Hair Restoration Blog

International Society of Hair Restoration Surgery (ISHRS) has done a nice work on its website.  The organization that is the most prestigious organization for hair restoration surgery has challenges people for the differentiating a transplanted hair to a natural head of hair without any hair restoration surgery done.

The site requires you to take a survey to see if you can detect which of the people in the photos in the site have had a hair transplant and to determine how important hair is to you. The survey will only take about 5 minutes to complete. Here is the questionnaire.  By responding to the hair transplant challenge survey you can help to add to the knowledge about hair loss and hair restoration surgery.

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Q:

We discussed the possibility to close the scar, which I think is a good idea, but again, I had already achieved camouflage with longer hair. While it may only be a 2-hour operation, I admit being very weary of such an operation because my skin is already so tight. I understand that the skin exercises you recommended should help a great deal, but for whatever reasons I am not comfortable with such an operation, especially considering that I would like to cover the whole head with some hair anyway. Perhaps you will convince me on the scar revision, or maybe you will advise me to pursue the FUE plan which would cover the rest of my head. Assuming I have an “average” density in the donor area, how many grafts do you think you could extract from it? How good or bad would be the mini-scars scattered all over the back of the head? I am assuming the surrounding hair will camouflage them?

A:

If you don’t want to pursue scar revision, the only option will be an FUE transplant into the scar from neighboring areas.  I recommend for you to wait until we see you in your follow up visit with a little longer hair before continuing. You also need to schedule for the FOX test to determine your eligibility for a Follicular Unit Extraction procedure.  The answer to your questions about how many grafts could be harvested in one session of your FUE procedure will be answered the day we do FOX test and confirm your eligibility.

You need to contact US Hair Restoration to schedule the FOX test as soon as you are able.  FOX test’s are done quite easily and assisted by numbing a very small area on the back of your scalp. The small scars of the FUE are going to be scattered throughout a larger area.  That can minimize the visibility of those pinpoint scars.  If you keep your hair not too short it is generally not possible to see them at all, but with a shaved head the tiny scars might be detectable from a close view.

I visited a 30 year old patiet for a hair loss consultation a while back who believed he lost his hair due to having too much sex.  The fact is that most patients attempt to find a reason for rapid loss of hair in the early stages.  Thas is often the same age that they are most active sexualy.  The combination of the two may convince them that they may have lost their hair due to having too much sex in those years.

These people are not the only balding peole who try to find an environmental situation and blame it for their genetic balding problem.  Many people blame their partner, bad relations, stressful situations and other significant events in their lives for their hair loss.  The reality is that gene, sex and time are the only major contributors to male or female patterned hair loss and environmental factors only may accelerate the presentation of the hair loss.  Normal people without balding gene may lose hair for different reason, namely stressful conditions, but the hair always grow back when stressor is gone.   This is not the case for people who have the gene of hair loss that may never grow their back what they lost after losing it due to stressors.

Q:

Hi Dr.,  I saw your TV show, and would like to ask you if it is ok for me to buy minoxidil and dissolve it in the shampoo?
Also there are products that says gradually will change the color of my hair to natural color, are they safe to use? wouldn’t they interfere with my scalp respiration?

Thanks a lot

A:

Minoxidil mixed with shampoo

Minoxidil is one of the FDA approved medications for balding prevention and hair loss treatment.  The recommended dose and method for its use is applying it topically on balding area twice a day and leaving the product without washing it off.
Although combination of minoxidil with shampoos are available commercially, I don’t believe you can get a complete result by using them because:
1.    Minoxidil would be diluted with shampoo and water and that will reduce its strength.
2.    The active ingredient (minoxidil) would be rinsed and it would not get enough time to have contact with the scalp skin.
3.    It would be less likely that it is used twice a day, which is the recommended method for its maximum result.

Hair product for white hair

To answer your second question, there are many products that are claimed to change the color of white and de-pigmented hair to a normal one.  Most of them are herbal extracts and there is just not enough long term studies that prove their safety that I am aware of.

According to a recent L.A. Times article, people in our current economy are scaling back on elective cosmetic treatments, and finding ways to negotiate costs and figuring out what’s really necessary (e.g. Botox) and what’s not (e.g. massages and body scrubs).  We have posted on Recession and hair transplant cost before.

US Hair Restoration understands that people have found themselves in challenging economic circumstances. Our goal has always been, “offering quality hair transplant for everyone”. We want to relieve the pressure on people by responding to patients’ needs for more affordable hair transplant prices.

Every year, we have a summer hair transplant special, but this year, we’re going to offer it several months in advance as part of an unprecedented and huge hair transplant cost reduction. And we promise it will be the lowest price ever for our hair transplants using our standby program.

For those who are seriously considering getting a hair restoration procedure, the best time to get one is when we have this reduced-price offer. This is a limited offer and the price might not ever be this low. Now is the time to take advantage of it.

Offering hair transplant cost discounts in our standby program helps us to fill all openings in our operating room schedules. On the other hand, for those people who can be a bit more flexible with the timing of the surgery, it helps them get a US Hair Restoration-quality hair transplant done at historically low rates, at one of our Southern California offices: Beverly Hills, Encino, and Orange County.

The bright side to the recession is that retailers and companies are offering lower-than-usual prices for their products, knowing consumers have become increasingly tight-fisted about their cash. Our earlier-than-usual summer special is our way of saying we are sensitive to our patients’ financial circumstances.

Check US Hair Restoration for more info on our hair transplant promotions.

Q:

hey doctor:

is it true i can lose hair by wearing a baseball cap a lot of the time? if that’s the case, then i guess baseball players are good candidates for hair transplants! =P. but really, is there any truth to that? I read that it doesn’t have an effect on a person’s hair, but i wanted to verify with an actually hair loss doctor.

A:

We can lose hair due to environmental trauma to the hair shaft and, consequently, to the hair follicles. The name of this condition is traction alopecia; it can be seen when people braid their hair very tightly. One type of traction alopecia is called turban alopecia, for people who wear turbans on their head for long periods of time and when they wear it tightly. Baseball caps are regularly used by people, and I have not seen it in those people who wear them. However, you can guess that a tight cap of any kind may mimic the turban effect and may cause traction alopecia in which hair follicles are being pulled over time, which destroy them eventually.

Q:

I’ve been using 5% topical minoxidil in liquid form for five months and see some positive results (I think) but I have two side effects:

1) itchiness–it’s mild, I can live with it

2) a crust forms that’s dry and I can pick it off, little dry flakes–that is.

Questions are simple:

1) Can/should I still use it?

2) is the foam better to avoid these symptoms?

3) Is there an inexpensive hair conditioner or shampoo I should use? Appreciate your feedback/thoughts…thanks

A:

1) Can/should I still use it?

Minoxidil use is lifetime in most cases. If you stop using it, you may lose the hair which grew from its effect. This is called shock loss and many people experience it when they get tired of minoxidil use and stop it after using it for a few years.

2) Is the foam better to avoid these symptoms?

To avoid the itching, the foam is better based on reports I am gathering from my patients who tried them both.

3) I am not aware of any conditioner and shampoo that can be used to help the growth of hair. There are some shampoos with active ingredients such as minoxidil. However, they efficiency in comparison to minoxidil topical solution is questioned.

Q:

Hey Doctor Mohebi,

I was wondering, I’m thinking about getting a hair transplant, but I’m afraid of telling my future wife and female friends that I’ve had a hair restoration. I know men may not care that much, but if I’m dating someone and eventually I tell them I’ve gotten a hair transplant, I fear that they may get turned off.

I kind of look at it like plastic surgery. I know when I meet women who has undergone a nose job, I kind of feel strange about it and think maybe that person was not happy with their looks.
To be honest, it  turns me off.

So, my question is: from your experience with patients, do they keep it a secret from others or do they not mind telling people?

A:

Today, we have capabilities we did not have 50 years ago. As a young soccer lover, I used to have the disadvantage of wearing glasses.  It was very difficult for me to stay competitive in succer team without wearing my glasses.  Every now and then, I use contact lenses to be able to put aside my glasses. I am planning to get a LASIK procedure for that as well.

If I undergo a LASIK procedure, does it make me an insecure person. Not at all. I call it using all your resources to look your best.

We do have technology that we did not have 10 years ago. I say: why not use it? A lot of people are doing it, and nobody cares if these peoples’ hair is native hair or transplanted. The point: they are not bald any more and they can be as competitive as their non bald rivals in life.

One time, I met a very beautiful woman at a party and I ended up having a conversation with her.  When I told her I do hair transplants, she told me a story about someone who proposed to her and she rejected him. She said the man was bald. But I’m not saying because he was bald that he got rejected, but because he did not do anything about it. I know the argument can be made that what the woman did is sad and superficial but, hey, looks do play a part in initial courtship, whether we would like to admit it or not. And it was her prerogative to make that decision.

My point is: 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.

Q:

Hiya Doc,

I’ve read in a book on hair loss that mentioned, in certain circumstances, hair loss can be caused by emotional or mental stress. I’ve started to lose a bit of hair, but I’m really hoping it’s only temporary, as I don’t think I have genetic hair loss because my two older brothers seem to be doing OK.

How common is it for hair loss to be caused by emotional distress?

Thanks,

A:

Many hair loss patients who come to me for their initial hair loss evaluation associate the beginning of their hair loss to some stressful event in their lives. Many say they notice hair loss when they moved to another city or different country, got divorced or had significant problems at work or in their personal lives. Usually, they are right as these types of evens can accelerate hair loss.

However, hair loss would not happen to these same people if they were not genetically predisposed to balding. In other words, at age 30 and after, we may have the hair loss gene which is supposed to cause balding. At age 30 or after, if we are involved in a stressful situation, an emotional traumatic event, or major surgical procedure, it can accelerate the hair loss process. So the loss expected to be seen in 10 years could come around sooner.

Stress, trauma, or major surgeries may cause hair loss in people who are not supposed to lose hair, but the condition is temporary and the lost hair will grow back after the passing of the stressful condition, or treatment of the medical condition.

In these cases, patients have a condition called telogen effluvium in which, due to stress, a significant number of hair follicles go to sleep. Remember: patients do not lose those follicles permanently and the follicles can produce new hairs in just a few weeks.

My recommendation for you is to see a hair specialist and get your hair miniaturization mapped by microscope; this way the doctor can tell you whether or not you are experiencing an early stage of patterned baldness or that you have lost your hair due to stress.

If your baldness has just begun, medication may help you. If you are experiencing telogen effluvium without being predisposed to pattern baldness, you only need to wait and your hair will grow back in a couple of weeks.

Q:

hi

I come from china ，I would like to consult your organization a few questions:

In your experience,usually Asians（chinese people) the normal growth of the number of roots Per cm² of hair? Head at the top and post-occipital whether there are different?
using FUE technology，on one operation ，After the occipital Site  get the maxinum number of FU (Asians including 2-3 days operation) at present,how much FU can be planted per square centimeter on Planting area? Between the scope of? and the percentage with normal?

Looking forward to your reply Details!

Thanks for your questions.

A:

Here are the answers in the order they were received:

The number of hair follicles

The number of hair follicles in non-balding areas of scalp like occipital areas have been studied.  A range of 80 – 120 follicular units (FUs) per centimeter were reported. The density of follicular units vary in different locations of the scalp. Also, the number of hairs per follicular unit vary in different areas and with different races. For example, Asians usually have less number of hair follicles per cm², so even with similar number of FUs per cm², the density of their donor area is still less than Caucasians. To calculate the number of hair per cm², you have to average the number of hairs per FU and multiply it by the number of FUs per cm².

Difference of hair on top and back

The shaft of hair may or may not be different in different areas of the scalp. Obviously, if you are balding, you see more miniaturization and less terminal hair, which makes the appearance of the hair less dense on the area. However, without baldness, hair quality would be the same in back and top of the head.

FUE and number of grafts

FUE (Follicular Unit Extraction) is more labor intense and requires more time for harvesting the grafts. For that reason, FUE procedures are generally smaller in terms of the number of grafts per session. What we do at US Hair Restoration is up to 1,500 grafts per day on average, for 8 to 10 hours work in a FUE procedure. The number may occasionally go up to 2,000 grafts, too, but not everyone can expect to get that number with FUE.

Density of transplanted hair

There are many research projects on this topic. The number can be as high as normal density in some circumstances. However, practically we can make up to 35%-40% of the normal density in one session. This is a good number if you consider that the density of hair on frontal areas could be about half of the hair on the donor area in some patients, so 35%-40% is not that far from the normal density in those patients.