Are scalp transplants possible, to change your hair type? I have african hair type and I want caucasian hair type. Is that possible?
Relaxing the hair is not a medical issue, but a styling issue. There are people in the styling industry who perform such treatments regularly. There is no way to change the way the hair grows out.
K doc, I know balding is damn near inevitable. I was wondering, do you encourage a specific diet to help nourish hair? For example, do you want us to avoid certain foods that is bad for our hair or eating a certain food (not drug) help promote healthy hair?
If you are in a civilized country with any reasonable diet, there should be no impact on your hair one way or the other. A poor diet is one that may be deficient in vitamins or calories. Any weight loss of a significant degree can produce hair loss, particularly if it is rapid or chronic.
What’s the difference between losing hair and hair breakage? If there is a difference,which are the causes of hair breakage and the possible treatments? Thanks for your time!
Hair breakage means that the the hair shaft has been broken, leaving the hair shorter and at times with split ends. There is no actual loss of the follicle/root. You will have new hair growing out continuously on the part of the hair that is emerging from the scalp. Hair breakages occur when the hair gets too long, too dry, is traumatized by vigorous brushing, or damaged in the management of grooming. Breakage can be also be due to chemical dyes or treatment, excessive blow drying , or the force of pulling the hair shafts apart from any rough handling.
The definition of hair loss means that the root/follicle disappears or become so fine (miniaturized), that it effectively has no bulk associated with it.
I am aged 23 years old and i am a African American. My hair is long to some sort. It falls to my mid upperback. But i have one problem, its thin. I do not have full thickness and on each side is thin as well. I have never dyed it but have used perms. I may perm 3 times a year about every 4 months. I tried hair thickness oils and all the hair volume supplies u will find in a beauty supply store. What can I do to receive full volume and to cease the thinning on the sides.
The things you are doing may be damaging your hair and causing hairs to break off, making the bulk appear less full and giving the appearance of a finer, thinner hair shaft. The more you treat it and abuse it, the worse it will get. There are hair thickeners that will cause the hair shaft to absorb water, making it appear thicker. Check with your hair stylist for recommendations. This is not a doctor problem.
Stress comes in all flavors including work, school, growing up, relationships, divorce, death in the family, illness and so on. I even found this one thanks to Google News, which connects infidelity with hair loss:
Hi there. I am a 25 year old UK doctor (straight black hair/olive skin). I first noticed hair loss about 4 years ago. It has progressed at a slow rate. I have not receeded at all but am a diffuse thinner – the main areas are at the front-top of my head (about 1.5 cms behind my adequately thick frontal hairline) and also at the crown.
My hair looks quite thin in these areas when wet (with very visible scalp) but if I blow dry my hair and wear it choppy/spiky/drawn towards the middle, it still looks good and my friends/family don’t think I look bald. I started propecia (with full compliance) 2 years ago with a good result – pretty much halted hair loss and possibly even grew back a little hair in the thinning areas.
However, over the last couple of months I have started to thin a bit further in these areas. I am considering buying a laser comb. (Not keen for topicals).
My questions to you are:
1. I know the laser comb currently has no FDA approval for hair loss but does have good(ish) reviews – do you think it is the most logical next step or should I go for minoxidil?2. Transplants – (which I realise would be a bad decision at my current level of hair loss): It sounds like for a successful transplant I will have to endure a period of going almost entirely bald first in order to assess what needs filling in and to avoid just losing original hair around the transplants over the following years – is this true or can you transplant around thinning hair?
Thanks
From your writing, it appears to me that you are experiencing male genetic hair loss which has responded to Propecia. I am glad to hear that you have been compliant on Propecia for 2 years, but as you know, Propecia may not solve the problem completely. The science is out on the various laser treatments including the laser comb/brush. As for the minoxidil, you can try it, but I would not recommended stopping the Propecia.
In terms of the hair transplant, there is a delicate balance of timing here. People do not have to go bald to get hair transplants, but preventive hair transplants are not indicated unless the thinning has moved past a particular point (something that a good, honest doctor who specializes in this field should be able to tell you). Patience is a virtue, but failure to make a timely decision is a liability. Quite a balancing act! You need to have your scalp hair mapped out to find out how far back the miniaturization is going, so that you can develop a Master Plan before attempting any surgery.
Most people in the know believe that Drs Walter Unger and Jerry Cooley have stood at the doorstep for the emerging arena of hair regeneration. They have both spoken at various medical meetings on the subjects of hair regeneration and hair cloning and they have been kind enough to comment on the history and status of the field. Included are comments on the company Intercytex from England, the company which has generated a great deal of hype and excitement in the field today, the company I have previously commented on in various postings.
The following segment is written by Walter Unger, M.D.
To put in perspective the results of this company and others it may be worthwhile to remember: when I was doing the cell therapy studies, we could successfully grow the hair follicle cells that we were interested in, in 100% of the cases, growing millions of cells from a single cell with no problem at all. We also could successfully transfer those cells into athymic mice and in almost 100% instances, grow hair on the mice. I was very excited when we got to that stage because I thought for sure we could use the same cells in the human donor and grow hair on them if we could grow their hair on the mice. In fact this didn’t happen; we grew hair on 1 of the first 10 patients and 3 of the 13 in the second study. But the numbers of hairs and quality of hair was not nearly as good in the second group as in the first. It was at that point that we ran out of funding as the sponsor took ill and ultimately died from that illness. What I’m trying to say and what I think most investigators in this field will agree with is that it’s a huge step from laboratory studies to actually getting consistent hair growth in a human. There is some missing factor or factors. I’ve concluded that this project will require some luck rather than just knowledge and hence my relative disinterest in doing further studies at this time.
The following segment is written by Jerry Cooley, M.D.
A multitude of labs have consistently regenerated hair follicles in animals and there have been a scattering of reports in humans–Colin Jahoda, myself, Aderans, Walter Unger, PheonixBio in Japan, etc. There is a wide gulf between animal research and human experiments at this point in time. But that’s pretty typical for the biotech pipeline. That animal research is making definite and exciting headway, for example in showing that ‘cloned’ hair does cycle, and that multiplications of 100 fold are possible from third passage cultured human Dermal Papilla cultures.
Not being directly involved in running a biotech company, I can only imagine that there is tremendous pressure on these people to generate media coverage for their ventures to keep the public and especially investors interested. You don’t get very far by telling reporters, “I’m not really sure how all this is going to turn out”. Many pioneers in surgical procedures created exuberant publicity for their techniques even before they were perfected, and it often had its unsavory aspects. Nevertheless, that publicity led to greater public interest and ultimately acceptance of follicular unit transplantation and megasessions. Perhaps we will see the same pattern play itself out with cell therapy.
Dr. Rassman,
I had a hair transplant about 5 weeks ago. After decades of “living” (and I use that term loosely) with Ludwig 1-2 FPB, I cannot tell you how excited I am.
This note is just to thank you for all the information on this website. You cannot imagine how helpful you have been.
God bless.
Gratitude is the best part of the business I am in. Anticipating hair growth is part of the excitement. I hope that you get what you expect, but do not forget that when I do the surgery, you have a partner in the process and I, like any good partner, is there for better or for worse. The good news about this business is that most of my experiences are for better, and that type of outcome is because I take extraordinary lengths to be sure that the expectations of each patient is properly set.
Thank you for your nice note.
Where do doctor’s get hair transplant training? What credentials should I look for?
Since I wrote this extensive answer to a similar question in the past, the International Society for Hair Transplant Surgeons have attempted to address the problem with little success. Although standards are now known, training is still an unsolved problem.
Please see my post from April 2005, Hair Transplant Doctor Training for the previous response.
i’m a 26 yr. veteran cosmetologist and surprisingly i lost my hairline to a mascara brush trying to cover the gray hairs! i thought i was being gentle by using no hairdyes and no relaxers,but with my luck i guess the curly hairs caught onto the brush wand.i don’t wear weaves,braids or ponytails.never in 43 yrs. have i had a problem with my hair falling out.i’ve been massaging these areas and using nioxin ,i’ts been almost 7 months and no hair in sight.also why is it that i can pluck my chin hairs several times a week and they grow back overnight?what’s the difference in these hair follicles vs.the scalp hairs?i did see a few white bulbs at the end of some of the hairs but didn’t pay it any mind cause the gray was covered! my girlfriend told me that a doc. gave her clobetasol cream to rub on her scalp when her hairline fell out from ponytails and she said it took her months to get to a doc. after the baldness and it grew back.last guestion if you still see a hole where the hair came from and the skin is not fused or scarred shut does that mean it is a possibility that the hair can grow back because it is not nickle smooth?
In answering this, I will first assume that this writer is a man — I apologize in advance if I’m mistaken. It is unusual that one plucking of a hair will result in permanent hair loss. I would certainly wait a year before assuming that the hair loss is permanent and with a pore present, that might suggest that the follicle may yet return. If it does not come back, you might have plucked out part of your juvenile hairline, which in many men is not permanent. Plucking out non-permanent hair like this or hair that is impacted by male genetic hair loss, may not return. For a woman, the juvenile hairline is called a female hairline and is stable for most of a woman’s life, so although I would still wait a year or so, the causes for failure of hair to return are not as well defined here.
With regard to clobetasol, it seems that this is part of the homeopathic drugs that are not well documented in their benefits. Lots of chatter about it on the internet, nothing firm from any credible source.
I have many questions for you: Are you male or female? Are you balding? Is the entire frontal hairline plucked out, if so how far back? I would expect that some of the frontal hairline must still be present. Did you use some harsh dye that could have damaged the hair follicles? The benefit of the FOX/FUE technique is that it cause no noticeable linear scar in the donor area. In term of shock loss, I believe that it is due more to making site at the recipient area than the harvesting area in the back of the head. I have seen diffuse hair loss due to the stress of the surgery. It is hard to predict shock loss, though the pattern has been more common in patients who have an active process of hair loss going on.
Hi Dr. Rassman,
Thank you for the very informative blog. My question: what is the difference between FUE and the strip surgery? What are the advantages and disadvantages to each? And do you perform both procedures?
Briefly, FUE is more expensive and time consuming and will yield less hair grafts due to the longer procedure time and technical complexities. FUE, however, does not leave a linear scar seen in the “strip” surgery. The traditional “strip” surgery is more suited for large hair transplant sessions. It does produce a linear scar, but with new scar reducing techniques such as the trichophytic closure, it is a great surgery for patients who want the most hair in one session.
Finally, our surgeons at NHI are very proficient and well trained in the FUE and the “strip” procedure. In fact we wrote the pioneering medical article on Follicular Unit Extraction (FUE). And way back in 1998, Dr. Jae Pak (with his engineering background) and I had developed an automated video FUE technique, which was awarded a U.S. Patent.
We have known for some time that one drug and one dose of that drug do not produce the same effect on everyone. Some of my readers do not like any drug that is ‘man-made’ and would prefer something that naturally grew in the rain forest (rather than something made by a drug company). Toxic side effects of drugs like Vioxx or Fen-Phen strikes fear in everyone that uses known medications and each and every time some news release or newspaper headlines focuses us upon a death from a drug’s side effect, we become more distrustful. Many readers to the BaldingBlog (at least the vocal ones) are detest taking drugs like Propecia, but they are willing to take something that has no value under the illusion that herbal products are safe and probably effective. The pharmaceutical industry is working hard, as are many universities, to develop safer drugs.
Some doses of drugs can be toxic in one person and not toxic in another person. Some people can get more value out of one dose of a drug than other people. In effect, the concept of Personalized Medicine is fast evolving to a new future in medications and the way we use them. A revolution in safe medications will evolve. In an article from the prestigious journal Science, a breakthrough in our understanding of how drugs work was just published. It shows the mechanisms on how to make one drug work better with smaller doses customized to a particular patient’s needs.
Here’s a quote from an article I found a couple weeks ago and forgot to share with you earlier titled, Researchers Believe They Have Found A Way To Change The Action Of 60 Percent Of Currently Available Medications:
The researchers believe they have found a way to change the action of 60 percent of currently available medications, in some cases making them many times more effective, according to an article published in the April edition of journal Science. The discovery has the potential to improve treatments for diseases including heart disease, cancer, diabetes, depression and arthritis. These same discoveries may mean that drugs that are developed to target these diseases, can be made more safe and more effective.
Breakthroughs like this will change the face of medicine in the years to come, extending our life, attacking diseases more effectively than ever before, reducing the side effects of drugs that normally might not be tolerated well at traditional doses. Although it will most likely have hair drug ramifications, I would not be so bold as saying that the ‘balding’ problem will be high on the drug company’s list, but alas, considering that half of the male and female population will bald in their lifetime, the drug companies usually follow the money.
Dr. Rassman, what approach do you take with young men who are not able to take Propecia. Do you never do transplants in them? Do you sometimes do transplants? I am a norwood 2 going on a norwood 3. I am considering getting small transplants to keep up with my hairloss starting in about a year when I will be 23 years old. Is is a bad idea? Going bald is not an option for me, so its either transplants or a system.
I hope you read the blog entry from last week where a patient whom I did not recommend getting a hair transplant was not happy with my recommendation and got a hair transplant from another doctor. Now he is worse off and more bald because he lost more hair due to shock loss.
I would not normally recommend a hair transplant to a Norwood class 2/3, but every patient is different and it would be impossible for me to give you personal medical advice without a person to person consult. You may be a Norwood 2/3 now but without a good exam and a good medical history, there is no way of knowing what Norwood class you would be at the age of 50 (this is where the Master Plan comes in). If you have miniaturization in the areas behind the frontal corners (like the top and crown of your head), then it would be suggestive that you are in for a lot of balding in your future and fixing a Class 2 pattern may not be good timing just now. Alternatively, if there is no miniaturization in the rest of your head and your family history does not show advanced balding, then maybe with the right doctor / patient relationship, a hair transplant could be considered. I am not excited about the idea of doing a hair transplant on someone with such a pattern and at your age, because the pattern of your future hair loss is not going to show up for another few years.
I would also question why you are not able to take Propecia.
Everything in the following article is not completely accurate, but worth reading if just to get another cultural variation to discussing hair loss. In reference to comments in this piece about Elton John’s hair transplants, I believe that he does wear a hair system (wig) and did not have a successful outcome for hair transplants as he received them in the early days when the technology was deforming. They call him a toupee wearer, but also say that his transplant was effective. I guess it could be weaved into his hair system to keep it on his head, thereby being effective in that way. Aesthetically though, it can’t be good.
After the post from yesterday (Fincar, Forcan, and Candid-B), I dig some more digging and found that Cipla is a pharma company in India that does not honor US patents. Apparently, as of late 2005 the country has agreed to enforce patents for new products, but not for products already pirated. So Cipla produces its own version of Proscar to be sold in India. This product is illegal to be used or sold in the US, and there is no way to verify that the product is manufactured by Cipla or even contains finasteride when the product is bought over the internet.