Month: April 2006

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Hair Loss Information » Color of Donor Scar 2 Weeks After Procedure? – Balding Blog

I am 2 weeks post-op a 2400 FUT.The surgery was performed by a very reputable Dr. and so far I am very pleased with the results.The recipient area has healed well but I still have a very pronounced dark pink line at the donor site from ear to ear.The scar itself seems only about 1 or 2mm wide but the dark pink line is about 4 or 5mm wide and very noticeable.I went back to the clinic and the Dr. told me I wasn’t being aggressive enough with washing the donor area and advised me to use olive oil to soften the area and lift off the secretion.Is the secretion causing the wide pink line and when can I expect this to look less noticeable?

After two weeks, what you are describing is not abnormal. Some people keep a red/pink color to the surrounding wound. This will become better over the next few weeks. Sounds like you doctor is giving you reasonable advice.

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Hair Loss InformationNext Line of Cures for Balding – Hair Loss Information – Balding Blog

What can we expect in the next line of cures for balding if cloning, as you suggest, is not going to appear in the next couple of years?

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There are many new approaches for the treatment of male genetic balding that fall below the radar. I tell my patients that there are a few hundred steps to growing and cycling hair in the human body. What we know appears to be very little with regard to the identification of each of these steps and in understanding how each step may or may not be dependent upon each other. There are drugs coming out that will address the hair loss problem, possibly better than Propecia, but it will take time to determine how these drugs work, as many of them were/are discovered by accident rather than by taking a model of the drug that fits into the defective pathway for balding. Once the drug is screened for toxicity in desktop or animal model, the predictability of these drugs in addressing the hair loss problem needs to be identified. Safety and effectiveness (a term I throw around a great deal when I am asked about potions and lotions offered to cure balding) must meet a stringent FDA standard, just to protect the public. I tried to research the drug pipeline to give my readers something to ‘cut their teeth on’, that might give them hope. I have outlined a couple of important articles that will shed light on either the potential of a new drug just recently hitting a press release, or an insight into the risk factors for dealing with new drugs to give the readership of this blog some insights into the scope of the problems and opportunities before us.

Safety determination is no simple job. Even with the most stringent testing for the toxic effects of a new drug cleared from animal testing, the risks take years to define. Unfortunately, the following linked article showed the risks all too soon for the 6 young people who became victims of the drug testing process. The point I want to make here is that you do not want this type of outcome from taking a drug, potion or lotion on any product that is not well tested and through thorough human trials run to strict standards. See: Parexel in hot water over drug trial scare

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Hair Loss After Stitches in My Scalp – Hair Loss Information – Balding Blog

Hey,
I’m 18 years and of african descent. My problem is that I’ve noticed that whenever I get my hair cut (down to the skin) the hair on the right-forward side of my head grows slower than the left. I have noticed signs of possible hair loss in future but nothing like this, hardly even a horseshoe pattern.

Also quite recently I was involved in an accident and got stitches on the boarder of my scalp (this was after I noticed thinning). I want to ask if this affects possible hairgrowth in the area. Thanks.

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It is not unusual to have hair loss around the scar for a distance of a mm or two. Most of the hair around the scar should grow back within a year but there may be a small area around the scar that will not grow hair. Sometimes, people who are genetically prone to hair loss may find that a bad cut or accident on the head could start the process off and without any balding present, the sutures can produce some hair loss. It may just appear as thinning or it could advance to general hair loss. If the scar is too big and unacceptable to you, hair transplants into the scar can help, but the diagnostic mapping of your head is critical for you to define just what is going on.

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So Many Products, So Little Results – Hair Loss Information by Dr. William Rassman

Hello. I’ve been experiencing hair loss since the age of 17, I am 20 now. Being in the National Guard and full-time in college, it’s a given I’m under alot of stress. I first noticed my hair started receding at the temples. I began using Rogaine 5% with some success as well as Procerin tablets. Some of the hair began to grow back. I stopped using both products in September of 2005 until December 2005. In December, my hair started to fall out in mass amounts in the shower. I began to use a solution called “Nutrifolica” and Procerin again. Since then, the temples have recovered, but I now have a very distinct patch of scalp showing almost dead center down the the top of my head. It starts from my part in the back, straight forward. It’s weird because the “crown” isn’t really receding (yet, I guess). But it’s fading all the while I’m applying Nutrifolica and taking Procerin twice a day, and using Rogaine after the shower. Oh, and I also tried the Nisim system to no avail. It seems there’s something new on the TV every week on infomercials but it costs $90 for a month supply. That adds up quick.

What are my options? (if any). I’m just completing my freshman year of college and have multiple to go, I’d like to keep my self-esteem in tact, I’m very conscious about my hair.

VacuumYou sound like a bright young man, so I must ask why you are not being smart when it comes to your hair problem? You are selling yourself ‘things’ that you see on TV which are promoted to cure problems with hair loss where the promoters are all profiting from the ‘buy’. Ask a fertilizer salesman what will make your flowers grow, and he will show you his fertilizer products. Ask a vacuum salesmen why you have allergies, and he will tell you that dust in your house is causing it, because the vacuum cleaner you are using is missing the allergens. But what you need to know in the second case is: Are your really allergic to dust? If not, then the $500 vacuum cleaner that this fellow is selling will only serve to make your $500 more foolish and reinforce the idea that maybe you were taken to the cleaners.

I always tell my patients on this blog to first find out if your are losing your hair to genetic balding by seeing an expert who can make a firm diagnosis by mapping out your scalp for miniaturization to determine what is happening to your scalp and hair. If you do have genetic balding, there is a wonderful treatment that really works in young men called Propecia. You could approach this scientifically and know what is happening or you can call that fertilizer salesman for some potion or lotion that will meet his needs and take some of your hard-earned cash.

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I Want To Undo My Hair Transplants – Hair Loss Information by Dr. William Rassman

I had a transplant procedure a few years ago and now have some grafts along the front of my hairline, an entire bald back (Norwood Class 7) and a raised scar in the back of my head where the transplated hair was taken from. I went back to the original doctor once, and he took out some of the grafts, but there is still pitting in the front and I need to wear a hair system to cover it up. How I hate that rug, I can not express enough. How do I go back to square one? Is that realistic? Am I trapped into having more transplants that I can not afford?

You asked about the skin deformity of the frontal hairline and about how realistic it would be that the small pits could be abolished. I think that it is unlikely that it can be completely taken away, but it would not be unreasonable to remove the present hair. Risks of scarring further is a real consideration as the smooth surface skin of a bald Class 7 patient will easily show any deformity by the glare of the light. The balding skin is atrophic, which means that it lost its normal texture, where small pores exist and the sebaceous glands wax the scalp. The normal skin is clearly different than the tissue paper thin skin of an advanced balding man. When something is done to an atrophic skin, it will never go back to its pre-surgical appearance. Some people ask about dermabrasion to smooth out the skin and I feel that this procedure would likely create more skin abnormalities and I would not recommend it, even though other doctors often do this.

As your goals are unclear and the amount of normal skin and hair is an unknown for me, I am assuming that you are a full, well established Norwood Class 7 patient, but I would suggest that you let your hair grow out a bit under the hair system so that a doctor can make a determination about your condition and patterned hair loss. To accomplish this goal, you will need to have your hair system converted to clips and away from the glues or tape you are probably using for the moment.

To remove the hair in the frontal hairline, an FUE procedure to remove the hairs in the frontal hairline is worth considering. To treat the scar in the donor area, you can either attempt to remove it with a surgical excision or fill in the scar with FUE grafts.

You can visit me for an extensive exam, or even send photographs as appropriate to improve our communication. Please do let your hair grow out under the hair piece after you convert to clips. Please also do not rule out a proper and complete transplant to get your original goals back as a consideration, but it would be a good idea to see patients at an upcoming open house event to make such an assessment. Whatever you do, take your time here to make an informed decision, something clearly you did not do when you started.

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I Want My Plugs Removed and Not Replaced – Hair Loss Information by Dr. William Rassman

Dr. Rassman:

I have approximately 110 plugs (from the late 1970’s) that were placed in the frontal hairline where your hair is receding according to your picture. Can the plugs be removed and not replaced without leaving obvious scars?

If not what is a viable alternative?

Yes, the plugs can be removed. There is no way that they will not leave some scarring. Each person is different with different skin types and skin textures that reflect light differently and produce different degrees of scarring. Plugs done in the 1970’s tend to have a great deal of skin taken with the hair. These skin discs will stand out because the flat nature of them with the associated scars, when placed into a smooth, rounded bald scalp, will reflect light such that the difference becomes very obvious. When you add the ‘plugs’ of pencil size hair in the normal scalp, attention is drawn to that area. Many times, if the plugs are lined up, they can be excised as a block, or they can be removed one by one. To determine the best approach, there is no substitute for a personal consultation to make the judgments that reflect your situation.

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5% Minoxidil for Women? – Balding Blog

Hello,
I am a 26 year old female and have been using 2% female minoxidil for a little over 6 months. I wanted to ask if it was safe for a woman to use the Men’s Strength 5%. Please advice.

You should use products as directed on the FDA approved label. 5% minoxidil is not available for women, but they are formulated for men. The women’s formulations are mostly water/alcohol based which makes it easier to style your hair. Most men’s preparations are oil based. You can use the woman’s alcohol base in the morning and the men’s 5% oil base at night. Some drug stores will make up the 5% alcohol base on prescription. Ask your pharmacist. Also, please see this article on HairLossTalk.com.




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Balding Forum - Hair Loss Discussion

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Hair Loss InformationTechniques to Minimize Donor Area Scarring – Hair Loss Information – Balding Blog

All skin incisions produce scars, including those made by the best surgeons. Traditional hair transplant donor scars have a width of 1-3mm in 95% of patients and 2-3% of patients may see their scars even wider. The key to minimizing scar visibility is to directly address the factors contributing to a widened scar, like the healing characteristics of head tissues and collagen. Fortunately, the New Hair Institute (NHI) uses many surgical techniques to minimize scarring and scar widening.

Figure A and Figure B

Fascial Closure Technique: A fascial closure can be utilized to reduce wound tension when two skin edges are brought together, therefore reducing the likelihood of scar stretching. Before exterior sutures or staples are placed, we imbricate (or overlap) the underlying fascia, which is the fibrous tissue network located between the skin and the underlying structure of muscle and bone beneath the skin. (Fig. A) A more complex fascial closure is made when tunnels are created below the fascia to further reduce tension upon closure. (Fig. B) The final sutures or staples on the skin are not shown in the diagrams.

Figure C

Trichophytic Closure Technique: A trichophytic closure, “hair loving” in Latin, promotes hair growth directly through a healing wound. For many years plastic surgeons have used this technique while repairing hairlines during brow lifts or in conjunction with face lifts. A small piece of one wound edge, as well as the corresponding hair, is removed. When the wound heals and a scar is formed, the buried and partially cut hair follicles will begin to grow through the scar. (Fig. C) Since hair follicles cut in this manner resume growth, there is no unnecessary follicle waste. When scars are wider than the 2 to 3mm range, this closure technique is less effective, because it typically promotes hair follicle growth only within a 2 to 3mm width where the trichotomy was done.

Figure D

However, both of these techniques do not account for patient variability. The physiology of wound healing and scar formation is a very complex matter with numerous books devoted to the topic. Some patients heal with a virtually undetectable scar, less than 1mm, without any special closures while others form a wider scar despite fascial and trichophytic closures. Scars within the 2-3mm range are widely accepted since surrounding hair growth usually disguises any scar formation and few of my patients ever complain of a 2-3mm scar (Fig. D) that they can not see.

Update: Please see Trichophytic Closure Photos

Illustrations by Jae P. Pak, M.D.

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Female Hair Loss After Anorexia and Bulimia – Hair Loss Information – Balding Blog

My hair was quite thick when i was younger but I suffered in the past of anorexia and bulimia and my hair got thinner. It has been now less than a year that i am cured but noticed that my hairloss has increased. Is there anything that you can recommend and will my hair get back to its original condition.

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First, hair loss comes from many causes so you need to have a complete medical work-up to separate the real diseases that cause hair loss from the genetic programming that we inherit from our family lines. There are many ‘medical’ causes for hair loss and maybe you have one of them, such as hypothyroidism, eczema, alopecia, dieting, malnutrition, autoimmune, drugs, infection, genetics, etc.

  1. Hormone levels for DHEAS, Testosterone, Androstenedione, Prolactin, Follicular Stimulating Hormone, and Leutinizing Hormone
  2. Serum Iron, Serum Ferritin, TIBC (Total Iron Binding capacity)
  3. Thyroid Stimulating Hormone (TSH)
  4. VDRL
  5. Complete Blood Count (CBC) to rule out anemia

A good doctor is your first step. The problem with women’s hair loss is that when it occurs, it may precipitate genetic hair loss, the thinning of which may not be reversible. In your particular case, it is possible that your experience with anorexia and bulimia earlier may have ‘triggered’ the genetic process (if you have it). Get your tests done and communicate with your doctor, bonding with him/her so that your problem is theirs as well and be sure that you do not have a precipitating cause of the hair loss.