Hi,
I accidentally laser hair removed too much hair at the hairline; now, the hair won’t grow back.My question is, will a hair transplant work in an area that has had laser hair removal? Will it impede the transplanted hair from growing? Thank you
Transplants are an ideal treatment for such a problem. The laser hair removal process will not impact future hair regrowth from a transplant in that area.
Doctor,
I’ve recently had a HT on the front of the hair line, the mid-section and crown were untouched. Only thing is, 4weeks after the surgery I’ve noticed more and more hair falling out from the crown and mid areas!
Does shock loss effect every area prone to hair loss?
Thank you
Simple answer — yes.
Longer answer — Shock loss usually impacts miniaturized hairs, and can even occur when only an anesthetic is used on the scalp with no surgery (this is very rare). We know that advanced miniaturization and active ongoing hair loss have vulnerable hairs which can be impacted by any vascular change in the scalp or stressful situation (like a surgery). For this reason, young men (under 29 years old) are wise to take finasteride when they are having a hair transplant. Even if it is not a guarantee, it puts the odds in one’s favor for less shock loss (if any), especially if there is a greater degree of miniaturization present anywhere on the scalp.
The older the patient is, the less likely that they will be impacted by shock hair loss (e.g. a 50 year old man with stable hair loss)… and for these patients I do not insist on their use of finasteride before surgery.
after hair transplant about 15 days, I have been infected with pimple not sure it is folliculitis or not. My doctor let me take doxycycline and use betadine leave it for 5 minutes and wash. If I use betadine 2 or 3 times a days can it affect graft survival?
Betadine is a strong antiseptic containing an iodine solution that will significantly reduce the presence of skin bacteria. Infections 15 days after a hair transplant rarely are caused by skin bacteria. Many times the cause is as simple as scratching the scalp, thereby breaking the skin and introducing a source for skin bacteria to invade into and through the skin. When applied topically, Betadine will not hurt the grafts at this stage.
I am not sure what the problem is that you’re experiencing, so it is impossible for me to comment on a treatment. At the least, a picture may help. But since you’re under the care of your doctor, I’d go with his/her treatment plan.
Thanks for the great effort here.
I just want to know, why minoxidil or finasteride are required after a hair transplant?
Let’s say a male, 45, with great donor area, Norwood class 6, had 3 sessions over 2 years, and was given 7000 – 8000 grafts covering his hairline, front, vertex and crown. Since most of his balding areas are covered, and the transplanted hair is genetically programmed not to fall off, why would this patient still require the minoxidil and/ or finasteride?
Thanks for your answer to this small query!
Most patients in that situation do not stay on these drugs. It is worth noting that if there is residual hair still present or the fringe area has not been impacted and shows signs of miniaturization, then these drugs have value.
If you were a Norwood 3, for example, then finasteride would help minimize shock loss following surgery and help to maintain the existing hair around the transplanted areas.
Any thoughts on this Help Hair product that claims to accelerate the growth process after a transplant, so that it only takes 6 months to see the full results after surgery? It claims to reduce or eliminate the telogen phase after a hair transplant!
Press release from 2011 – link
Product page (with link to a study of 115 hair transplant patients) – link
I have been following the Help Hair product for some time, but I have been reluctant to hop on board because of the lack of clinical evidence that it works. On a positive note, it is logical, and the theory that “increased anabolic metabolism can affect regeneration of the hair follicle” makes sense (after all, we are what we eat). The change in diet brought on by this product may have no effect on a person who is healthy and eats healthy foods, but there may be a fine line between those with a good diet and those who might benefit from a better diet.
If I saw a good scientific study, I might want to endorse this product’s use in our practice, but as this increases the costs for our patients, I really want to see better evidence.
In our practice and in the years I have been doing hair transplants, most of the grafts routinely have started to grow within 6 months, and once hair starts to grow, it grows at 1/2 inch per month. So for example, for the transplanted hairs that grow out by the 5th month, we will see 1/2 inch length at the 6th month. I would be interested to see reports of when the hair actually starts to grow, and then use the 1/2 inch rule to determine when the “full results” are actually achieved.
Doctor,
After 9 days I’ve begun shedding. Is this too early? I’m really worried.. All I can say is I’ve been relaxing in my hotel with air conditioning would that of helped ‘dry up’ and speed the process up?
10 days after my hair transplant, the scabs have formed and are flaking off, however, I’m noticing some hair inside the flake! I thought shedding occurred 2 weeks after op?
Thank you doctor great website!
I am not sure what you mean by shedding. If you are talking about the grafts falling out with hair in them at 9 days, that is typical and should be of no concern. Although we call this a hair transplant, it is really a stem cell transplant and that the stem cells shed off of the graft into the recipient site. At the point when the grafts are routinely shed, the stem cells already are secure in the recipient area, even though most of the grafts have fallen out. Then comes the dormant phase, followed by hair growth some months down the line.
If you are saying that the native hair around the transplanted grafts in the recipient area are shedding, then I would be concerned. I routinely put my young male surgical patients on finasteride (as well as anyone actively losing hair) prior to the hair transplant to prevent this type of shedding, also referred to as shock loss.
Snippet from the article:
BALDING brothers Barry and Brian Cowan have gone back to their roots to save their careers. Barry — lead guitarist with Scots indie band Vigo Thieves — and male model Brian were horrified when they began losing their hair. So the boys, from Wishaw in Lanarkshire, decided to do something about it. They discovered a revolutionary new transplant treatment on offer for the first time in Scotland.
Yesterday, at The Glasgow Clinic in the city centre, the brothers had around 5,000 hair follicles transplanted from thicker hair at the back of their heads to the thinning top and crown.
Read the rest — Cowan brothers baldly go for hair transplant treatment
I guess this was news because it hadn’t happened in Scotland before, but we have had many dual procedures where brothers go at a transplant on the same day, even some sets of twins. We have had father and son transplants on the same day as well. This produces great spirit and brings our staff together in great joy.
Hi Doc Rassman,
my compliments for a fantastic webpage. I’m a 39-year old male, had FUE 4 weeks ago on the front of my head. So now after 4 weeks, my surgeon has prescribed 5% Minoxidil solution to be applied twice a day on the transplanted area and the crown. (Not on the sides and back he said)
From your blog here I understand that this needs to be applied lifelong? And if I stop,then whatever hair has grown/ strengthened will also fall off. In this event, is it advisable to start the minoxidil? I have already had a transplant, so is there really any need for this solution?
If I want thickness in certain areas, I can always use hair concealers like Dermatch and Toppik.
What are your thoughts about this assessment of mine?
Thanks for your help.
Once you start the medication it is generally recommended that you take it indefinitely. If you stop, the gains you see from the medication will go away. Using topical concealers is up to you.
I’m not sure how big your hair transplant procedure was, so I don’t know if the medication may be beneficial. Why don’t you ask your doctor what the Master Plan is?
Does the single hair graft and double hair graft affect the survival? which one has a more successful rate? Example: a doctor likes to claim that in eyebrow transplants you will get single hair grafts, which make eyebrow transplant more successful. Is that true?
If the surgeon knows what he/she is doing, it does not make a difference. In fact, if one divides a two-hair graft into two one-hair grafts, then there is a risk that the growth center, which is largely located just below the sebaceous gland, could be damaged resulting in the death of that particular hair. Making one-hair grafts out of two-hair follicular units is a special skill obtained with lots of experience.
Just to clarify as well: eyebrow transplants are not any more successful than a scalp hair transplant. So the argument of a one-hair graft being more successful, in my opinion, is not valid.
Excellent website. I have a question about FUE and strip surgery. I have read on forums and other hair loss websites that say its better to have a FUE transplant first if it is your first time getting a HT done rather then doing strip surgery. The strip method should be saved for any additional surgery that is needed or if you can in a second time. For some reason, they didn’t specify what type of surgery to get based on the size of the balding or number of grafts needed. I have read on this website that the larger the balding area the better it is to do strip because you can take out more grafts.
I am contemplating getting a surgery done, however, I am worried in the future my balding will progress and if I have to shave my hair in the future I don’t want a ’smiley face’ in the back of my head. Not to mention, if I need additional surgery and do choose to do strip again for some reason, I don’t want two smiley faces on the back of my head. I also wanted to add, I am 30 years old and have temple recession and a little thinning on my hairline and mid scalp. I know I will need a surgery in the future. I am on propecia so the crown has been holding well.
Take care.
For less extensive balding patterns in the Norwood class 3 range, either FUE or strip will get you where you want to be. If you start with FUE for a class 3, then you should finish with FUE. The choice here may be price of the procedure, as FUE is generally more expensive. The bond with the doctor you link with is also a factor. For the advanced balding patterns (class 5, 6, and 7), extensive harvesting with strip surgery is well understood with considerable experience in the hands of most surgeons. The FUE technique may not get you the yield in the 7,000+ graft range typically harvested with extensive restorations in some of the advanced balding patterns. I am assuming that the surgeon does not go outside the permanent zone for additional donor grafts.
For a graft yield in a Caucasian male, 5,000 – 8,000 follicular units may be an upper end for donor supply in FUE. The yield goes down in Asians and Africans, as the density is lower in these races. These numbers were calculated as follows:
The permanent zone contains 25% of the original hair. In Caucasians birth hair numbers are 50,000 follicular units, in Asians it is 40,000 follicular units, in Africans it is 30,000 follicular units. For FUE, the doctor can harvest no more than 2/3rd of the follicular units safely in the donor area in a Caucasian (that is 8,250 follicular units). If the density is higher than average for that particular individual, then the numbers can rise. For example, if a person is born with 60,000 follicular units (not uncommon in a Caucasian male with higher than normal density), then the surgeon may be able to harvest over 10,000 FUE grafts. That requires a high density birth hair presence which is present in less than half of Caucasians, rarely in Asians, and almost never in African hair type individuals.
