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Hair Loss InformationWhat to Look For In a Doctor? – Hair Loss Information – Balding Blog

What should I look for in a doctor that does hair transplants?

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In real estate, the most important thing is location, location, location. In hair transplant doctors, the most important thing is experience, experience, experience. You should look for someone who has years of experience in performing surgical procedures, such as a general surgeon, a plastic surgeon, or a dermatologist who does surgery. On top of that, you would want someone with years of experience doing hair transplants, and preferably someone who does that exclusively. You would also want to know what type of technique he/she uses, and only go with someone who does state of the art follicular unit transplants. You would want to know about the medical assistants that work with the doctor, since they are critical to the operative results. Hair transplantation is such a labor intensive operation that no doctor can do it alone; he or she needs help, and the assistants must be as good in their part of the operation as the doctor is in his/her part. The other thing that is important is that you see doctors’ work, preferably at a open house situation where you can actually see surgery being performed and see actual patients that they have operated on, and look at the result in person, not just in pictures. You need to spend time with the doctor, have your questions answered fully and with candor. You must have full confidence in him or her, and be assured that they are not just someone who wants to sell you something.

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Almost Bald at 40 – Hair Loss Information – Balding Blog

i’m a 40 year old white male that is totally bald on top,with hair just on the sides. i have alot of baby hair or very small white hairs in the balding spot.i’ve been bald totally on top since i was around 25 to 30 yrs old. will transplants or drugs work for me………help

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The ‘baby hair’ you are reporting in the balding area is what we call ‘miniaturized hair’ which means that the hair shaft is reduced in diameter and takes on the fine baby hair appearance we had at birth. This is a process that precedes the final balding stage. If the miniaturization is caught early enough, there are medications (like Propecia) which may reverse the process. Near the end of the loss process, it would be unlikely that the hair can be brought back. As the process you are describing sounds like the end stage of the loss, then the only solution may be hair transplantation. This is well defined on newhair.com, which has hundreds of photos of men who have had the hair moved into the balding area from other parts of the head.

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Hair Loss InformationFUE and Scars – Hair Loss Information – Balding Blog

I would like to get HT, but one question: how do you determine as to the donor site location? My friend had 2000 FUE’S and it seems like his donor cut was equal level with the eye brows, is this OK? He told me that he had a HT doen ten years ago and his FUE dr. told him that he would remove the old scar which was that high as well. What if he became so bald that his hair loss went lower than his current scar? Can HT doctors determine as to future loss?

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Thanks for the fine questions. Donor incisions, if placed in the middle of the permanent hair zone should be covered with the hair that is there for the life of the patient. FUE (Follicular Unit Extraction) is an alternative, but you must be sure that you will be a candidate for such a procedure. I would want to see you and test your hair to find out if you are a candidate. I suggest that you read up on FUE at newhair.com. It includes pictures and videos of the procedure as well as post-operative patient followups. Scars from traditional hair transplants can be fixed in many cases. Again, I would have to evaluate the person in order to judge repair possibilities. To answer your last question, yes doctors can determine what your most probable hair loss situation is, provided that you are over age 30.

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Shedding After a Hair Transplant – Hair Loss Information – Balding Blog

I had a hair transplant 4 months ago and I lost hair in the months that followed. Is that unusual and will it return?

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Shedding is not common after surgery on a patient who had a previous hair transplant nor on patients who are taking Propecia. In the days before Propecia was available, hair loss (shedding) following the first hair transplant was common in the younger men and less common in the men over 40. When the hair loss happened in the younger men, it frequently reflected what I might have guessed would have come out by itself in the next year or two. I only remember a small hand full of patients who lost some of their older hair transplants after a new procedure, but all of them (less than 1% risk) had the hair return at between 4-6 months. If it is the transplanted hair from a previous hair transplant, I am confident that it will all return.

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Hair Loss InformationMinerals Causing Hair Loss – Hair Loss Information – Balding Blog

You mentioned that some vitamins may cause hair loss. Could you elaborate on that?

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Essentially, overdosing anything that may be good taken in low quantities, can cause hair loss when taken in high quantities. In my brief review of the subject, the data is not clearly defined. There is a worthwhile site for answers to your question, written by Dr. Michael Biamonte, found here.

Summarizing what he said: We know that toxic levels of minerals such as lead, cadmium, mercury, iron, aluminum and copper commonly cause hair loss. Copper also prevents zinc from its effectivness at preventing hair loss.

Zinc, iron, B vitamins, essential fatty acids, amino acids and other nutrients are responsible for hair growth. If deficiencies occur, for whatever reason, hair loss is likely. Poor diet or malnutrition also can contribute to hair loss as the body will shut down hair growth to save nutrients for other ‘more important’ functions.

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Avodart (Dutasteride) – Hair Loss Information – Balding Blog

Hi DOC… just wanted to know what you think about avodart for the treatment of hair loss? I have been on propecia and would like to switch. Does Propecia or Avodart stop mpb permently?

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The final story on Avodart safety and effectiveness are not out yet. All DHT blockers last only as long as they are active in your body. Propecia is ‘good’ for 24 hours only, so you must take it every day. Avodart lasts 3+ months (possibly in your body for over a year), however they recommend a daily dose for prostate problems, which makes no sense to me. I have gotten reports that Avodart is a better DHT blocker for balding than Propecia, using a slightly different mechanism of action. I have not yet prescribed Avodart, but I am presently reviewing the indications for doing so on a case by case basis. There are early signs that point to Avodart’s effectiveness, but there is more involved when one goes outside the FDA guidelines for prescription drugs.

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Your Pictures Are Too Bloody – Hair Loss Information – Balding Blog

I noticed that many of the photos show red head where the transplants are. Is that what I am going to look like and have to walk around with?

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The pictures we show that are ‘bloody’ red or pink, reflect the time that they were taken (usually minutes after the surgery). Most are in the first 24 hours after the surgery when we have access to the patients. After that, the patients wash their own hair and the pinkness goes away faiirly quickly. What I mean by fairly quickly is that most people with dark, medium, or olive skin color rarely show any red color within 24-48 hours of the transplant. People with very fair, pale skin tend to show more pink or red in the wounds, but these people fall into two categories:

  1. The first are the people who have what I am going to call ‘Histamine’ positive skin. These pale skinned people tend to develop redness in any scratch or trauma to the skin. They store higher amounts of the chemical Histamine at the ends of nerves which release to cause vaso-dilitation of the blood vessels. If you are one of these people, you can easily see it, just by taking your fingernail and scratching your arm. The people who are Histamine positive will develop a red-streak within a minute of the finger nail scratch. When we know that people are in this category, I treat them with two medications to minimize the redness and how long it lasts.
  2. The second group of people are those who are not Histamine positive and they will respond like all other people with the redness or pinkness gone in just a day or two.

If you come to one of our open house events, we usually have someone there who had surgery earlier in the week. This allows you to see the post operative wound and the issue of social detectability, within a week of surgery.

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Reversal of Plugs? – Hair Loss Information – Balding Blog

I have seen your articles on the net and have a video from NHI. I’m a victim of a bad hair transplant and would like your advice. The “Doctor” transplated doll looking hair in my hairline back in 1993. At the time, I was a naive kid at 23 and was afraid of losing my hair. Today I could care less if I was bald, but to deal with this freak looking hairline is an every day battle.

Basically, I’m wondering if there is any way to replace the grafts back where they were? Remove them from the front and replace them in the back again. Is this possible?

I keep my head buzzed now, and the scar on the back really looks horrid. Any advice would be appreciated. Thank you.

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The good and the bad news about hair transplants is that they are, for all practical purposes, permanent. The problem with attempting to wipe out that they were done is that you will have a ‘trail’ of scars showing each step of the process from creation to reversal.

I have written extensively on the subject of repairs. The better way is to fix it such that it does not show any more. There are many examples of this on the NHI site, and in the articles we published on the subject. I hope the photos do not scare you.

See the following links for the published articles:

Again, although you can remove the transplants, you may look like a person who had brain surgery. I hope that this answers your questions.

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Blood Pressure Medication and Minoxidil – Hair Loss Information – Balding Blog

Ron asks…

I am one of your patients ,I take high blood pressure medication would there be any advantages to taking Minoxidil orally in addition to or instead of my present medication?should I ask my doctor about this ? What dose would be effective ?

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Ron, thanks for writing. The question you posed is a good one.

Minoxidil was a poor anti-hypertensive when they produced it for that purpose in pill form. As a topical medication for hair, the absorbed dose rarely produces an effective drop in blood pressure. Controlling blood pressure is a science and it is critical for your overall health. Best to stick to medications that are known, have been tested in you and are reliable in you. Then, adding another drug will only lead to more risks for you, but with that said, topical use of Minoxidil should not impact your blood pressure when used as directed, twice a day.

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Hair Loss InformationHair Cloning, Revisited – Hair Loss Information – Balding Blog

It has been about six weeks since I’ve posted an entry about hair cloning, but I’ll revist the topic again because I get quite a few requests for information. People generally want to believe that cloning is just around the corner.

Why can’t we clone hair, since scientists can clone a sheep? When can we expect to get a cloning treatment and how will it be done?

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When it comes to cloning, hair follicles are in a tough spot. They are too complex to be simply cultured because follicles are not whole organisms like Dolly the sheep. The focus of cloning for hair is to move cells that can stimulate growth from a normal hair follicle, to an abnormal (genetically impaired) hair follicle. Although this is not actually cloning, the growth stimulating cells from the normal hair follicle can potentially be multiplied in a Petri dish and then moved to the area of genetically impaired hair. Some of these cells are capable of turning themselves into hair, bone or muscles and this has been shown in what I will call ‘uncontrolled experiments’. Because people who are balding always have some non-genetically impaired normal hair, we do not need a person to person transfer.

There are problems that are yet to be solved. The primary problem is to identify which cells are to be moved. Other problems are once the cells have been identified. We must ask, “Can we successfully create enough of these cells to work with, and is there certainty that the cells that are created and moved will maintain their capability to stimulate growth in the genetically impaired hair follicles?” It is anticipated that whatever process we come up with, there will be a type of medical ‘soup’ which the doctors will inject into the genetically balding areas of the scalp. When they are injected into the balding scalp, they must consistently be able to stimulate hair growth. Unfortunately, the success of this entire process has been relatively low so far. There have been some successes, but these have not been replicable, suggesting that we do not have control of the process. We also have to be 100% sure that this process is safe. Do we know that these cells will not produce a cancer or other problem? Safety and effectiveness is critical for any FDA approval and it will take years for this to be worked out. Don’t hold your breath, no matter what you hear!

For more information, Dr. Bernstein wrote an article about hair cloning in our 2004 NHI Newsletter, available here. Adobe Reader is required to view the file.

To read more newsletters, medical publications, and the PDF version of The Patient’s Guide to Hair Restoration, please see the NHI Medical Publications page.