Category: Hair Loss Causes

Very happy camper with terrific results after one hair transplant session. He was more than willing to allow me to show the dramatic changes. The before picture showed the distribution of the 2678 grafts on the day of surgery

For some of you that may think the results are still thin, the difference is that he now has a hair line. The density can be achieved with a future SMP Scalp Micropigmentation to the entire scalp.

BEFORE

AFTER

I always find the online posts about the relationship between hair loss and weight training, most of the posts stated that weight lifting could increase the testosterone level, it will be bad for the hair follicles since more testosterone will transfer to DHT so that the follicles will be attacked more often by that. I know wight training can increase the male hormone level to build up more muscle, but I suspect that it will cause hair loss at meanwhile, do you think the statement making sense? Thank you.

Online Internet is as full of misinformation as it is with good information. Weight lifting does not cause hair loss in men (or women). The most common cause of hair loss in men is Genetic (called male patterned balding – MPB) or androgenic alopecia (AGA). It is not the testosterone (or even DHT). It is the genes that you inherited from your mother or father. If you have the genes for hair loss, then DHT (dihydrotestosterone) is one of the key hormones that seem to precipitate the male pattern balding. Propecia is a drug that impacts the way DHT works by competitively blocking the enzyme that converts testosterone to DHT at the target organ (in this case the target organ is the hair follicle). Many online and Internet sites take this information and infer that since DHT is derived from testosterone that an increase in testosterone will cause more hair loss. This logic is flawed and human biology does not work this way. You have to look at the main underlying reason for hair loss (which is genetic). If you are not confused about this thus far, you may find it interesting that testosterone is made from cholesterol (as is many other hormones). The online (bad) logic will dictate that high cholesterol will now cause hair loss but this is not the case either if you extend the logic saying that cholesterol is used to make testosterone which is needed to get DHT.

I am considering a FUE op . I already have a strip from an older op. I will have to shave my scalp for the FUE . I was thinking i might have a SMP on the scar prior to the fue . The question is , can SMP on the scar be done without saving ? (please notice that after the FUE i do not intend to shave ever again ) . If so , how much time do i have to wait between the SMP and the FUE ?

You can have Scalp MicroPigment (SMP) to the linear strip scar first if you are thinking of shaving. Then the scar will not be as noticeable with the hair shaved and FUE can be performed. The time between SMP and FUE can be about one week (after your last SMP session). Keep in mind FUE will also cause scars (hundreds of tiny 1mm white dots). If you ever what to address the FUE scar with SMP you would need to wait about 3 to 6 months.

FUE after SMP = wait 1 week
SMP after FUE = wait 3 to 6 months

Finally you must ask yourself as well as your doctor the main reason why you are planning a FUE if you already have a strip scar. You can easily have another strip surgery without your hair shaved and all of this may not be an issue. Every patient and their reasons for doing such procedures are different so that is where the individual one on one patient to doctor relationship is important.

FUE scar (before SMP)

FUE scar (after SMP)

I am a 30 years old male, I have found that my falling hair have different textures. I notice this when I shower. Some of the hairs are much finer and lighter in color while some hairs are thick and dark. By the way, the falling fine hairs in the bath are generally shorter than the falling thick hair in length. I do not understand this situation, I guess those fine hairs are the ones still in process of growing out? Or those fine hair are actually from shrunken follicles? Cheers.

The falling fine hairs are likely miniaturized hairs that may be at the end of their life cycle. They sometimes become lighter losing their dark color, almost blonde or gray in a black haired male.

Hi Doc. I was just reading your recent article “Hair Transplants with Scalp Micro-Pigmentation (with Photos)” and was wondering whether or not the patient would be in the same position now if you knew the hair transplant techniques back then, that you know now.

Is it possible that with ultra refined techniques the transplanted hairs would have been transplanted more evenly around the head meaning that Scalp Micro-Pigmentation would not have been necessary.

Best

The simple answer to your question is: Yes! Many people with advanced balding patterns just don’t have enough donor hair to cover the entire balding pattern, so SMP (scalpmicropigmentation) solves this problem.

I hear ultra refined technique used sometimes but it is more of a term described in forums such as Hair Transplant Network. That terminology is just semantics. The GOLD STANDARD in hair transplant surgery is transplanting one follicular unit at a time. It doesn’t matter what you call it. AT NHI we have being doing this since we opened in the early 1990’s and have pioneered and published on this technique (HERE).

To be clear, no matter how perfect the technique (you can use ultra refined technique if you would like), you have a LIMITED and FINITE supply of donor hair. So no matter how refined, you can never have the fullness of someone who is not bald. Hair transplant is great at providing a non balding look and creating a solid non-receding frame to your face. But hair transplant is in essence moving hairs around from one place to another.

Scalp Micropigmentation (SMP) is not perfect since it is not hair. However, (like Toppik and DermMatch and other concealers) it reduces the contrast between hair and scalp providing the look of fullness that a hair transplant may not provide. It also provides an EVEN appearance when you shave your scalp. More importantly, SMP provides any hair transplant patient an option to SHAVE their scalp and disguise the donor scar. Even for people with FUE surgery, there is a scar in the form of DOTS. SMP can also blend in these FUE dots.

SMP is a great adjunct to hair transplant.

I have a question regarding traveling with finasteride. Can any problems be caused at customs when you take international flights etc. Is the drug illegal in any country to your knowledge? I read rumors online that apparently it is banned from pharmacies in Russia and the middle east? is this true? and can issues be caused at customs if you have a large supply (2-3 months when going to another country)?

You can always check with the laws of countries you are traveling to, but I have not heard of Propecia (finasteride) being banned in countries. Having a few month supply is different than having multiple unopened bottles that look like you are bringing it in to sell the drug.

The British Journal of Dermatology (2014 May 16. doi: 10.1111/bjd.13114.) The authors were Fischer TW1, Herczeg-Lisztes E, Funk W, Zillikens D, Bíró T, Paus R..

The study suggested that caffeine promoted hair growth. Human male and female hair shafts were cultured in the presence of testosterone. Many factors were studied. “Caffeine enhanced hair shaft elongation, prolonged anagen duration and stimulated hair matrix keratinocyte proliferation”. Females were more sensitive to caffeine than males. From the abstract I read, it was not clear that drinking caffeine in your coffee or tea worked as the study was on human hair shafts out of the body.

Dr. Jerry Cooley (not a researcher in this study but a practicing hair transplant surgeon) reported the use of topical caffeine products such as “shampoos like Hair Surge or topical leave ins like Nioxin Diamax, which has been rebranded as Pantene Age Defy and Head &Shoulders Advanced Thickening Tonic;” however, I have no experience with these for promoting hair growth. What is needed is a real human clinical trial before drawing conclusions that there is some value in caffeine in some form.

About two years ago I noticed thinning at the front of my scalp and corners, now I still have thin hair at the front but what really bothers me is that there are two dime sized patches of hair that is not completely bald but much much thinner. will this progress? and should I expect more thinning in the future?

I often get these questions emailed to me. Actually I get these questions asked alot! I just want to make it clear that I am not a fortune teller nor can I diagnosis hair loss over the Internet. If your hair loss bothers you, see a doctor. You can always search the Internet but you’ll end up with mixed messages or information. I can tell you in general the most common cause of men’s hair loss is genetic and it is known as male pattern balding (MPB). If you have MPB and would like to do something about it, there are medications (Rogaine or Propecia) and hair transplant surgery. There is also Scalp Micropigmentation (see scalpmicropigment.com). When people describe circular dime sized or quarter sized bald patches, it makes me think of alopecia areata (AA), an autoimmune disease that requires a doctor to make the diagnosis. There is no cure for AA, it has a different cause than male pattern balding and if hair is transplanted in to these ‘dime sized areas’ it will not grow unlike male pattern balding where good results from a transplant can be expected.

I have just turned 27 and I am concerned about my hairline . I have never really given it much thought but then someone commented on it and I noticed it is a triangle shape. I am concerned that I am going bald but have heard of the term mature hairline. I have drawn in a line to show my highest wrinkle. I am thinking about getting a hair transplant as the hairline looks rather odd. My crown is fine I think ! I have attached photos which may be of use. There are no bald people on either side of my family which is why I find it strange that I could be.

Any help or guidance would be much appreciated.

If you are concerned about your hair line and considering a hair transplant, you should see a hair transplant surgeon. I don’t mean to sound obvious but there is not much I can say here. Balding occurs in the 20s for most men. From your picture there are two things happening: (1) your forelock comes down to the highest crease which indicates it is located where it was when you were 5 years old, and (2) you hairline on the corners is certainly receding upwards giving you a bizarre shape to the hairline that that makes it look pointed. If you transplant the frontal corners, you can move to a different hairline that better fits with your look. You are in your 20’s and that is when such frontal recession appears.

You mentioned in one of your posts that you generally use grey/black or grey/brown ink tones. I understand that they will fade over time but does the fading change the remaining pigment to a slight blue tone. This is the type of thing you see with tattoos that use black ink which generally fade to a blue tone over time. Or does the ink hold its colour integrity over time? Thanks

All pigments deposited under the skin will turn blue/ green over time. The time frame that this happens is within a week to a month (not years). And the blue I am referring to is nothing like the blue in this post, it is a black color with a tinge of blue to it.

Any claim that it does not is a marketing gimmick as the human body will react with the pigment as well as the layer of overlying skin will alter the perception of color. For example your red blood vessels will look green under your skin but the green you see is an absorption issue because these blood vessels contain red blood, yet these blood vessels don’t look red under the skin. There is actually a paper written on this topic HERE.

The green /blue that some may think of (or you may be referring to) are the old pigments or cheap brands that oxidize and actually change color dramatically. The green/ blue I’m referring to is generally not noticeable unless you have a keen sense of color. If the SMP pigment is high quality and the person applying them is experienced you should not have this issue. The best and ultimate test is to physically see a SMP patient up close in person. Don’t rely on advertisements or photos.