April 2010 – Page 10 – Balding Blog

April 6, 2010

Using the Sides of the Head as Donor Hair? – Hair Loss Information – Balding Blog

Greetings,
Solid good data base you have built on this blog Dr. rassman. Thank you

My question is: Can you transplant hair from the upper sides of the head “left and right” about 3 inches above the ears, or is it only possible as a donor area to be from the lower back above the nick ? Reason I’m asking this question is because I have what i want to define as “Global hair loss/damage”. Meaning even in the donor area it’s clearly visible that i do not have a normal hair distribution/density “there is holes among the donor area” but, in my sides “just below the flat crown of my head” the hair is extremely healthy/dense/thick and can grow for long time with out being damaged.

Your time and answers are greatly appreciated

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NW7 First I though you were describing diffuse unpatterned alopecia (DUPA), but if there are clearly areas of your scalp that are full and lush, and they are about 3 inches above the ear, I would rule out DUPA on first glance. I would have to examine you to understand what you are telling me.

As a rule, however, the donor fringe is only 2 1/2 inches high on the back of your head and about 3 inches high on the side above the ear. Donor hair implies that the hair is permanent when full balding (up to a Class 7) occurs. Note the diagram at right of a Class 7 figure and you will see the 3 inches high fringe above the ear. Donor hair taken above the 3 inch level will not be permanent hair for the advanced balding patient.

April 6, 2010

Dimethicone and Rogaine – Hair Loss Information – Balding Blog

I’ve recently read on a couple of websites that the silicone compound Dimethicone, an ingredient in most shampoos and conditioners, could impede the absorption of topical minoxidil products (eg. Rogaine). The theory is that this ‘slilcone oil’ leaves a thin film on the scalp (even after rinsing) that prevents the topical solution from penetrating. Could this be the reason that many men see little or no result from Rogaine, while a minority of patients see significant regrowth of hair? Should all Rogaine users ensure that their shampoos and conditioners are dimethicone-free?

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It is, of course, just a theory that dimethicone impacts Rogaine (minoxidil)’s absorption…. but if you’re concerned about it you can buy dimethicone free shampoo. I do not believe that any single process or product will be responsible for drug absorption or modifying the results of specific drugs. Men have seen variable results from this medication since it was first released as a topical for hair growth. I don’t have an exact explanation why, though.

I’ve actually posted something about this before — Is Dimethicone in Shampoo Preventing Minoxidil Scalp Penetration? — and the commenters at the bottom have some added information that you might be interested in.

April 6, 2010

Hair Loss InformationAderans Purchases Intercytex Assets – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I thought this might be of interest to your other readers. It looks like Intercytex’s old technology has found a new home.

ARI Purchases Intercytex Assets (PDF file)

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When word came out earlier this year that Intercytex was closing shop, I received a few emails inquiring about where their assets might wind up. Months later, the announcement has been made. And the winner is…

Atlanta, GA – March 25, 2010 — Aderans Research Institute Inc. (ARI) announced it acquired key technology assets from Regenerative Medicine Assets Limited (formerly Intercytex Group plc), a leading UK hair regeneration company. By acquiring the scientific assets of one of its chief competitors, ARI has further solidified its position as the leading research company in the hair regeneration industry.

“This acquisition is a major step forward for ARI,” said Vern Liebmann, Vice President, Operations. “Through this deal, we’ve been able to consolidate the majority of key patents and know-how in the hair regeneration field, an achievement that can accelerate our ability to deliver a commercially viable product to market. This acquisition was only possible thanks to the considerable financial support of Aderans Holdings Company, Ltd., of Japan.”

The purchase includes assets related to the ICX-TRC product that had been a research focus for Regenerative Medicine Assets Limited. ICX-TRC is an autologous hair regeneration therapy for the treatment of male pattern baldness and female diffuse alopecia.

The deal comes as ARI is extending its Phase 2 clinical study of cell-based hair regeneration, in which it recently treated the trial’s 100th subject. “We’ve acquired important proprietary knowledge that includes Intercytex’s clinical efforts to date,” noted Ken Washenik, MD PhD, Executive Vice President. “This information should substantially augment our efforts to create a viable cell-based solution for hair loss.”

“Cellular regeneration represents the leading edge of research into hair loss,” said Kurt Stenn, MD, Vice President and Chief Scientific Officer. “Combining the knowledge stores of two of the leading companies in this field is a significant step forward in our efforts to pioneer a regenerative process that can deliver enhanced hair growth to millions of people around the world.”

April 6, 2010

My Hair Looks Withered at the Ends – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman,

How are you Doc? Excellent work with the blog!

Here is my question: I’ve noticed recently that some of my hair has a “withered” look to it. The hair seems normal and healthy until about 1 cm from the top, then it becomes very thin and wispy looking. Could this be from MPB, poor nutrition, or lack of a recent hair cut?

I’m a 23 year old male, and though I have some miniaturization, these withered hairs seem to be much different than my miniaturized ones.

Thanks and keep up the great work!

Although your description of “withered” doesn’t really explain what you’re seeing, it doesn’t sound like genetic hair loss if the hair is growing healthy from the scalp. Perhaps it is split ends, which can be solved with a haircut. Talk to your barber or a hair stylist.

Paid advertisements (not an endorsement):

April 5, 2010

Can’t I Have Body Hair Transplanted to Scalp If I Don’t Intend My Hair to Be Long? – Hair Loss Information – Balding Blog

Hi am 30 years old with a norwood 6 level of baldness. I currently shave my hair with a razor. As i have an extremely large amount of body hair and i guess limited donour hair on my head, is body to head transplant possible? Would it be possible for the transplant to cover the crown as well as the front of the head? What is meant by resting phase for hair and how does that vary from the head and the body? I dont intend on growing my hair long and i would like to keep it at a buzz cut so it would not matter if the transplanted hair was to go frizzy or curly. But i am concerned if there will be a noticeable difference between my current head hair and the transplanted hair. Would i still be able to razor my head after i had a hair transplant? would the be any scars or signs of a hair transplant?

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Clippers I don’t know why you’d want to just guess about the availability of your scalp donor hair. Have you been examined by a doctor? Body hair transplants (BHT) are technically possible, but they are not something I’d recommend for multiple reasons that I’ll try to explain simply. Body hair is not the same as scalp hair — it looks different, it feels different, it grows different. Even if the procedure is a technical success, it’s not going to give you natural looking results like you can achieve by using hair from the back of your head. Plus, I don’t know enough about your hair loss (donor, density, etc) to really be able to know if you’re even a candidate for any kind of hair transplant surgery.

As you seem to be aware, body hair does not grow at the same rate as scalp hair and about half of transplanted body hair is in a dormant state (see more on that here). Scarring in the recipient area depends on the skills of the surgeon and staff… but if you’re going to shave your head in the future why would you even want a hair transplant? Wouldn’t that be like getting a nose job right before you decide to take up boxing as a sport?

April 5, 2010

Less Propecia, Less Side Effects? – Hair Loss Information – Balding Blog

Dr. Rassman,

Thanks so much for this valuable site.

I am considering Propecia. It is the possible sides, not the $$$, that has me hesitating. I have done the research on Clinical Studies, Dr. Frankel’s article, your posts, etc. The data seems to indicate, and you’ve agreed that .5 mg is roughly 80% as effective for hair growth/retainment as a full 1mg. My question is, are the side effects proportionally decreased? Is there any data out there?

B/c of the efficacy of the .5mg dose, and because the decreased DHT/Serum levels appear to stay in the same range for almost 72 hours, my plan is .5mg Merck Propecia every other day, in order to decrease any chance at both short and long term side effects. Does this sound logical to you?

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I really do not see your logic. I mostly see your fear… fear that the drug can give you side effects. Is it worth the risk (for you)? Maybe you should question taking it altogether. There is a phenomenon known as the placebo effect… and it goes both ways. If you are preoccupied that a drug will give you a side effect, then you will likely see that side effect because that is what you believe will happen. If you don’t try it you will never know if you will have a side effect.

I don’t know if there is statistical data available that shows decreased side effects with decreased dosing, but I’ve seen that to be the case if a patient has experienced side effects from the full dose. If you have genetic androgenic alopecia and Propecia is recommended by your physician, then I would start with the recommended dose. If you end up with a side effect then you can just as easily not take it and the side effects would be gone.

April 5, 2010

Shaving the Recipient Area to Prevent Shock Loss? – Hair Loss Information – Balding Blog

Hi Doc,

I have read places that shaving the recipient area before surgery prevents shock loss and has a higher graft success rate. Do you know if this is true or do doctors who require you to shave your head just want to make the surgery time shorter? Thanks!

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It’s probably not true… and you probably learned it from a clinic where the doctor insists on shaving the head. At NHI, we only shave the area that we remove in the donor. The best way to prevent shock loss is to take finasteride before the hair transplant and stay on it for at least one year (better, lifetime). For an experienced doctor and staff, shaving the head is more of the doctor’s preference and doesn’t have much to do with growth / success rate.

April 5, 2010

Hair Loss InformationReader Says DHT is Overrated – Focus Should Be on IGF-1 – Hair Loss Information – Balding Blog

Hi Dr. Rassman

I always hear of people searching for unwarranted ways to lower DHT to combat MPB. Whether it be herbs, soy, or saw palmetto, there’s much focus on DHT levels as a marker for MPB. In fact, low DHT diets are all the rage on most balding forums. Perhaps rightly so, however we know the scalp’s sensitivity to DHT is a significantly more accurate marker of MPB and to my knowledge there’s no sure-fire way of calculating this. I say DHT is overrated, and a new focus should be pinpointed on IGF-1 / IGFBP-3 plasma levels.

Some quick definitions…

IGF-1: Insulin-like growth factor 1 (IGF-1), which was once called somatomedin C, is a polypeptide protein hormone similar in molecular structure to insulin. It plays an important role in childhood growth and continues to have anabolic effects in adults.

IGFBP-3: This gene is a member of the insulin-like growth factor binding protein (IGFBP) family and encodes a protein with an IGFBP domain and a thyroglobulin type-I domain. The protein forms a ternary complex insulin-like growth factor (IGF) I or II. In this form, it circulates in the plasma, prolonging the half-life of IGFs and altering their interaction with cell surface receptors.

The study below took 431 men (128 whom had vertex balding) and tested IGF-1 and IGFBP-3 levels in all of them.
-Those with vertex balding had high IGF-1 levels and low circulating levels of IGFBP-3.
-Those without vertex balding had significantly lower IGF-1 levels
(Low IGF-1 levels generally mean a high amount of circulating IGFBP-3 as they show a trend of being inversely significant in a number of other studies)

PubMed – J Am Acad Dermatol. 2000 Jun;42(6):1003-7.

Interestingly enough, in this study Finasteride signficantly increased IGFBP-3: PubMed – Cancer Res. 1998 Jan 15;58(2):215-8.

Perhaps IGF-1 and IGFBP-3 levels can be a highly accurate marker of vertex balding and finding ways to increase IGFBP-3 could serve as a powerful combatant.

I’d like to add that a low-glycemic diet and a diet low in saturated fat have all shown to increase circulating levels of IGFBP-3 as well as increase IGF-1.

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Thanks for sending this. It’s beyond me, but I wanted to post it for those that had interest. Let the research begin!

April 5, 2010

Propecia and Oral Sex – Balding Blog

Hi Dr, I was reading a number of your responses to the queries posted here and was really pleasantly surprised by the straight ahead and honest answers you provide.

I have a query related to what precautions should be taken in one’s sex life when taking propecia, apart from avoiding potential pregnancy. Could the drug be potentially damaging to a man’s partner otherwise? ie during regular sexual intercourse? or, for instance, in oral sex?

I realize these questions may sound ridiculous to someone more informed in the actual working of the drug, but there is a certain amount of vagueness surrounding these issues with propecia that I think a lot of people would like to have clarified.

many thanks. all the best

Sex It’s not ridiculous to ask questions. If a pregnant woman gives oral sex to a man that has been taking Propecia, I would doubt that there was any side effect possible with this related to the drug (the same goes for sexual intercourse). Have fun and you can even return the favor, as there is no risk the other way around either.

For further confirmation, you can refer to a statement from the drug’s manufacturer (Merck) that I published a couple years ago related to this very topic — Propecia’s Effect on Sperm and Pregnancy.

April 2, 2010

Hair Loss InformationCheap Hair Transplants Are Not Such a Good Deal After All? – Hair Loss Information – Balding Blog

Money I’ve been thinking about the case I wrote about last week — “How Many FUE Grafts Actually Grew?” — about how a patient (we’ll call him Mr. Smith) came to NHI after feeling royally screwed over by another clinic he went to for his follicular unit extraction (FUE) procedure. It’s quite an interesting case of being scammed by a doctor that advertised super low prices, so I really suggest you read it if you have the time. Even so, I want to talk a little about value in surgery…

If you run the numbers, you will see that the actual growth of hair was only 25% of what he got transplanted. There were two consequences of this:

Of great importance is the loss of your finite (limited) supply of donor hair. In the case of Mr. Smith, his surgeon killed 3 out of 4 hairs that were transplanted. These hairs are forever lost to the patient. I also believe that there was damage produced to the donor area, evident by a thin see-through appearance. His donor supply is significantly worse off following his FUE procedure than if a scar formed from a strip surgery, which could have been easily hidden by surrounding hairs. FUE is not always the answer to harvesting hair without post-surgical consequences, as seen in Mr Smith’s case.
Of lesser importance, the cost per graft was multiple times higher than what the patient thought. Let’s assume that Mr. Smith paid $5/graft. When measured against growth, his actual costs were $15/graft for the work that was done. The rate he paid had nothing to do with the value he actually received (in his end result), as he really was paying more for less. That’s quite a bit of money out of his pocket.

The lesson here is that experience in a hair transplant surgeon and his team is directly related to the actual costs when measured by the yield of what actually grew from the hair transplant. My advice to prospective patients is to change the way you look at value! In our practice, we allow prospective patients to meet our patients to see what type of results they got. As these Open House events are open to all patients (or future patients), anyone with results like shown in Mr. Smith’s example will be as evident as the nose on your face. This will help you in the education and selection process. This type of surgery is forever, and unfortunately some patients have to learn the hard way when they try to pinch pennies by going to a surgeon that has no business messing with your hair.