Month: January 2023

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Lateral Slits

Thank you for answering all our questions. This site is a great help!
Can you address the below paragraph pulled of Hasson & Wong’s (Canada) website?

“Hasson & Wong have pioneered the revolutionary Lateral Slit Technique. This technique of creating recipient site incisions allows for far more accurate control of hair graft angulation and direction. In addition, the coverage of bald scalp is increased on average by two hundred percent…Hair transplant surgery utilizing the Hasson & Wong Lateral Slit Technique is the only technique that is able to duplicate the alignment and distribution of hair as it occurs in nature. The result of this amazing technique is the complete absence of plugginess seen in other techniques including standard follicular unit transplantation.”

Hasson and Wong do very nice work. I have nothing but admiration for them both. With regard to lateral slits, I have been doing them on all my cases for three years, but I have never been convinced that they are superior to vertical slits. The written studies done by different doctors throughout the world have not proven that lateral slits are any better. Patients who have had lateral slits on one side and vertical slits on the other side, are split on which side is better. So while there may not be any scientific proof that lateral slits are superior or inferior, it becomes a matter of physician preference, and my choice is to use lateral slits.

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Late 50s, Noticing Acceleration in Hair Loss

I am 57 years old and have maintained a good head of hair (albeit grey these days) throughout my adult life. I did notice in my late teens and early 20’s some recession at the temples, but overall I have what is considered to be good “coverage” when compared to others in my age group.

I have been on Flomax for a urinary flow issue (high bladder neck) and Androgel for hormone replacement for 5 years now. Recently, I added Plavix, Enalapril, 81mg aspirin and Vytorin to the regimen because of an angioplasty and to lower my lipids.

In addition, I take Fish Oil, Folic Acid (5mg) Saw Palmetto and CoQ10 (200mg) although these are not prescribed, only suggested.

Recently, I have noticed some acceleration in hair loss at the crown and frontal area, although it’s progressing slowly and mildly.

I am wondering if the new combination of drugs might be the reason, or if this is simply the natural progression of MBP. I imagine at this point a minaturization study would be a good idea instead of speculating on the impact of my drug cocktail.

Please advise, and thanks for your excellent site as well as your candid, well-researched and scientific approach to this problem.

Yes, I believe a miniaturization study may be of benefit. Genetic male pattern balding (MPB) may be a cause of your hair loss, but is rare (although not unheard of) to occur so late in life. Of note, taking Androgel may contribute to the MPB due to its androgenic properties. However, you should always consult with your physician before starting or stopping any medication. It is unusual that hair loss starts in a person of your age, so I would look to the medications that you use as a possible cause.

If your hair loss is related to MPB, there are medications (such a Propecia) that MAY offset it.


2007-08-03 13:35:10Late 50s, Noticing Acceleration in Hair Loss

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Late 20s, want a hair transplant and need to know how many grafts I would need (photo)

I am in my late 20s and have been balding since 22. I started taking finasteride over a year ago, and while it reversed the balding a little bid (about 20% hair grew back in the bald spot), it’s been stuck at this level for a while. I am trying to figure out how many FUE grafts I will need if I am going to do a hair transplant surgery to cover this up, and whether I can get this done under $10k in the US/California. If not, I am debating making a trip to Turkey for a cheaper all inclusive surgery. I didn’t include a picture of the front, because my hair somehow hasn’t receded in the front.

Thanks in advance

You need a Master Plan to determine not only what you need now, but what is likely to happen to you in the near or long term future as hair loss is a progressive process. As you are in your late 20s, I could transplant the crown (depending upon your hair being fine, medium or coarse) the range of grafts would be between 1800-3000 (more for fine hair.

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Lasers Used in Hair Transplantation?

Do you know if Laser Hair Surgery requires you to go under anesthetic? I have a real phobia of anesthesia, so would prefer not to get knocked out during surgery!

Laser hair transplantation was used in the 1990s, which had a laser cut into the skin, then the grafts were placed into these laser-created wounds. The wounds produced a surface that would not allow the grafts to be held into place, so they just slipped out. Also, the laser burned the skin at the wound edge, creating a great deal of damage and producing wound healing problems. It was largely abandoned by every doctor who promoted it at the time.

As for sedation in hair transplant surgery, we’ve written about that here. Different clinics may offer different sedation options. You don’t need to be completely knocked out during a hair transplant.


2012-08-13 10:41:03Lasers Used in Hair Transplantation?

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LaserComb Versus Bigger Laser Machines

Dr. I bought the hair max laser comb, i cant tell if it is producing results or not, my hair is still pretty thick, my question is, is there a difference in the hair max laser comb compared with the machine that you sit under, is there a difference in quality or the results you can expect?

Unless you have a camera that takes pictures at the exact and repeatable spot on your scalp, it is almost impossible to tell. One researcher (see: Analyzing the Results of the HairMax Laser Comb) used a small tattooed dot on an area of interest and took serial photographs at regular intervals to see if there is a change in hair count. I reviewed that particular study, as you can see in the above unfavorable reference. To my knowledge, no comparable study has been done so far for the lasers that you sit under.

With respect to your question asking if laser comb and the ‘bigger’ laser machines differ, well, the size comparison is obvious — one is a comb and the other is a big hood that you sit under. If you are asking if one is better than the other, I have no way of telling, but based upon the study of the laser comb, which was most unimpressive, I might think that the comb has very limited value. The subjective feedback of patients who have experienced the larger system seems positive, but there are no objective criteria for me to endorse. If you are asking for the results, I have no way of telling at this time.


2006-10-27 14:26:54LaserComb Versus Bigger Laser Machines

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Laser Treatment (LLLT) for Hair Loss (with Photos)

Update: We are constantly asked about the effects of Low Laser Light Therapy (LLLT) for hair loss. A man who used the laser on our office showed me the impact of the laser on his hair with before and after pictures. He went to a company called Laser Hair Solutions, which uses a proprietary laser (we have one in our Los Angeles office) and a series of solutions which are religiously applied to the scalp. Minoxidil is one of the agents in the solutions that are applied to the scalp. I would like to say that I can tell which of the treatment solutions worked to increase the evident thickness shown in the photographs, but knowing that minoxidil alone could do it (a 3-15% chance of good growth with minoxidil alone), I can not attribute the benefits completely to the laser or to the minoxidil. I have reviewed a substantial number of publications (mostly European) on LLLT, and there is a good basis to show that LLLT does increase blood supply. Possibly when LLLT is added to Minoxidil, there is an additive effect. With that said, the results on this one patient are quite remarkable in just 90 days of using the combined treatment. Again one might ask, would the same effect have occurred with either the laser or minoxidil alone? This man was thrilled and only noted that ‘the’ treatment worked.

The below 1st set of photos were taken on October 10, 2005 before laser treatment. Click the photos to enlarge.

The below 2nd set of photos were taken on January 9, 2006 after laser treatment. Although I did not take these photos, a comparable set of photos were taken by me which essentially show the same effect as those taken on January 9th. I am comfortable that the photographs show what this man saw and is not a trick of the camera or lighting. Click the photos to enlarge.

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Laser Resurfacing for Scalp Scars

Dear DOC, what do you think of LASER FRAXEL SR1500 resurfacing of scalp scarring?

Any resurfacing of the scalp will damage the pigment cells and cause the color of the skin to lighten. It may also change the character of the skin surface and this may be more true when used for the treatment of a scar, which will require a deeper burn to get below the scar. I am not excited about resurfacing the scalp skin. I am not an expert on this though, so do ask your doctor for what his/her goals are — and specifically if the potential problems I discussed here are reasonable concerns.

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Laser Removal of Body Hair While Taking Propecia?

I started taking propecia about a month ago. Im starting to see gains and am very happy with the results thus far. Prior to starting propecia, i had gone for a few lasic hair removal sessions for my back and arms. I have a few more sessions for lasic, but i wanted to make sure that the two processes (for hair loss and hair gain) won’t fight and i can continue with both. Thanks for the great blog. it really helped me decided that Propecia was the right choice for me!

There is no problem with performing laser hair removal at the same time while you are taking Propecia. What the laser does is burns the hair follicle and kills it, but it is not 100% as hairs that are in the telogen phase will not be impacted and the general success rate for the ‘kill’ is usually 50% per treatment. Good luck!


2008-11-24 16:20:07Laser Removal of Body Hair While Taking Propecia?

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Laser Comb, Provillus and Procerin

I’ve used the laser comb for several months, and cessation or regrowth of my hair didn’t happen. Then I wanna try other methods. I’ve searched in Internet, and found that Provillus and Procerin are effective and convenient for use. I do wanna know ur recommendations. Could u please help me do the choice? Thanks a lot.

I would have expected the results you reported. Look up the other products here on this site (use the search box in the top right) and you may see similar predictions. Why not do it the right way and get your hair mapped out for miniaturization and then get a competent doctor to make the diagnosis? Then with the correct treatment, rather than waste all of this time and continue to lose hair, you might get some control of your problem.


2007-07-26 11:33:09Laser Comb, Provillus and Procerin