I heard of the possibility of shock and its harm to cause loss of existing hair from hair transplantaion. How frequentlly does this happen and is the risk lower with follicular unit extracton?
Shock loss occurs in the recipient area, so the method of extracting the donor hair is not impacted. The best way to reduce the risks for shock loss is the use of Propecia (finasteride 1mg) to be taken orally prior to the surgery and for the subsequent 6-8 months.
Dear Dr.,
I am 23 years old and have had full thick hair my whole life. Recently when I was washing my hair I felt a bald spot on the back of my head close to the top of my neck. It is about the size of quarter. I have no other bald spots on my head nor is my hair hair thining anywhere. I have gone to get blood work done, and the have checked everything from my thyriod to the female horomone levels. Everything has come back normal except for my white count which came back at 13, which is just a little high. They still cant figure out what is going on. what do you think could be possibly going on?
Infection (ringworm) and alopecia areata are just two examples of diseases that can produce what you’re seeing. You need to see a good, competent, and caring dermatologist.
I have always had a pronounced window’s peak and now that I am losing my front hair, I have decided that I want a hair transplant. Can you put back a widow’s peak with hair transplants?
Absolutely. This is one of the things I love to do. I particularly like actor Andy Garcia‘s widow’s peak.
Yo, doc!
I’m not sure if you’ve read the study yet, but here’s yet another delicious piece of the pie:
Dickkopf-1 biggest factor in DHT signalled hair loss.
Recent studies suggest that androgen-driven alteration to the autocrine and paracrine factors produced by scalp dermal papilla (DP) cells may be a key to androgen-potentiated balding. Here, we screened dihydrotestosterone (DHT)-regulated genes in balding DP cells and found that dickkopf 1 (DKK-1) is one of the most upregulated genes. DKK-1 messenger RNA is upregulated in 3-6 hours after 50-100 nM DHT treatment and ELISA showed that DKK-1 is secreted from DP cells in response to DHT. A co-culture system using outer root sheath (ORS) keratinocytes and DP cells showed that DHT inhibits the growth of ORS cells, and neutralizing antibody against DKK-1 significantly reversed the growth inhibition of ORS cells. Analysis of co-cultured ORS cells showed a significant increment of sub-G1 apoptotic cells in response to DHT. Also, recombinant human DKK-1 inhibited the growth of ORS cells and triggered apoptotic cell death. In addition, DHT-induced epithelial cell death in cultured hair follicles was reversed by neutralizing DKK-1 antibody. Moreover, immunoblotting showed that the DKK-1 level is up in the bald scalp compared with the haired scalp of patients with androgenetic alopecia. Altogether, our data strongly suggest that DHT-inducible DKK-1 is involved in DHT-driven balding.
Interesting study! Thank you for the information. The complete abstract is available here, at the Journal of Investigative Dermatology.
Since I really have nothing further to add, perhaps they should consider a name change — something other than Dickkopf. It is bad enough that Propecia is already associated with a similar sounding, although untrue, side effect.
Dr,
with reference to the reply you gave me regarding the below thread on the 15th August 2007: ‘Would You Prescribe Dutasteride If It Was Approved for Treating Hair Loss?‘You stated that the safety concerns have yet to be fully established until FDA approval is give. I believe I am correct in stating that Dutasteride is already approved, but not for hair
loss so wouldn’t it be safe for human consumption irrespective of the fact that hairloss approval has not been given?
The average age of men that seek treatment for hair loss is different than the age of those that require treatment for prostate disease. Older men generally do not have children, while younger men do. So for example, how long does one have to be off the medications before pregnancy is safe? That is unknown. The recommended dosage of dutasteride to prevent hair loss is also unknown. Yes, dutasteride itself is proven to be safe in older men with prostate problems and is FDA approved for treating the prostate, it is still undergoing testing for a greater segment of the adult male population that are looking to use this drug for treating their genetic balding.
According to Newsweek, plastic surgery is a way for a man who does not feel masculine enough to become full of machismo by changing his nose or transplanting hair onto his chest. This is a growing trend among men. Interesting reading, of course.
From the article:
George’s quest for maximum hirsuteness isn’t as unusual as it may sound. He’s part of a growing group of “retrosexuals”—men who shun metrosexuality, with its often feminine esthetic, in favor of old-school masculinity. Cosmetic and hair-transplant surgeons on both coasts report increases in patients seeking a more rugged look: hairier chests and beards, squarer chins, more angular jaw lines.
Full article: Looks: A Manly Comeback
My sister in law had extensive chemo and radiation, cancer cells were detected in her brain few days ago, she is going to receive more radiation directly in her head, doctor told her that she’s going to loose her hair permanently.
Doctor I’m wondering if you could harvest some hair follicles for cloning and then when she’s well you could transplant those follicles back in her scalp. Can you respond quickly, since she’s started the new radiation today.
Thank you
There has been considerable research on taking hair follicles, freezing them and trying to ‘wake them up’ for reimplanting later. Failure is very high and after a few weeks, there is virtually a 100% failure rate. It appears that freezing them with the various techniques available will kill the hair follicles.
Hi, I’m a 25 yr old female who has noticed lots of hair loss and scalp showing. When I put my hair down the middle part is getting a bit wider and is creeping further back. When i put my hair up, I have to be careful that hair is covering the scalp showing on the sides.
My dad’s side has hair loss and I’ve been taking diet pills from 1998- 2007 (abused lots of ephedra-based ones) and have dealt w/binge eating, bulimia, and a serious case of anorexia. Is this all catching up w/me?
Either way, WHO do I go see to get a diagnosis? Someone told me endocinologist while others say dermatologist. I’m a college student w/no health insurance so money is very tight. Any
suggestions would be GREATLY appreciated!Thank you for taking your time to read this and I hope to hear back soon.
You need a primary care doctor first and foremost. It is highly likely that your erratic diet is central to your hair loss, so that is where you need to start. Weight loss and poor diet are contributing factors for hair loss.
Hi Dr.,
Are there any Doctors in New York City that are performing Body Hair Transplant (BHT)?
I have a lot of scaring from my previous transplants (no more donner area available). My hair on my scalp is also thinning more, resulting in my existing transplants not to look natural. I
would like to visit with a BHT Doctor in New York City.
I believe Dr. Robert True in New York does body hair transplants (BHT). I am generally not an advocate of BHT (see I Want Body Hair Transplants for my reasoning).
I had liposuction with local anesthesia about 4 months ago. I seem to be losing a lot of hair. I knew it could happen with surgery but local anesthesia?
Any stress can cause hair loss. I can not give you any other explanation.
i got transplants in 1983 that were less than satifactory.i have been wearing a hair replacement for about 15 years.my question is this.i want to shed my hair replacement and go to the shaved head look,but the donor area in back is my problem.can plastic surgery cut outthe plug area tomake it look natural? i appreciate your advice
I see patients like you almost every day. A small portion of my practice is based on correcting bad hair transplant surgeries, like the old plugs. See Patient Photo Gallery – Repair Work for some examples.
It is very difficult to remove the scar so that you can shave your head, because the scars are going to have a white appearance. If you goal is to keep your head shaved, look at a Horror Story with a… Happy Ending?, which shows the use of tattoos to solve the problem in the donor area. It is relatively easy to disguise the unnatural scar and plugs with a follicular unit extraction (FUE) hair transplant surgery, but some hair length may be important. I would want to know how many ‘old type scars’ you had, as they may allow me to have some creative input. You must be seen in-person for a real opinion.
Further reading can be found at:
I live in Washington, D.C. and I have the hair loss problem, but I’m 18. I have tried Rogaine, I have tried Fo Ti, I have tried everything (except for Propecia) including going to the hair club, where they would glue a wig to my scalp. I called hair loss clinics all around my area to ask them when it would be right to have implants/ transplants done and they say that I have to wait 6 years, that is, until I have completed my transformation into Patrick Stewart. I am about a 50% on the Norwood scale and I don’t want my life to pass me by. Do you think that it would be right to get surgery done at this point in time? I don’t see any other way. Is there a minimum age for implants and if done before the minimal age will the implants fall out? Also, is there a way to keep them in (rogaine, propecia, etc.)?Thanks for your help
I hope to hear from you soon
When a wig is applied to your scalp with glue and other similar attachments, it will pull out the hair and produce more hair loss (traction alopecia). As a result of this, you can be ‘hooked’ on the wig for the rest of your life. There is no real minimum age for a hair transplant, but generally speaking, we tend not to do these in young men under the age of 24, because the hair loss pattern is not clearly defined. Simply said, hair transplants are performed by moving the hairs from the back of the head (donor area) to the areas you need hair (front, top, crown, etc). So as long as you don’t have an underlying genetic condition such as alopecia, your hair transplants will stay in forever (independent of age). As we always want a Master Plan for each patient and their balding pattern, we need time to get there. Propecia (finasteride 1mg) works well in young men to prevent or stabilize the hair loss and that should be your first line approach.
Greetings Dr. Rassman,
I’m one of your patients (procedure in 3/07). Things are going well. You gave me a bottle of Propecia to try and I just started taking it about 3 days ago. I had been holding off taking it until I did some more reading (OK – I’m a slow reader)
I found this article; I thought it might be a good addition to your Blog:
MedicalNewsToday.com – Finasteride For Prostate Cancer Only Short-Term Risk For Sexual Dysfunction
Best regards
Thank you for the information. Of note, the article reports:
The 2003 results of that trial, conducted by the Southwest Oncology Group in more than 18,000 men, showed that finasteride could reduce a man’s chances of getting prostate cancer by almost 25 percent.
and…
The authors, who surveyed more than 17,000 men 55 and older for seven years, reported their results in the Journal of the National Cancer Institute. … The study suggests that finasteride will cause little or no sexual dysfunction for most men who decide to take it, conclude the authors.
The study was funded by the National Cancer Institute. Citation: Journal of the National Cancer Institute, DOI: 10.1093/jnci/djm023
i am a 24 year old male with a high forehead. my forehead has a lot of loose skin. i would like to lower it a little bit through surgery. is it better to have loose skin for that procedure. do you of and good surgeons in ohio that could do this. i want to do this in the next couple of months and the cost
You need to be evaluated by a competent doctor. You can check with a plastic surgeon for this procedure. The costs vary with doctor. I do not have any Ohio recommendations.
I generally prefer to restrict this surgery to women. Men who might lose hair will recede behind the surgical site where the hairline was advanced. The scar, which is usually hidden, might show up if recession of the hairline occurs. Loose skin does make the surgery easier.
Hello,
I had 1600 hairs transplanted in March, 2006 and it seems that I need a little more fullness. I was thinking of purchasing some clip-in hair extensions around 1″-2″ wide to add fullness here are there. They are apparently undetectable and can be taken out easily. Do you think these could cause any damage at all? Thanks again for all your great work.
Clip-ins may produce traction alopecia (hair loss), particularly when applied in the same place each time. As the clips are generally fixed to the wig, they almost always may be applied to the same place or the wig is out of place. I would think twice about producing that type of damage for the long term.