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Folliculitis Decalvans is a terribly aggressive disease. I have seen this appear in a couple of patients over the past 27 years in practice and it is difficult to manage. I would consider an alternative like Scalp MicroPigmentation which will not be aggravated by this disease.

See here: https://scalpmicropigmentation.com/bold-shaved-look/

You seem to keep your hair cut short and that means you would be an excellent candidate for this procedure as it will cover all of the scarring on your scalp.

We’d both be 19 if he was still here. We were pretty alike. Both were studying together. Life bummed him out but not that much. Then hair loss hit. He started losing hair all over his head. Every doctor just said it was aggressive hair loss. His worries become amplified ten fold. Everything bummed him out, he wouldn’t leave his house. I wake up one day to my mum telling me that he hanged himself in his room when everyone was away. Nobody talks about how hair loss made everything worse. I understand depression plays a huge factor but it would have never happened if hair loss treatments were not complete bull shit. Guess what though? Now i’m going through the same thing. Rapidly losing my hair and people are noticing it. My own parents won’t even look at me the same way. Can the industry get its act together? I want to live. Why can’t people understand how balding screws up your mind at a young age.

Hair loss can be treated and today, with modern technology, almost every person can get the hair that they are losing back when in the hands of an experienced, ethical and skilled doctor. There is no hopelessness with balding, not at all. Yes, our industry may not focus well on people like you and your friend. I, for one, have had too many young men in your situation and I spend a lot of time with each of them. Most of the time I am successful in bonding in a positive way to impact their depression; however, depression needs professional help. I had one young man commit suicide after being mutilated by a hair transplant doctor with the old plugs and many scalp reduction surgeries. I knew about him because his mother and I bonded over his management, but he lived far away and a phone connection was not enough. When his mother called me and told me the terrible news, I felt that maybe I should have flown out to see him or send him the money to come to visit me in LA, Hindsight does’t help. Hair loss just adds to the depression that already exists in such young men and I keep seeing young men voice their depression about hair loss and relate it to hopelessness.

I’m so fearful that I made a bad decision about having a forehead lift because I, too, am losing lots of hair from the top and sides of my head. I am 7 weeks out and panic struck because I am starting took bald around the incision. It looks like I have cradle a cap that is starting to come off and the surface is raw underneath. I’m using Silvadene on it. My surgeon keeps saying that it’s all fine, but I look horrible. The suture line has not healed yet. I do have a condition called Frontal Fibrotic Alopecia. Oddly enough, the hair transplants in the area are growing!

You are fortunate that the hair is growing since this disease can impact much of the frontal hair. Hair loss is not uncommon after any facial surgery in women.

Does swelling always happen and then gravitate to the eyes like mine at day three? My doctor’s pitch to sell me this procedure was that in his hands, swelling never happens. So I selected him and now I am swollen just 3 days from the FUE I had done. Could this swelling have been stopped?

Yes, swelling always happens unless God is your surgeon. Since I think that only humans do this type of surgery, your surgeon could have done two things to stop the impact of the swelling:

(1) use a steroid at the time of the surgery, and

(2) use a tape on the forehead to prevent the swelling from moving from the upper forehead into the eyes.

This woman had hair loss and went to a surgeon a few years earlier who recommended surgery. Her condition is a clear diagnosis to a doctor with experience, a disease called Fibrosing Frontal Alopecia, which will cause any hair transplant to fail. Although this occurs more in women then men, it does occur in men and an astute doctor who is knowledgeable is critical before you get a hair transplant that will fail if you have this condition.

If half-life of fin is 6-8 hours in the blood but 5-6 days in tissue (scalp) why don’t people apply topical every 3-4 days to minimize systemic?

Topical finasteride goes systemic. Perfect Hair Health has shown the relationship between systemic DHT level drops with higher and higher topical finasteride dosages as the effective topical dose increases. For men highly sensitive to finasteride, the standard topical finasteride will not change their problems by switching unless it is the liposomal preparation. Tissue levels remaining after stopping finasteride. Officially symptoms’ like sexual side effects should disappear within 6 days, but from my experience, it can last a month or more.

This was a question posted in the comments of this post about FUE failures:

Dr…You mention the many small dot scars with FUE – does this just come with the territory or can a good DR minimise this? I have very fine hair which I like to clip quite short and as such would never want a strip procedure. I assumed that an FUE would be ok.

It comes with the territory. All FUEs produce punctate scars. Just as in strip scars, there are some people who heal better than others. Some of these people will stretch the punctate scars. In those that stretch the scars (particularly in people with fine hair) the larger the punctate scar, the more detectable it is with a close buzz cut. Fine hair just does not hide the scars as well as a coarser hair would. With these statements, I can not state with 100% certainty that the larger scars are strictly the results of the differences in healing.

There is another variable here that should be mentioned — the size of the punch. I believe that the smaller the punch used to extract the graft, the less likely the scar will stretch. The range of punches used today are from 0.5mm – 1.5mm. I believe that the punches which are under 1mm will usually scar less than those over 1mm; however, with that said I don’t have personal experience with punches over 1mm.

Dr. James Harris, who uses 1.25mm punches with the ARTAS FUE robot, tells me that the scars are not worse than those produced by using punches under 1mm, so as I respect his opinion, I report it here for you to judge. We use 0.9mm punches with our FUE procedures.

This is called sublingual dosing of a drug. For some medications, slow action is better than fast action, especially for drugs that drop the blood pressure or have heart effects that are supposed to be taken as a pill. See this article here: http://journalofpharmaceuticalresearch.org/index.php/kpc/article/viewFile/118766/81984