Hair Restoration Blog

US Hair Restoration sees hundreds of Hair loss patients each year. Many people find seeking treatments for hairloss to be embarrasing and prefer to keep them confidential. Every now and again there are individuals who are confident in overcoming any social taboo’s about hair replacement, and let others know about their new found joy and are excited to share how their lives changed because of new hair growth.

Recently, one such patient shared his new more youthful look with the world and was happy to let us know of his actions. We are pleased whenever we get to share our art and science of hair transplantation, but when an individual goes out of their way to do something we never asked or imagined, we take pride in knowing we changed someone’s life. We want to say “Thank You” to this individual for:

Allowing us the opportunity to make a difference in his life
AND
Letting others know there is a solution for balding!

 US Hair Restoration always appreciates when individuals spend time on their own to let others know about their satisfied results, and we are happy to share them with others. We encourage our patients not to feel ashamed about recieving a hair transplant, but rather accept the fact of baldness being a reality for many which today has natural, lifelong alternatives. People always feel better when having a solution to any common problem, and we are happy to be available as one of those solutions!

Q:

I went to a couple different hair transplant doctors for evaluations when I was 24/25 and was told I have a juvenile hairline and that i have a good donor area and scalp laxity. The doctors recommended around 2000 grafts to fill in the diffused area at the time.

One of the doctors I visited told me to give propecia another try which I did for an additional six more months, but stopped because it seemed to have no effect and from my understanding it doesn’t really help with hair in the frontal area which was my main problem. I also did not want to risk getting any more health side effects from taking propecia.

During this time I was also taking biotin supplements which I had read are good for hair but they didn’t have any noticeable effects. I decided against getting a hair transplant because of my age and I wanted to see if the hair might grow back naturally (some people who have lost hair from accutane reported regrowing their hair several years after taking the medication).

I have a history of MPB in my family but it seems to be hit or miss. My grandfathers both had full heads of hair, my dad and 1 of his brothers are completely bald but another brother has a full head of hair. My mom has 1 brother who is bald and another with very thick hair and a low hairline (which my hair most closely resembled before taking accutane). I also have a brother who is 21 and has extremely thick hair like I used to with no signs of hair loss whatsoever.

A:

Male patterned baldness (MPB) is a progressive condition and it generally won’t get better without treatment.  The medications that are being used for the treatment of hair loss are generally for maintaining your existing hair and have preventative effects rather than restoring your hair at its full thickness like what you had in previous years.

A good hair transplant surgeon can help you realize what the best options for hair restoration are; whether it is a surgery or medication.  Using Accutane could cause hair loss as one side effect, but that is reversible within a few months after stopping it.  That is the most common case for medication related hair losses.

It is important for you to develop a good relationship with a qualified hair transplant surgeon whom you can trust.  Then let him walk you through this process.  Using medications for a while is a good idea and some patients respond well to using them.  Unfortunately the results are not permanent and most hair loss sufferers continue losing hair, but at a slower rate.  

You can use medications such as Propecia or Rogaine to minimize the speed of hair loss. When it is the time for a hair transplant you can consider that as another option as well.

Q:

My doctor put me on propecia at 21 when I told him about the hair loss and I took it for about six months but it had no effect on my hair loss. I also started to use rogaine around age 23/24 for a couple of months but stopped because it made my hair loss worse (before rogaine the majority of my hair loss was in the front area of my head and after using rogaine I started to lose hair on my crown as well). My hair loss has been pretty stable over the past 2-3 years and I have continued to lose some hair but nowhere near the amount I lost initially.

I wash my hair every 2-3 days and only notice about 20-30 hairs lost compared to the hundreds I lost early on. My hairline has not really been effected at all and my hair loss doesn’t seem to match any on the norwood scale, it is just diffused loss throughout and matches the description of many accutane users who have lost hair. I have also been using the ProThik concealer spray for the past 3 years which works great because my hair loss is diffuse and makes it unnoticeable, but the process of applying it in and combing through it causes my hair to get tangled and pulled out so I think over time that has also contributed to my hair loss. I lose far more hair putting in the concealer than I do washing it and combing through it naturally.

For the first 2 years of using it I would wash my hair and re-apply it daily, although over the past 6-8 months I have gone 2-3 days between washing and reapplying it and only lose 10-20 hairs when I comb through it in the morning. I am not sure how much of my hair loss in recent years has been caused by this but I suspect that is has had some effect, especially during the time I was applying the concealer every day.

A:

Many young hair loss patients may start taking finasteride or minoxidil when they see the signs of active hair loss in their early 20s.  That is the time most people lose hair at its maximum speed.  Medications such as finasteride or minoxidil are only to prevent hair loss or even in some cases slow down the process.  They are not to bring your hair back to where it was before you started the process of hair loss.

I recommend you visit a hair specialist who can perform microscopic evaluation of your scalp (miniaturization study).  That can give you more information about the type of your hair loss and the treatment methods. Having regular follow up visit with your hair doctor helps you to know whether or not your hair loss medication works.  You may also need a hair transplant when the time come and the time and type of the restoration surgery could be discussed with your hair transplant surgeon.

Q:

Hello. I am considering getting a hair transplant and had some questions for you. I am 27 years old and began losing hair around age 21 immediately after using the drug accutane. I was on a very high dose and took more than the recommended amount during those couple weeks because I thought I would get better results. Within 3-4 weeks of starting the medication I lost an incredible amount hair. After losing the hair I read online that hair loss is a possible side effect of accutane and stopped taking it immediately . My hair went from being as thick as possible (my barber would using special thinning scissors because it was so thick) to being able to see my scalp within a month. The hair loss started in a diffuse pattern about 1-2 inches above my hairline and initially the affected area was about the size of my hand. Over the next 6-12 months I lost a ton of hair and was probably shedding a couple hundred hairs a day. I also had a burning sensation on my head for several weeks after I stopped using the medication. The shedding gradually slowed down over time but the hair I lost did not regrow.

A:

Many medications like Accutane may have hair loss as one of their side effects.  If your hair loss was only because of the use of this medication, it should have been improved after stopping it.  You  started losing your hair at the time that most people show early signs of Male Patterned Baldness (MPB).  Being on Accutane may have accelerated the pattern that you were supposed to develop, but probably was not the only reason for your hair loss.

Alopecia areata (AA) is a type of local hair loss due to autoimmune reaction of the patient’s body against hair follicles.  Alopecia Areata generally presents as circular coin shape hair loss lesions, but it can progress to involve larger areas of the scalp (Alopecia Capitis) or even the entire body (Alopecia Universalis).

Several treatment options are recommended for inducing hair growth for treatment of alopecia areata. Some patients may recover spontaneously over a period of time; because of this patients should be evaluated and selected carefully.  It is important that the options to forgo treatment are reviewed with the patients, as well as discussing the high failure rate of all the various options available.

Most people who have hair loss on the hair line prefer to treat this condition more aggressively with a variety of medications.  The chance of spontaneous recovery appears to be more in patients who have smaller and fewer hair loss paths.

• Topical Steroids

Topical steroids for treatment of AA has been widely used with little evidence of success.  They are easy to use and more affordable to many patients. However, the current lack of evidentiary success does not make this a valuable recommendation for patients.

• Local Injection of Steroids

Infiltration of long acting corticosteroids into the AA lesions has been studied with some degree of success.  Patients with smaller lesions of alopecia areata may respond better to local steroid injections.

This type of local injections of steroids is most desirable for limited lesions of cosmetically sensitive areas like hair lines and eyebrows.  The most common used medication is Triamcinolone acetonide (5-10 mg/mL).

• Systemic Steroids

Systemic treatment with steroids may stimulate hair regrowth in a limited number of patients.   Continued use of steroids is generally needed in most of these patients to maintain the level of hair growth.  Pros and cons of long term use of steroids should be discussed with these patients before initiating systemic steroid therapy.

• Topical immunotherapy

Topical immunotherapy utilizing allergens has been studied and proven to have some success in patients. The protocol for contact immunotherapy using DPCP has been recommended. Continued use of DPCP is needed to keep the skin irritated for a long time.  The inflammation seems to be able to change the progress of immune reaction that causes hair loss in alopecia areata.

Treatment should be discontinued only after full regrowth is apparent.  This can take an indeterminate length of time, and during this period patients may have to tolerate inflammation of the skin.  A high rate of relapse after discontinuation of treatment makes this option less desirable for most hair specialists.

• Other treatments of alopecia areata

Other medical treatments such as phototherapy, photochemotherapy, minoxidil and dithranol  have shown limited improvements.  Finally patients with extensive stages of hair loss with no response to treatment options may use wigs or hair systems.  That is more desirable for many women with extensive hair loss due to alopecia areata that are having zero to minimal response from any other treatments.

Q:

Hi Dr Mohebi,

Can you tell me your opinion on products like iGrow (low level laser therapy).

Thanks so much,

A:

Hello,

Unfortunately, there has been very little research done on different types of laser treatments for hair restoration and most studies are done in small numbers, lacking significant results.  As you already know there are a variety of devices such as laser combs, hoods, or brushes, yet most of these do not show significant improvement like I continue hearing from my patients who used them before. In spite of all this, I have heard a growing number of hair specialists talk about how they are seeing good results from the Laser Cap.

It seems like the best candidates are people with generalized hair thinning, as in typical female patterned hair loss.  Laser cap treats entire scalp with 224 individual red 5mw – 650 laser diodes.  This is much more coverage than the comb or other hand held laser devices offers.

I reviewed your file and based on your microscopic evaluation from 3 years ago you might be a good candidate.  However, I would like to evaluate your current condition with another microscopic evaluation.

Q.

Hi Dr. Just got back from my vacation in XX, had a good and relaxing time. While I was gone for 2 weeks all the scabbing from my hair transplantation is pretty much gone in the donor scar and the implanted areas. Also I noticed that I did lose hairs as you mentioned would most likely happen. the hairs that fell that looked like the grafts were just the hair shaft that I saw fall. I did not see skin attached to the end of the hair shaft so I assume the follicle survived in the skin where it was implanted. not all have fallen but I did notice a good amount. I also notice small dark hairs sprouting in the implanted area. I assume these are coming from where the originial grafts shed?
 
Its almost a month post op and I feel no pain and have all feeling back on my scalp. I pretty much wash and style my hair as usual.
 
Is all this normal progress after the surgery?
Thanks.A.

It is good that you had a nice vacation! 
 
One month after hair transplant surgery is the general time which you should have lost most of your transplanted hair shafts.  The follicles are now part of your scalp and will be growing new hair in 2-3 months.  Your inflammation should be subsided on both the transplanted and donor areas.  Minor itching might be noticed at this time which is a good sign of the scalp wound healing.  You may have lost or will soon lose some of the bulk of your existing hair due to the shock loss.  Using finasteride can significantly minimize it.  You will be noticing new hair growing in 2-3 months from now and the hair shafts will continue getting longer and thicker till about one year from the time of your hair transplant.

As with all New Year’s celebrations come new resolutions for the next year to be the best one yet! In spite of the predictions for the world to end according to the Mayan calendar, we at US Hair Restoration plan to be here long after 2012, and have developed some very exciting plans for the future.

The most exciting news for the turn of the New Year is our expansion to the two new hair loss treatment offices in Santa Barbara and Bakersfield  . We will have these brand new locations, which will utilize our newest hair transplant technology through the expansion and use of our new assisted telemedicine system.

There has been a growing trend for hair transplantations throughout the world as per ISHRS newly released stats, and we have noticed many of our patients commute from Bakersfield and Santa Barbara. It is our aim to ease the pressures which come from the time and resources needed to travel and thus, we will meet our patients where they are.

Our Santa Barbara Hair Transplant Office serves the city of Santa Barbara, Ventura County, Oxnard and northern cities of San Luis Obispo and Santa Maria. Our Bakersfield Hair Loss Office can serve residents of Bakersfield, Lancaster, Visalia, and Fresno.

We are excited for this new venture and look forward to all that comes in 2012 and beyond!

Here is our recent instructional Scalp Exercise Video which is to be done at home prior to a Hair Restoration

It is very important to do these scalp exercises prior to a hair restoration procedure as it increases the laxity needed for the Follicular Unit Transplant (FUT) strip method. When the skin laxity on the back of the head is increased, the size of the donor strip is also increased and more hair grafts can be transplanted in one surgery as well as receive minimal scar results. This pre-operational exercise has helped to move the hair restoration industry forward into having larger one-time procedures which has helped to save time and money for both the patients and physicians. Taking the necessary time to properly do these will help to bring about the best possible results.

Q:

Is my donor area thick enough and did I have any signs of miniaturization there? Most men I have seen that are bald on top have a much thicker back area of their hair that is not affected by mpb than I do. From your experience and knowledge is it good enough not only to be used as a donor now, but also in the future if I need to cover crown or do any other procedure. It seems to me that my hair is too thin in the back to conceal a scar and that it might possibly thin out a lot when im older. But I’m not a professional so please give me your opinion and insight. The scars all look thin enough for contentment but its when you dont have hair growing around it making it look like someone scrapped a bald line in the back of your head with a hair cutting tool.

A:

When I reviewed your microscopic exam I found it to shows you have only 10% miniaturization in that particular area.  Less than 20% hair miniaturization measurement is within normal range for someone with male pattern baldness (MPB). As we discussed before, if you keep your hair the same length as during your consultation, you should not be able to see the scar. We perform double edged trichophytic closure for most patients which minimizes the visibility of a scar even when you decide to keep your hair very short.