Hair Restoration Blog

Q:

Hello Dr Mohebi,

I recently read an article on the web that you commented on Harvard research for hair cloning.  I am in my early 40′s, fairly broke, and eagerly awaiting the day that hair cloning is successful and available to the market.  For the past decade, I keep hearing the same promises that it will arrive in 5 years, but still no luck.  Can you comment on why it is not here yet, and perhaps when we will see it.  Thanks in advance.

A:

Hair multiplication also referred to as “Hair Cloning” is a hot topic in hair restoration over the last few years it is garnering more and more attention.  The research for multiplying hair (hair cloning) has been going on for years now in several centers around the world over the past few years.  The study that we performed with collaboration with some scientists in Cedar Sinai is only one of the many steps that need  be taken to successfully multiply hair.

Hair multiplication would offer superior benefits to patients and represent a significant advance for medical science and hair restoration. Still the march towards this being a medical reality moves slowly for a several different reasons:

1.  Although hair loss has detrimental effects on patients’ lives, is yet to be recognized as a burning issue in medical field to warrant more funding for hair loss research.
2.  Hair multiplication studies are usually done in private setting without the support of larger institutions such as universities and NIH (National Institute of Health).
3. The growth rates of the hair stem cells are extremely slow in cell cultures.  That makes the overall period of hair multiplication timelier and adds exponentially to the cost of these studies.

The combination of above three factors and other obstacles in this process has made progress of hair multiplication very slow.  My best estimation of current research is that hair multiplication is probably at least 8 years away from practical medical application.  The reason for this is that any new medical treatment or device needs to go through different phases to obtain FDA approval for its use in the U.S.

The last phase necessary in development of a new treatment is ‘clinical trials’. The phase three is done on volunteer patients to find out more about long term complications that might be associated with the treatment. At this time no study has reached the clinical trials stage this makes it unlikely that we can have hair cloning available to public within the next eight years.

Today, technological advances in medicine have opened up new options in all areas of medicine. We have watched the evolution of glasses to hard contacts to disposable contact lenses to Lasik surgery. The benefits of these new procedures empowered many to change their destiny. People do not have to live with conditions like eye problems, obesity or baldness that strongly effects and influences their self-esteem and quality of life.

In my experience as a hair transplant surgeon many women will reject men only because they are bald; many others associate baldness as being less masculine. Now this is not true for all women, but certainly there is still a palpable negative social stigma associated with baldness.

I had the opportunity to study, research and publish on the psychology of hair loss and hair restoration. Today, we know that hair loss is a real concern affecting many men and women’s well-being  This is a social reality. More importantly it is fact that medically we now have amazing solutions for many types of hair loss conditions.

The advance in hair transplantation technology over the past decades makes available procedures like FUT, FUE for hair restoration procedures that provide natural and proven results. I say: why not use it? A lot of people are doing it, and nobody knows if their hair is native hair or transplanted hair. The key point here is: they are not bald anymore and they feel good about themselves. People with today’s natural and permanent hair transplants face the world happier and more confident people.

Here is what I recommend: Be yourself and do whatever makes your heart happy. No matter what you do with your life, there are going to be people who may not like it. It should not influence your decisions. If you think an elective surgery such as hair transplant can drastically improve your life don’t hesitate. Seek a professional consult from a hair transplant doctor. Let baldness be only a thing that our ancestors had to experience.

Q:

I have read online that Propecia can cause depression as a side effect. Some articles I read say it is a very rare side effect and others say it can occur in 75-80% of the time. Which is correct?  Thanks.

A:

The primary clinical trials on finasteride (Propecia) were conducted with a large number of patients over a period of 5 years. These initial trials did not reveal any evidence of depression in the participants. However, subsequently a few more recent reports indicate the possibility of depression occurring after taking finasteride.

A prospective study on 174 young men in 2004 suggested a higher chance of depression in men who used finasteride. The authors of the study concluded that finasteride might induce depressive symptoms. The recommendation from this study was that finasteride should be prescribed cautiously in patients who have higher risk of depression. This could be further underscored by the studies on psychology of hair loss and hair transplant in patients which notes alteration in self image and esteem and possibility of improvement of depression. The 2004 study emphasized that further clinical research is necessary to evaluate the behavioral effects of finasteride in higher doses in patients who are more susceptible to depression.

Based on the results of this study, we cannot suggest a percentage for depression in patients taking finasteride. Obviously, if you are experiencing mood disorders or any other symptoms while taking finasteride, you need to discuss it with your doctor for further diagnosis and treatment.

Q:

Dear Dr. Parsa Mohebi,

Exactly 2 years ago (2011), I was diagnosed with Oral Candidiasis (Candida Albicans, Yeast, Thrush. Till presently, I still suffer from Oral Candidiasis and oral hair growth. My gums get itchy to the point of comparison to poison ivy, & hairs which feel like multiple splinters in my gums.

In the beginning, my gums were so soft that they were literally piecing off. In the back of my left, last tooth it was so unbearably itchy and the skin became multiple white balls coming off the gum. It was biopsied for cancer, although I had expected that the results would have rather been that of a diagnosis.

Within the past 2 years, my gums and teeth have been suffering from this phenomenon. Within the past year and a half, I had a tooth extracted, which immediately after the anesthesia had worn off, began feeling like something sharp was inside the gum. The dentist would not fully examine it, and before I realized the extent of it, hair (some resembling nasal hair and stubble) was growing in, and coming out of my gums; increasing in numbers, forms and areas as time has passed.

Having gone to over twenty-five doctors/specialists, not one is knowledgeable, nor believes that anyone can have hair growing in the oral cavity.

Despite indeed this is a rare case, after reading your blog, articles, and speaking with you, I have the utmost confidence with your knowledge and expertise, that you will be of great help in solving this dreadful, debilitating health issue.

Thank you ever so much!

A:

Hi,

Growing hair inside mouth is an extremely rare condition but it was reported in medical literature in past as “oral hirsutism”. I have written a post on that in our blog in November of 2009 as Hair Growth in Woman’s Mouth. The diagnosis on that particular case was hyper-androgenism. Hyper androgenism is due to excess secretion of the male hormone (testosterone). Elevated testosterone could be present in some conditions like polycystic ovary disease or other endocrinology disorders.

In your case, you need a lab work to check your hormonal levels. Most importantly, the levels of testosterone and DHEA should be measured. If any of those hormones are elevated, further investigation is warranted to find out the reason for the excess hormones. Then your oral doctor should find the exact location that grows hair and try to remove the hair follicles.

There should not be any further growth of hair, if the elevated hormone is treated and after the hair follicles are removed. Thank you for sharing with us your condition. I hope this condition gets treated completely soon.

Hair stem cell and its role in future of hair restoration has been a hot topic in recent years. Hair multiplication also referred to as hair cloning is a process of culturing cells responsible for development of hair follicles. This is necessarily done by generating new hair in refined laboratory conditions.. The concept is that then those hairs manufactured hairs could then be transplanted for hair restoration purposes. It is easy to understand how success in the area of Hair Multiplication would be another quantum leap in hair restoration. People affected by patterned baldness could have the stem cells of hairs from their permanent zone multiplied for hair transplant.

A new article was published in e-Publication Development by Chi W. et al. This article reviews a critical stage of hair development regarding which one of the two hair stem cells is most important for size and shape of new hair.

Dermal Papilla (DP)

Dermal papilla (DP) develops a new hair. The DP is located in the hair bulb. Dermal papilla’s interaction with stem cells from the bulge area leads to generation of a new hair. Laboratory tests on mice indicates that the number of DP cells in the follicle correlates with the size and shape of the hair produced .

The study of mouse model allowed for selective ablation of DP cells in-vivo. The result of the study demonstrates that

• DP cell number dictates the size and shape of the hair.
• DP cells help develop hairs of different sizes or types.
• The number of DP cells plays a critical role in the size of hair shaft that will get developed.
• DP cells play an important role in activation of stem cells leading to the formation of new hair shafts.

These scientists also observed that when the number of DP cells fall below a critical threshold, follicles fail to develop new hairs. Based on this new development, it is easy to understand the mechanism of degeneration of hair in hair loss situations in relation to a drop in the number of DP cells.

Reference:

Chi W, Wu E, Morgan BA. Dermal papilla cell number specifies hair size, shape and cycling and its reduction causes follicular decline. Development. 2013 Mar 13, http://www.ncbi.nlm.nih.gov/pubmed/23487317

Innovation in Hair Loss

Hair loss continues to be one of the leading medical cosmetic concerns among men and to a lesser degree for women. Modern hair transplant is a proven natural solution and continues to benefit many people. Follicular Unit Extraction (FUE) is growing in popularity and can offer a unique solution to some individuals with limited donor hair.

Many men today are opting for shaved or ‘military type hair styles where the entire scalp and hairline frames the face with closely cropped ‘stubble’ hair. A person with limited donor hair can be a prime candidate for this safe and less invasive hair transplant procedure.

Hair Transplant Surgeon Can Combine both Techniques

Skilled hair restoration surgeons can take individual follicular units (FUs) and create the maximum balanced coverage over the scalp. They can then create further ‘look of density’ by simulating hair stubble with scalp micro-pigmentation (SMP).

SMP is a procedure where special surgical needles are used to inject dermal pigments into the scalp or other areas such as eyebrows into the skin. The color of pigment selected is close to that of the patient’s hair resulting in a cosmetic hair shadow. SMP is a safe and very non invasive procedure.

Combining FUE and SMP to resolve the challenge of hair loss for people with little alternatives and represents an advancement in modern hair restoration. This solution is not for everyone but is a welcome choice for some people who previously had limited alternatives to resolve their hair loss problem.

Testosterone therapy is used more commonly in recent years in women for treatment of a variety of conditions.  Based on the evidence of current studies, it is reasonable to consider testosterone therapy for a symptomatic androgen-deficient woman with Women’s Sexual Interest and Desire Disorder.

Q:

Doctor Mohebi,
I have heard having an orange a day keep your hair healthy and may thicken your hair.
Is it true?

-

A:

Taking an Orange a Day is a good healthy habit. In fact, taking any fruit on a regular basis can help get reasonable amount of fiber and vitamins depends on the type of fruit you are taking. However, there is no scientific reason that prove taking Orange can help your hair loss condition. There is no active hair loss component in orange that makes it an exceptional fruit for hair loss treatment or prevention.

If you have hair loss, you need to see a hair specialist and get started with a macro and microscopic evaluation of your hair. Your doctor may need to prescribe hair loss medications that can help slow down your hair loss condition.

Thanks,

Follicular Unit Extraction (FUE) and Slap Micro Pigmentation (SMP) could be both used to minimize the visibility of the scalp scars after a strip hair transplant procedure.  At US Hair Restoration, we offer both these techniques.  However, there are pros and cons to each that the patients need to know before proceeding with the procedure.

FUE for Scar Revision

FUE transplantation into the donor scar: Left side - Intact scar, Right side - FUE grafts transplanted into the scalp scar

Since the extraction of individual follicular units (FUs) is done individually it is perfect for the small procedure of revisioning a hair transplant scar from a previous hair transplant. The surgeon can extract a small number of grafts from the permanent zone and artistically and strategically place them in the scar. This process of using FUE uses hair to obscure and blend the margins of the scar to the surrounding scalp.

SMP for Scar Revision

SMP to minimize donor scar visibility after hair transplantation - Picture is taken immediately after the SMP procedure

Scalp Micro-Pigmentation is the process of using special pigments and fine needles to create the shade of stubble or shaved hairs on the scalp. SMP utilizes dermal pigments that match the patient’s hair color. Used in scars like FUE it can artistically applied revises the margins of the scars. This revision results in the obscuring or blending of the scars margins to the surrounding scalp.

SMP vs. FUE for Scalp Scar Revision

choosing FUE rather SMP for revising the scalp scar has to do with the type, location and size of the scar.  It also has to do with the patient preferences.  If patients are willing to keep it very short or they want to completely shave it.  It is good for the patients to educate themselves with pros and cons of each technique in order to make a more informed decision.

FUE and SMP

FUE and SMP are two methods that can also be used in conjunction with one another to revise a hair transplant scar. Recommendations and the preference of the surgeon most often provide the best results. These modern advances in scalp scar revision are performed in Los Angeles leading hair transplant centers like US Hair Restoration.

Q:

I started the hair medication finasteride. Will this help stop me losing more hair? I was concerned that if you restored my hairline would I need to do another surgery in years to come if my hair continues to thin and fade behind where the restoration was done? There are many stories on the internet of people that have had multiple surgeries (other doctors) and they are still not satisfied so I just wanted to take the opportunity to gather as much information and ask the appropriate corresponding questions so I can make the most educated decision.

A:

While reviewing your miniaturization study (the microscopic evaluation you had in our office), it indicated that you have some hair loss activity on the top areas of your scalp as well, but it is very minimal. If you continue using medication, your hair loss will range from none to very minimal in the next few years. One hair transplant procedure in combination with medical treatment with Propecia (finasteride) can maintain your look for many years to come.