Other than finasteride, which seems like you are taking, there is nothing else to do if you achieved your goals. The nice thing about hair transplants is that they are permanent just like your normal hair. If you lose more hair, or didn’t get the full benefits from what you had done now, then another hair transplant may be reasonable. However, if your donor density limits were exceeded for FUE, then a strip surgery alternative may be the best option, if you need more hair transplants.
Follow-Up — Dr Rassman’s Recent Hair Transplant (with Photos)
As promised, here are some follow-up photos from my recent hair transplant surgery. I, as everyone else, will be waiting out the growth period. I expect that I will see some of the growth in 4-6 months and will share any exciting pictures with you at that time.
These photos were taken 19 days after the procedure. You can see how my donor scar is looking in the photo at the left, and the crown on the right. Click the photos to enlarge:
And in case you missed it in the original post, here’s the before photo:
Sunburn to grafts
I have walked outside very briefly to do things like get groceries. I’ve also driven places with the sun coming through the car windows and sat in the car with the sun blockers down. Is this enough to have ruined my hair transplant? I’ve noticed one side seems thicker than the other and I’m about 19 days after surgery. I didn’t know the sun exposure issue was something that you’re supposed to avoid so hardcore or for so long (‘m reading anywhere from 3-6 months).
The hair transplant has skin at the top of the graft. This skin, which comes from the back of the head, has been protected by the hair for your entire life. They will get sunburned quickly when they are in the recipient area because they never saw the sun. Protecting these grafts is important. I have seen some men with multiple red dots on the transplanted grafts, reflecting a sunburn to the tops of these grafts. It takes months for these grafts to be able to tolerate the sun. In addition, the UV Light may not be great for healing.
Forza-T and Hair Loss
I’m 23, male… Normally I have healthy hair as does everyone in my family, but about 6 months ago I took Forza-T that I think caused my hair to thin out. Forza-T boosts testosterone, so I figured my DHT level got too high. So I took DHT blockers just recently and that made it worse! My hair is noticeably thinner/weaker, and overall I just feel unhealthy compared to how I was before. I’m positive the DHT blockers caused it because I noticed a significant difference in my hair and skin within minutes of taking them. Anyway, is this permanent or is there something I can do to fix the problem… in a natural way. i’m scared to take anything now that’s not completely natural. Thank you!
Forza-T claims an increase in free testosterone from the use of this product. There is, of course, no proof, but if you take that claim at face value, it will almost certainly increase hair loss.
You sound like you are playing with fire. DHT blockers (I am assuming that you are talking about finasteride as that is the only FDA-approved medication for treating hair loss that blocks DHT on the market today) will NEVER give you an instant change. Please note that hair above the skin is dead, not alive, so it could not possibly change in minutes. Are you possibly body dysmorphic?
2007-05-21 13:32:472007-05-21 13:32:49Forza-T and Hair Loss
Switched from Propecia to 1/2 Proscar Each Day and Now My Hair Is Falling Out Rapidly
Hello again Doctor,
About 3 months ago, I switched from taking Propecia to Proscar. I found the pills to be difficult to slice into 4 pieces, so I just took 1/2 of one instead (the pharmacist only charges me a $10 co-pay, so I can live with spending an extra $5 a month). I asked Dr. Bernstein if this was OK, and he said yes. The problem is my hair has been falling out more rapidly and I’ve become extremely frustrated. My question is this – is this coincidental or should I go back to taking Propecia? or is it possible that I am taking too much?. Thank you for this website and for your time.
I doubt that the higher dose (2.5mg finasteride) that you’re taking will work less effectively than the lower dose of Propecia (1mg finasteride) and cause you to rapidly lose hair. It might just be a coincidence, but you should discuss this with your prescribing doctor.
FUE Back into the Linear Scar vs Scar Revision
I’m thinking about getting a strip method hair transplant and then just filling in the scar with FUE. Is that an option thats worth pursuing? I don’t want the line scar but I want every graft transplanted. I understand FUE has problems with transection or something.
I get this question quite a bit from patients who have already had the hair transplant strip surgery and then inquire about having a follicular unit extraction (FUE) procedure to follow it up. It makes little sense for the person that already has a strip scar (no matter how wide it is) to have an FUE into the donor harvest. If it’s just about treating the linear scar, better solutions would be a scar revision or Scalp MicroPigmentation (SMP). FUE grafts used in linear scars are generally wasteful and an expensive way to treat the scar with less than ideal results.
My complaints about the way the FUE technique is used are:
- It’s generally more expensive than a scar revision for those with a troublesome linear scar.
- The grafts do not come out of the sweet spot in the middle of the donor area (where the grafts are easily taken by a strip).
- In my opinion, the overall survival of the FUE grafts are not as good as those harvested from a strip in most doctor’s hands (I do not believe that is a problem in our hands).
As the first to publish a paper on FUE (introducing it to the medical community), I can speak with authority on these issues. The ARTAS FUE robot has not really changed the process, except for leveling the playing field for those doctors not skilled in the extraction technique. The FUE technique, as done in most doctor’s hands without the robot, is not as good as the grafts produced by a strip surgery. If there was a formal study, I would expect that each doctor would show variable comparative results when comparing their FUE results with this strip results, making such a comparison between FUE and strip surgery essentially worthless.
The presence of a fine line scar will not be seen in most patients who had a strip procedure, because they generally leave their hair just long enough to cover a strip scar. If they were to cut the donor area hair very close to the scar, at some point (depending upon hair length) the scar will show. I had two hair transplants and although I have a scar, few people can see it even when I show it to patients who visit me in the office. The public does not understand that there is scarring in FUE procedures, even though some doctors and clinics promote it as “scar-less” surgery. In some patients we have had to treat these FUE scars with SMP to allow for a close haircut or shave. The SMP process is the only one that treats FUE scars today and we are seeing more and more patients with this problem as time goes on. I suspect that the strip scar issue is more of a problem with a person who has dark hair and white skin, than the person who has medium brown hair and an olive skin. Nevertheless, both techniques do have consequences.
Here is an example of scarring from a large FUE procedure with the hair cut short. While there is no linear scar, you can clearly see the white pinpoint dot scars all over the back of the scalp. We’ve treated this with SMP (photos to come in a follow-up post later). Click the photo to enlarge.
With all that being said, I am not denigrating FUE. It is an important technique and in certain situations it may be superior to a strip surgery. Examples of superior candidates include those without large balding areas, and athletes who want to be able to resume full exercises and swimming within a week of the surgery; however, in patients with large balding patterns, taking the required number of grafts through FUE is not efficient and is relatively more expensive. There is massive experience with strip harvesting (some good and some bad). I have seen in some patients that visit me, that many doctors are harvesting grafts with FUE from the non-permanent areas to reflect a large need for grafts in a single session. Grafts that are taken from the non-permanent zone, may not last.
Systemic Inflammation as a Cause of Hair Loss
I am a cosmetologist and have been so for over 25 years. I’ve been doing extensive research on hairloss for several years. Recently I’ve been experiencing hair loss myself. I have rosacea, the kind that results in acne like bumps. It creeps into my scalp also. After finding out that I have an inflammatory condition found in my lungs, it’s all starting to make sense. My pulmonologist is drawing lines connecting inflammation in my skin and scalp to this. Many people who have acne or other inflammatory conditions also experience hair loss. This is believed to stem from inflammation brought in by either infection, autoimmune disease or allergic response. I have rosacea and hair loss. I’ve not taken any oral antibiotic for this, although it has been prescribed (minocyline) . This drug is used to treat inflammation, not so much as an antibiotic. I’ve used metrocream on my face with no great results. My dermatologist switched me to soolantra and it is working wonders on my breakouts and redness. She says this cream works to fight against the allergic response to skin mites. It is so interesting that the inflammation is due to an allergy. It’s probably also in my scalp too. If you have an inflammatory skin condition, you most likely also have the same in your scalp. Because of the cycle of the hair growth and shedding, you might be experiencing hair loss a while after the inflammation began at least 6 months or so. I’m curious how many of you have experienced other inflammatory problems like IBD, joint pain, high blood pressure.
Stress from inflammatory disease can be a cause of hair loss. It sounds like you solved the problem. Your story is a good one so thanks for posting it!
2018-10-07 06:44:212018-10-10 11:39:41Systemic Inflammation as a Cause of Hair Loss
FUE, I Still Have My Frontal Recipient Area Swollen at 6 Days, What Do I Do?
The swelling will go away, just give it time. I always use an elastic tape to prevent forehead swelling.
2020-05-06 04:00:352020-05-04 12:46:42FUE, I Still Have My Frontal Recipient Area Swollen at 6 Days, What Do I Do?
Taking Avodart Bi-Weekly To Avoid Propecia-Like Side Effects?
Dr. Rassman:
Prior to reading this, thank you for your time. Your insight and knowledge is of great appreciation.
My situation is as follows:
I started propecia, was on it for a month, then underwent a HT of 1,900 grafts mainly in the front hairline. I continued to use propecia for 2 more months and began to experience some serious sexual side effects. I stuck it out for another 3 weeks however the side effects continued so I stopped the propecia. The sad part is that the propecia began to halt my hairloss however I could not deal with the sexual side effects.
Sadly my hair is shedding. After another apt with my hair restoration doctor, he suggested I take Avodart 0.5mg twice/week. He had mentioned that some of his patients who were having side effects from Propecia took the Avodart bi-weekly, (due to the drugs long half life) and were able to halt hairloss but did not experience the side effects which I was experiencing from my daily 1mg Propecia regiment. I have read all of your posts in regards to Avodart and I understand that it is not FDA approved nor do you prescribe it to your patients.
My main question to you and issue at hand:
I know that when people start taking Avodart they experience a shedding phase which generally kicks in after the first month or two of starting the drug and can last a few months there after. My first question – If I am only taking the drug twice a week and have only been off of propecia for 4 weeks will I also experience a shedding phase? I am confident that the shedding phase is the transition to a greater good…as the weaker hairs fall out months later they are replaced by stronger, new hairs. My problem is that I am in the entertainment industry and will be starting a one month taping of a TV series from June 30th-July 30th. I would like to have as much hair as possible by that time so would I be better off waiting to take the Avodart after the taping is complete, or should I start now and hope that the avodart will not cause a drastic shedding phase and help me stabilize the hair that I currently have? I guess this really comes down to a game of timing.
It will be 5 months since my HT when the taping starts in June so I am hoping that the transplanted hair will already be popping up. Also, most of the hair that I am losing is from the front hairline and temples. The crown seems to be doing ok.
Thanks again for your time and I would also be interested in undergoing a transplant with your team following the taping.
I really do not have a clear answer to your situation. In general, Propecia or Avodart will not be as effective on your front and temple areas. They each work best on the top/crown areas of your scalp. I do not know if you will have more or less shedding as everyone has different results, different side effects, etc. Shedding isn’t seen by all men that start the medication. Really, only time will tell and there is no clear way to predict this.
It would be interesting to know if Avodart did indeed change your sexual side effect issues, as I would expect that it would not make it better. There’s not enough reported about Avodart dosing in the treatment of hair loss for me to suggest that bi-weekly pills are the way to go.
2010-05-06 14:31:532010-05-06 08:59:29Taking Avodart Bi-Weekly To Avoid Propecia-Like Side Effects?