Hair Restoration Blog

Join us, yet again, with US Hair Restoration Medical Director Parsa Mohebi, MD as he discusses popular hair loss topics. So often we receive phone calls and email inquiries regarding common questions people have about the art and science of hair restoration and how it can affect them and their personal situations. Here are the most recent topics discussed by Dr. Mohebi at our recent webinar:

Reframing the Face With Hair Transplant Surgery

Most people are not aware of the rule of thirds and how facial symmetry affects ones appearance. In this lecture, Dr. Mohebi discusses the importance of choosing a good hair line to achieve the proper facial symmetry.

Female Hair Loss Treatment

It is quite common to receive calls and emails about women and hair loss as most are under the impression Hair Transplantation is merely for men. In this webinar, Dr. Mohebi explains the differences between male and female hair loss and what procedures take place in order to determine the candidacy of female patients for hair restoration.

Male Patterned Hair Loss Treatment

The most common type of hair transplantation surgery procedures performed are for men suffering from Male Patterned Baldness (MPB). Dr. Mohebi discusses the effects balding has on men and the solutions available to restore their lost hair.

At US Hair Restoration, we are excited to connect patients and curious patrons with Dr. Parsa Mohebi to hear about popular hair loss topics and the options available. Here are some of out recent topics discussed with Dr. Mohebi:

Hair Loss Psychology

Learn about the commmon effects balding has on individuals and their self-worth. There are proven solutions with positive results from hair restoration procedures.

Hair Transplant: How Does It Work?

Different methods exist which are readily available with the right hair restoration surgeon. Some may choose the FUT strip method, while others are more comfortable with the FUE method.

Latest Technology in Hair Transplantation

The art and science of hair restoration is always evolving and here Dr. Mohebi talks about the current options available.

We often get questions here at US Hair Restoration as to why there is little talk of women getting hair transplantations?

This question and others about female hair loss treatment options are commonly asked about.  The answer is found in the differences between common male hair loss and that of women.  Some of the differences between male and female hair loss are:

1. When looking at female hair loss in its most common type, it is not nearly as common as typical male hair loss, also known as male patterned baldness.
2.  Women’s hair loss rarely leads to complete baldness.  It often presents itself merely as thinning.
3.  FPB, or Female Patterned Baldness, usually touches the entire scalp with no donor hair protected in the back, unlike men with Male Patterned Baldness (MPB).
4. Women suffering from hair loss are much less accepted than men. MPB hair loss is known as a normal variation among men rather than a disease because most men have some degrees of hair loss after the age of 50.

Many women may benefit from hair restoration surgeries by restoring their hair in the balding areas.  The most important factor that determines a woman’s ability to receive a hair transplant is their donor recipient area.  That is to say, women whose hair loss is more similar to male patterned hair loss are far better candidates for a hair restoration procedure.

When considering their candidacy we need to keep in mind the common differences of balding between men and women.   A hair transplantation surgeon should be intentional in setting realistic expectations.  A man suffering class VI hair loss, having no hair on top of his head, might be thrilled about having a mere 40% of his original density on the bald areas after a procedure.  For a women, having only 40% density, will probably not be acceptable.

Women who desire close to 100% density in the bald areas should be told the truth which is they might need more than one hair transplant surgery.  Although women hair restorations can help most female patients, the candidacy for hair restoration in women should be carefully calculated before planning a hair transplant surgery.

These are the factors which should be met for determining proper candidacy for women regarding hair restoration surgery and before finalizing the surgical plan for female hair restoration:

1. Donor/Recipient mismatch: This means the donor hair on the back and sides of the woman’s head should be better quality than balding areas
2. Limited balding area: This means the area suffering balding or thinning must be limited.  Women with diffused hair loss wanting increased density everywhere are generally not good candidates for female hair restoration surgery.
3. Realistic Expectations:  The reality is hair transplant surgery only moves hair from one area to the other.  It is not about creating new hair.  Because of this, women need to understand hair restoration helps them to redistribute hair to cover the areas that are more important to them.  Creating 100% original density requires more than one hair transplant surgery.

A final important factor for women who are looking into a hair loss procedure is to consider finding the right hair transplant surgeon who has experience handling hair restoration procedures in women.  Female hair restoration is an art in itself and should be considered properly.

Female hair restoration is not simply another version of the common hair transplantation done in men.  The common size of a woman’s skull, the dynamics of the scalp skin, and the precision of making sites for the new grafts are important skills for a surgeon to understand. A good, well knowledgeable, and experienced surgeon will be on top of these things and do the best job possible to help reach the desired goals.

When we at US Hair Restoration receive inquiries, we find most people merely consider hair transplant surgery to simply be the permanent remedy for hair loss or complete baldness. It is true modern day hair transplantation is the only truly natural, proven, and permanent option for reversing the effects of hair loss. This art and science continues to improve the lives of thousands of individuals each year by restoring self-confidence and renewed youthfulness.

Most people do not consider the reality that there are times when hair transplant surgery has absolutely nothing to do with restoring hairs which disappeared with time. Rather, for some it is about creating facial symmetry and proportion which may have faded, or never even existed.

The famed Renaissance artist Michelangelo explained about “the rule of thirds”, which is to say there is a proportional frame of the human face. The hairline acts as the top of the frame and the chin as the bottom. These “thirds” are evenly spaced sections that give the face an attractive, aligned appearance: the hairline to the top of the eyebrow, the top of the eyebrow to the base of the nose, the base of the nose to the bottom of the chin. Even a slight alteration in this rule would cause the face to look out of proportion. When it is the hairline that is positioned beyond its desired starting point, the individual tends to look older than they really are.

The art of creating the desired proportion and facial symmetry in both men and women, with naturally receded hairlines, is treatable as a result of advances in modern day hair transplantation surgery. By using the rule of “thirds”, an experienced hair loss surgeon can design the ideal hairline location and starting point. This is unique for each individual patient. It is through the application of a blend of ingenuity and proper hair transplant surgical training, that a new hairline will mirror the natural growth pattern of the hair, and will act as the ideal top frame of the face.

Here at US Hair Restoration, we are constantly hearing about the concerns of our many patients who have been prescribed the popular hair loss preventative medication known as Propecia (finasteride). Most patients with concerns have seen recent news reports, commercials, or magazine ads talking about the dangers of taking Finasteride. Since this is an effective medication proven to aid in the sustainment of receding or thinning hair, it is important to explain the facts in comparison with the rumors.

Early side effects (1 year)

The reported side effects based off of precise medical research for Finasteride at the 1-mg dose are uncommon and reversible. The one- year drug related side effects were over 1% greater than in the control group. The data showed that 3.8% of men taking Finasteride 1mg experienced some form of sexual dysfunction verses 2.1% in men treated with a placebo.

Most reported rumors center around sexual dysfunction occurring after beginning use of the medication, but there have been reports of sexual dysfunction that have occurred at later points in time. When studies were performed based through proper research methods, the sexual side effects were reversed by all the men who discontinued therapy, and in 58% of those who continued treatment. Once the medication was stopped, side effects generally disappeared within only a few weeks.

The initial studies done on finasteride for 12 months show that 1.4% of patients taking Propecia (945 patients) were discontinued due to adverse experiences which may have been drug related.

Here is the break down on the sexual side effect of finasteride in the patients who used it for one year only.

The men who continued using finasteride resolved some of the side effects in many cases. The resolution of the side effects was compared in the drug and placebo group. The incidence of each of the above adverse experiences decreased to ≤0.3% by the fifth year of treatment with Propecia.  This shows improvement of the side effects in the patients who took it over time.

In a study of finasteride 1 mg every day in men showed some decrease in volume to ejaculate of 0.3 mL (-11%) compared with 0.2 mL (–8%) for placebo in 48 weeks after beginning the treatment. Decrease in ejaculate was shown more significantly in higher doses (5mg) of finasteride which is approximately 0.5 mL (-25%) compared to placebo in ejaculate volume.  However, the decrease in ejaculate has been seen to be reversible after the treatment has been stopped.

In the clinical studies with Propecia, the incidences for breast tenderness and enlargement, hypersensitivity reactions, and testicular pain in finasteride-treated patients were not different from those in patients treated with placebo.

Long term side effects (up to 4 years)

Long term side effects of Finasteride were extensively studied in the Finasteride 5mg (Proscar) Long-Term Efficacy and Safety Study for 4 years in 3040 patients (1524 on Finasteride 5 mg/day and 1516 on placebo). 3.7% (57 patients) treated with finasteride 5 mg and 2.1% (32 patients) treated with placebo discontinued therapy as a result of adverse reactions related to sexual function, which are the most frequently reported adverse reactions.

Although the initial side effects of Finasteride has been higher than placebo over time the difference decreases to the point that in years 2-4 of this research, no significant difference between the two groups (treatment groups and placebo) was reported in terms of the incidences of impotence, decreased libido and ejaculation disorder.

The new study published in the Science Translational Medicine Journal has shown there is an association of prostaglandin pathways in hair growth.  The study was done at the University of Pennsylvania and was published in March 2012 by Catseralis et. al. which reveals a new pathway for balding.  This has the potential to be a revolution in the treatment of hair loss in the most common type known as male pattern balding (see link).  Dr. Catseralis and his lab team at the University of Pennsylvania are known for their work on hair growth and its association with wound healing.  They have done similar research to what we performed at Johns Hopkins on wound healing and hair growth.  Their work on discovery of wnt-pathway has proved a link between wound healing and hair growth and has been one of the milestones in the field of hair restoration.  His other work was published in Nature Journal in 2007 (see link).

The authors review the main cause of male hair loss as testosterone.  Although the authors announce that the real mechanism of androgens on male patterned baldness is not clear, they try to go deeper and find the main mechanism of male patterned baldness at the molecular level. The study shows that the enzyme prostaglandin D2 synthase (PTGDS) is elevated at both the mRNA and protein levels in men with typical men hair loss (AGA). It is also documented that the product of PTGDS enzyme activity or prostaglandin D(2) (PGD2), is elevated in scalp skin. The animal studies show that during normal follicle cycling in mice, the levels of those prostaglandins increase, suggesting an inhibitory effect on hair growth.

They showed that applied prostaglandin (PGD2) minimizes hair growth in human hair follicles that are planted in mice. Hair growth inhibition requires the PGD(2) receptor G protein, but not the PGD(2) receptor 1 (PTGDR).

These scientists have proven that prostaglandin in the mouse skin is associated with development of men hair loss, hair miniaturization, and scalp oil gland enlargement which are all hallmarks of male patterned hair loss. The study is especially significant because it introduces prostaglandins as a main player in inhibition of hair growth in male patterned hair loss. It suggests the prostaglandin related pathway as a potential target for treatment of common hair loss in men.

As announced before, the next webinar series will begin in less than one week. This event will allow patients and those looking to learn more about the science and art of hair restoration an opportunity to hear popular topics discussed by Medical Director Parsa Mohebi, MD who will be available for questions as well.

The last webinar featured 3 topics which are frequently asked about by persons wanting to know more on hair transplantation. The first discussion was “Hair Loss Psychology” where Dr. Mohebi spoke about the embarrassment some people experience because their appearance is lacking its former more youthfulness look. This situation is difficult for many people and Dr. Mohebi spoke about the different situations people speak of.

The second topic was, “Hair Transplant: How Does It Work” which explained the different options for a hair restoration procedure and what can be anticipated before, during, and after the surgery is completed.

The conclusion to the 3 lectures was “The Latest Technology In Hair Transplantation” which explained the updated and current methods in the world of hair restoration. New products such as the Laxometer, and popular surgical methods were discussed.

The next webinar is on Tuesday April 10th at 6PM. Dr. Mohebi will discuss 3 new and popular hair restoration topics. There will be a time for Questions and Answers as well as special incentives for joining. If you would like to be a part of US Hair Restorations next webinar and have a chance to personally connect with the staff please send an email to webinar@ushairrestoration.com or call (888) 302-8747.

In every organization there are leaders with great levels of knowledge and expertise. Often times those leaders get bogged down with the demands of their organizations which makes it difficult for them to personally connect with the people who they are trying to help. At US Hair Restoration, Dr. Parsa Mohebi wants to connect with all who are interested in the art and science of hair restoration.

Since the world of Hair Transplantation continues to expand each year, many have questions they feel are not being answered. Dr. Mohebi is continuing his webinar series for this very reason, where he will make himself available to those who have questions about hair loss or other related topics.

This next webinar will be happening live on April 10th at 6PM.  There is limited space so the quicker a spot is reserved, the better. To reserve a spot for our webinar, send us an email at webinar@ushairrestoration.com and we will send a confirmation reply.

Hair stem cell research is one of the most promising areas for hair restoration in the future.  Currently there are many advanced techniques for hair transplantation; however a long journey remains in order to provide hair loss sufferers with an unlimited source of hair, and stem cells might be an answer to this need.  In the past we have reported in our blogs of the newest advances in hair restoration through stem cell research from our own research and that of other centers.

A new article published in the Journal of Dermatology Science in February of 2012 sheds fresh light on the subject.   Authors, Dr. Chen and Dr. Chuong from Taiwan reported on the type of environment hair stem cells require in order to produce new hair.  Hair Stem cell circulation has been thought to be regulated by signals from the micro-environment which is close to them in skin tissue named the “stem cell niche”.

The authors proposed recent studies which reveal that there can be multiple layers of environmental controls. These environmental controls were reviewed using the paradigm of hair stem cells. This is because in order to properly observe and analyze hair growth, it is easier to see their regeneration pattern characteristic that occurs on a regular basis in different phases.

The duration of hair growth determines the actual length of hair fibers. We now know the generation of a new anagen hair is a result of the interaction between the two different stem cells in each hair follicle.  Hair stem cells located in the bulge of the follicle interact with signals from the dermal papilla to produce a new hair.

The activation of hair stem cells has been shown to be modulated by molecules secreted from the intra-dermal fatty tissue as well as other hormonal signals, immune reactions, neural activities, and the aging process. The general physiological status of individuals is further influenced by cyclic rhythms and changing growth periods. The interactive networks of these environmental factors provide new understanding on how stem cell homeostasis is regulated.

The authors also discuss the environments which are involved in order to make new hair.  My hope is that as we become more aware of the circumstances involved in hair growth and development, we can develop more practical ways to use advanced stem cell technology for hair restoration.  The optimal solution for hair restoration might not be through the multiplication of hair stem cells, however increased knowledge on the environment which hair follicles grow can lead to procedures that reactivate the existing hair stem cells that are progressing toward miniaturization and eventual baldness.  Many physicians believe balding does not permanently affect hair follicles; rather the bald follicles keep their potential to be reactivated and grow healthy hair. This is of course, as long as the right environment is provided for the hair follicles to grow.

Recently a patient contacted us here at US Hair Restoration wanting to know about shampoo and the effects it can have on hair loss. Here are the questions and answers in the order they were presented:

1) What kind of shampoo helps me the most and where do I buy it?
 
Although choosing the right shampoo can keep hair clean and add shine, shampoo cannot replace hair loss for individuals suffering from patterned baldness in either men or women.
 
2) Which shampoos should I avoid all together? 
 
As we discussed before, most shampoos only affect the hair shafts which are not the life component of hairs. Because of this fact, there is very little damage shampoos can cause.  Of course there are some chemicals which can damage hair shafts, which is a good reason to stay away from shampoos containing those bad chemicals.  However, most shampoos generally found in every day stores do not have those ingredients.  My regular saying to my patients is: “Do not stress too much about the shampoos”.

3) How often should I shampoo and use conditioners? Is conditioner a good thing? How about scalp cleanser? Or any other product you deem necessary for damaged hair. I have been using a product called “Biotin 24″, for last ten years, it is supposed to be all natural ingredients!
 
If your hair is oily you can wash your hair every day with shampoo.  Even more than once a day is okay if your hair is not dry.  Washing more than that may make your scalp dry and should be avoided, but if you do not have dry or sensitive skin, washing your hair once a day won’t affect you.  Scalp cleansers are mostly for removing the secretions of sebaceous glands and make the scalp dry.  Regular shampoos which have a certain amount of cleansers and the shampoos that are used for oily scalps might have more concentrations of those. 

Cleansers don’t affect the health of your hair.  You may find in some advertisements which claim cleansers open the scalp pores and help oxygenation of hair follicles. This is not true.  Hair follicles don’t obtain their nutrition or oxygen from outside.  There are many shampoos like what you mentioned with different ingredients.  These generally do not affect the growth of hair. For example it is stated that this certain shampoo has 22 amino acids to help improve the tensile strength of the hair.  The reality is that the necessary amino acids for hair follicles should be absorbed from blood stream and not from the surface of the skin.
 
4) Should I wash my hair as little as possible (I usually go to gym and exercise which makes me sweat, consequently I sometimes wash my hair twice a day) or should I keep my hair very short, to avoid it from falling off.
 
There is not a perfect regimen for washing your hair.  Washing too little cannot damage your hair and washing every day cannot hurt the growth of the grafts either.  As stated before, excessive washing may remove the necessary scalp moisture and oils that may lead to scalp dryness.  That is more problematic, but only if you have an already dry scalp to start with.