What is more important when your blood pressure is up? Systolic or Diastolic readings!

Systolic hypertension (?140 mm Hg) was associated with a greater risk (hazard ratio per unit increase in z score, 1.18) than diastolic hypertension (?90 mm Hg; hazard ratio per unit increase in z score, 1.06). The investigators found similar results with the lower threshold of hypertension (?130/80 mm Hg). (Taken from Medscape)

What does this mean? It means that both numbers have to be normal to reduce your risk of heart attacks and stroke. Your doctor can regulate it!

What is magic about delaying surgery until I am 25?

If you are 19, neither the surgeon nor you know what is going to be your final hair loss pattern so decisions made at 19, mean (1) possibly using up your donor bank of hair, (2) having a hair transplant every year as your balding pattern progresses which is does in many young men. When a man reaches the age of 25, their hair loss pattern is often evident and knowing this allows the surgeon to make a Master Plan not only for the hair loss you have now, but for the future prediction of your hair loss from the diagnosis of your future loss pattern. Donor grafts must be saved for the future loss predicted by the surgeon at 25 years of age?

What is happening to my scalp and hair?

I would see a dermatologist. I suspect that you have developed Alopecia Areata but there are other things it could be. A Biopsy is needed, then followed up with appropriate treatment

 

 


2021-01-27 14:45:50What is happening to my scalp and hair?

What Is Happening to My Face?!

In the past year or so I’ve slowly lost my facial hair. First it started with a small patch then grew bigger. My wife looked up what could this be from and came to he conclusion ring worm. But at the time I had no round red ring on my face. Interesting though the very next morning I woke up to a very obvious red ring on my face. I bought lotriman and applied to my face as more then recommended. Then my skin was dry and red and then the baldness spread to my neck. I started seeing a dermatologist at this point 8 months ago and she prescribed cortisone cream and cortisone shots. Nothing and spread to other side of face. I’m not seeing her anymore and I don’t know what to do. It is very embarressing! Now on the opposite side of my face I have another suspicious red round mark with itching and dryness. Please help! Any, Any thoughts on why this is happening to my face?

You need to see a dermatologist. As you hopefully know, dermatology is a specialty and the doctors trained in this field are more familiar with this type of presentation than I am. Emailing a surgical doctor 3000 miles from you, unfortunately, is not in your best interests.

What is Hair Bonding?

What is hair bonding? Can it give a natural look?

Any treatment available to people over 60 years of age, with long standing baldness?

You may be taking this term out of context. Glues that are used to attach hair systems (wigs) are said to be bonded to the scalp. These can cause damage to weak hair, leading to further loss. They may look natural, but they also could take a lot of work and money to maintain that natural appearance.

Hair loss treatments that I recommend include transplantation and medication. Your options depend on a variety of factors, but since I have no info about you (aside from age) I couldn’t begin to list what those options might be. But yes, generally there are treatments available even at 60 years old.

What is going on in my donor area

The question I ask is: Is this shock loss or donor site depletion?

How many grafts have you had? This is likely donor site depletion. At 8 months any shock loss will have reversed. If this does not reverse, the only treatment for this that is effective is Scalp Micropigmentation (https://scalpmicropigmentation.com/) which, although it is not hair, will make the donor area look normal. This is something we do all of the time.


2020-07-13 20:21:11What is going on in my donor area

What is FOX Negative?

What does FOX negative mean?

Thanks.

We coined the term “FOX” at New Hair Institute back in 2002 for FOllicular unit eXtraction. We thought FOX sounded better than FUE. We also published a paper on follicular unit extraction, describing how some patients are good FOX/FUE candidates and some are not.

I realize FUE is performed at many clinics without any pre-testing on all patients who want to have the surgery, however at NHI we pre-qualify potential patients with a FOX/FUE test to see if they are good candidates. A very small percentage of patients will have high transection rates with FUE and these are the FOX negative patients we are talking about.

We generally do not recommend FOX/FUE surgery if the transection rate is approaching 20% or more. If the patient is FOX negative, it is an inherent problem to the patient (not the doctor or clinic or machine). As we wrote about our experience with NeoGraft a week ago, the machine could not successfully harvest a known FOX negative patient.

What is Dandruff

Dr. Thomas Dawson wrote a good description of Dandruff in the Hair Transplant Forum May/June 2017 issue as follows:

WHAT IS DANDRUFF?
Normal scalp has few flakes and healthy appearing, smooth skin. Dandruff is characterized by loosely adherent flakes and itching. Specifically, dandruff has no inflammation and is confined to the scalp, while seborrheic dermatitis has yellowish, piled adherent flakes that can extend beyond the scalp to beard, moustache, and eyebrows accompanied by visible inflammation.1 Seborrheic dermatitis is more than superficial flaking, including hyperproliferation, excess lipids, and poorly differentiated corneocytes across the scalp.4 Dandruff requires three factors: fungi (Malassezia), sebum, and individual susceptibility. While there remains much debate in the current medical literature, upon review, the vast majority of evidence points at the very least to a fungal “initiator,” most likely Malassezia fungi.


2020-08-08 09:40:16What is Dandruff

What is Dandruff and Why Do I Have More of It Than My Friends?

What is dandruff and why do I have more of it than my friends? I can’t wear any dark shirt without snow on my shoulders. What can I do about it? Please help me understand what is happening to my scalp!

Skin is not static. It changes and we shed it like a snake sheds its skin, but we do this a little each and every hour of the day. In two weeks, the average person will shed their entire skin surface and replace it with new skin. Scalp skin takes about a month to turn over, so the process is a bit longer. To understand dandruff, let’s take a quick look at psoriasis. “Psoriasis is a skin disease that causes scaling and swelling. Skin cells grow deep in the skin and slowly rise to the surface. This process is called cell turnover, and it normally takes about a month. With psoriasis, it can happen in just a few days because the cells rise too fast and pile up on the surface.” (source: NIAMS). Dandruff is like psoriasis in that the skin turnover is faster than normal (not anything as fast as psoriasis) and before it can be shed, it cakes up to form the flakes that you are observing and complaining about (dandruff).

Skin on different parts of the body shed at different rates and as we age, it is the genes in our body that determine how quickly the normal aging process occurs in our skin and the turnover rate of that skin for our age. The rate of aging and the daily changes in our skin can be influenced by extrinsic factors that can act together with the normal aging process to prematurely age our skin. Sun exposure is one of the most important factors that cause our skin to age but the way we use our body also impacts us. Exposure to varying environments will change the rate of skin turnover as well as the moisture that our skin has in it. Other external factors include things we do, like smoking, which has a duel effect, not only aging the skin and changing the water content of our skin, but it also decreases blood flow to some part of our skin anatomy (scalp). Over time, exposure to the sun damages our skin and impacts our ability to repair itself. Much of the damage is probably related to our exposure to ultraviolet (UV) light which damages our skin’s ability to repair itself. The skin which envelops our body becomes loose as we age and this process is accelerated when we do not protect our skin from sun exposure. The rate of skin turnover varies between people and dandruff is probably a reflection of the rate of skin turnover of our scalp skin for the flakes of dandruff are actually pieces of our skin which are shed prematurely. The higher the turnover rate, the worse the dandruff and the more frequent will be our complaints (e.g. itching, dryness) which plagues many of us.

The best way to manage your skin is to develop a sensible skin care routine. The scalp is no different. The use of moisturizers will soften and wet our skin; conditioners made for dry skin and dry hair will help restore moisture that is lost from the shampoos we use, which remove many of the protecting oils made by our sebaceous glands (sebum) that are designed to hold in moisture. Most important of all is the way you protect your skin from sun exposure, which can produce structural changes in your skin that are permanent. Older skin does not hold on to water very well, so older skin dries easily. Our outer skin layer (stratum corneum) may shed less as we age and the normal texture of the skin changes to reflect the loss of the supporting structures below the top skin layer. An older person’s skin appears dry and crinkly and this reflects a slowing down of collagen production as well as the fibrous elements that we call elastin. Elastin brings the recoil that returns the skin back to its normal position if we pull on it. In the typical aging person, the skin does not recoil very well when pulled upon and as such, it stands up after being pulled upon and it is also more fragile to injuries and environmental factors. Aging is a continuous process that normally begins in our mid-20s when most of our skin is healthy and hopefully not yet damaged by environmental factors. Dead skin cells do not shed as quickly and turnover of new skin cells will decrease as we age. The signs of aging are typically not visible for decades and this reflect the fact that our skin can take considerable abuse before it shows its age.

The dandruff on your head reflects many of the elements discussed above and the scalp skin is constantly exposed to drying from air and UV exposure, building up more damage over time.

Our body’s ability to replace itself varies significantly by body part and organ. For example, the outer layer of our skin completely replaces itself in about 2 weeks (scalp 4 weeks), while the lining in our intestine does it every 5 days. Our red blood cells replace themselves every 4 months (about 1/120th per day) and our bones about 10 years. Our chest muscles last 15 years, and our brains, well the part of it reading this blog, is as old as you are. So next time you get frustrated over the dandruff, think about what you have learned here, as it is a lot easier to moisturize and protect your scalp skin from sun damage than to simply ignore it as most of you do now.