Month: April 2007

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Hair Loss InformationScalp Tunnels and Attaching Wigs to the Scalp – Hair Loss Information – Balding Blog

Received two semi-related questions, so I’ll answer them as one —

Hello,
Several years ago I had tunnel graft surgery and I’m now in need of the clips. Can you advise me on a source where I can find them? It’s been rather difficult to locate them

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Someone told me that you could sew a wig into the scalp. Is that true and does it work?

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Unfortunately, I do not know who might sell these clips.

For those of you who do not know what a scalp tunnel is, it is described in PubMed as:

A new procedure for attaching a hairpiece to the scalp is described. Two skin-lined tunnels in the anterior and posterior scalp are built, using a strip of free full-thickness donor skin fron the postauricular area. Silicone-coated metal clips, suitably fashioned from .062” Kirschner’s wire, are then attached to the hairpiece. The metal clips are inserted into the skin-lined tunnels and thereby anchor the hairpiece to the scalp.

These permanent tunnels (more like bridges made of scalp skin) are created to hold a wig (also known as hairpiece or hair system) in place instead of glues or tape. It is a barbaric and deforming process, not considered anyone’s standard of care today. Note that the description on PubMed is dated October, 1976.

There have been many things that people have done that are (in hindsight) a little nutty. There are three ways that I have seen the wig attached to the skull.
Sew scars

  1. The picture on the right was of a patient who went to a company in New Jersey who hired retired doctors to actually sew wigs through the scalp skin directly (see photo at right of patient with scars from this procedure). These almost always got infected and when the patient came back to the doctor, the stitches were switched to a non-infected part of the scalp. As you can see from the pictures, the scalp was heavily scarred from the infections. At one point, I was hired by the New Jersey Medical Board to prosecute the doctor, but the doctor was replaced by another who then went through the same legal process. When the State tried to shut this company down, the company closed down and opened under another name. I do not know if they are still playing this ‘cat and mouse‘ game with the State of New Jersey.
  2. A doctor actually drilled a metal connector into the skull. The wig had a male like clips that connected with a mechanical fit to the part that was drilled and cemented in the skull. The wig could be buttoned in and out with great ease.
  3. The art below shows skin tunnels (an old procedure that required a skilled surgeon to fashion in the scalp) which are use to tie ‘shoe laces’ that were attached to the wig. The process was promoted as simple as putting on and taking off your shoes (except you just did it with your wig).
Tunnel

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Flaking Scalp After Hair Transplants? – Hair Loss Information – Balding Blog

Dear Doctor:
I have had two hair transplants, the latest one being last year. After each one, I had and still have skin flakes that shed off my scalp everyday. Is this a side effect of the transplants? And what can I do to stop it? An ordinary dandruff shampoo won’t work.

I also have a habit of picking the small oil deposits out of my scalp which sometimes is accompanied by a hair. The hair club for men told that that the oil deposits sometimes cut the blood/oxygen flow to the hair follicle. Nevertheless, I probably should stop doing this right? Are there any bad consequences to it?

Thanks!

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If you do not wash your hair vigorously after a hair transplant, you will have crusting that may last for a month or more. Dry skin that may follow a hair transplant requires good skin care. Good hygiene is also critical. In over 90% of my patients, I get the crusts off in the first day following a hair transplant.

You should get advice on the scalp treatments from your hair transplant doctor, who should be interested in your recovery. The same goes for the picking you are doing, which is dangerous because it sets you up for folliculitis, particularly after a hair transplant when the skin is fragile. See your doctor!

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Shock Loss and No Feeling in Scalp for Months After Transplant – Hair Loss Information – Balding Blog

I have had two hair transplants. I was never bald but have thinning hair. After the transplants my head had no feeling on top for about six to seven months. Seems it made me lose as much hair as I got from the transplants. There was a doctor there but he did not do any of the work other then the cut for the hair grafts. What if any tests I can have done before going to a different doctor. I feel it was a waste of money.

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Were you on Propecia (finasteride) prior to the surgery? If not and you are young, you should have been taking the drug, as the loss of hair after the transplant is a consequence of young men who are not protected with finasteride. Numbness to some degree is normal, but your sensation should return in a few weeks/months. I have seen some clinics that employ doctors as technicians who just do the ‘cutting’ and take no responsibility for overall patient management. If this is what you had, it may have been a “waste of money” for you (that is, if you did not see any cosmetic benefit from your surgery). There is also the negative value of having hair moved that did not survive (if it did not grow then it must be dead). That is why I stress the importance of a Master Plan when planning your surgery and being able to trust your surgeon. You may want to get another opinion with an examination by a competent and honest doctor. As I have said before, Let the Buyer Beware!

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Congenital Adrenal Hyperplasia and Hair Loss – Hair Loss Information – Balding Blog

I’m 32 years old/female. I have recently been diagnosed with CAH and wanted to find out if there is any chance my hair will grow back if my condition is being treated and the hormone levels (DHEA-S and 17a-OH Progesterone) return to normal levels. Does hair loss in the pubic region, eyebrows, and eyelashes also occur in patients with adrenal disorders?

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The scope of hair loss varies with individuals that have CAH. If you happen to have the genes for hair loss in women, then CAH could activate the process. If you get your hormones under control, chances are that your hair loss may grow back. You might have to wait one or two hair cycles (5-12 months) to know one way of the other. Hair loss could occur anywhere on the body, including the pubic region, eyebrows, and eyelashes. See eMedicine for more information.

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Leukemia and Hair Loss – Hair Loss Information – Balding Blog

i have been diagnosed with c m l leukemia. for 7 months i have been taking gleevec 400mg by mouth each day. i have been successful with the blood work but my hair is getting thinner each month. first my curly hair went straight, then it began falling out one hair at a time. now it is very thin. do you know if it is permanent? i need some info. can you help?

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Generally, hair loss from chemotherapy reverses as the hair cycles out of telogen and into anagen (about 6 months from the end of the chemotherapy). That assumes that you are not a male who is undergoing genetic hair loss as well. In men on chemotherapy who have genetic hair loss as well, some of the genetic process may be accelerated. Much of it should reverse for women and in men over 40 (general rule).

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Rapid Hair Loss in the Past Year – Would Propecia Help? – Hair Loss Information – Balding Blog

Doctor,

Slow hairloss over the years. In my early 50’s. Have noticed some rapid hairloss the last year. Though I still have what looks like a full head of hair I can definately notice a difference. Would propecia help?

And if I took propecia for a few weeks and had to quit due to side effects, would the short duration of use cause increased hairloss?

Thanks

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A short run on Propecia should not impact you at all, but you said that you noticed rapid hair loss and that is why you went on the Propecia. You need a proper diagnosis, as this is an unusual observation for a 50 year old man if the cause is genetic. From there, more decisions can be made.

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Taking Propecia for 5 Months, Hair Worse Than Before – Hair Loss Information – Balding Blog

My question is about Propecia. I have been on it for almost 5 months now and I have experienced a terrible shed. It is now almost 5 months that I have been shedding and it does not seen to improve, even after all this time. My front hairline is now much worse and Propecia has made my hair much more thin than it ever was before. If Propecia does not cause balding, then why is it doing this to me? I would have been much better off not taking it at all. Will the hairs grow back that shed or have I lost them forever?

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Clearly what you are telling us is very unusual. Usually the hair loss stops or slows in less than 5 months. I would certainly check with your doctor for the possibility that you have a cause of hair loss that is not classic male patterned hair loss.

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Can a Woman Who Doesn’t Want to be Pregnant Take Propecia? – Hair Loss Information – Balding Blog

Hi, I have 30 years old and i have a huge loss of hair in the top of my head… my question is./.. i don’t pretend be pregnant soon… like years… so can i take propecia?

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Propecia (finasteride 1mg) has not been shown to be effective in women’s hair loss. Women’s hair loss is a different ‘beast’ than men’s hair loss, as it is not DHT dependent. As far as safety is concerned, I might worry about women who have the ‘breast cancer gene’ who are taking Propecia.

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Taking Propecia for Non-MPB Hair Loss – Hair Loss Information – Balding Blog

I have a question about Propecia. In my country (China), a generic is available OTC without a prescription. While we do have clinics specializing in hair loss, virtually all the doctors just push clients to do expensive and dangerous grafts, even when it’s not needed. I have had considerably thinning at the front of my hairline the last three years, and really up onto the crown. My temples aren’t too affected, so I have a hard time seeing myself matching a Norwood too clearly, but my dad is mostly bald on top. I also have dense body hair, which I’ve read is usually caused by the same chemical causing hair loss.

It seems likely this is DHT-caused, and I would like to start taking Propecia. I just have one question: if I am wrong, my hair loss has another cause, and it’s not MPB, it will obviously continue regardless of Propecia. Would quitting Propecia if this turns out to be true cause any kind of “shock loss” that I may not have gone through otherwise? I know if Propecia is helping you out and you quit it, nature comes back to get you with a vengeance, but what if you’re taking it and your loss isn’t being caused by DHT?

Just something I’ve been curious about.

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These are important questions. First of all, Propecia (finasteride) at the 1mg dose adequately slows down hair loss in all men undergoing genetic hair loss. I am firm about this opinion so if you are thinning, then finasteride is a critical correct step in the process. If you stop taking it, you develop what I call catch-up hair loss, which means that all of the benefits will be reverse from the day you started to take the drug. The drug must be maintained for your lifetime to hold any benefits that it brings. Even with the drug, it may not stop the hair loss, so hair transplants may be the right solution. In my opinion, it is wrong to undergo a hair transplant without taking finasteride if you are under the age of 35-40. For those people who are taking finasteride without balding of thinning, stopping it after they start it will have no effect on normal hair.