Hair Density in Scars

How many hairs can you transplant into a square centimeter? I have a scar, and I want to fill it in. I am trying to find a doctor who can fill it in with just one surgery. Is this a reasonable question?

An excellent question! The calculation is one that is used in the industry as a benchmark measurement. The average person with 100,000 hairs on his head has 1250 hairs per square inch or 193 hairs per square centimeter.

But what is the number to use in determining the correct density for a hair transplant? Some doctors use high density numbers to define how good they are. However, there is a balancing act between maximizing density at the time of a transplant surgery and maximizing growth months later. Experienced doctors are the key.

The reasonable upper limit of density numbers from a transplant perspective is up to 120 hairs per square cm. This type of density, however, requires supple skin that still has elastic properties. Scars do not have this characteristic. Also scars have an abnormal blood supply when compared with normal skin. Much of the infrastructure and microcirculation in the vasculature is not present in scar, so transplanting very high densities may not produce good growth.

You need to be examined by a hair transplant expert, who has the experience to give you a reasonable answer to your specific need. While I understand that you would like to have this completed in one surgery, that may not be in your best interest. Only your doctor will be able to advise you.

Hair Darkening taking Finasteride, Is This a Good Sign?

Yes, it is a good sign because miniaturized hairs don’t have the pigments that normal hair has. When the miniaturization is reversing, many people get some return of their original color.


2020-03-06 09:42:36Hair Darkening taking Finasteride, Is This a Good Sign?

Hair Damage from Hot Straightening Iron

Hi, I have caused extensive damage to my hair through the use of a hot straightening iron. I am a 31 year old male who had minimal recession at the front and thick hair all over. My hair is now damaged and thinned all over from the hot iron and has recessed at the front dramatically in 6 months due to the damage. I have regrowth coming through but not really at the front from the damage. Is it wise to start propecia at this point I’ve stayed off using it waiting to see where the hair may grow back but after 6 months have not seen much at the front.

Thanks

You need a diagnosis as to the degree that genetic balding may be present. I would want to know where the damage is — is it limited to a particular area? There are many things that an examination of your scalp would show me, so rather than shoot from the hip, I would suggest that you go to a hair expert or dermatologist to work through the problem with you. It sounds bad, too serious to be treated over the internet.


2007-02-09 13:41:45Hair Damage from Hot Straightening Iron

What Do We Do with Hair Cure Breakthroughs (from Reddit)

Thanks for the article. One important comment in the article is: “Also, as with all scientific research on hair regeneration, there are a lot of unknowns and there is no easy way to tell whether a particular research will be brought to fruition or not. The same goes for PTD-DBM hair regeneration.” What this is saying is: don’t count on any short-term answers. Because of articles with positive mouse testing and human skin on mouse studies that are successful, too many people think that the cure for balding is at hand. I have seen this same “story” told over the past 25 years, and still, no cure is available.

For most young men losing hair, the problem is now, not sometime in the future. They want solutions that work now, and these solutions are limited to Minoxidil and Finasteride or hair transplantation.

Korean scientists breakthrough in hair regeneration targeting CXXC5 protein and WNT Signaling Pathway from tressless


2018-06-26 13:42:47What Do We Do with Hair Cure Breakthroughs (from Reddit)

Hair Cooling Can Prevent Chemotherapy Induced Hair Loss

I’m worried about losing my hair from chemotherapy. Obviously treating the cancer is the most important thing but can I avoid going bald? I read some stuff about cooling the scalp. What can you tell me about that? Thanks

Hair loss from chemotherapy is a common problem with certain drugs used to treat a variety of cancers. Recent reports show that systems like the Paxman Hair Loss Prevention System can prevent chemotherapy induced alopecia. It doesn’t work for everyone going through chemo, but cold cap systems like this have shown some success. You can learn more about it here.


2012-02-22 09:27:59Hair Cooling Can Prevent Chemotherapy Induced Hair Loss

Hair Continued Thinning After Hair Transplant, Now I Want to Undo It All

Dr. Rassman,

I had a transplant procedure 7 or so years ago. Since then, my hair has continued to thin and even though the hairline was done well, one can discern that they are transplants. If I was to have the donor scar repaired and buzz my head to a # 1 clipper, would the transplant sites be very discernable (on top of my head?) If I was to pluck them out, would the recipient sites have scars? I am not really sure what to do. If I hadn’t gotten the procedure done I would probably shave my head close. I would also like to know if I had additional procedures done, would I be able to go with a buzz (#1) cut? Thank You

A hair transplant is forever, which means you shouldn’t do it unless you fully understand what is going to happen to you, even in the worst case scenario. I don’t know how to answer your question without seeing you. If the transplants were follicular unit transplants (FUTs), there is a good possibility you could shave the hairline, but based upon the what you describe, I suspect that the grafts were not follicular units. When there is any significant amount of skin in the transplanted graft, the skin will have some deformities associated with it. The larger the amounts of skin (which comes with procedures like minigrafts, micrografts, larger plugs, follicular families, double follicular units, etc), the harder it would be to get away with shaving the frontal scalp. Most people like you are easy to fix with more transplants, but it has to be done with FUTs and in enough numbers to fill in the problem area, but again I can not say this for sure without seeing you or your photos.

As you indicated that you’re in New Jersey, Dr. Robert Bernstein has offices in your area, so I would suggest that you see him for a straight answer, or you can send me photos to the address on the Contact page (reference this post, please).

Hair Coloring and Hair Loss

sir,
i sm 20yrs of age. i use to have very thin hairs. i not use any hair oil or any hair ointment, but use to shampoo twice a week. Also i have habit of applying my hand on my hair regularly, but now the problem is that my hair starts falling & shine is also lost. Please tell me if applying hair color is safe or not. so please send me the related information.i shall be highly thankful to you.

Daily washing of the hair is a good idea, but being gentle is important. Fine hair is more fragile then coarse hair, so damaging it is a real consideration with a strong massage or heavy handed brushing. Ask a good hair dresser for advice. Careful coloring should not be a problem provided that high quality materials are used by a professional skilled in the art.


2005-11-03 12:54:57Hair Coloring and Hair Loss

Hair Coloring After Transplant

Hi Dr. Rassman.
First I would like to thank you and Dr. McClellan, for doing such a great job. It has only been a week since my surgery 1,700 grafts. 5 Years ago I had 1,100 grafts. Healing is occurring quite rapidly, and I feel the positive results around the corner.

I have somewhat fine, and curly hair age 38. Auburn brownish is my natural color. Redhead when I was younger. My father grayed heavily in his thirties, as did my brothers & I. I use either “Grecian Formula”, or “Just for Men” 5 minute hair coloring. (Light Brown to get as close to my natural color as possible). About a month prior to surgery, I had my hair highlighted bleach blonde, and the results were fantastic. I looked a lot less bald, with wonderful full blonde curls, and my brown underneath. It looks so natural and subtle that everyone thinks I have just been in the sun for a week. I am very pleased with this coloring. Because I only highlighted, the brown color treated area remains, its brown status.

The main question becomes at this point, is when can I use the “Grecian Formula”, or the “Just for Men 5 Minute Hair Coloring again as my base?

And, when can I “bleach” highlight again?
A) My regular area.
B) Donor, and Transplanted area.

Thanks again to Dr. McClellan for doing such a great job last week.

Thank you for your kind words! I am hesitant to post this for fear that readers may think this is a ‘planted’ question, but you do raise some issues that have not been addressed in this blog. You can begin to color or bleach your hair once there is no more scabbing present and the skin is smooth. This usually happens within the first after surgery (in some people in days). I generally advise people to dye their hair immediately prior to the surgery so that there is no significant disruption to their schedules.

You also bring up an important point on the value of hair coloring. Lightening the hair always adds the look of fullness. In a question posed to me on April 21st (see: Platinum Blonde Patients), the question of blonde hair came up in a different context. That question has bothered me since it came in and as I looked through hundreds and hundreds of patient photos, fewer blondes were in my hair transplant group than non-blondes. Then I realized that the lack of blondes in my database of photos came about for two reasons:

  1. There are fewer blondes in the population (estimated at less than 10%). We are led to believe that the actual number is higher because there are many, many blonde women. Could it be that because ‘Blondes have more fun” women are becoming blonde far more frequently than men are?
  2. A platinum blonde man can lose 85% of the hair on the front, top and crown without knowing that he is going bald. This is because of the low color contrast between hair and skin color and that the shiny hair platinum blondes have makes balding less prominent.

In conclusion, men who are balding should think more like you and consider taking charge of coloring like some of the women out there are doing regularly. Maybe, just maybe, coloring can solve the hair thinning problem without a hair transplant for those who are not quite bald yet.

Hair Cloning

Benjamin asked…

Are there any doctors who can clone donor hairs so that the amount of available donor hairs is no longer an issue with transplants?

The hair cloning issue keeps coming up because it seems to be promoted by some unscrupulous people who use the cloning ‘card’ as a way to elevate their own position of authority in this business. There is no cloning on the short-term horizon for hair, despite claims to the contrary. If and when the cloning problem for hair is solved from a research perspective that can be replicated , it will take legislation to make that reality into a clinical tool. Hair was first cloned by Jahoda in Scotland in the late 1980s. Since then, there is been a relatively long silence in the industry on repeating his work. His report stands alone as a successful cloning experiment. Attempts to do this in mice and other animals have produced many dead animals in at least one study I have been told about. Attempts to do this in humans have met with failure after failure. Fortunately, no deaths have occurred. I would urge all of my readers to be cautious about the cloning option and look skeptically at anyone who promotes it at this time.