Category: Uncategorized

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Supplement Ingredients and Hair Loss

Hi Doc, I have purchased 3 supplements for working out…ce2 ethel ester (creatine), papaya enzyme, nitro tech whey protein made by muscle tech. Are you aware of any of the ingredients in these that cause hair loss?

No, I am not aware of any specific ingredients in any supplements (when taken as directed) that could cause hair loss. Some of the supplements that may have steroid type effects cause hair loss. Keep in mind any medications, supplements, and food when taken in excess can be harmful to your body.

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FOX Procedure Pricing?

I am really interested in the Fox technique, do you think it will go down in price over time?

The FOX Procedure (follicular unit extraction) is heavily labor dependent and takes much more time to harvest grafts than a traditional strip procedure. Without a new breakthrough, I doubt it will go down in price much, as there are not many doctors who are doing the procedure completely.

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Switching brand of finasteride

I’ve been prescribed finasteride by my dermatologist and I’ve been taking it since the 1st of Jan, about more than 3 weeks ago. I’ve also been using Ketoconazole 2% since then for my dandruff & itchiness. Helps alot! So far I’ve been shedding and hair seems thinner, but im being optimistic & hoping for regrowth at the 6-8 month mark. My crown feels like its thickening up, but my temples & the frontal area seem thinner now, could even see my scalp under light…. Anyways, I was just curious if I could use another type of brand of finasteride once the one I’m currently taking is finished in March.

In theory, all drugs cleared by the FDA should be the same as the label states; however, I have heard complaints from some men who switched brands find that the effectiveness has changed. I don’t understand this other that some of these brands could be counterfeits, something more common than most of us realize.


2021-01-23 08:56:41Switching brand of finasteride

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FUE Caused Necrosis of Patient’s Donor Area

A report published by the Journal of Plastic, Reconstructive & Aesthetic Surgery a couple years back has recently come to my attention. Here’s part of the abstract:

Follicular unit extraction (FUE) has been developed as one type of follicular unit transplantation surgery, a widely accepted hair-restoration technique. FUE has many advantages, including a small donor area scar, less pain and a slender graft without extra surrounding tissue. Complications are uncommon in the literature. We describe a case of donor-site necrosis after hair restoration with FUE, leading to cicatricial alopecia in the left half of the occipital region.

Read the rest of the abstract — Necrosis of the donor site after hair restoration with follicular unit extraction (FUE): a case report.

I have seen the impact of large sessions of grafts using FUE on patients who came to our office over the past 10 years. Most of these necrotic areas were small, so they were easily addressed by good, traditional surgical care. I expect that we will see more of these severe complications as more and more doctors start pushing the number of grafts performed in a single FUE session, just as we saw when doctors who did not know enough about FUT caused similar degrees of necrosis. I believe that those doing FUE procedures and their patients need to be aware of this risk. This complication, however, was a disastrous problem for the patient referenced in the above report, as he lost part of his scalp.

The full article states, “One hundred fifty cubic centilitres (cc) of 1/100 000 adrenaline solution was injected gradually into a 10 by 12 cm area in the left occipital region during surgery over 4 hours. Nine hundred fifty follicles were removed using 0.8-mm punches connected to the end of an electrical driver drill“. So less than 1000 grafts were transplanted with a small punch and yet the complication occurred. This punch size should have minimized the risk. The article does not discuss the density of the punch holes in the donor area. On the surface, nothing was really done wrong.


The article further reports: “digital gangrene and ischaemic necrosis after the use of local anesthetics with adrenaline and chemotherapeutic agent extravasations have been reported.” Our operative consent discusses this risk. We forget that any hair transplant (FUE or FUT) is a surgical procedure and with it, there are risks that must be discussed with the patient. We have previously reported a patient death in a medical office a few miles away from our office, so necrosis is just another one of these rare risks. Clearly, the death that occurred years ago was probably the result of doctor incompetence, so some of the things that the patient must pay attention to when evaluating asurgeon is: their track record, their experience, and their reputation.

I respect the courage of the doctors in this necrosis case, because by reporting it to the doctors performing this in the field, we become aware that the doctors do not control every risk in every patient surgery. As we know very little about this particular patient’s activities after the surgery or his health before the surgery (e.g. was he a smoker?), I can not discuss the article further.

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I Have Systemic Lupus and Have Scars on My Scalp. Can I Get a Hair Transplant to Treat These Defects?

People with autoimmune diseases like Lupus, LPP, FFA, alopecia areata, and alopecia totalis can’t be treated with hair transplants while the disease is active. For all of the diseases mentioned (except alopecia totalis, which is not transplantable), the disease must be inactive for 3 years. There is always a risk of recurrence even after 3 years, in which case, if it should happen, all of the transplanted grafts would then be lost.

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FUE in the UK?

Hello,

i am thinking of having the fue procedure in the uk and would like to know which is the best surgeon to see. Trying to avoid surgeons that have a high rate of fue failure due lack of skill.

many thanks in advance for your help.

You’ll have to do your own research to be sure you’re getting exactly what you want and to be assured that you found a doctor you can trust, but Dr Bessam Farjo is a good place to start (offices in London and Manchester). You can also use our handy guide to selecting a hair transplant surgeon — here.

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Taking Biotin to Prevent Hair Loss?

I am a 22 year old male, and have just recently started noticing minor thinning in the front of my hairline. Male-pattern baldness runs in my family. I consulted a stylist who told me that taking a supplement with Biotin can prevent hairloss. I am not worried about regrowing any hair, as it isn’t a problem yet, only maintaining what I currently have. I ordered 3 month supply of Provillus, which contains both Saw Palmento and Biotin. My plan is to see if it has any effect or not. Is this a good approach and also what else could I do if this doesn’t help?

Why experiment when we know that if the diagnosis of genetic hair loss is confirmed, then finasteride works? Every day, every month, and every year you experiment, you will allow your irreversible hair loss to get worse and worse and worse and worse. Stop playing Russian Roulette. Biotin is no answer to your problems, unless you are deficient of biotin.

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FUE: Surgical Skills and Robots (Part 3 of 4)

So far, we’ve looked at the history of FUE in part 1 and graft quality/survival in part 2…

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FUE Today:

The FUE market may reflect as much as 40% of the total hair transplant market today. I believe that 20% of the doctors offering FUE, are skilled in the process; however, a majority of the doctors who offer FUE today are not skilled in the process. With such a large gap between skilled and unskilled doctors doing FUE, one would ask what the doctors are doing about it, because no doctor wants to be second class. The doctor must get the expertise that they need… somehow.

Some doctors try one of the various instruments that promise great success with the FUE process. Some instrument entrepreneurs try to convince the doctors that if they purchase a particular instrument, great success will befall them and every new doctor purchasing these system, want to believe it. I admire Dr. Jim Harris, who pioneered a special instrument because he offers training on human volunteers to physicians who want to master his unique approach. I have participated in his course and own one of his instruments. There are instruments that:

    (a) drill out the follicular unit with a slow variable drill
    (b) that vibrate and/or rotate when they drill the hair graft
    (c) have variable depth control to minimize damage to the deep portions of the graft
    (d) claim that their punches are sharper than all other drills or punches on the market
    (e) are made dull intentionally to minimize transection, etc..

Drilling is the most popular way of performing the FUE and most doctors seem to favor the drill. Prices for these drills (the doctor’s costs) run as low as $1200 to as high as $220,000 plus $1/graft. Each vendor claims some advantage over the other.

With the discrepancy between $1200 and $220,000, let’s see what value comes with each package.


ARTAS:

The ARTAS system made by Restoration Robotics is the $220,000 unit for FUE harvesting. The sole function of the ARTAS system today is to core grafts from the scalp, leaving them in the scalp until they are manually removed. Their ARTAS system does the coring with a high degree of accuracy. It does this with robotic efficiency using optical siting technology (initially designed and patented by Rassman and Pak — Patent 6,572,625). The ARTAS uses a sharp punch to score the skin and then a dull punch (designed and patented by Dr. Jim Harris) measuring 1.2mm each. The hair shaft lies mostly below the scalp surface and the angle of ‘attack’ by the robotic punching system is calculated by knowing both the angle of the hair stubble above the skin and an estimate of the bend in the hair follicle found below the skin. The hair is left with stubble when the scalp is shaved so the part of the hair shaft that is exposed allows the optical siting system to establish the needed alignment for the extraction. The bend below the skin is consistent in adjacent grafts, but vary in different parts of the head and constant adjustment is needed as the instrument moves from one area to another. The robot can not ‘feel’ the graft, so the extraction is done by science and math, while all of the other instruments on the market allow for the ‘feel’ of the graft as the instrument plunges into the scalp.

A skin stabilizer (invented and patented by Rassman) is used to stabilize the skin for the extraction that follows. The ARTAS leaves the graft in the scalp and moves from one location to another until the entire drilling process is complete (speed of drilling is about 300-400 grafts per hour). About one graft is excised out of every 5 in a single field of view and this variable can be dialed into the ARTAS controls. The robot is very efficient in making the calculations to remove 20% (or 25%….) of the follicular units in any one field of view. The coring is where the automation ends. Once the grafts are cored out, the rest of the process, including the removal of the grafts is a hand process.The ARTAS damage to the follicular units from the drilling part may range in the 5-10% in each patient. The variations by the team or with the patient dictates most of the variables and most damage occurs when the grafts are transected or ripped out after the drilling process.

Restoration Robotics intends to automate the entire hair transplant process some time in the future. They are estimating that the complete automation may be accomplished in 2-4 years. When they complete the automation for implantation, the art of the hairline has to be dealt with and I am interested in seeing how they go about the rest of the automation process. The ARTAS system requires the least training for the mechanical extraction of any instrument available today. In fact, once the diagnosis is complete and the plan is laid out, the surgeon becomes superfluous to the process. As the doctor pays $220,000 for today ARTAS and $1/graft, these costs must be put into the final price for the consumer making the ARTAS FUE possibly the most expensive technology for the consumer today.

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The final part of this series will be posted tomorrow, where we’ll discuss Neograft and manual processes for FUE.

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Taking Propecia and Viagra

First off I have learned alot from your web site. I’m sure all your readers are very greatful. I know I am!! My question is If someone already suffered from impotence and taking viagra or a simaler product for this would mixing propecia with it for hair loss be a problem. Is it a safe mixture in other words?

There is no difficulty taking Viagra and Propecia. They do not interact with each other. This way you can enjoy both good sex and great hair. That is a winning combination.

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Full Head of Hair with Shedding

My hair right now is very thick, and my hairline is a Norwood 0-1.5 depending on who looks at it. But sometimes when I’m showering and also when I put gel in my hair, I notice that some of the hairs that shed are very thin. They are so thin that they are hard to see unless you are looking for them. Other hairs that shed are very thick and can be felt on my hands, while the thin ones can’t. Is this a bad sign?

You may be seeing miniaturized hairs that are falling out. Miniaturization is part of the early balding process. A good video microscope purchased from Amazon for under $20 can tell you if you are miniaturizing. You can read my many posts on miniaturization on BaldingBlog.com (https://baldingblog.com/?s=miniaturization+hand+microscope&x=0&y=0).

 


2018-06-22 13:00:06Full Head of Hair with Shedding