Month: November 2014

I have lived With my nightmare Freaky hair transplant look too long, what can I do about it? Can you help me?

This patient would not allow me to show his pictures, but I will tell you in general what his “freaky” hair looked like. He had four scalp reductions (removal of bald scalp from the crown of the head) which left a scar down the middle of his head, and he had 4 partly failed transplants creating the old doll’s head look. Between all of these procedure, his entire donor area (except for one area high in the donor area that might still provide for hair for another hair transplant – perhaps not the best option). You can see through the hair on the back of his head and he looks like a cancer survivor despite his good health. This surgery was done over 20 years ago by a Los Angeles surgeon known to the professional community for this type of terrible work, but not known by his victims. The patient was in his early 20s back then and wanted to believe in the doctor and after many surgeries there was a progressive loss of trust. His hairline was placed an inch too far above its normal position, so he even looked worse.

My job was to assess his situation, communicate realistic (not idealistic) possibilities clearly to him and then recommend a possible treatment for him – if one was possible or agreeable to the patient. Many patients like this have few options and the 8 previous surgeries and all of the deformities that were created, left him mistrusting all doctors with few options. None of the options would bring him back to being completely normal without sacrificing certain styling options. Some of these options were:

1- Shaving his head and having Scalp Micropigmentation done, This is a reasonable option if he can put up with a shaved head and many people in his situation select this option. For an example of a result he might expect, go to scalpmicropigment.com and see patient 161 who has deformities in the back of his head similar to this patient. His after pictures show camouflage of these deformities but the deformities and scarring will still be there on close inspection.

2- Fortunately, I believe that he has enough hair that I can still harvest to recreate his frontal hairline with hair transplants. Then he can then have SMP done to cover the massive scars on the back of his head and cover the scars in the front, top and crown of the head. A good frontal hairline will allow him to let all of his hair grow out and style it once the new frontal hairline is created. SMP will help to minimize the look of thinning and scarring.

I have literally seen thousands of patients like this over the past 24 years, and helped many of them. By helping I do not mean making the deformities go away, but with good styling and some surgeries, at times, a much improved look is very feasible. Since Scalp Micropigmentation has been available in our practice, we have been able to create amazing improvements in patients like this. I think that we have done more of these types of repairs than any medical group in the world today.

November 11, 2014, Los Angeles Times: REGULAR POT SMOKERS HAVE SHRUNKEN BRAINS, STUDY SAYS: “Experimental mice have been telling us this for years, but pot-smoking humans didn’t want to believe it could happen to them: Compared with a person who never smoked marijuana, someone who uses marijuana regularly has, on average, less gray matter in his orbital frontal cortex, a region that is a key node in the brain’s reward, motivation, decision-making and addictive behaviors network. More ambiguously, in regular pot smokers, that region is better connected than it is in non-users: the flow of signal traffic is speedier to other parts of that motivation and decision-making network, including across the superhighway of “white matter” that connects the brain’s hemispheres.”

There has been much speculation on this fundamental issue but it is not surprising to me because we seem to easily forget the impact of chronic alcohol intake on brain function (se:http://en.wikipedia.org/wiki/Wernicke%27s_encephalopathy). Excess has its costs, so how do we determine just the right amount of alcohol or pot that is safe. I suspect that it is different between people, some get these problems with lesser dosages.

I know there is often a lot of talk about celebrity hairlines, but one celebrity whose hair I’ve never seen on any blog is John O’Hurley, who is in fact known for his thick head of hair. I take particular interest because my hairline is very similar to his. It forms a stark v-shape and leaves his top brow ridge, but as far as I can tell has not receded over the decades. Is this representative of the “mature hairline,” or has he possibly had this hairline since birth? Any insight would be most appreciated.

Mature hair line is basically a hair line that develops from childhood to adult transition. Many young men think it is a sign of balding and toil over the definition or seek a diagnosis of this phenomenon to assuage the insecurity of hair loss.

John Hurley is not bald or balding. He still has a great head of hair as he had in his earlier years. The shape of his hair line is just his trait. I do not know what his hair line looked like in his childhood. Maybe his hair line changed a bit as he aged, but he is clearly not bald or balding.

Dr, what do you think about the new paper published by Dr. Irwing for Post Finasteride Syndrome: Androgen Levels and Semen Parameters Among Former Users of Finasteride With Persistent Sexual Adverse Effects. Are you still not convinced that PFS is not real?

Let’s put things in to perspective. Just because a study or paper is published does not make things a fact. Many people use the Internet and find their “truth” or “proof” based on simple statements without really looking at what has been done or studied. Few ever think about the study parameters and the limitations of the findings.

The study was conducted on only 24 participants. Participants were recruited from a website forum called propeciahelp.com It is a website that advocates class action lawsuits for people with side effects from Propecia. I don’t know what the readers may think of this, but wouldn’t you think there is a self selection bias here?

The study found low serum androgen levels but the study also admits to no baseline levels to compare this with. This means there is no way to determine if Propecia was a cause.

The paper is not a research paper, but just a letter that was submitted to a journal.

The “Limitations” mentioned on the paper was that it was a “Retrospective study design, small sample size, recall bias”

I believe there are patients out there who are suffering from sexual issues and that they believe it may be from Propecia. They can also be suffering from the same sexual issues irrelevant to Propecia and this is very hard to negotiate with the individual who is convinced that their symptom can only be from the Propecia use. These type of papers only further confuses the issue with no solution or clear explanation of the cause of the problem further propagating the conspiracy theories and frustrations of the people who are suffering from a problem.

I do agree that further research should be done with better methods and sample size.

I am losing hair at the top of my hair and now my scalp is becoming visible. I have tried strategically placing my hair pieces but its becoming very consuming. Please help me.

If your hair loss is an issue and you want medical or surgical options, you can always contact my office for a consultation. (800) NEW-HAIR

I’m 23 and I just started taking propecia for the first time in a year. Here is my 10 week before and after and the results are incredible so far. Frontal hairline is regrowing. Please blank out face if you are to use them.

Propecia usually do not work for the front areas and it takes several months to see results. But once in a while some do see great improvement.

Dr. Bernstein, my former NHI colleague, has many before after photos of men who only took Propecia and got phenomenal results. see: http://www.bernsteinmedical.com/medical-treatment/medications/propecia-finasteride/

BEFORE

AFTER

AFTER

I am 18 years old and i have experience the hairless of a 40 year old man. The front of my hairline is 3 fingers above what it should be, and my temples are about 5. I have no idea what i should do. I tried laser but it does nothing but thicken my existing hair. I am losing hair fast and have been told i am a candidate for FUE. I wanted to ask if this is an acceptable procedure for someone my age and will I have to shave my hair. I am still in high school so obviously shaving my head is going to raise some discrimination on me. I try to hide by keeping it long but now its just a matter of time before someone makes a comment. What can i do

Genetic male pattern balding starts in your teenage years. I am sorry to say what you are going through can be considered normal for a 18 year old who was born with the genes for hair loss. If you want to do something about it from a medical point of view, you need to see a doctor who can guide you and explain to you all the options. Note that there is no cure for genetic hair loss. Hair transplant, drugs such as Propecia and Rogain can help, but there is no clear cut solution for everyone. Every person’s goals and expectations are different. There are many teenagers who shave their head without any discrimination but as you state, shaving your head will be an issue.

I have a question regarding to human hair whorl, if we talk about the hair loss on the top for men, does it normally begin to thin from the whorl area? Cheers

Genetic hair loss in men have a certain “pattern” as described by Dr. Norwood. That is why it is often called Male “Pattern” Balding. For those patterns that start on the top crown area, it starts around the whorl, but I do not think you can say it starts exactly at the whorl as it often appears as general thinning of the entire area around and including the whorl. It certainly looks like it may start at the whorl because that is where the hair changes direction and looses its ability to overlap hair on hair, so it looks the thinnest and it is a focal point that draws the eye to the center of the whorl (even for non-balding men).

I am a 30 years old man, I have a hairy body, full beard and full chest hair, does it relate to baldness? I guess it means high in DHT to grow a hairy body, moreover, I saw most hairy men are bald, then it makes me think they are relevant, but what is your answer? Thank you

Body hair or beard hair does not relate to genetic male pattern balding. It is not the DHT that directly cause balding. It is the genetic trait that cause balding which, when present, triggers the balding process. If you have the genes for male pattern balding then DHT impacts your scalp hair usually in a pattern that is dictated by your genetics. If you do not have the genes for balding, the DHT does not matter.

What you are observing may be observation bias. Plenty of bald men have very full body hair.

Swedish researchers published an article in the British Journal of Medicine (October 2014) which showed that a “high intake of milk may be associated with higher mortality and fracture risks in women and higher mortality risk in men”.

61,433 women and 45,339 men (women 39-74, men ages 45-79) were followed during a medium of 22 years. They were asked about diet early in the study with questionnaires. 15,541 women died and 17,252 had fractures. during a 13 year follow-up, 10112

They analyzed outcomes from enrollment (from 1987 to 1990 for the women and January 1998 for the men) through December 2010. During a median of 22 years of follow-up, 15,541 women died and 17,252 women had a fracture. During a median of 13 years of follow-up, 10,112 of the men died and 5379 men had a fracture.

The harm came from drinking 3 or more glasses of milk per day. “The researchers found that women who drank three or more glasses (680 g) of milk a day had almost twice the risk for death compared with women who drank less than one glass a day (hazard ratio [HR], 1.93, 95% confidence interval [CI], 1.80 – 2.06). Women who drank more milk also had a higher risk for any type of fracture (HR, 1.16; 95% CI, 1.08 – 1.25) and for hip fracture specifically (HR, 1.60; 95% CI, 1.39 – 1.84).”

Although the researchers found that men who drank three or more glasses of milk had a slightly higher risk for death compared with those who drank less than one glass (HR, 1.10, 95% CI, 1.03 – 1.17), men did not have the excess risk for fracture seen in women.

Men did not see the high fracture rate thwt women experienced. Yogurt and cheese did not show higher risks for either death or fractures.

Further analysis of the men and women who had increased risk was not done.