Month: October 2014

This is a review of what is possible when you combine Scalp MicroPigmenation (SMP) with a hair transplant surgery using the Follicular Unit Extraction (FUE) technique performed at New Hair Institute by Dr. Jae Pak.

The following patient is in his 30’s and always wore hats. Even in the house with the family or with friends he wore hats because he was not happy with his balding pattern. He eventually decided on a FUE procedure because he didn’t want the linear scar on the back of his head in case he wanted to shave his head in the future. If all else fails, he thought at least he can shave his head without any worries about scars. He eventually went on to have 3 FUE surgeries over the years as his hair loss progressed and received about 5000 grafts. Despite the new look and the permanent transplanted hair, he wanted fullness and even wanted to shave his head for a buzz cut look.

Eventually, he had the Scalp MicroPigmentation procedure and he had the best of all scenarios: He can cut his hair long or short and he will always have the look of fullness.

Note that hair transplant procedure is a great option for those who are balding. But you will never get full thick hair since the basic concept of a hair transplant surgery is just relocating hair from one location (back of head) to another location (front and top of head). There is nothing new being added. Hair transplant is basically artistically rearranging the hairs around. Scalp MicroPigmentaion is used to augment the limitation of a hair transplant to provide the look of fullness by minimizing the contrast between hair and scalp.

This patient finally threw away the hat he wore for so many years.

Thank you for the great blog. Can you kindly comment on the study of the hairmax laser comb? There was a study published on the American Journal of Clinical Dermatology in 2014: Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Pattern Hair Loss: A Multicenter, Randomized, Sham Device-controlled, Double-blind Study

It seems like a good study but the results and conclusions from the study is plainly states: “A higher percentage of lasercomb-treated subjects reported overall improvement of hair loss condition and thickness and fullness of hair in self-assessment, though the results did not always reach statistical significance.”

It means the subjects felt improvement but the results did not always show statistical measurable significance. In fact, it states Rogaine and Propecia worked better overall in the end.

The report ends by stating: “Further clinical trials are needed to define the optimal duration of treatment, the duration of response, and the use of the lasercomb in other alopecia conditions.”

This reflects what I’ve been saying and seeing in my office. I personally do not think that the laser therapy for hair growth works. I have seen many patients over the years and some say it helped a bit but they cannot see the gross cosmetic difference (a real change someone can see). I have not been able document the results in numeric terms or objective terms even with our recent laser trials here either. It doesn’t mean patients were not dissatisfied but I did not find a documented benefit. I still remain unconvinced that it works. As for my opinion, it’s a free world and a free market. Any one is welcome to spend the money to try it for themselves. It’s apparently declared safe by the FDA.

We’ve written about it here, here, and here.

Dear NHI Team – your blog is one of the most informative and professional online resources.

In the past you have written that of a belief that Propecia works for all men. Dr Bernstein in NYC, Dr. McAndrews in LA have made similar statements. The Merck claim is that it stops hair loss in 9/10 men. Perhaps you are saying that the one man left will go on to lose hair but a slower rate?

Could please elaborate on your opinion?

Propecia is for the treatment of androgenic alopecia in men. I’m not sure if Merck claims it “stops” hair loss, but I think Merck is claiming it works in 90% or 9 out of 10 men. The degree of how well it works on the individual is variable. Over the long term, even if you do take Propecia, you will continue to lose hair, albeit at a slower rate. For example, instead of losing most of your hair in your 20’s you may be able to prolong that fate to your 40’s. To some that may be worth it.

Finally, unless you’re doing this for research or intellectual purposes, the statistics don’t matter when it comes to personal experience. No matter what the percentage of successfully growing or slowing down hair loss, men may try the medication in hopes it will work. Likewise, no matter what the percentage of negative sexual side effects, men may not try the medication due to fear of it happening to them.

This is a review of a 20 year old patient who started to bald after he hit puberty. He was so devastated he actually skipped going to school for over a year. He shaved his head and tried to accept his genetic fate when he found out about Scalp Micropigmentation. After his transformation, he came back and gave all the staff a big hug.

This is a video review of a FUE procedure at New Hair Institute Medical Group

Dr. Jae Pak is performing the FUE procedure without shaving the head. This is a special technique limited to small number of grafts (300 to 600) for those who want the FUE procedure but do not want to shave their head.

I am about to undergo Chemotherapy for breast cancer and I have been told that I will lose my hair. Is there anything I can do to prevent this?

We have written about a device called the Cold Cap before HERE

Many patients over the years have written to us about the successful use of the Cold Cap at preventing hair loss from Chemotherapy. You can review our previous posts on the subject. For reasons unclear to me, I have been told that many cancer oncologists resist this approach under the analysis that if there is metastasis in the tumor, the reduction of blood flow to the scalp limits the amount of chemo-drugs to the scalp skin. The value of not loosing ones hair seems far more advantageous to a remote risks that were brought up by some opposing doctors.

This is a review of a hair transplant surgery at the New Hair Institute and what is possible for a Norwood 5 patient.
This patient had two procedures totaling 4774 grafts. He still has about 2000 to 3000 graft extra reserve if he has further hair loss on his crown area where there is significant miniaturization. He should stay on Propecia/finasteride to slow down the crown hair loss which is an almost certainty considering the amount of miniaturization that he has in the crown. Needless to say a very happy patient!

After photos – taken September, 2006:

I am a medical student and was wondering how finasteride works to give people a fuller appearance of hair.

In the Journal of the American Academy of Dermatology July 2006, Volume 55, Dr. Vera Price summarized the action of finasteride as follows:

“Long-term finasteride treatment led to sustained improvement in hair weight compared with placebo. Hair weight increased to a larger extent than hair count, implying that factors other than the number of hairs, such as increased growth rate (length) and thickness of hairs, contribute to the beneficial effects of finasteride in treated men.”

This is important, because what she implies is that the miniaturized hairs reverse. That is why it is so important to map out the scalp for miniaturization and to perform bulk measurements with the HAIRCHECK instrument. These two approaches used prior to starting finasteride (Propecia) gives us a baseline metric to determine the value of the treatment. I have seen people with miniaturization in the 80% range, reduce substantially to almost normal levels (under 20%). This is why everyone taking finasteride should be evaluated prior to starting the treatment by a doctor who understands this process clearly.

I am a 17 year old male. When i turned 13 I dyed my hair about 5 times, and bleached it once. The following year I began to lose my hair. You can see my scalp on the back of my head, not greatly, but very noticablly. The hair on top of my head is very thin now, and u can almost see through to my scalp. My hair has stopped falling out since then but the damage has been done. I have been to several doctors, and dermatologists, they all say it’s hereditary, since my father is bald. My questions are, if the hair loss is hereditary why did I start losing my hair at such a young age? If my parents and I consider hair transplantation am I guaranteed to have a full head of thick(er) hair? If we decide to have the surgery should I start taking Propecia to prevent any future hair loss? I would love nothing more than to have a full head of thick hair again. This has been a very stressful situation, being in my prime teen years, and entering my junior year of high school in September. I would greatly appreciate it if you respond to my message. Thanks for your time!

You are almost certainly too young to have hair transplants. Wtihout seeing you and examining you, I can not really understand what your hair looks like throughout the scalp. Seeing through the hair to the scalp means that you hair is probably very, very fine. This is a common look, something that my generation called a towhead. I would not be surprised to hear of balding in your family as 50% of men in their lifetime do have some form of balding. Some of your hair loss may be the results of the chemicals you put on your head when you were young. Before you start on a treatment plan, please read Miniaturization: Critical to the Master Plan for Hair Loss and develop a Master Plan for your hair. I can not really advise you without seeing you.

Dr. Rassman

My daughter has many bald spots on her head, we noticed this back in August of last year and it dosen’t seem to be getting better. I am at a loss as to what to do. I have had her saliva tested and put her on a vitamin and mineral regiment. She has also started to eat more vegetables at our urging to help with her problem. She is seven years old and has always been concerned with her appearance, I am very concerned that this will progress and affect her forever. Please send me any information that you think may help us.

Take her to a good dermatologist. Spots of hair loss are signs of something wrong like a fungal disease of the scalp or alopecia areata or a variety of other conditions. This is not the place for the amateurs (or even online opinions) and your daughter deserves a good professional opinion from an expert in person.