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Hair Loss InformationTransplanting Into Scalp Scars – Hair Loss Information – Balding Blog

i have an unsightly scar on the side of my head approximately 4 inches long and 1/4 inch wide. is there anyway of repairing this? i tend to wear my hair short and i am fairly conscious about it.

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Scars of the scalp can be difficult to deal with. I am assuming that the scar you are talking about is not related to a hair transplant. The management of scars is not well understood by many doctors because they generally do not look at the hair solutions that are, at times, critical in the final repair of the scars. Neurosurgery scars, accident scars, burn scars and the like require specialized knowledge of the scalp’s ability to heal in the area treated and the direction and location of the scar determine much of the outcome. Many scalp scars may have come with good medical care, so one has to think differently about scalp scars: what will make the next treatment better than the last one?

Send me a photo (preferably digital) and be sure that the scar location is clearly shown. Your confidentiality will be assured. My email address is on the Contact page.

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Hair Loss InformationPigment Loss After Laser Hair Removal – Hair Loss Information – Balding Blog

I am 22 years old. I underwent 3 treatments of laser hair removal and believe that I have made the biggest mistake of my life. It was after my third treatment that I realized that the results I had in mind were not feasible at all. I have since stopped the treatments and am now trying to determine how much permanent damage was done to myself. My last treatment was in September of 2004. For many months there were lots of spots that were bare, but in the last couple of months I’ve noticed lots of hairs growing in. It seems as though it is filling in almost as thick as how it was before I started treatments. Although none of the hairs are growing in white, some of them are growing in light with hardly any pigment at all. Is this permanent or will the pigment fill in with time? Basically this question is leading into my next one which is the most important to me. Have I damaged the melanocytes in my hair or my in skin?

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In response to your multiple questions, I can simply say that lasers do cause damage to the pigment cells both in the skin and in the hair. Hair has an amazing ability to come back, so maybe the changes in color that you noticed, may return after the hair goes through another cycle. There is nothing to do here other than wait it out. Be patient.

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Hair Loss Information » Hair Cloning – Balding Blog

Benjamin asked…

Are there any doctors who can clone donor hairs so that the amount of available donor hairs is no longer an issue with transplants?

The hair cloning issue keeps coming up because it seems to be promoted by some unscrupulous people who use the cloning ‘card’ as a way to elevate their own position of authority in this business. There is no cloning on the short-term horizon for hair, despite claims to the contrary. If and when the cloning problem for hair is solved from a research perspective that can be replicated , it will take legislation to make that reality into a clinical tool. Hair was first cloned by Jahoda in Scotland in the late 1980s. Since then, there is been a relatively long silence in the industry on repeating his work. His report stands alone as a successful cloning experiment. Attempts to do this in mice and other animals have produced many dead animals in at least one study I have been told about. Attempts to do this in humans have met with failure after failure. Fortunately, no deaths have occurred. I would urge all of my readers to be cautious about the cloning option and look skeptically at anyone who promotes it at this time.

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Hair Loss Information » Hair Cloning – Balding Blog

Benjamin asked…

Are there any doctors who can clone donor hairs so that the amount of available donor hairs is no longer an issue with transplants?

The hair cloning issue keeps coming up because it seems to be promoted by some unscrupulous people who use the cloning ‘card’ as a way to elevate their own position of authority in this business. There is no cloning on the short-term horizon for hair, despite claims to the contrary. If and when the cloning problem for hair is solved from a research perspective that can be replicated , it will take legislation to make that reality into a clinical tool. Hair was first cloned by Jahoda in Scotland in the late 1980s. Since then, there is been a relatively long silence in the industry on repeating his work. His report stands alone as a successful cloning experiment. Attempts to do this in mice and other animals have produced many dead animals in at least one study I have been told about. Attempts to do this in humans have met with failure after failure. Fortunately, no deaths have occurred. I would urge all of my readers to be cautious about the cloning option and look skeptically at anyone who promotes it at this time.

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Hair Loss InformationAppropriate Graft Numbers – Hair Loss Information – Balding Blog

I was told by my doctor that I need 3000-4000 grafts, but it would take at least 3 surgeries. He said that their maximum per day is 1000-1200 grafts. He said that limiting the number of grafts is better for graft growth and for patient comfort, since each surgery will take 7 or 8 hours. What do you think?

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In your doctor’s hand, if his comfortable number is 1000-1200 grafts, than that is what he should do. Seven hours of surgery is a lot, so the number he is quoting is reasonable for him. In our practice, we often perform 3000-4000 grafts in a single session and it takes usually about 5 hours or so. The reason we can do this is because:

  1. We have been doing megasessions for 13 years, originating the technique back in 1992.
  2. We have very experienced team members who do this every day. Many of our staff have been with us for up to 10 years.
  3. Our staff is very efficient. Having enough efficient staff allow us to do more work in less time than most medical groups.
  4. Better growth reflects the issues of quality control and the time it takes to get the grafts into their recipient site. Keeping them out of solution for more than a few seconds, damages the grafts during the placement process.

In conclusion, three sessions of 1200 grafts moves the same amount of hair as one session of 3600 grafts, but it would not be in your best interest to push your doctor’s estimate of what he will transplant in one session for it will, almost certainly, reduce graft growth in his hands.

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Hair Loss InformationAppropriate Graft Numbers – Hair Loss Information – Balding Blog

I was told by my doctor that I need 3000-4000 grafts, but it would take at least 3 surgeries. He said that their maximum per day is 1000-1200 grafts. He said that limiting the number of grafts is better for graft growth and for patient comfort, since each surgery will take 7 or 8 hours. What do you think?

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In your doctor’s hand, if his comfortable number is 1000-1200 grafts, than that is what he should do. Seven hours of surgery is a lot, so the number he is quoting is reasonable for him. In our practice, we often perform 3000-4000 grafts in a single session and it takes usually about 5 hours or so. The reason we can do this is because:

  1. We have been doing megasessions for 13 years, originating the technique back in 1992.
  2. We have very experienced team members who do this every day. Many of our staff have been with us for up to 10 years.
  3. Our staff is very efficient. Having enough efficient staff allow us to do more work in less time than most medical groups.
  4. Better growth reflects the issues of quality control and the time it takes to get the grafts into their recipient site. Keeping them out of solution for more than a few seconds, damages the grafts during the placement process.

In conclusion, three sessions of 1200 grafts moves the same amount of hair as one session of 3600 grafts, but it would not be in your best interest to push your doctor’s estimate of what he will transplant in one session for it will, almost certainly, reduce graft growth in his hands.

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Hair Loss InformationHair Loss From Hair Color? – Hair Loss Information – Balding Blog

Carol asked…

I have hair loss. I also us an herbal hair color. Is using hair color promoting hair loss?

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Hair coloring agents only impact the part of the hair follicle which is essentially the visible hair located on the head. Hair represents highly compressed skin which is not alive. As such, coloring agents can not promote hair loss of new hair per se. If chemicals are used which go down below the skin level, then damage to the growing elements of the hair follicles can occur. This would be difficult to do and would require a real chemical burn. What most people who report hair loss from topical solutions are talking about is the hair that is already outside of the head, the hair that we comb and style. Hair can be made brittle by the use of chemicals and as such, hair can break off, creating the illusion that it is promoting hair loss. But this hair loss is strictly above the skin and does not usually impact the hair below the skin which is deep and well protected from the things you can do to it. The new hair, which grows at about 1/2 inch per month, will replace the fallen hair almost 100% of the time. If you are used to hair that is 6 inches long, the normal replacement might take 12 months on its own (a half inch per month), reinforcing the concept that topical agents can promote hair loss.

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Hair Loss InformationSuture Scarring – Hair Loss Information – Balding Blog

I have a couple stretch marks in my back donor area performed years ago from older methods of harvesting graphs.

My new HT doctor has revised these stretch marks by suturing into the subQutaneous. What is your opinion on this?

Thanks,
Tony

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I am having difficulty understanding your question. I think you are saying that there are ‘rail road tracks’ where you were stitched years ago. If widely spaced sutures are placed a bit of a distance back from the wound, they tend to produce ‘hash marks’. Today’s suturing with very fine sutures close to the edge of the wound does not produce ‘hash marks’. Is this what your doctor is suggesting?

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Hair Loss InformationDutasteride vs Propecia, Round 2 – Hair Loss Information – Balding Blog

Another Propecia question, this time from Thomas…

I have been on propecia now 9 months and have receded more and gotten thinner on top. Propecia either accelerated my mpb or did nothing for it. I am worse off now then when i started. I never used to have hair in the shower, on my hands, or in the sink..Ever since the 3rd month on propecia, it has not stopped. My head even itches now sometimes when it NEVER used to before. My question is can Dutasteride help me or because i had no response to Propecia, is it a waste of time?

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I do not know your age or family history, when you started balding, or what pattern you are heading to. This information is critical. Already you know that Propecia has not helped you (slowed or stopped the hair loss) so this is already atypical. It is possible that you have other than a genetic cause for hair loss. Thyroid disease and some other medical conditions can produce hair loss that will not respond to Propecia.

With regard to Dutasteride, there is no doubt in my mind that it is a better DHT blocker than Propecia, but it has not been proven to be by appropriately controlled studies. A few doctors who I respect have used it for genetic hair loss and they tell me there is significant benefit in some patients that do not respond to Propecia.

First and foremost, you need to have a competent doctor make the assessment. If it proves to be genetic hair loss, then using a non-FDA approved medication (called off label use) has implications for both you and your doctor. If you are in the California area, I would be happy to see you personally and make that assessment.

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Hair Loss InformationPropecia and Prostate Cancer – Hair Loss Information – Balding Blog

I am almost 30 years old and just started propecia. My general practitioner advised against taking it due to the risk of prostate cancer. I’ve tried to research this and have not really found any evidence to support this other than the increased risk at the 5mg level.

I’ve been told by a few doctors that I should take propecia and not necessarily have a hair transplant at this time given that my hair is only beginning to thin; and that propecia should help.

Additionally, I’ve heard recently that I should not be surprised if “hair cloning” becomes available in the next few years. Would appreciate any comments.

Best Regards

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Propecia, according to a recent article in the New England Journal of Medicine, reduces the risk of Prostate cancer by 25% in the men who were studied. I personally believe that it is a good medicine for this. There is some general argument on those who may develop cancer while on the drug, that the drug may have made the tumors look more aggressive. I think that the evidence amongst most knowledgeable people points to safety and Propecia is not a carcinogen. Your doctor is misinformed.

Hair cloning, I believe, will not be addressed in the next decade.

CNN released the following news in 2003: In the study, which was funded by the National Cancer Institute and published in the online version of the New England Journal of Medicine, researchers at 221 sites nationwide followed nearly 19,000 men older than 55 for seven years. About half of them were assigned at random to take either finasteride, a drug that lowers male hormone levels, or a placebo. By the end of the trial, those taking the drug reduced their risk of prostate cancer by nearly 25 percent over those on placebos.

Also, give the following reference to your doctor: New England Journal of Medicine Volume 349:2387-2398, December 18, 2003, Number 25, The Long-Term Effect of Doxazosin, Finasteride, and Combination Therapy on the Clinical Progression of Benign Prostatic Hyperplasia, John D. McConnell, M.D.,et. al.