In type 1 diabetes, the immune system attacks cell in the pancreas that make insulin. For half a year, 21 patients received injections of an “insulin precursor molecule” every few weeks. A year later, those who received the treatment when compared with the control group, were able to stabilize their insulin levels. This is early but exciting stuff (source: New Scientist, August 2017)
2017-09-08 06:14:002017-09-08 08:58:43Immunotherapy may halt diabetes
https://www.ncbi.nlm.nih.gov/m/pubmed/29224108/
A former patient came to my office last week complaining that the hair from the transplant last year did not grow. He wanted to discuss his options with me. When he came in, I pulled out his before pictures to be sure that both he and I would be talking about the presence or absence or change. As he looked at his before pictures, I asked him again to repeat the complaint. He repeated it despite looking at a before picture of himself — when he was a bald man. Then I gave him a mirror and asked him to look at the pictures from one year earlier, and then look back at the man in his mirror. I asked him if there was a difference.
He looked confused. When I probed his confusion, he told me that his wife was totally convinced that the hair did not grow. She reported to him that she had watched for his hair growth very closely and never saw the growth occur. He did admit that the man in the mirror was hairy and the man in the picture was bald. To help him through whatever problem he was having, I told him to think about planting grass seed or watching a child grow. The more closely you watch, the less change you see. Clearly, his wife had that problem and complained over the past year that the transplant was a waste of money. Then I suggested that he take home pictures of himself before the surgery to show to his wife, and see if her view changed. That seemed to solve the problem and he left very happy.
We see the same thing echoed by many men who are amazed that their hair transplant was never detected, even by them. In the workplace, the change occurs so slowly, that people who see you every day never notice any change. We quickly adjust to what we see before us, not the image we stored in our memories.
I always enjoy these return visits a year or so after the initial transplants were done, to be able to compare the image stored in the before photos to the ‘hairy’ person in front of me.
2005-06-07 08:16:062005-07-05 07:03:36Impact of Change In Appearance
Dear Dr. Rassman,
A few months ago I visited you and you mentioned you were right on the edge of creating an improved tool for Follicular Unit Extraction procedures.Are we there yet?
There have been recent improvements in technology related to the tool used in the FUE process and I personally believe there is room for even more improvements. There are still some patients who do not make good candidates for FUE and if it is possible to get around whatever the limitations are that we are experiencing with hopefully better instruments. As the instruments improve, then the FUE technique may become more common place. Unfortunately, it is now a limited offering by a very select few physicians who have invested the time and put their skills to the test to become good at it. It is the curse of a perfectionist to always try to improve from the status quo, but clearly as some people are still not candidates for FUE, the present has another surgical option that is already good, reliable and replicable (the Follicular Unit Transplant with strip harvesting). What is needed for FUE is an instrument that works in other than God’s hands, like the mortal surgeon I am, trying 100% of the time to be better.
Nizoral is an anti-fungal shampoo that treats dandruff reasonably effectively. It does not, contrary to what many people seem to believe, address the genetics of male pattern balding.
2018-11-30 06:40:302018-11-14 09:18:42How Important Is Nizoral in the Treatment of Hair Loss?
Dear Doctor,
You routinely advise people to stay clear of Scalp Med, Follicare, Spectral DNC and other similar products. Your reason is that all of the aforementioned products contain minoxidil and if they work, at all, it is simply due to the minoxidil contained in them. Your conclusion: Just buy plain minoxidil!
Well, I would agree that many products have probably a zero chance of working. Fabao, for example, contains nothing more that Chinese herbs and is formulated based on folklore and an ancient meta-physical concept of disease. I seriously doubt it does anything. On the other hand, products like Follicare and Spectral DNC take a known active ingredient (minoxidil) and try to improve on it. These products take many promising ingredients that have been shown to grown hair, to some degree, in certain studies, like Adenosine, Amenexil, free-form fatty acids, caffeine, etc. They also add other things like either DMSO (in Follicare) or nanosomes (in Spectral DNC) to increase absorption. Clearly, the makers are going all out to “turbo charge” ordinary minoxidil.
Although none of these ingredients are effective enough to be used as a stand-alone treatment, nor are any of them proven, they all, at some point, showed some degree of promise or effect. Dr. Peter Proctor, in a Q & A session on one of the forums, said that “any ingredient that has ever been claimed to grow hair, probably does to some degree — in some people.” With logic like that, these companies take the “best of the best” of the unprovens and add them to a proven ingredient (minoxidil.) With few exceptions, I think most of these companies have good intentions to make the most effective product they can with what is currently available to them. I think very few are outright, deliberate scams.
It seems clear and logical to me that when these extra ingredients are added to a proven minoxidil base, there is bound to be some beneficial, synergistic effect.
The Million Dollar Question: Putting aside cost and value, which I don’t think should be a factor in choosing treatment, do you really believe that one of these products is not likely to be more effective than plain minoxidil?
Could the opposite be true — manipulating the basic minoxidil may make it less effective? Where is the science here? I don’t believe everything I read and when someone or some company is self-promoting the product or process and then makes claims of benefits, what proof is there really? I need to see actual proof before I can even remotely consider giving something a thumbs up. And as you suggested, most of these products seem like they’re just combinations of every herbal that is rumored to have hair benefits, along with a proven treatment like minoxidil. So then when the minoxidil ultimately helps, they can say “See, our product works!” — but in reality, it’s just a more expensive version of generic minoxidil with added vitamins that may or may not be of any use to the hair growth process.
Good intentions or not, it is a buyer beware process and these companies are ultimately just out for your money (makes sense being a business). Cost might not be a factor for you, but I don’t think many people would agree with that notion, especially in this poor economy.
Hi Doctor Rassman,
I have a few questions concerning transplants.
— How big of an issue is scalp laxity? I.e., do you often have patients who still possess donor hair, but who are unable to have FUT a 2nd/3rd/4th time because their scalp has become too tight? Should this be a concern in planning for the future?
— You’ve said that one of the drawbacks of FUE is that it can waste precious donor hair (i.e. some hair doesn’t survive the transplant procedure?) — just how much hair might be “wasted” by going with FUE rather than FUT?
— Why are some readers so concerned about FUT scars? In most of the photos I’ve seen, the scar is a very thin hairless line — not a repulsive, gnarled mass or anything like that. Even if one cropped one’s hair short so that the scar were visible, what’s the big deal?
Thank you so much for taking the time to do this blog.
Scalp laxity become tighter after successive procedure, but this is not usual. The use of scalp exercises solves the problem. It sometimes takes 30 minutes/day for 3 months to adequately address the scalp laxity.
In our original article when we introduced the FUE technique a decade ago, we reported a situation where patients differed with transection rates. We believe that if you assume that the surgeon does FUE perfectly, that some percentage of patients will have unacceptably high transection rates. Although this has become less of a problem as we perfected our FUE skills, it is still present in about 10% of patients. It will be interesting to see if the ARTAS robot can impact these problems in those patients. As Dr. Robert Bernstein (co-author on the original FUE article) just got an ARTAS robot, it will be interesting to see if he experiences the 10% patient problems with transection. FUT should produce less than 5% damage in the hands of a good surgeon.
FUT scars are, as you said, not a problem in 95% of patients on the first procedure. Rarely can you see the scar when the hair is kept long. Even after a second procedure the incidence of scarring is not high either, but if it can be seen, it is only seen if the hair is cut very short or if one lifts the hair to examine it. I would ask, even if the scar is visible, how many times would a person with such a scar that is hidden with longer hair (1 inch in length) gets stopped on the street and asked about it.
Conditioning your hair is valuable if you are losing it from genetic balding because when you comb it, you want the comb or brush to slide through the hair and not pull on the miniaturized hair. Miniaturized hairs are fragile, and rough brushing or styling of your hair without conditioner is not a good idea. I always recommend that my patient used a wide-toothed brush when combing because it doesn’t pull on the hair at the root.
2018-07-10 06:44:442018-07-19 05:50:42How Important Is It so Use a Conditioner?
Hi
I’ve just started on finasteride, and I’m wondering if it is possible to see side effects (impotence) after only a couple of days on the drug. I’m not sure if it’s just my anxiety and over-analysis causing the problem, or if it’s actually the drug itself. I’d really really appreciate a private answer.
Thanks!
(24 year old male)
What you’re experiencing may be due to anxiety and what I generally tell my patients is to continue the medication for a month and try to ignore the erection problem if it is there. I do not know anything about you. I would need to get to know you to assess the anxiety element. The power of suggestion could certainly be in play here.
If you got the drug over the internet, this means that there is likely no professional guiding you on your problem. Consider seeing a good doctor if you do not have one… or if you do, then go back to him/her and ask the questions you posed here.
2010-07-08 12:54:462010-07-06 11:51:40Impotence After a Few Days on Propecia — Is it The Drug or Anxiety?
I am 25 years of age and i am concerned about my bald spot. I noticed it about 4 or 5 months ago. At first it was the size of a dime and now its bigger than a half a dollar coin. I am worried about my bald spot and i don’t know what to do. I also do not have any family history of balding.
Is there any treatment for my balding spot? Help me
Click the photo to enlarge:
An examination by a good doctor is critical. The bald spot looks bare and I wonder about whether this could be alopecia areata, as part of the differential diagnosis to genetic balding. It could also be an infection of some sort. Get to a good dermatologist as the first step in your travel through this process.
