Day: January 1, 2023

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Scalp Expansion

For FUT I know some people have tight scalps and it’s hard to do FUT on them without leaving a wide scar. So kind of a strange question, but I know and have seen some other people who had large burns scars on their scalp or large sections of scalp removed due to cancer. In order to remove the cancer/ scar, close it up properly and make sure there was hair coverage over the area, they put what looked like silicone implants under the scalp; over the course of a couple of months, they filled it with saline to pre-stretch the skin and then took it out so when it came time for the reconstructive surgery, they could stretch the hair covered scalp over to cover the removed area of the scalp without any issues and without leaving a big scar.
So someone with a big balding pattern who would better benefit from the larger graft count that FUT provides, if their scalp is tight, can they first get these silicone implants to stretch the skin before the the FUT strip is taken? Better yet, can a person with balding just get this done to stretch their hair bearing scalp over the bald area without even needing to get transplants?
Scalp expansion with balloon expanders is a procedure commonly performed for injuries of the scalp, burns and other such problems. The normal scalp can be stretched over time if a balloon is placed under the scalp and slowly expanded. The expansion process requires a surgical strategy that requires a special type of expertise. Rather than answer you directly here, I will refer you to other posts on Baldingblog show examples of some patients who came to me with problems requiring balloon expansion or other such cases I became aware of; see here: https://baldingblog.com/?s=balloon
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Scalp Exercises to Regrow Hair?

Dr.,

I came across this web site: https://www.hairloss-reversible.com/my_approach.htm

I’m curious as to your opinion on the possibility that these “scalp exercises” might possibly regrow hair in some individuals after 8 or so months of doing the exercises as a result of increased blood flow to the scalp. It seems like a bunch of unscientific, hocus pocus to me, but if you read the other info on his site, it appears to be very accurate and makes the author
sound very credible.

Thanks.

I visited the above referenced link. It is based on the authors’ personal assumptions on the mechanism of hair loss. He tries to come up with a novel method for treating baldness based on his observation of his bald family members. Although it is interesting to follow his thought process, it is not scientific. Today’s medicine has changed drastically in comparison to 200 years ago. Back then, doctors had their own individual methods of treating different diseases, which at times where completely different and even conflicting with the others.

We use evidence-based medicine to support most of our treatment plans. Although lack of blood and oxygen of the scalp was once thought to be the main cause of baldness, today we know that the scalp oxygen level and blood supply is the same in balding and non-balding people. Massage therapy to increase the blood circulation can not stop the balding process.

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Scalp Exercise Device?

As an innovator in the field and with many patents to your name I am curious as to whether you have ever given thought to inventing a “scalp exercise” device. Imagine a motorized device strapped around one’s head moving the scalp up and down to increase one’s laxity in preparation for a future transplant. It would basically work as a scalp massage.

For a couple hundred dollars I’m sure many transplant patients would invest in one to maximize their graft numbers. Doing these exercises with the hands can get quite exhausting just after a few minutes.

It’s a good idea, but there have been a few patients who have came up with their own scalp exercise ideas that they are pursuing. In the grand scheme of things, scalp exercises are not the rate limiting step, nor do the exercises have a drastic impact on the success or planning of a hair transplant procedure in most situations.

Believe it or not, if I were to create a device for scalp massages and claimed it could loosen the scalp, it would be a medical device from the FDA’s perspective. It would then have to be proven safe and effective, a tall and expensive undertaking I might say.


2012-06-10 10:59:16Scalp Exercise Device?

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Scalp DHT, Propecia, and Androcur

Dear Dr. Rassman,

Article at hairlosstalk.com includes the following statement of “Spironolactone effectively prevents DHT from attaching to the receptor sites on the hair follicles. As a result, the follicles no longer atrophy and can mature again to their normal size. And it does so without decreasing the circulating levels of DHT in the body.”

1. Is it sufficient just to block scalp DHT levels, or serum DHT reduction also necessary to combat MPB? If scalp DHT inhibition is sufficient for MPB, is serum DHT inhibition dangerous for the body as claimed by this doctor?

2. You’ve told in one of your comments that propecia is a anti-androgen, but the prospectus states that it does not have an anti-androgenic effect. Could you please clarify?

3. It’s mentioned that Androcur is the best against MPB. Is this the case?

Your reply will be much appreciated.

Finasteride needs to go through the blood stream to get to the hair follicles. When it gets to the hair follicle it then fixes to the tissue and blocks the DHT. Finasteride is not dangerous to the scalp.

Finasteride blocks DHT and when it does this, the testosterone levels often rise. If the body would not produce testosterone in response to a DHT block, then one would say it is anti-androgenic, but it is foolish talk like that because testosterone needs to be present to have DHT made by the body (DHT being a byproduct of testosterone).

Drugs like Androcur are good blockers of androgens and can produce major side effects on the male sex drive, something I would not recommend for patients with male patterned genetic balding.


2009-03-17 16:39:58Scalp DHT, Propecia, and Androcur

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Scalp Burn Treated with Balloon Expander, How is it Done?

let’s assume that the burn is in the front and top of the head. A balloon is then placed in the crown to expanded in the scalp over a couple of months. Each week, about two times, fluid is injected into a ‘port’ on the balloon. With each injection, the balloon expands until it is stretched enough with enough redundancy to cover the burned areas. Then the burned scar is removed and the new scalp is advanced forward. I have been involved in a number of these challenging cases and the results are very rewarding. I have seen fully half of the scalp burned and treated successfully this way, sometimes with added hair transplants for fine tuning the process.


2020-03-05 15:03:59Scalp Burn Treated with Balloon Expander, How is it Done?

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Scalp Biopsy Misdiagnosis?

Is it possible to have a misdiagnosis from a scalp biopsy?

It depends upon what the biopsy is for. If it is for classic male pattern balding, then the answer is yes. If it is for cancer or other real pathology, there are always human variables that relate to skills and specialization.


2007-08-30 08:34:52Scalp Biopsy Misdiagnosis?

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Scalp Aches After Laser Therapy

I am a 23 yr old male, suffering from thinning hair. I went to a Dr, and he gave minoxydil as part of the treatment, and laser therapy as the other. He uses a laser pen like device, and runs it through my scalp for about 15 min. Well my question is that: everytime he does the laser therapy, my scalp aches a bit. I told him about it, and he says that it is normal, but i need more reassurance.
Thank you

I am unfamiliar with this “laser pen” he is using, but if you think that the aching follows the use of the laser pen, then I would believe that the laser pen is the cause. Perhaps it would be helpful to read my past blog entries regarding the use of lasers in hair therapy, and more specifically, this blog entry about Low Laser Light Therapy. I’m sorry I couldn’t be more helpful, but if you could get me the actual name of the device, I might be able to research it further.


2005-12-28 13:03:26Scalp Aches After Laser Therapy

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Why are my scabs still on my scalp

What you have are not scabs but necrosis of the skin in the recipient area. This means that these black areas have skin that has died as a result of your hair transplant. You need so see your surgeon as this will require wound care and eventually you will be left with a scar in that area with no hair growth in the blackened area.


2019-01-14 13:48:29Why are my scabs still on my scalp

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What do I do about my scabs now 9 days after my hair transplant? (photo)

These scabs (crusts) should have been prevented with good washing techniques the day and the day after surgery. Once they form, you run a risk of graft loss until 14 days at which time you can get them out by leaving a shampoo on the area for 10 minutes, getting it water logged, and then gently rub them off with your finger tips. Repeat this daily until the area is crust free. I take it that you are a female as the hairline shape, a concave shape, is the classic female pattern.

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Scabs, Burns, Brittle Hair After Bleaching by a Hairdresser

(female) I recently had my hair bleached from black to blonde by a hairdresser. They put 1 and a half big boxes of bleach onto my hair, which was very dry anyway, then put clear bags over it and sat me underneath the heat for 20 mins. He told me that he’d never tried this before, but it ‘should’ work. My hair was around 5 inches past my shoulders.

As a result of this, my hair on the left side of my head snapped off, so it is all around 3 inches in length, at the longest points. I also have burns on my head, which I obviously can’t see, but are extremely uncomfortable. They have scabbed up in the past few days, and this was done exactly a week ago. What will happen to my hair? Will it fall out with the scab? And do I have any rights, enabling me to take legal action?

I cannot give you any legal advice on your situation. You should see a lawyer for that.

Many men and women use bleach to lighten their hair color, but this can be dangerous in the wrong hands. Bleach is a chemical that causes irritation to skin and may even cause burns. If you are considering any legal action, you should at least see a doctor for an examination to medically document your burn and scabbing. A good photographic record of what is happening to you is important and these photographs should be taken often. A good doctor should be able to answer your medical questions in detail regarding your recovery and prognosis.