Category: Uncategorized

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Persistent Scalp Pain 5 Years Following a Hair Transplant

Hi,

I had a hair transplant 5 years ago. Some months after the procedure, I noticed some persistent pain and sensibility in my scalp, mainly in the scar and areas near it (example: where the eyeglasses touch my head). But it did not heal. The areas near the scar are extremely sensitive. I need eyeglasses to work but its impossible to use them (my astigmatism is incompatible with contact lenses), so my situation is very hard.

Some surgeons said that its necessary to remove the scar, because I could have some neuromas. The scar is very homogeneous, it is not wide, and the HT was made by a very experienced surgeon. He said that this never happened to his patients and has no idea of what happened with me.

I went to some pain specialists (psychiatrists) that told me to take amitriptilin (50mg/day) and pregabalin (Lyrica, 225mg/day). None of them had any effect. Other things I already tried are: laser therapies, topical capsaicin and local injections of corticoids. No results.

Now, the surgeons think that the only thing to do is to a surgery to completely remove the scar, like a new strip (very very thin) for hair transplant, without transplanting follicles. Do you think it is a good idea or the situation can become even worse?

I already did lots of search and some web sites and surgeons comment that it is possible (very rare) to have persistent pain after years of HT, but I never found suggestions of how to treat it.

Thank you.

You have risk no matter what you decide. Have you had injections of steroids into the painful part of the scar? I would need to evaluate you before giving you a recommendation. I’ve written before about nerve damage from a hair transplant in some past posts that might have some value to you:

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Physical Activities That Can Cause Hair Loss?

Hi doctor Is it normal for the left side of your hair line to be higher and thinner than the right? Also besides genes what are some physical activities than can cause hair loss?

Hair loss, when it occurs, is often not symmetrical. If you’re seeing the left side of the hairline creep higher than the right, there’s nothing unusual about it.

There are no activities that should cause hair loss. Unless you count pulling on your hair as an activity, but I think you mean something like sports or hobbies. You need a good examination to determine if your hair loss is genetic and then map out the status of your hair loss (see Mapping Your Own Scalp for Miniaturization).


2009-03-19 13:51:19Physical Activities That Can Cause Hair Loss?

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cut my dose of finasteride by half and the sexual side effects went away

I posted a while back asking if anybody had any anecdotes for taking smaller doses to alleviate sides. Well I bit the bullet and bought a pill cutter last Thursday and from then until Monday took 0.5mg fin every day. It was by the Monday that I woke up with proper morning wood for the first time in weeks and had the horn all day. At this point I noticed more hair in my hands than normal after washing, so went back to 1mg Monday night.

You should probably stay on the half dose as it is 80% as effective as the full dose.

 


2019-05-10 12:43:14cut my dose of finasteride by half and the sexual side effects went away

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I have pimples, but went to Turkey for my surgery and I am not in that country, what do I do?

You should certainly see a doctor and get a diagnosis in the case that these pimples reflect an infection. Of course, that is the problem when you go to Turkey, there is no follow-up of problems but you should be able to find a doctor in the UK that will see you


2017-12-29 09:29:56I have pimples, but went to Turkey for my surgery and I am not in that country, what do I do?

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Daily hair loss normal at 100 hairs/day

A local doctor told me that it’s normal to shed 80-100 hair a day, but hairloss starts to occur when these shed hair are not replaced., Is this right?

We all shed about 100 hairs per day and replace that same number. IF you calculate that we have approximately 100,000 hairs on the head (typical Caucasian) and with a 3 year hair cycle between anagen and telogen, the growth cycle in a typical male is about 3- 3 1/2 years.


2020-12-26 15:46:11Daily hair loss normal at 100 hairs/day

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Plugs to Bald (with Photos)

I hate my look. I answered an ad in the newspaper when I was in my early 20s and very depressed about losing my hair. It was not bad then, just starting to thin in the front. The doctor’s sales guy came in and did a job on me, telling me that it was on special and that he would give me 50 free grafts on top of the reduced price and I would never have to deal with the balding again. I scheduled for surgery done the next morning. This was 8 years ago and have hated myself ever since. I did not see how bad they looked until the hair fell out in the front, all within a few months of the surgery. Now I just want to become bald. Can I do it?

My astute readers will notice that this is the 3rd blog entry I’ve made in the past week relating to this very issue (see also: Alas, Bald Again and Years After Transplant, I Want To Shave My Head ), but it is very important to drive home the fact that hair transplants are forever. I know that these deforming surgeries are what most people think that a hair transplant is, but based upon what I see in these pictures, I would expect that you had this 15 or more years ago, not 8. This is malpractice today and I believe even so 8 years ago. The way the doctor unleashed the salesman on you was downright immoral and I would report that doctor, at the least, to the medical board of the state. In California, the medical board takes responsibility to protect consumers against such behavior.

I think that going backwards and becoming bald may not be your best choice, because even if each of these plugs were removed, the scalp skin would then show the individual scars from each excision and the reflection of any light in the room would show the deformity. I suspect that the situation can be improved as shown in these articles and this patient example (see Dean’s Story link below).

You need a good doctor working with you one-on-one who has the experience to address YOUR needs. This requires both a very experienced hair transplant surgeon, one with good communication skills, compassion, and understanding. Then the two of you can work out what your real options are. For those readers who are seeing this scary picture, don’t think that this is the standard of care (take a look at what is the standard of care today in our Photo Gallery).

Note: This work was NOT performed by New Hair Institute. Click the photos to enlarge.


2006-05-23 15:21:16Plugs to Bald (with Photos)

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Decision from The California Medical Board: Only doctors can perform a hair transplant

There has been a huge effort to get the California Board of Medicine to rule against doctor who use technicians to do their hair transplants in their surgical centers or their offices. This has been a real problem in the field, as technicians have been hired by doctor to do this surgery so that the doctor can ‘CASH IN” on the huge rise in demand for FUE hair transplants. Many of these doctors are not trained in the field of hair restoration, never did a hair transplant and don’t understand the basics of the anesthesia or the surgery but, nevertheless, driven by a desire to MAKE MONEY. These doctors hire technicians, or companies that supply technicians or even nurses to do the surgery for them. We have seen terrible complications, including one death in California from a surgery performed by someone who didn’t know what he was doing. Now it is against the law and any doctor doing this type of phantom surgery (many doctors were not even in the operating room while the surgery was being done), will be subject to California Board of Medicine legal action and could lose their license to practice medicine. Most states follow California on such policy matters so I hope that this ruling will propagate in other states and other countries as well.

CLICK TO ENLARGE

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Possible Triangular Alopecia

This young man sent these photos to me asking about this area of extreme thinning, which appears in the same place, even on the other side of his head. He said he had this same thin area when he was younger and it is also on the other side of the head, just less prominent. This is often an inherited balding area called triangular alopecia, which is always found in this area. A simple hair transplant can permanently fix it if it is triangular alopecia. It could be alopecia areata, which is rarely in the same place on both sides of your head.

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Depleted Donor Area From FUE (with photo)

I am seeing more and more patients with depleted donor areas and thinning/balding in the back of the head where the hair formerly looked normal. This can be avoided in FUE by controlling the number of FUE grafts excised. It can only be treated with Scalp Micropigmentation which we do routinely in our office.

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