Month: July 2014

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Hair Transplant Technicians and Technology Are Now Offered to Untrained Doctors – Hair Loss Information – Balding Blog

When a doctor exploits his medical license by offering hair transplants without training or experience, his activities reflect a flagrant disregard to the welfare of the patient. I am fully aware that bands of technicians are offering inexperienced doctors the opportunity to enter the business of hair transplantation with a focus on new sources of revenue for their practice. This is becoming more and more common. Although these technicians bring the technical skills to do the transplant, they do not bring along with it the competence that is learned by proper training and experience in the field. I warn all prospective patients to be very careful of any doctor offering this service if they had not done at least a hundred of such cases and have been trained in the field. Always check out the doctor’s experience in the field.

William Rassman, M.D.

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Using Different Minoxidil Strengths – Hair Loss Information – Balding Blog

I am a 23 Female, I have been losing hair for 2 years now. My dermatologist prescribed minoxidil 2%, but after 4 months i didn’t see any results. Is it safe to use both 2% and 5% (2% in the morning and 5% at night) to make it more effective?

Thanks

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In general we advise our female patients to use minoxidil 5% twice a day, although the official recommended dose is 2%. We take the blood pressure of the patient prior to prescribing this medication. Although this medication can be purchased directly from any pharmacy or grocery store, there are side effects that you must read about prior to starting the medication.

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Not Hair Loss News – Aspirin Slows Down Aging – Hair Loss Information – Balding Blog

“It is well known that a person’s lifestyle affects the risk of cancer. Swiss scientists have now shown that this is at least partially the result of effects of lifestyle factors on the genome. While aging is slowed down with regular aspirin use, smoking increases it. The study was published in the “Journal of the National Cancer Institute”. ”

The Journal further reported “that regular aspirin use and smoking led to changes of gene markers – however, with opposite effects: while smoking accelerated the effects, aspirin slowed them down. Genes that are associated with the development of cancer are particularly affected by this, said lead author Faiza Noreen. “

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If there is a wonder drug, it seems to be aspirin. I have taken it for years. There seems to be beneficial effects on aging (see above), heart and vascular disease and cancer prevention. What else could you ask for?

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Hair Loss InformationBeware of Hair Growth Formulas and Inappropriate Claims for Minoxidil Regrowth – Hair Loss Information – Balding Blog

According to the indictment below, a named doctor has been using the Internet to sell non-approved doses of Minoxidil with claims that are not proper. Read the document below for details

SALT LAKE CITY ‹ Four men, including two Utah’s, face federal charges for allegedly selling hair replacement drugs over the Internet without U.S. Food and Drug Administration approval. Dr. Richard Lee, 72, and James Dorius, 69, both of Whittier, Calif., owned Regrowth, LLC, a business that made and sold hair treatment drugs online. Alexander Ahn, 32, and Min Kim, 32, both of Provo, ran a Utah company called Minoxidil Solutions that sold the drugs after Regrowth had agreed with the FDA to pull them from the market, according to the indictment.

The indictment alleges that the FDA discovered that Regrowth was selling drugs Lee made using his own formulas and recipes dating back to 1996. Some of the products contained active pharmaceutical ingredients. The company was not registered with the FDA and did not seek or obtain approval to sell its hair growth drugs, according to the indictment. As apart of an agreement with the FDA in February 2011, Lee stopped selling the products and sent customers an ³urgent drug recall² notice informing them of potential health hazards. Two months later, Lee and Dorius delivered Regrowth¹s remaining drug
>ingredients and manufacturing equipment to Kim and Ahn in Utah. According to the indictment, Kim agreed to pay Lee and Dorius half of what Minoxidil Solutions earned on the sale of hair growth drugs made using Lee¹s ingredients and formulas. “These kinds of cases are important because in many instances individuals are advised by FDA that they cannot lawfully manufacture and sell unapproved and misbranded drugs, yet even after warning, they continue to manufacture and sell these prohibited drugs,” said Patrick J. Holland, special agent in charge of the FDA criminal investigations office in Kansas City. Lee, Dorius, Ahn and Kim are charged with conspiracy to introduce misbranded drugs into interstate commerce, which carries a penalty of five years in prison and a $250,000 fine. All four men are scheduled for an initial appearance in U.S. District Court on Oct. 23.

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My Hair Stopped Growing After My 2nd Child Was Born – Hair Loss Information – Balding Blog

i have been losing my hair since the birth of my first female child. i am now 40 and with the birth of my 2nd female child 8 years ago, my hair has completely stop growing. i have multiple bald spots-the sides, top of crown and side back of my head. do you think the birth of my daughters affected my hair loss?

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What you describe requires a doctor’s in office assessment. You might have developed an autoimmune disease like alopecia areata – I do not know. But guessing without seeing you is not in your best interest.

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Hair Loss InformationNot Hair Loss News – I Don’t Feel Well So Please Prescribe Me an Antibiotic – Hair Loss Information – Balding Blog

Ever since I became a doctor, friends and family have asked me to prescribe antibiotics for them as a favor when they don’t feel quite right and think that they are coming down with something. They don’t want to go to a doctor’s office when they have the flu-like or upper respiratory complaints such as a cough, a runny nose, sinus pain, and many other such miladies. When I have refused to prescribe the requested antibiotic, my routine, they make me feel as if I have betrayed them, after all, it is so simple for me to do it.

“The Centers for Disease Control and Prevention (CDC) reports that each year in the United States, at least 2 million people become infected with bacteria resistant to antibiotics, and at least 23,000 people die as a direct result of antibiotic-resistant infections.

Tom Frieden, MD, MPH, CDC Director, points out, “It’s clear that we’re approaching a cliff with antibiotic resistance. But it’s not too late. Clinicians and healthcare systems need to improve prescribing practices. And patients need to recognize that there are both risks and benefits to antibiotics — more medicine isn’t best; the right medicine at the right time is best.”

The above quote was taken from Medscape General Surgery website July 7, 2014 and after reading it, I felt better about turning down my friends and family when they don’t feel well and ask me to prescribe an antibiotic for them. There clearly is some misconception in our society that antibiotics cures the common cold, flu, coughs and sinusitis. FYI, none of my family or friends died or became hospitalized as a result of my turning them down for their requests.

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SMP Scalp MicroPigmentation for Blondes? – Hair Loss Information – Balding Blog

Scalp Micro-Pigmentation for Blondes

Hi Doc. I’m a blonde guy wondering about your Micro-Pigmentation. You can use this image of me if you want (it is my photo and it is of my head):
reader_blond

That photo was taken 9 months after a hair transplant. Obviously its still quite sparse in there. If the 5000 odd transplants don’t take would I be a candidate for Scalp Micro-Pigmentation?

If the grafts do take would, is dermtech or toppik better for a blonde male.

One more question. I have to ask. Like I said its been 9 months since my transplant and I’m not getting much growth. Is it common that people don’t get much growth until around the 9 – 12 month mark.

And are there cases where for some reason, (i.e physical chemistry), that maybe transplants and some people just won’t work? Because to be honest I feel jinxed right now…

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Most blond people have a dark root color when the hair exits the scalp and then it is exposed to light, it turns blond. If the hair is shaved, it would show to be a dark grayish/ brown. To test this in response to this question, I cut some hair from my platinum blond wife and I saw that the hair exiting the skin was grey/brown. When it got to a length of 2mm, it turns her platinum blond.

Dermatch or Toppik in blond colors have not been well received by the patients who have used these products. With regard to your report of what sounds like a failed transplant, you need to get a second opinion. In general it takes about 6 to 12 months to see results after a hair transplant surgery.

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Hair Loss InformationDHT Types, Finasteride (Propecia, Proscar) and Dutasteride (Avodart) and male pattern balding – Hair Loss Information – Balding Blog

Good day to you sir. I read in a previous post dated over a year ago that type II DHT is linked to hair loss, but type I DHT has not been linked/proven to cause hair loss. Is there any news/updates on the two types of DHT with the relation to hair loss? Thank you for your time!

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Nothing has changed in recent times.
For clarification, Propecia is a brand name of a generic drug named finasteride in 1mg strength. Proscar is also a brand name of a generic drug named finasteride but in 5mg strength. Avodart is a brand name of a generic drug named dutasteride in 0.5mg strength.

Propecia is the only FDA approved oral medication for the treatment of Androgenic Alopecia (AGA) which is a genetic cause of Male Pattern Balding (MPB)
Avodart and Proscar is FDA approved for prostate condition known as benign prostatic hyperplasia.

Propecia and Proscar works by blocking an enzyme called 5?-reductase type II which ultimately reduce the DHT level.
Avodart works by blocking the same enzyme 5 alpha-reductase type II but it also blocks 5 alpha-reductase type I which ultimately reduce the DHT level.

You would think that if DHT is responsible for men’s genetic hair loss, that if you block DHT entirely and most efficiently (with Avordart) you would stop the hair loss. This is not the case! It has been found that blocking only the 5 alpha-reductase type II is what you need to treat male pattern hair loss. Blocking that extra type I enzyme with Avodart does not necessarily equate to better result in terms of treating hair loss.

But people don’t really pay attention to science and research. People generally look for the most extreme treatment and non-scientifically based Internet anecdotal reports. So people are using Avodart thinking it has DHT blockade than Propecia (finasteride). For this reason, many who have tried Propecia (finasteride), with no significant or dwindling results switching to Avodart thinking it will work “better”. They don’t realize or factor in their genetic predisposition. They also do not realize the possible long term and increased sexual side effects with Avodart.

In the end Avodart is still used by many for treating hair loss in men. But its true efficacy and advantage over Propecia is not completely clear.

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Hair Loss InformationXELJANZ® (tofacitinib citrate) on curing balding? Alopecia Universalis Totalis – Hair Loss Information – Balding Blog

i would like to know your opinion on a medication called
tofacitinib citrate which was used to treat a man with alopecia
universalis, could this work for someone with DUPA seeing that DHT
might not play a part in this hair loss type?

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tofacitinib

Tofacitinib is a medication to treat rheumatoid arthritis. There was a report by Yale University professor Brett A. King, M.D published in the Journal of Investigative Dermatology that the medication grew hair on an alopecia totalis/ universalis patient.

Alopecia Totalis or Alopecia Universalis is thought to be a condition where the patients own immune system attacks their own hair follicles which results in hair loss. It is hypothesized that the drug diminished or interfered with the immune system attacking the hair follicles. Tofacitinib is not approved for hair loss by the FDA. Tofacitinib will not likely work for genetic androgenic alopecia and there are many safety issues (i.e. infections) with the drug which must be considered.

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FUE and Strip Donor Area Harvesting – Insights – Hair Loss Information – Balding Blog

Dr. Bill Reed, a hair transplant surgeon in San Diego, California, wrote the following piece in an email to a group of doctors. I asked him if he would allow me to share it with our readership, and he agreed.

“Hyperbole, some of you might assert. That may be but I can’t see the flaw in my logic so perhaps one of you can help me figure it out.

Assume that a strip harvest is a limited scalp reduction of the donor. Unlike FUE, a strip harvest removes the bald inter-follicular skin as well as the follicles. An FUE harvest takes only the follicle, more or less and does not do a scalp reduction to take out the virgin laxity to create a snug closure (the scalp reduction). If the end point of donor depletion is determined by removing as many follicles as possible to the point that it starts to look thin and “moth eaten”, (not factoring in how much more thin it will become with age, a point that Walter emphasizes), then the procedure that removes the bald inter follicular skin is obviously superior, i.e., the strip excision.

However, it is not that simple.

Dr. Beehner’s study on scalp reductions done in the 1990s showed a “stretch back” of 40% with vertex skin put on a comfortable tension as is done with the strip excision. In other words, 40% of the hairless, inter follicular skin that was removed is recreated by the stretch back. One is still 60% better off with respect to the density done with FUE which doesn’t remove any of the original virgin laxity.

Trying to create the most conservative estimate, factor in a 2mm scar which strip creates and FUE does not. That 2mm is 15% of the 1.5 cm width so back out 15% from 60% to get 45% superior density due to the “scalp reduction” of removing the bald inter follicular skin with a strip excision instead of merely taking the FUE punch. Although other factors, such as fiber diameter, color contrast, curl, contribute to the “moth eaten” end point, each patient’s end point when surgically removing hair is dictated by density. Even if stretch back is 100% with subsequent procedures (because the laxity of subsequent procedures is created by the stretch back of the previous procedure) there are still the lost follicles, the follicular holocaust, from FUE by not taking the initial virgin laxity. 45% superior density has to be equilibrated with FUE’s density before each has reached its end point. Strip’s superior density is equilibrated with that of FUE by offering up more grafts. 45% superior density after the first procedure translates into 3000 grafts x 0.45 or 1350 grafts.

I believe that this number is for the entire safe donor and relates to the end point of the entire safe donor from multiple procedures. FUE will be approaching its end point by harvesting the whole safe donor with each procedure; strip will be spreading outward to get to the margins of the safe donor. John Cole’s careful work determines that the safe donor is roughly 200 cm2 with a donor density of perhaps 80/cm2 or 16000 grafts. If one estimates that 50% can be harvested before looking thin (a dangerous oversimplification when applied to all patients), then there are 8000 grafts available for harvest. I believe the points I make suggest that with the strip harvest’s mini scalp reduction that removes the virgin laxity with the first procedure, the total number of grafts available with strip excision is 8000 plus 1350 or an extra 17%, a percentage higher than that from the multi-bladed knife that made Dr. Bob Limmer cry out and coin the term “follicular holocaust”!

The FUE genie is out of the bottle and there is no putting it back. Nor should it be stuffed back in as there are good indications for it, but if a patient may need to maximize his donor harvest over his lifetime, FUE appears to me not to be the method to maximize the patient’s limited donor resources. I believe a surgeon has to offer both strip and FUE to offer maximum benefit to his/her patients.”

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