Category: Hair Loss Causes

I often get emails for hair cloning and hair multiplication from people around the world who want to believe:

READER COMMENT 1:
Um, doc, there is a working model in place. Not just Aderans and Histogen, but Dr. Gho’s hair multiplication at HSI. Yes, say what you will about Dr. Gho’s history, but his clinic is performing daily procedures without depleting the donor — I’m not surprised that this continues to be ignored or laughed off because the procedure is patented and would render every other FUE/FUT procedure obsolete. But the truth won’t stay hidden from the wider populace forever.

MY REPLY:
I’ve already written about that HERE. Proof is in the pudding.

READER COMMENT 2:
Yes, doc, and you can eat pudding every day in their clinic if you just went over there and saw the results for yourself as I did. The donor regrows. Every day they’re doing it and they’re booked through the fall of 2011. Here’s an idea: why don’t you call them or email them and ask them to send you photo-doc proof of one of their patients as I have? Aren’t you curious? Don’t you as a peer want to reach out to them after they published a peer-reviewed article in the journal of dermatology about this procedure?

I saw Dr. Gho’s presentation at the ISHRS medical convention and read the journal article. He was doing FUE and I believe that he was splitting the follicular units in the scalp, removing a hair from the follicular unit. That would allow him to leave some hair behind and remove others producing the illusion that the hair was regrowing at the point of extraction. I would embrace what he is doing if he was actually regenerating/multiplying hairs, but as far as I could see, this was not the case. If he is splitting follicular units, I would think that telling the world that he solved the hair multiplication challenge would be less than honest. Of note the published study in 2010 was on only five individuals. After four years, I would think it would have revolutionized the world of hair transplant as we know it, if it really worked.

I read this blog entry HERE and there’s something I just don’t understand. You say that the body’s feedback loop causes raised testosterone levels in men that are taking finasteride. I thought the rise in testosterone was caused by the fact that finasteride prevents the conversion of testosterone into DHT, thus leaving more testosterone in its original form. I thought that the feedback loop DECREASES artificially raised testosterone levels caused by finasteride. You are saying the feedback loop causes a rise in testosterone on finasteride, and that makes little sense to me. Have I got this all wrong?

There are reports that serum testosterone levels rise when finasteride is used: “Finasteride treatment led to a generally modest increase relative to placebo in serum testosterone, with the greatest increases occurring in men with low baseline testosterone levels.”
Even my colleague Dr. Bernstein writes about it HERE We also wrote about it yesterday: HERE

I am aware of a couple of places in Los Angeles that claim, they offer hair cloning. Since all of the so called kinks haven’t been worked out yet, isn’t there a potential of a cell being cancer producing.

Cloning hair in Los Angeles? It would have made Time Magazine, Newsweek, New York Times, and all the major headlines if it was true. Cloning hair does not exist as of 2014 except in the hands of sleazy people. The claim is likely a marketing gimmick and it may be subject to the California Medical Board’s attention on false advertising if it is promoted by a doctor.

With regard to your question concerning cancer and hair cloning, there is a risk of cancer in some animals who were given stem cells. This produces an unknown factor with stem cells and if it ever went to human use, this question will be on the top of the FDA concerns that would have to be addressed.

Hi doctor. how are you. I have asked you questions before and you have replied to my answers, and I want to thank you for that. Keep up the good job.

Correct me if I am wrong. In this article that someone posted to you it states that finasteride lowers T levels(testosterone) as well.
here is the link: http://baldingblog.com/2010/09/13/mercks-fda-submitted-propecia-documents/

Here is my question. I thought finasteride lowers DHT and increases testosterone by about 15% or something. Does finasteride lower testosterone as well? And how would this affect building muscle and body building?

please clarify this for me doc.

Propecia slightly raises testosterone initially but eventually your hormone levels should return to normal. The reports in the literature seems to go both ways. Some reports indicate a rise in Testosterone while others show a decrease. Unless you are a biochemist/pharmacist doing research, I do not think these are significant issues. Propecia will not make you into Arnold Schwarzenegger or Urkle.

You are trying to make sense and correlate biochemical hormonal variation with clinical issues that may not be related. If you are asking your question for pure scientific purposes, I would take a course a biochemistry for a better understanding or speak to a research pharmacist/biochemist. My desire to revisit my biochemistry days and contemplate professorial issues are not really there.

I do occasionally run into men who are heavily into weight lifting and body building and use anabolic steroids. One of them was convinced that Propecia made them weaker and gave them a disadvantage. A few have insisted taking Propecia to counteract the hair loss from their anabolic steroid use and didn’t report any changes in strength or muscle mass. But these are all anecdotal (non-scientific) and subjective stories. In my humble opinion, Propecia has negligible impact on testosterone and strength. Even the professional world of sports have taken the position that it is not a performance enhancing drug.

Many readers here on Baldingblog are here to seek information for their hair loss issues. There are many who are “scared” or concerned with side effects from Propecia which can actually help with male pattern balding. The most noticeable side effect in question is the concern for erectile dysfunction or loss of libido as there are numerous Internet sites that propagate this issue.

While everyone has their right to express their opinions and I would like to assume what they are experiencing is “real” to them, I would like to caution the reader to keep in mind the big picture.

People take medication to treat something. But ALL medications have side effects! And if a medication has side effects that cause erectile dysfunction and decreased libido, then you need a doctor to manage it. Some medications that have many known side effects (which include erectile dysfunction) that are commonly used include: Paxil, Prozac (psychiatric medication), Lipitor (cholesterol medication), Metoprolol (blood pressure medication).

Many men who do not take any medication also experience sexual dysfunction as part of their aging process or as a result of some problem with penile blood flow from conditions such as vascular disease or diabetes. Sexual dysfunction may be more frequent than what we all may expect because nobody really wants to admit they have a sexual problem. After all it is a sensitive topic! Propecia (finasteride) has a sexual side effect risk of 2%.

Now if in the end one experience a real side effect from Propecia, you can always STOP taking the medication. But always discuss these issues with your doctor first! At least you tired! Because all side effects from Propecia is reversible.

(Photo : MIT Fluid Interfaces Research Group)

A ‘wearable ring helps the blind read’ shown here is a great advance. I am amazed how much technology can help the handicap person. It makes me feel real good to see such advances in technology that helps such people. The advances keep coming with artificial limbs that work more naturally, artificial pancreas for diabetics

I was just curious if you planned on experimenting with acell injections along with your other acell trials.
If you are I would love to pay to test the effectiveness of the product, as I can not use finasteride due to side effects.

thank you for your time,

There is no rational nor are there valid research studies for ACell injections into a bald scalp. We do not do things that do not have the potential to work. Thanks for asking.

Do you have a cost to remove hair plugs and what will the scalp look like after removing them?

I’m in Kansas City?

The cost to repair this type of problem can range from $3000 to over $10,000. Most doctors have developed strategies for the treatment of hair plugs that include:

(a) This problem is created when the doctor tries to thicken the frontal hair where balding or thinning occurs. Over time, the hair is lost from continuation of the balding process and only the plugs remain. This patients hairline was easily 1-2 inches lower than the lowest of the hair plugs in this picture. Direct removal, possibly using a punch like instrument, depending upon the size of the plug works, but this often leaves whitish scars where the plugs were originally located. This may turn out to be expensive and with the scarring it is not satisfactory. The larger the plugs, the worse the scarring. Many doctors charge a per plug cost with a minimum fee. If you had this problem, I would recommend the approach shown in (b) below.

Some example are HERE

(b) Partial removal: This has gained popularity over the past decade where a punch is used to remove some of the plug (between 30-80% of it) and then re-transplant what was removed around the original plugs to produce either more fullness in the vacant areas, or create camouflage around the areas where the plugs are detectable using more hair transplanted grafts to fill the area up. This technique has been pioneered by us and is a standard around the world.

(c) Camouflage with small grafts: This is effective, providing that the plugs are not in the frontal hairline and there is enough donor hair. The patient should understand that he often must keep his hair long (at least 1 1/2 inches). We often do some partial plug removal for plugs that are in the area of the hairline. For plugs in the frontal hairline in addition to thinning these plugs out, we often recreate a new hairline at least 1/2 inch in front of what was originally the pluggy hairline. If the above patient were to take this route, the pluggy hairline is so high, that a new hairline in a normal location would create a very normal look. When such patients comb their hair back, the old hair transplants are hidden behind the new hairline. Creation of a new hairline may be expensive both on hair and money as it often takes approximately 1000+ grafts for a good job depending on how far forward the new hairline is made. Many people with the old pluggy look have depleted donor areas so that the choice of creating a new hairline may become impractical. This technique has been pioneered by us and is now standard around the world. This would be our preferred approach to this problem for most patients.

(d) Scalp Micropigmentation (SMP): This is a new approach and is now used more and more in our practice. SMP which is truly an artistic process, accomplishes three objectives. (1) The presence of the pigmented ‘dots’ obscures the large plugs. This can not be performed at the hairline level, only behind the hairline, and if the man in the photos wanted this, he would have to maintain a shaved scalp with the newly created pigmented hairline in front of the plugs, (2) it works by filling in the areas between the plugs so that the plugs will not easily be seen, and (3) it can be used on scars in the donor area where greater than 90% of the scars can be successfully camouflaged with this technique. See Scalpmicropigement.com

Sexual dysfunction prevalence vary widely, but is much higher in the general population than most people are willing to accept.

Causes include: smoking sedentary lifestyle, poor general health, endocrine, cardiac, circulatory, structural, psychological, social, marital and other idiopathic causes. Because of this complexity it is difficult to make the correct diagnosis as to its cause, even when Propecia (finasteride) is not in the mix as shown in a recent survey of patients in a Canadian primary care setting where there was reported a 49.9% prevalence of erectile dysfunction in 3921 men 40-88 years of age (ave. = 56.7) and 30% prevalence in men in their 40’s. Although there is a statistically small relationship between finasteride and erectile dysfunction, the connection is far less significant than the reports in the general population (* see reference below).

Ref: Grover S, Lowensteyn I. The prevalence of erectile dysfunction in the primary care setting: Importance of risk factors for diabetes and vascular disease. Arch Intern Med 2006: 166; 213-219.