a lot as well.
DR. OSEI-TUTU: Best way to gather information and steal people’s things to bring back to patients at home.
DR. ROSSI: So when your doctors go away to conferences, it’s not just for fun.
DR. OSEI-TUTU: No. There’s rarely time for that. It’s an exchange of ideas. We’re learning. We’re teaching techniques. And especially for hair, the field is constantly evolving. Hair transplant is an art form. There’s so much happening both surgically and non-surgically. We’re refining techniques so results look more natural.
DR. ROSSI: We’ve come such a long way, especially with textured hair.
DR. OSEI-TUTU: Yes, absolutely.
DR. ROSSI: My family are hairdressers, so I grew up seeing hair transplants walk through the door. We saw the evolution from plugs to follicular units. And you handle some of the hardest cases, especially scarring alopecia.
DR. OSEI-TUTU: That’s probably what I do the most.
DR. ROSSI: Which is the hardest.
DR. OSEI-TUTU: Very challenging, but fun.
DR. ROSSI: Tell us a little about scarring alopecia.
DR. OSEI-TUTU: When we talk about hair loss, we break it down into scarring and non-scarring. With scarring alopecia, the follicle is completely and irreversibly destroyed. It’s usually due to inflammation. We break it down by the immune cell type attacking the follicle. The one I see most is lymphocytic: central centrifugal cicatricial alopecia (CCCA), most often in women of African descent, and also men. Then there’s lichen planopilaris, which is very itchy. Then frontal fibrosing alopecia, which in Black patients can look like traction alopecia.
DR. ROSSI: It’s important to understand not all hair loss is just “you’re getting older.”
DR. OSEI-TUTU: Exactly. And some people want to hear that because it’s easier to treat. But inflammatory conditions require getting to the root issue. And often patients have more than one thing happening: CCCA plus traction alopecia plus hormonal hair loss. You need to address everything to optimize growth.
DR. ROSSI: Traction is different — it’s pulling hair tight.
DR. OSEI-TUTU: Exactly. Traction comes from styling: braids, weaves, wigs rubbing the hairline. CCCA is autoimmune or auto-inflammatory. Multifactorial. Genetics, styling, scalp organisms, metabolic issues. It’s important for patients of African descent to have a biopsy and diagnosis from a dermatologist. Turkey is popular, but if you transplant on inflammatory scalp disease, the grafts can fail.
DR. ROSSI: Yes — you can waste the trip.
DR. OSEI-TUTU: We also see lichen planopilaris, frontal fibrosing alopecia, lupus. All require proper diagnosis.
DR. ROSSI: Hair loss needs its own visit.
DR. OSEI-TUTU: Absolutely. There’s a full battery of tests we can run. We check labs because vitamin deficiencies, thyroid disease, autoimmune diseases can all show up as hair loss. Sometimes labs are normal, but it’s important to check.
DR. ROSSI: When you don’t find anything, what do you do?
DR. OSEI-TUTU: I talk about everything. Daily habits, stress, lifestyle. We come up with fancy regimens but if you’re not going to take them, they won’t work. I need to know if you avoid medication, if you prefer holistic, if you’ll take vitamins. If someone is overwhelmed, I start slow. If they want everything, we do everything. If they need surgery, we decide when. Stress also matters. Are you even in a place where you can prioritize treatment? Hair requires a motivated doctor and a motivated patient.
DR. ROSSI: And hair is a non-essential organ.
DR. OSEI-TUTU: Exactly. If your body is under stress, hair is sacrificed first. So we must treat the whole person.
DR. ROSSI: What about topicals?
DR. OSEI-TUTU: Minoxidil works. But with curly or coily hair, you must be careful. Over-the-counter minoxidil is in an alcohol base, which can cause breakage in textured hair. You must moisturize well, apply to the scalp not the hair shaft, and monitor breakage. Compounded formulas are fine with proper diagnosis. And yes, you can use it on eyebrows with a brush — carefully.
DR. ROSSI: And you do eyebrow transplants.
DR. OSEI-TUTU: I do. With curly hair, you must be careful because it can grow in all directions. You keep brows short, use gels, sometimes lamination — but be careful because lamination is basically a relaxer. We take donor hair from the finest area of the scalp. Men can use body hair. In big cases, body hair is added for density.
DR. ROSSI: Explain donor dominance.
DR. OSEI-TUTU: You take hair from a DHT-resistant, immune-privileged area like the back of the scalp. But the recipient site can still thin — called recipient site influence. If you don’t maintain medical therapy, you’ll lose the surrounding native hair and be left with only the grafts, which can look odd. Surgery must be paired with long-term therapy.
DR. ROSSI: Especially for medical tourism.
DR. OSEI-TUTU: Yes. If you have no follow-up, you risk wasting your investment and running out of donor. Always get diagnosed here, choose a reputable surgeon anywhere, and have a follow-up plan.
DR. ROSSI: What about finasteride?
DR. OSEI-TUTU: It can cause sexual and mood side effects but they are not common. You weigh risks and benefits. Some patients take it with no issues. If people fear it, we use topical finasteride, oral minoxidil, or inject dutasteride into the scalp. Injectable dutasteride means office visits and cost. It’s all about preference.
DR. ROSSI: And for women?
DR. OSEI-TUTU: Very helpful. Women can have androgen-driven loss too. Spironolactone blocks androgen receptors. Bicalutamide can work even better but it’s a cancer drug so we use it carefully. Postmenopausal women can use finasteride or dutasteride. Premenopausal cannot use them if pregnancy is possible. Mechanisms aren’t fully understood.
DR. ROSSI: We even use spironolactone in breast cancer patients.
DR. OSEI-TUTU: Yes. And bicalutamide can also be used in women after assessing risks.
DR. ROSSI: How do you feel about PRP?
DR. OSEI-TUTU: Great as part of a combination. Rarely as monotherapy unless the patient only wants that. Combo therapy is always best. PRP hurts, but we numb. Numbing hurts too.
DR. ROSSI: And exosomes?
DR. OSEI-TUTU: Controversial. Data on hair is limited. Less than 10 human studies. Plant, cord, placental — variable. Bone marrow–derived had the best data but the company pivoted to COVID. I explain cost, evidence, and frequency. We now have a new device called TricoPat for iontophoresis to deliver actives. It’s about tailoring to the patient.
DR. ROSSI: And telling patients when something won’t work.
DR. OSEI-TUTU: Exactly. You cannot revive a scarred follicle. Sometimes transplant is the only option, and sometimes even transplant won’t work if the disease is active.
DR. ROSSI: And you do Docs for Hair.
DR. OSEI-TUTU: Yes, with Mina. We host a textured hair workshop teaching derms all the techniques that aren’t covered enough: nanofat, PRP, microneedling, SMP, long-hair FUE, strip. Everything. Textured hair deserves expertise.
DR. ROSSI: Hair is way beyond “hair club for men.”
DR. OSEI-TUTU: Absolutely. It’s a great time to be a hair surgeon. New medications targeting new pathways are coming. Hair cloning someday — still far off, but it will be a game changer.
DR. ROSSI: We’ll talk about that next time.
DR. OSEI-TUTU: Yes, we will.
DR. ROSSI: Thank you for being here.
DR. OSEI-TUTU: Thank you.
DR. ROSSI: Thanks for listening to Give Good Face. Subscribe on Apple, Spotify, YouTube, and follow along on social at @DrAnthonyRossi and @RossiDermMD.