Day: January 1, 2023

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Persistent Scalp Pain 5 Years Following a Hair Transplant

Hi,

I had a hair transplant 5 years ago. Some months after the procedure, I noticed some persistent pain and sensibility in my scalp, mainly in the scar and areas near it (example: where the eyeglasses touch my head). But it did not heal. The areas near the scar are extremely sensitive. I need eyeglasses to work but its impossible to use them (my astigmatism is incompatible with contact lenses), so my situation is very hard.

Some surgeons said that its necessary to remove the scar, because I could have some neuromas. The scar is very homogeneous, it is not wide, and the HT was made by a very experienced surgeon. He said that this never happened to his patients and has no idea of what happened with me.

I went to some pain specialists (psychiatrists) that told me to take amitriptilin (50mg/day) and pregabalin (Lyrica, 225mg/day). None of them had any effect. Other things I already tried are: laser therapies, topical capsaicin and local injections of corticoids. No results.

Now, the surgeons think that the only thing to do is to a surgery to completely remove the scar, like a new strip (very very thin) for hair transplant, without transplanting follicles. Do you think it is a good idea or the situation can become even worse?

I already did lots of search and some web sites and surgeons comment that it is possible (very rare) to have persistent pain after years of HT, but I never found suggestions of how to treat it.

Thank you.

You have risk no matter what you decide. Have you had injections of steroids into the painful part of the scar? I would need to evaluate you before giving you a recommendation. I’ve written before about nerve damage from a hair transplant in some past posts that might have some value to you:

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Persistent frontal hairline

I have published on the genetics of the persistent frontal hairline. This man could bald and yet keep his frontal hairline. For a hair transplant surgeon, that means that he will not have to get the leading edge of his hair transplant, saving the patient money and donor grafts. For him, it means that he will retain a frame to his face with a good comb-back of his hair for styling purposes.

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Permanent Problems from Propecia?

Hi Doc,
Is anything known about the permanence of the sexual side effects of Propecia? I’m concerned about serious fertility problems if I start using this drug, and I’m skeptical of Merck’s claim that all side effects go away quickly once you stop usage (how would they know? Propecia hasn’t been around that long). I’ve just been browsing comments about Propecia on the web and, from reading about various people’s experiences with it, it’s not so clear to me anymore that this drug won’t cause a permanent problem.

I’ve written a lot about Propecia on this site. Please do a search for Propecia or Propecia side effects to read my many blog entries about this. Quite simply, if you do not trust the drug company or the FDA, then you should not take the drug. In fact, do not take Propecia or any drug unless you have confidence in the information sources; in this case Merck and the FDA.

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Permanent Finasteride Side Effects Article in Journal of Sexual Medicine

Dr. Rassman, et. al, the Journal of Sexual Medicine has recently published an article describing the permanent sexual side effects of using finasteride. I quit taking propecia approximately 2 weeks ago and am terrified that I have permanently damaged myself. What are your thoughts on the article?

Adverse Side Effects of 5?-Reductase Inhibitors Therapy

Many of my patients have been taking Propecia for over a decade without side effects. I have yet to meet a person in my practice who complains of permanent side effects associated with Propecia after they stopped the drug. The few that do have side effects at all elect to stop taking the medication and the side effects have subsided as their hair tumbles to the ground. But that is just my humble experience.

The article itself doesn’t provide anything new, just reviewing previously published reports from a subset of men that raises the possibility of a casual relationship. They did report a single case of a man with total sexual function loss, but that sounds peculiar and I’m not convinced. I would wait for confirmation by other investigators on claims of permanent damage from finasteride. The Journal article was digested by the Boston Globe here and even mentions what we’ve been saying for years about the percentage of those that saw side effects:

“In one trial, about 1.9 percent Propecia takers who took the drug for up to two years experienced a loss of libido compared to 1.3 percent of placebo takers; 1.4 percent of Propecia users had erectile dysfunction and 1 percent had an ejaculatory disorder compared to 0.9 and 0.4 percent of the placebo takers.”

For most of the frightened men, I wonder what they’re so terrified about. Did they actually have side effects? Are these men willing to risk balding over a 1-2% chance of side effects? As I’ve often said, the medication is completely elective. You don’t have to take it and I am not trying to convince anyone to do so. I am just presenting my opinion based on experience. The Mayans predicted the world will end in 2012, so I would be more terrified about what will happen in 11 months!


2011-01-12 08:34:55Permanent Finasteride Side Effects Article in Journal of Sexual Medicine

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Permanent Female Hair Loss from High Doses of Chemo?

(female)
I am currently receiving chemotherapy for my synovial sarcoma. I have 2 more rounds of Ifosfamide to go (Cisplatin/Adriamycin in my previous rounds). I will have 6 total rounds of chemo. I’ve read everywhere that permanent hair loss can occur if there has been very high doses of chemo given. What counts as “high dosage?” Do you think 6 cycles of my chemo will cause permanent hair loss? I just want my hair back!! Thank you.

The reason for hair loss with chemotherapy is because these drugs kill cells that are fast growing, and hair cells fall into that category. We may not know immediately if the hair loss is permanent or temporary, because some of the women who have had such treatments may also have genetic hair loss that is triggered by the drugs. Only time will tell.

Within a year, there is enough time to survey the hair loss. Doing bulk measurements on the newly grown out hair and then repeating such measurements over time will tell much about how the hair may or may not be recovering.

I suggest that you finish your course of chemotherapy and after 6-12 months, you might consider being evaluated by someone like me if you are in the Los Angeles area. At one year out, call me and send me photos so we can start a dialogue.


2012-09-13 11:45:04Permanent Female Hair Loss from High Doses of Chemo?

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Is permanent Erectile Dysfunction (ED) going to happen to me?

I have been on for almost a year and i noticed recently in the past few months that my erections have gotten weaker. is this going to be permanent? I have stopped taking fin and i’m hoping for the best for my sexual health and my hair

We just polled a group of experts who have written at least 10,000 prescriptions of finasteride to find out what the incidence in the hands of good doctors who have good communication with their patients. I believe I am one of them. Everyone of them has never seen a permanent case or ED. I will comment; however, that in this group of doctors, most commented that they recommended that patients with ED that don’t respond to a decreased dose, were recommended to go off the drug. Maybe that is why the incidence is so low in this group of doctors, but we really don’t know for sure.

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Periodic Shedding from Finasteride?

i have been taking proscar for probably 7 or 8 years. a few years ago i had a pretty bad shed. freaked me out. however the hair did come back. again, i am having another shed and i\’m pretty stressed about it. is it normal to have sheds periodically even while on proscar?

It is important to realize the the genetic hair loss has its own course, independent of the effects of the drug. What you think is shedding from finasteride, is probably more genetic hair loss. Hair loss goes in waves and cycles of loss (shedding) most likely be due to your genetics, not the finasteride. You should discuss this with your prescribing doctor.

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Perfect mature hairline (photo)

Note that the middle of the hairline is about one finger breadth above the highest crease of the furrowed brow. The hairline is one looks to the sides, creates a gentle V-Shape. The hairs in the hairline are mostly single hairs that allow a transition that makes the hairline not a line. Because this man has coarse hair, it is easier to see the single hairs in the front of the hairline on the photo below. This is a transplanted hairline but one would never know it by looking at it.


2021-07-17 17:03:18Perfect mature hairline (photo)

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Perfect Hairline

Sometimes it is unfair that some people get a great hairline regarding genetics. I believe Stalin might never have succeeded as a dictator had he been bald! A full head of hair gives great confidence to those with it. Look at Bill Clinton’s hairline as such an example? Men’s Fitness did an article some years ago reviewing the political ramifications of not having hair. Since Eisenhower, there has not been a bald president in the United States. Donald Trump knew this and tied a perception of good hair with a lace hair system (a wig) to build his personal confidence. The public doesn’t know Donald Trump is bald because they know him as a hairy man with a strange hairstyle.

Response from Reddit poster: I had this happen to me firsthand from 16 until 24. I ran a community in the mountains of Ohio, and year after year, we were gaining more and more followers. I could Stockholm syndrome a beatiuful model, even a wealthy businessman in no less than 3 hours. Then baldness struck, no new members, all my wives left me for one of my enforcers who had beatiuful luscious hair, but I guess the hair loss saved my ass the feds raided the community like a year later. I’ve been saving up for a $30,000 for graft treatment, so maybe one day I can create another community

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This Is the Perfect Female Hairline (Head Shaved)

It is rounded and there are no temple peaks because they are incorporated into the rounded hairline. This is the same hairline that she had when she was a child at 5 year of age.


2019-02-14 06:24:22This Is the Perfect Female Hairline (Head Shaved)