Chance of Infections from Hair Transplant Clinics

/by William Rassman, M.D./0 /

Dr. Rassman,

Given that most of the hair transplants typically do not take place in strictly-regulated facilities / hospitals, and that the invasive procedure takes hours to complete — what is the chance of suffering an infection (HIV, Hepatitis, other blood-related ones) from a transplant?

I asked same questions to my dentist and according to him HIV virus cannot sustain for more than 15 minutes outside human body, but there is a very low risk of Hepatitis infection if the dental facility does not follow the strictest standards.

Do hair surgeons follow some minimal set of established operating guidelines to prevent infections et al?

Thanks

All medical facilities should follow established operating guidelines, but there are no guarantees. The HIV virus dies almost immediately when the virus is outside of the body and exposed to air. Hepatitis is more robust and some forms of the virus can move more easily between people. One of the reassurances may be to ask to see medical facility licenses and check if the hair transplant clinic is certified as an outpatient surgicenter, as ours is. Hair transplants are done under ‘clean’, not sterile conditions, but all equipment should be autoclaved or disposable to avoid infections. In our hands, infections are very, very rarely seen. I can not comment on other facilities or other doctor’s track records. With our certification process, our infection rate is compared to hospitals or other outpatient certified facilities and we do better than most. For most hair transplant facilities which are not certified, there is no review process from ‘outside the clinic’ so it would be impossible to answer your question. I suspect that infections are relatively rare in most clinics.

Tags: hairtransplant, hair transplant, clinic, infection, hepatitis, hiv

Immunoprivileged Follicle

/by William Rassman, M.D./0 /,

I saw the previous comment about obtaining hair follicles from a donor (another person than yourself) transplanted to the patient. I’ve looked on the internet and did a search for “immunoprivileged follicle” and found dozens of articles that suggest that the follicle of the hair seems to fall in the category.

They’d even claim that it is also trans-gender: www.nature.com/nature/journal/v402/n6757/full/402033a0.html
and the Journal of Investigative Dermatology Symposium: www.nature.com/jidsp/journal/v8/n2/full/5640115a.html

Does this mean that it is possible,after all, to obtain hair follicles from a donor? Thanks!

It may be possible, but for all practicality, not probable. Even with the best case scenario, where would you get the donor hair? Could this give a new meaning to selling your hair for money?

Generally hair transplantation from one person to another carries the same risk as organ (liver, heart, kidney) transplants. There is a risk of rejection and failure and life long anti-rejection medication. You may accept the risk of rejection when faced with threatening situations such as heart/ liver/ kidney failure, but most people spending thousands of dollars for a cosmetic (hair transplant) procedure may not accept the failure risk. One might think that hair from a newborn baby might be immunoprivileged (it seems to work for a heart transplant), but again, who would endorse such a donor?

Tags: hairtransplant, hair transplant, immunoprivileged, hairloss, hair loss, organ

Are Thinning Temples Part of a Mature Hairline?

/by William Rassman, M.D./0 /,

Dear Dr. Rassman,
I have been on propecia for close to 3 months now, and in that time I seemed to have noticed the temples thinning more than they ever had. The hair above the sideburns (that comes to a point above the eybrow) is also seemingly thinning. I notice much more blonde hair in these areas, yet I am a fairly dark haired person. Could this be just evidence of a maturing hairline (although I feel it is going beyond that) or could it be evidence of a shed from propecia? Or could it have probably happened anyway and hopefully propecia is slowing it? I’m sure you can’t tell me for sure, but any insight would be appreciated. Thank you.

There is no way to answer to your question without a good physical exam, which includes a miniaturization study. To better assess the hair loss you are noticing we would need to compare your miniaturization state before you started Propecia and your miniaturization state now. Moreover, Propecia is not reported as effective on your frontal hairline and your temples (although I am not sure that I believe that it is completely ineffective). Thus, your hair loss may just be a part of your male pattern hair loss or your maturing hairline (depending on your particular pattern).

Tags: hair loss, hairloss, mature hairline, hairline

Using 30% Minoxidil

/by William Rassman, M.D./2 /

I asked this questin eariler but got no response- I am a 21 year old male and have been using 30% minoxidil for a month now cause of severe thinning all over. Are the new hairs that are suppose to be growing in vellus hairs or are they going to be terminal hairs. In addition are new hairs unaffected by MPB and untreated by any drug or anything say in the back of the head thinner and lighter in color as they emerge through the scalp or are they regular terminal hairs? In addition is it possible for miniturization to occur all over the head or only in areas affected by MPB. Thanks

I also have noted some patients reporting hair loss after starting minoxidil. While the exact mechanism is not understood, it is thought that hair cycle is “reset” as you start using minoxidil. So the hair follicle is accelerated to a telogen (hair loss) phase as it gets ready to go into the anagen (growth) phase. If you use minoxidil on your arm, for example, it will produce vellus hair. A 30% solution is high, so be careful for side effects, which will be more common.

Tags: minoxidil, hairloss, hair loss

Balding, Obesity, and Heart Disease in Young Men

/by William Rassman, M.D./0 /

Is there an association between balding, obesity and heart disease in young men? The following link is to an abstract of the article that shows that such an association is probable.

Previous investigations have revealed an association of androgenetic alopecia (AGA), especially in younger subjects with severe early-onset AGA, with ischemic heart disease.

Tags: hairloss, hair loss, obesity, heart disease

Using Minoxidil On Newly Transplanted Hair?

/by William Rassman, M.D./0 /,

Hello-

What is your recommendation regarding the use of Minoxidil post-op on the newly transplanted hair?

Does Minoxidil really do anything to speed the growth of the new transplanted hair?

It seems like half of the guys use this and half do not.

Thank you.

You can use minoxidil after a hair transplant surgery, but there is no conclusive proof that it will speed the growth of the newly transplanted hair. In the end, if your hair transplant was a success your hair will grow with or without minoxidil.

Tags: minoxidil, rogaine, hairtransplant, hair transplant

Losing eyelashes in one eye.

/by William Rassman, M.D./1 /

Hello,

I am losing eyelashes in my left eye. I don’t use mascara or any kind of make up. Please help me.

You may be suffering from alopecia areata. This skin disorder can affect any part of the skin and the patients’ hair loss is usually patchy and can affect one or several areas. You need to see a dermatologist for confirmation of the diagnosis.

Tags: alopecia, areata, hair loss, hairloss, alopecia areata, eyelashes

What Do Fewer Grafts Look Like If You Can’t Afford More? (with Photos)

/by William Rassman, M.D./0 /, ,

I am what you call a Class 7 pattern with black hair. I am 55 years old and I dye my hair black. I know that if I came to see you, you would want to do thousands of grafts, but I am a bus driver and just would not be able to afford a large transplant. I might save up enough for a second surgery, but I would want to enjoy the hair while I am still young. I just got a divorce and want to start dating so my bald head really bothers me.

I am going to show you a Class 7 patient who is about your age with just about the same problem you had. Although I would have recommended 3,000 grafts because of the large balding area, I gave this man 1677 grafts instead. Here are photos of his before and after (1 year) results. Click to enlarge.

 

He has a frame for his face and uses a ‘comb-back’ to cover the area which was not transplanted. After a year, it almost covers the entire bald area. Many doctors are reluctant to perform smaller sessions on people like you, but with a good artistic feel, the doctor should and can produce an acceptable result in one session (in most circumstances) with a thin look (as if he is losing his hair). It is important for prospective patients to be aware of these results. They can help by not dying the hair black and keeping it either salt and pepper or white, or even go sandy blonde, as it will always look fuller.

Please also note the scar on this man. We used a trichophytic closure of his wound with exceptional results, but as I have said before, the wounds are a reflection of not just the surgeon’s skills and the techniques used, but also the healing ability of the patient. Scar photo below. Click to enlarge.

Tags: hairtransplant, hair transplant, trichophytic, closure, donor, scar, hairloss, hair loss

I Want a Hair Transplant, But I Don’t Want a Noticeable Scar Around My Head

/by William Rassman, M.D./0 /, ,

How many years are we from a transplant without a noticeable scar (Donor Scar) around someone’s head? Im sure that a lot more people (especially people with shave fades or short hair) would get a transplant if there wasnt a large ugly permanant scar around their head.

The answer is NOW!

We have a follicular unit extraction (FUE) technique called the FOX Procedure that has been pioneered by me in the early 2000s, and was presented at the International Society of Hair Restoration Surgery (ISHRS) conference in 2002. In fact, a company in San Jose is currently working on a robotic system to accomplish this task. This technology was invented and patented by Dr. Pak and I back in 1998.

The FOX/FUE technique leaves virtually undetectable scars. It is important to understand that all surgical cuts will create a scar but the FOX/FUE technique involves extracting single hair follicles, one at a time, leaving a scar the size of a small dot. Since these dots are random and small, you would not notice the scar even if you buzz cut your hair. In other words, there will be no linear scar. If you look at this earlier posting, you will see a patient who had no detectable scar even with a shaved head.

Tags: fue, follicular unit extraction, hair transplant, hairtransplant, scar, donor, hairloss, hair loss

Hair Loss from Motorcycle Helmet?

/by William Rassman, M.D./0 /

Dear Doc,
Can pulling on and pulling off a motorcycle helmet every other day cause hairloss or weaken hair at the root so it falls out? I try to be as careful as possible but rubbing my hair on the sides is unavoidable! Thank you.

Usually hair loss from motorcycle helmets if fitted properly should not occur. However, I recently saw a patient who wore a very tight (not properly fitted helmet) for a few months and he had hair loss on certain areas where the helmet was rubbing on his scalp/face. This type of hair loss is caused by traction and is known as traction alopecia, commonly seen in women who braid their hair too tightly. This type of hair loss may be permanent, depending on how long the insult has been occurring.

Tags: helmet, motorcycle, hairloss, hair loss, traction alopecia, alopecia

Out of Box Thinking for Poor Hair Supply — Using Glue

/by William Rassman, M.D./0 /

The technology of hair transplants have certainly changed since I first started with Dr. Sparkyl. NHI has refined and developed techniques that has been appreciated by all of us.However the denisity of hair and the amount of donor sites is limited and can limit the final outcome.I’m interested in developing a method where two to three hair would be glued around existing hair and eventually would come of after 4-6 weeks similar to a traditional hair piece.The question I have is somebody working on this process, and if not what do you see as potential problems or any valuable suggestion for this project.

I am not aware of anyone working on this today. There is a problem in that any hairs that are glued to existing hair will ‘pull out’ the existing hair and create traction alopecia. I’d love the opportunity to talk to you about it.

Tags: glue, density, hairloss, hair loss

Hair transplant scars

/by William Rassman, M.D./0 /

What does a normal scar look like?

The first photo is a patient from our office who had one procedure totaling 3000 grafts. The scar measures about 2-3 mm wide and with his hair combed down, unless he shaved his head or cut it very, very close, it would not show. The second photo is my scar. I believe these to be scars that represent what’s “normal” and I am showing them to educate those people who are overly concerned about scars and want to know as much as they can.

Click the photos to enlarge.

The scar of a patient who had 3000 grafts in one surgery:

 

My scar:

 

My Twin and I Lost Leg Hair

/by William Rassman, M.D./1 /

I’ve been reading some of the postings about hair loss on calf. You commented about not knowing age & also about role of DHT & hair being one of the benefits.

With that in mind, here’s another one for you. My fraternal twin & I have both lost the hair on the calves of our legs. Happened in late 30s-early 40s. All the males on father’s side are pretty hirsute, as we are. In my case, I have all the hair I’ve ever had everywhere else, including the tops of my feet and toes! I’m a little thin on top, too, as is my brother. But, I’m also now dealing with rampant eyebrow hair growth & hairy ears needing trimmed. I have pitting edema of lower calves as well, but normal warmth and good pedal pulses. What do you think?

Thanks!

Pedal edema (swelling of the feet) usually reflects some medical problem. With swollen feet, there may be a connection. Does your fraternal twin have pedal edema? Good chance that there is some genetic cause, but I am stumped.

Tags: pedal edema, edema, hairloss, hair loss, leg hair, twin

Hair Loss from Hair Twirling?

/by William Rassman, M.D./0 /

Does twirling the hair at the front of the head cause extra hairloss? I am 37 and have had male pattern baldness.

Only if you pull on it while you are twirling it. If you have not seen hair loss in the area you are ‘working’ I would not worry much about it.

Tags: twirl, twirling, hairloss, hair loss

I’m a Female with Thinning Hair

/by William Rassman, M.D./0 /,

Hi Dr Rassman,

I am a 27 year old female. Just under 2 years ago I began to notice my hair was quickly becoming thinner and thinner and stacks of it fall out each day. I have not counted exactly how much hair falls out, I just measure more by the thickness and amount left on my head and also the density on my scalp. I am about 1/4 Lebanese on my dads side but his sister has lots of hair and she’s 60. The men in my family still have full heads of thick hair, and most of my female relatives do too, although my mum and grandmother have had hair thinning, but after menopause, some stress and in my grandmother’s case, after prednisone.

My hair is sort of wavy/messy curly and I used to have very thick hair up until the last few years. I have many health concerns at the moment, but I’m pretty sure I have been tested for things like thyroid function, lupus and hormone levels. I have been on and off medicines such as the pill, some antidepressants, epilum and zyprexa, but even after being off all medications for a couple of months, my hair continues to fall out. I do not brush it very much, but I am not concerned that the loss from brushing is a build up over days, I also do not blow dry, straighten and colour my hair more than a few times a year. I even tried laureth sulfate free shampoos which seemed to possibly slow down the loss for a couple of weeks, before it resumed again, but its hard to tell. Do you know of anywhere in Sydney or Canberra Australia that does this miniaturization testing you speak about?

Are there any other causes you know of, or things I can do to help this problem? I am pretty young to be on Rogain or permanent medicine.

Any advice or insight would be appreciated, as I am frustrated and concerned by the hair loss and the lack of answers.
Thanks.

You clearly need a good doctor to take charge of your complex situation. See ISHRS.org for a doctor in your area. There are a number of good doctors in Sydney and throughout Australia.

Tags: hairloss, hair loss, female hair loss, female, australia