Is there facial and body hair loss DUPA? And if not what type of hair loss could cause diffuse hair loss all over?
By definition, diffuse unpatterned alopecia (DUPA) can be over the face and body, but we generally only use the term to describe hair loss on the scalp. There are other conditions that cause hair loss on the face and body, such as alopecia areata or alopecia totalis.
Hello Doctor,
I went for an initial consultation to a very reputable HT surgeon in Ontario a few months back… I was recommended a 4000 graft procedure, however this would not include any crown coverage. I was told I may want a second procedure in the future to cover the crown and I should have 3000 grafts left to accomplish this…I am around a Norwood 4 and in my late 30’s…The more I think about it, 4000 grafts with no crown coverage seems like a heck of a lot, or is it just me?
Yeah, that does sound like a lot! Maybe you have a large head… or really fine, almost invisible hair? If you’re concerned about the recommendation, get another opinion. I can’t really comment on what is appropriate for you without seeing / knowing more your hair loss. Also, are you sure the recommendation was 4000 grafts and not 4000 hairs? Each graft can contain multiple hairs.
Take a look at our patient photos and see what other people had done for their balding patterns. There are hundreds of patients (with thousands of pictures) on the site. This should be a reality check for you.
OK, here is my take on the latest happenings in the hair-loss debate…the recently reported topical inhibition of PGD2 and hair loss / re-growth.
OK, prostaglandins are both a GOOD and a BAD thing. You need some prostaglandins, but not others. Some prostaglandins are required for the inflammation associated with healing, while some are responsible for the negative effects of inflammation – mainly pain and the link in the chain that results in disease.
If prostaglandin D2 is indeed partially responsible for hair loss, then why not simply use a product that reduces or inhibits prostaglandin formation? These products do indeed exist. They are called COX-2 inhibitors, namely NSAIDS. However; all NSAIDS are not created equal.
One of the most potent, and selective COX-2 inhibitors is called Meloxicam, otherwise known as Mobic. It is an extremely effective pain reliever and anti-inflammatory. It’s anti-inflammatory properties are due to its inhibition of the cyclooxygenase-2 enzyme (COX-2). Since Meloxicam is soluble in methanol (think EverClear), why not simply put a few Mobic pills in ethanol for a few days, then simply apply it to the balding areas?
I do not claim to be a doctor, I do not even play one on TV. That right is reserved solely for Dr. Rassman, so I may be completely ignorant of the chemistry involved here.
Dr. Rassman, do you think this may be a viable approach to inhibit prostaglandin D2 topically? While I am pretty certain it could not cause harm, since it would not be absorbed systemically, would it be of any value as a topical PGD2 inhibitor?
As always, my deepest respect and thanks to you, Dr. Rassman.
While your insight is interesting, I do not think think the solution is that simple.
For argument’s sake, let’s say you dissolve Mobic in methanol and apply it to your sore back. Do you think it will relieve pain? It does not. Drugs don’t work this way. And I haven’t found any study that shows people who are on chronic pain medication like Mobic (that inhibit prostaglandins) have more hair growth or less hair loss.
The research on PGD2 is interesting, but it is only part of the big picture. I am sure that there will be research carried out.
This is a question asked in reference to our post from earlier this week, Do Bald Guys Have a Full Head of Hair That Just Won’t Grow?:
So does this mean that if a man has mild thinning, you can transplant hair to that region and the thinning hair will receive more blood and possibly flourish again? Or, are those cells still going to miniaturize because they have a receptor(s) for balding?
The notion that thinning hair from balding is a blood supply problem is not true. The loss of blood supply in the thinning or balding scalp is the reflection of loss of hair (not the other way around). When you get a transplant into a thinning scalp with reduced blood supply, there is an increase in the blood supply because of the demand from the new hair. It is not a chicken/egg type of thing.
The loss of the blood supply came after the hair is killed off from the genetic balding process.
I am a female (57) with receding and thinning hairline and temples (not as shown in the female balding diagrams), and just now reading about the FU HT alternative and would like to know:
1. Do both FU & Strip procedures require general anesthetic?
2. What would be the approx size of the donor area, needing to be shaved for the FU HT?
3. What is the difference in per graft costs, as I’m seeing wide variations ranging from $2.25 to $8
4. Do the FU grafts also fall out following the surgery and regrow as with the Strip method?
5. Transplants are advertised by several companies on TV as being permanent, but I’m reading in blogs etc that many patients appear to be requiring 3 or more procedures (along with lots of horrendous “gone wrong” outcomes from well known companies leading the field in HT which is very unsettling. Once started, is this an ongoing procedure and if so, how often might it be required to maintain the same thickness?Thank-you
To clarify, I assume when you refer to “FU”, you’re actually asking about “FUE”. Follicular unit extraction (FUE) and the strip method are the 2 techniques used to harvest donor hair for transplantation.
1. All hair transplant surgeries are done with local anesthesia (much like when you see a dentist). You are not put to sleep.
2. Shaving the donor area is not necessary for regular hair transplant surgery. If individual hairs are extracted one by one, the back of the head would have to be shaved. This method is known as follicular unit extraction (FUE). FUE donor hair harvesting is usually performed with a 1mm cylindrical punch. The other method is often referred to as “strip” surgery, where a strip of scalp is removed from the back of the scalp. Both FUE and strip surgery fall under follicular unit transplantation (FUT), a generalized term of doing hair transplant surgery one follicular unit at a time. Strip surgery does not require shaving the head, but it will leave a linear scar that will be covered and unseen if you keep your hair long. FUE surgery will leave thousands of white 1mm dots that would be visible if you shave your head completely. Some men who cut their hair really short (less than 1 inch) sometimes prefer to have the FUE since the dots will not be seen. Most women choose the strip surgery over the FUE surgery.
3. The difference in graft cost you see on the Internet is similar to the difference in any cosmetic surgery cost. Not all surgery results and reputations of clinics and doctors are the same.
4. All the hairs or follicular units transplanted will fall out within the first month or so. The follicles will go through a dormant phase and start to produce a new hair shaft after several months. So the results of the surgery will not be evident for several months. 6 to 12 months is a general time frame we tell our patients.
5. The transplanted hairs are permanent, but it may not be enough if you are continuing to lose your existing hair. Some also have higher expectation and desire more fullness after their initial surgery. So there are patients who have more than one surgery to achieve their specific/individual goals. With respect to horror stories you read about and surgeries that go wrong, it is directly tied to your question number 3. It is up to you to do the research, as this is a cosmetic procedure and not like buying a commodity or buying a car. Not all hair transplants are equal.
Doctor Rassman the propecia website is back up again. looks better. Propecia.com
Well, I guess they were due for a face lift. I’m assuming there is a new batch of conspiracy theories floating around as to why the site is up again.
(Speaking of redesigned sites, we just launched a redesign of the NHI website.)
Dear Sir .. I am suffering from severe hair loss since last one year.
Recently my doctor prescribe me the Dutasteride (Avodart) Medication for hair loss prevention. I continued the medication for 10 days and then I started to get severe Abdominal Muscle Cramps. After I stopped taking this medication the pain subsided slowly. I have recently read the article about Prostaglandin D2 protein and baldness on some website. Wanted to know that the Dutasteride is the cure for Prostaglandin D2.
Now I am confused that should I continue the Avodart medication or should I discontinue it permanently. I want my hair so I wanted to have your help, If you can prescribe me a good medication for hair loss prevention and regrowth .. So that I can discuss your prescription with my doctor.
Will be thankful for your reply and suggestions.
Regards
First things first — Avodart (dutasteride) is not approved for treating androgenic alopecia, and I don’t know what dose you’re even taking. I’ve read internet reports of abdominal cramping for some users upon starting Avodart, but I don’t really have much info beyond that. With respect to taking a prescription medication, you need to discuss these issues with the doctor that prescribed you the medication, especially if you feel you are having side effects!
As far as I am aware, dutasteride has no correlation with prostaglandin D2.
Dear Doctor:
I have thin patches in my eyebrows and want them treated, preferably by means of an eyebrow transplant. Dr Rassman is one of my three short-listed doctors and I have several questions, which I would be extremely grateful if they could be answered.
Many thanks in advance
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Questions re FUE/FUT, yield etc.
1. Does the doctor recommend FUE or FUT for the eyebrow and why?2. How does Dr Rassman avoid shock loss when implanting grafts amongst existing eyebrows?
3. How does he optimise yield of transplanted grafts?
4. What determines which follicles Dr Rassman selects for an eyebrow transplant?
5. What is unique about Dr Rassman’s approach for eyebrows as compared to similar leading transplant doctors?
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Questions re physical apperance of eyebrow6. What is to prevent the hair turning grey later on, with age etc.?
7. How can you properly trim eyebrow hairs if they are growing horizontally?-with a simple nail scissor this would not be possible.
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Questions re preparation for operation:8. How can you ensure the recipient area is in a healthy state to accept transplanted hairs? Should creams be used to ‘disinfect’ the area?
9. What factors would make an eyebrow transplant unsuitable for a patient?
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Side effects:10 . Can having an eyebrow transplant affect the muscles around the brow, leading to future risk of a descending brow?
11. Is it risky operating on an eyebrow from the perspective of harming arteries etc. close to the eye? Can this harm the eyes? Have any patients experienced this?
12. In what percentage of cases, is the patient dissatisfied with his results?
13. Many of Dr Rassman’s patients travel from abroad and so can only avail themselves of an online transplant prior to the op. Upon closer inspection on the day or the day before the operation it may transpire that the patient is not a ‘good’ candidate for a transplant. Does the doctor in these cases advise against going through with a transplant? How many times this year, for example, has the doctor turned down a patient on the day or the day before an operation?
14. What controls does the doctor put in place to measure the performance of the various technicians?
15. Does the doctor, have a feedback system with a standard feedback form for post-op patients?
Now that is some due diligence! Below are the answers to your questions.
For more information on eyebrow transplants see:
Do not hesitate to call my office @ 800-NEW-HAIR to setup a phone consultation with me if you’re not local.
I have been taking 1/5 proscar for the past 6 months and I noticed I have a patch on both my lower legs where there is less hair. It’s in the same spot on both legs and it is roughly 2 by 4 inches big. It’s clearly visible and I haven’t noticed any changes in body hair on my chest, arms or any other body part. I’m not complaining but I would like to know if it’s normal.
I do not know how this could be related to the use of finasteride. If there are stubs of hair (like a closely shaven leg), it could be from traction. Perhaps you are wearing boots or pants that are rubbing in the area? Maybe the spots was there before and you never noticed it? Maybe it is something else entirely. It sounds odd, particularly if it is on both sides. I just do not know.
As promised, here are some follow-up photos from my recent hair transplant surgery. I, as everyone else, will be waiting out the growth period. I expect that I will see some of the growth in 4-6 months and will share any exciting pictures with you at that time.
These photos were taken 19 days after the procedure. You can see how my donor scar is looking in the photo at the left, and the crown on the right. Click the photos to enlarge:
And in case you missed it in the original post, here’s the before photo:
