Is it safe to use a Laser Comb after transplant surgery? Do you recommend such use?
While I believe it is safe to use a LaserComb after a hair transplant surgery, I do not necessarily recommend its use.
This 24 year old man presented to my office today with hair falling out. He has been on Propecia for 9 months. Upon examination I made the following observations:
- His hair density was low all over the scalp.
- He is losing substantial amount of neck hair disproportionally to other hair.
- He has miniaturization in the donor area to about 30%.
I am concerned that this young man has Diffuse Unpatterned Alopecia (DUPA) and that he may lose some of his donor hair in the future. This condition is an absolute contraindication for hair transplants and at the age of 24, what is the rush? As you can see from the photo below, his hair looks full, but just thinner in the frontal area. I told him that he needs to be followed closely over the next few years and that his Propecia is the correct medication to try to hold his condition at bay. Many other doctors with less scruples might transplant him and if they did, he might accelerate his balding pattern in the recipient and the donor area and a see-through look could develop from the sides. The last doctor he visited never mapped out his hair for miniaturization and as such would have missed the diagnosis.
Click the photo to enlarge. Note that the miniaturized hair count is about 30% from the donor area.
Hi,
i recently went to the doctors and i was worried about the thinning of my hair, and that my scalp was extremly itchy a lot. He told me to use selsun blue or sebulex, beucase it was most likely the sebacious something? (not really sure what he said it was). But i was wondering if i should go get it checked out from a dermatologist, if its something else. AS well, all the females on the mothers side have thin hair, but none of the men do, or did. Just wondering?
thanks
Some doctors feel that selenium has value in treating hair loss, but there is no proof that there is a deficiency of selenium with hair loss. There are even numerous claims that selenium causes hair loss. It is very confusing and I have no direct knowledge to based an opinion on.
Head and Shoulders Intensive Treatment and Selsun Blue both contain selenium sulfide, but this is topical and not in the vitamin supplement area. These two shampoos are both good shampoos, but I do not believe that they will help treat your hair loss. For more on selenium, see Medline.
Is there any special consideration or precaution needed to start medication (Rogaine or Propecia etc.), if the patient is above 60 years old?
All men over 50 years old should obtain a PSA (prostate specific antigen) test prior to starting Propecia, since it may lower the blood level in those who may be harboring an early cancer (delaying the diagnosis). Other than this one observation, the risks of side effects are the same for older men as younger men. There is no similar problem with minoxidil, but as minoxidil has antihypertensive effects, it has been known to produce lightheadedness from small drops in a person’s blood pressure.
Propecia is the brand name for finasteride in 1mg strength. Finasteride in 5mg strength has been reported to lower the risk of certain prostate cancer.
Hello Doctor,
I have had male pattern hair loss for about two years and now am a class 3 patient. I have been taking proscar for about 6 months and I still lose hair. I would like to know if my hair loss may be caused by hyper, or hypo-thyroidism? How can I find out if it is my thyroid gland? Also, how long should I wait for proscar to start working?
You need to see a doctor who can perform blood tests for thyroid issues. Finasteride (Propecia / Proscar) generally takes about 6 to 12 months for one to see some results, but it should be noted that these results may be only a cessation of hair loss. If you do have a thyroid problem, then hair loss associated from it will not abate until you tackle the thyroid problem. Generally, thyroid problems will produce hair loss all over your scalp and not in a Norwood Class 3 pattern.
Doctor,
I have 2 side effects from propecia. Increased libido (not a problem) and unfortunately nausea and heartburn. I take it after dinner, but don’t have GI problems until middle of the night. Are GI problems common? I’m at the point I may have to discontinue it. Any suggestions?
BTW: You site is a terrific balance to all the misinformation out there.
Before associating your nausea and heartburn with Propecia, you should have your symptoms evaluated by your physician. You may have have other underlying conditions such as heart disease or reflux esophagitis. Sometimes heart disease can present with nausea and heartburn. Please go see your doctor.
And thanks for your kind words about the site!
I wanted to send a question in about receiving prescriptions overseas. I live in Japan, and have started to notice that I’m going a little thin in the front. My Grandfather on my Mothers side was very bald so I’m assuming it a MPB thing. I’m in my mid twenties, not stressed out, drink a little bit more then I should, but eat very healthily.
My questions is do you know if prescritpions such as proscar are available overseas? And what kind of Dr. should I be going to to get checked out (that way I can tell my Japanese friends what kind of doctor I need to see and they can help me find one). Thanks for any information you have.
I am sure finasteride is available overseas. Finasteride is a generic drug name for Propecia and Proscar. Note that Propecia (which is prescribed for male pattern balding) is finasteride in 1mg strength; Proscar is finasteride in 5mg strength. Any physician can prescribe these medications, including your family doctor.
Dear Doc,
I’m a girl and i’m 22 years old. My dad is almost bald while my mom has thick wavy hair. My head hair is thin and not very dense. My hairs near the hairline are very thin and they dont grow at all ,that is, they have a fixed length. Please guide me as to whether it would be effective if I shave them off, those near the hairline? Would their length increase afterwards? Is there some other way using which I can make them grow longer? Kindly help me out please!!
The hair at your hairline may not grow as fast as hair elsewhere on the scalp. This is particularly true in the corners. You should be evaluated by an expert in-person; without seeing you and examining your entire scalp, I can not help you properly.
In the piece dated October 19 “Goodbye Combover, Hello Hair!”, I am critical of your choice to limit the graft numbers. You should have performed 5000-6000 grafts in a Class 6 patient. Why didn’t you?
Here’s the post you’re referencing.
The number of grafts that were transplanted on this patient was the maximum safe amount that could be harvested, reflecting the density of this man’s hair in the donor area. If the grafts were cut down to single hair grafts, the number would have been more, but the amount of hair would have been the same. Some doctors would have cut the follicular units down to single hair grafts to make some more money out of the patient (since they charge by the graft). Not only will that not produce more hair, but it would be unethical to milk this patient’s pockets for more money. Cutting the grafts down would have yielded less hair in the long term, as all of the cut grafts may not grow as well.
With his fine hair character, this patient needs 5000-7000 grafts to get excellent coverage. On the day the initial blog post was published, I repeated the procedure and only got out 1706 more grafts — again, because that was what was safe (there are no results photos yet, as the procedure was just over a month ago). Each person is different, and while some people have enough scalp laxity to allow for a larger strip (with more hair), some people will only have enough for a smaller strip.
The photo on the left is before; the photo on the right is after one procedure of 2590 grafts. You should note that the transplants were artistically weighted to the frontal area to produce the best frame for his face and distributed to the back with a much lower density to reflect the limited number of grafts. Click the photos to enlarge.
More photos of this patient can be see at the original post —Goodbye Combover, Hello Hair!
I have heard of a technique called auto-cloning performed by Dr. Gary Hitzig in New York, New York. He tweezes beard hair under the chin which leaves part of the root to regrow and part of the hairs root stays with the tweezed hair to grow in the transplanted area. I would be very interested in having this procedure performed to thicken my mustache both because of my limited donor hair and for having the thickness and texture of beard hair. Facial hair and body hair transplants are becoming increasingly common why is this technique not more popular as it solves many problems for people who have limited donor hair? Is there a problem with this technique?
My medical group had tried to repeat the work after we heard about it from the doctor who said that he invented the technique. We did it just as he said it was to be done, and as was expected, the results were essentially a complete failure to grow hair. As far as I am aware, nobody has proven this technique or published the method in a peer reviewed journal for confirmation, which says a great deal about credibility. If it worked, I am sure that the technique would be available everywhere, because it infers that you get two hairs for one (hair replication)… something that has not been done by any other.
I also look to the credibility of the ‘inventor’ and via Google, I turned up with the following links:
Hey doc, I am 61 and I have been taking propecia for a year and a half. Three quarters of the time I have been taking 1/2 a pill. This is because I felt like down there I felt disconnected. My privates just don’t feel like it used to. Also I feel like my breasts have gotten bigger.
I don’t want to lose my hair but it seems like my hair has progressed to get thinner and thinner. The diameter of the hair really is thinning. I don’t want to stop taking Propecia cause I’m afraid to stop. It even seems like I should take the whole dose instead of the half dose. It seems everyday I am questioning my taking this pill but like I said I’m afraid to stop. I didn’t start noticing losing any hair until I was about 56 when it really started to thin. Do you think at the age of 61 Propecia is really necessary? By the way I have fair coverage on my head except on the crown it’s really thin and the last year the rest of the top had thinned noticeably.
Can you recommend what I should do. Thanks Doc for this forum.
My best recommendation is for you to see your doctor (the doctor who prescribed you the medication) and address these significant issues with him or her. Breast enlargement is a rare side effect associated with Propecia. It is reported that 0.5% of men taking five times the dose of Propecia will experience such breast enlargement or tenderness. These side effects are reversible once you stop the medication.
I would question the value of Propecia in a man of your age, so the more basic question here is whether you really need it.
I have had hair loss int he past caused by stress and depression in the form of scalp inflammation, itchiness, and bleeding. i went to a dermatologist but every sample take showed nothing. The problem is gone, but my my hair wont grow in some spots and is very visible when I let my hair grow. Im tired of people looking up at my hair, or at least im paranoid to think they are. Is there a way to make it grow, or is it completely damaged?
I’ve never heard of depression or stress causing a scalp to bleed. Is the bleeding self-inflicted from pulling your hair or scratching your scalp? You may have permanent hair loss from those actions. If your hair has not grown after about one year after the insult, I suspect it has been killed off. I also suspect, based on what you’ve written, that you must’ve been scratching the scalp to cause the bleeding and hair loss.
Hey doc. im an 18 year old male. I cut my hair almost once a week to were its bald but not skin bald, I use hair clippers and about two months ago i started getting a bald spot that grew from a pea size to a quarter size and its starting to really worry me.I went to a clinic and asked a doctor and she told me that it will grow back and she dont know what it came from but, I wasnt sure if she was telling me the truth or just trying to get me out of the way. I dont know what its from im thinking its from the clippers because they were kind of dirty, and then rescently I got another one but alot smaller, is it from stress or from the dirty clippers? thank u doc.
Without seeing you and examining you myself, I really can’t render an opinion on your particular case. When bald spots appear, this could signal many dermatological conditions such as alopecia areata, fungal diseases of the scalp (infection), etc.
I am a 40 year old woman. In the past two years, my menstrual cycle has become much heavier and longer. Since April of this past year, I have had several stressors, one after the other, that usually don’t occur this simultaneously(i.e my 4 yr old son had surgery, my house flooded, and my husband was going thru some real medical issues). In July-Aug (within a 2 week timeframe), I lost a large amount of hair from the top middle-left side of my scalp. I just had a full CBC and hormone level count done and my iron was just a line below normal. I am now on an iron therapy. My doc thinks it could be iron deficiency coupled with a lot of unusual stress. Does this sound familiar to you?
Yes, it does sound familiar. Stress can certainly cause hair loss and getting this stress under control will generally result in the hair growing back within a year, though this is not a guarantee. Adding this stress to a pre-existing iron deficiency does sound like a recipe for hair loss in a woman.
The Wall Street Journal reports —
Doctors and patients alike have noticed that eyelash growth is a side effect of a glaucoma drug called Lumigan, sold by California drug maker Allergan Inc. That phenomenon has set off a race among cosmetics companies to create new eyelash treatments that contain either bimatoprost — the active ingredient in Lumigan — or other so-called prostaglandins found in glaucoma drugs.
Read the full article: Drug That Lengthens Eyelashes Sets Off Flutter