It appears that you have ‘crater’ scars with your FUE. I don’t believe that I ever saw this type of scar so I wonder what instrument your doctor used to get the FUE done. Can you find that out and let us know?
I’m just wondering something. I’m in my early 30s now and always dreaming of a hair transplant. Maybe the older guys know an answer to this question: do you think (good) hair transplants will get more affordable and better in the future? I know that in the past it was mostly FUT so I think FUE is definitely a step up. But I’m wondering if there’s still room for improvement besides this procedure so one can hope. I’m not talking about unrealistic stuff (stem cells, yeah been hearing this for years now…) but just for more efficient ways that are in development? How has the industry changed over the last ten years and what can we expect for the next ten?
The procedure for hair transplants is now very efficient and that is why it is becoming more popular. This is a rapid growth industry now growing in excess of 20% per year, as high as 65% in some areas of the world. We have not tapped the balding market yet, but the number one problem is dishonest representations of the goals that are realistic, often pushed by salesmen employed by somewhat unscrupulous doctors. Young men, in particular, tend to fall for the lines of the salesmen that work for doctors who hustle for business and may get commissions for closing the sale (this could be you). Let the buyer beware.
- the longer you take fin the more chances side effects increases.
- Going off fin despite length of time (ie 2 months vs 2 years or vice versa) can lead to hormone crash. Fin makes your hairloss worse years after stating treatment
- Would love to know as these three kinda scare me. If it’s a fact please state why and the likelihood of it.
The ANSWERS to your questions are below:
- No body knows for sure, but there is a suggestion that the longer you stay on the medication with sexual side effects the greater the risk of the sexual side effects not leaving after you stop the finasteride. This is based on no valid information, more a feeling from experienced doctors who seem not to get long term post-finasteride syndrome.
- No such thing as a hormone crash from finasteride on or off and finasteride will not make your hair loss worse in the future after taking it for years
- Absolutely no, the longer you take finasteride, the longer you hold on to your hair.
I have worked with Dr. Bernstein and he is one of the smartest people in this industry. I think that if you spend the time to listen to this podcast, you will be smarter for the time invested. Bill Rassman
I m 30 years old male with a complete Class 6 pattern of balding and I have had two FUE transplants with little to show for it. I want to try Propecia to revive the dead hair making i alive again. is that possible?
The drug finasteride does not bring back the dead hairs that you used to have. Photos would help me help you. The best approach is either to complete the transplant with a doctor who will give you a realistic expectation or get Scalpmicropigmentation to create the look of a full head of shaved hair, see: https://scalpmicropigmentation.com/bold-shaved-look/
I had hair transplant in 8 months ago.I noticed the new hair growing in the opposite direction compared to the original very early in the growth of the new grafts. The density is also a problem. People can tell something wrong with my hair. I tired style this with gels but I got tired of it & cant stand having hair anymore. What can I do?
This is a very difficult problem. I would have to see you and determine if we could use FUE to remove those hair that have the problem hair direction and then re-implant them. I would have to understand how many of the grafts have this problem but it can be done!
Finasteride, like all medications, can produce an allergic reaction. If you stop it, it should go away and if you restart it, it will probably reappear.
I figured I would offer my opinion here since the reader asked for a reply from somebody who had a similar experience and the response doesn’t really answer the question. I used Propecia about a decade ago and developed general sexual dysfunction (not just ED) that continues to this day.
Unfortunately nobody can provide you with the reassurance that you say you desperately need. You won’t know for sure if the side effects will be permanent unless you stop taking the drug. The doctor highlights that you risk “catch up hair loss” which provides an incomplete picture to the decision you need to make. On the other hand, if you continue taking the drug you risk “catch up side effects” because the side effects can get worse than they are today. You need to think about what is most important to you and how much you value your general health versus your hair in order to make a smart decision. There is uncertainty in making a decision like this which is stressful but the right decision is different for everybody.
Dr. Rassman’s Comments: The following article appeared in Medscape warning of the potential harmful effects of absorption of toxic chemicals when most sun screens are used. Not the only safe sunscreens are highlighted in RED below. This is critical to protect your children from the toxic chemicals in sunscreens.
Every patient in a small, randomized clinical trial testing over-the-counter (OTC) sunscreens quickly developed systemic levels of active ingredients that exceeded the 0.5 ng/mL concentration the US Food and Drug Administration (FDA) guidance says should trigger systemic safety testing, FDA researchers report today in JAMA. While the study authors and the authors of an accompanying editorial are careful not to discourage sunscreen use, they call for prompt safety testing of these compounds.
The FDA research team, led by Murali K. Matta, PhD, took on the question of systemic absorption only after the agency tried and failed to get sunscreen manufacturers to produce such data, according to the editorial by Robert M. Califf, MD, a former FDA commissioner now with Duke University School of Medicine in Durham, North Carolina, and Kanade Shinkai, MD, PhD, from the Department of Dermatology, University of California, San Francisco, and editor in chief of JAMA Dermatology.
Matta and colleagues enrolled 24 healthy volunteers in an open-label, randomized trial of four commercially available sunscreen formulations (two sprays, one lotion, and one cream). The primary outcome was the maximum plasma concentration of the active ingredient avobenzone. Secondary outcomes were maximum plasma concentrations of three additional active ingredients: oxybenzone, octocrylene, and ecamsule.
Sunscreens were applied consistent with current labeling — 2 mg of sunscreen per 1 cm2 to 75% of body surface area 4 times per day for 4 days. The researchers collected 30 blood samples over 7 days from each subject. The study was conducted indoors without exposure to heat, sunlight, or humidity, and wasn’t designed to look at differences in absorption by the type of sunscreen formulation, skin type, or age of the user. Matta and colleagues found that on day 1 after 4 applications, 23 of 24 subjects had systemic concentrations greater than 0.5 ng/mL for all active ingredients in the formulation applied. This is the Threshold of Toxicological Concern (TTC) FDA adopted to approximate the highest plasma level below which the carcinogenic risk of any unknown compound would be less than 1 in 100,000 after a single dose. Systemic levels above 0.5 ng/mL were reached quickly: within 6 hours after the first application of avobenzone, 2 hours after application of oxybenzone, and 6 hours after application of octocrylene.
Moreover, the concentration of the agents continued to increase over time, indicating drug accumulation. With avobenzone, the maximum plasma concentration was 4.3 ng/mL at 67.5 hours with one formulation, whereas the maximum oxybenzone reached was 209.6 ng/mL at 57.0 hours with a different formulation. The authors point out that the clinical effects of plasma concentrations greater than 0.5 ng/mL of these compounds is unknown, “necessitating further research.” Among their concerns are prior reports of oxybenzone in human breast milk, amniotic fluid, urine, and blood, and the possible impact of oxybenzone on endocrine activity. “In this preliminary study involving healthy volunteers, application of 4 commercially available sunscreens under maximal use conditions resulted in plasma concentrations that exceeded the threshold established by the FDA for potentially waiving some nonclinical toxicology studies for sunscreens, Matta and colleagues write. “The systemic absorption of sunscreen ingredients supports the need for further studies to determine the clinical significance of these findings. These results do not indicate that individuals should refrain from the use of sunscreen.”
In the editorial, Califf and Shinkai explain that approval of OTC sunscreens for prevention of sunburn continues to follow standards from “before the modern era of drug evaluation” and that this needs to change to facilitate accurate risk/benefit analysis. They write, “Sunscreen users reasonably presume that companies that manufacture and sell sunscreens have conducted basic studies to support the safety and effectiveness of their products and that the medical profession would demand high-quality evidence. However, sunscreens have not been subjected to standard drug safety testing, and clinicians and consumers lack data on systemic drug levels despite decades of widespread use.” Absent such data, Califf and Shinkai advise clinicians continue to recommend sun protection for skin cancer prevention based on “strong biological rationale and modest clinical evidence.” Physicians should at least recommend sunscreen formulations containing “generally regarded as safe and effective” (GRASE) ingredients, which are titanium dioxide and zinc oxide, plus the advice to wear protective clothing, hats, and sunglasses, and seek shade.
They write that the most urgent unanswered questions are whether systemic absorption of sunscreen poses risks to human health; the effects of different formulations, skin characteristics, and exposure to sun and water on systemic absorption; and whether systemic absorption in infants and children, who have a higher ratio of body surface to overall size, is different from adults. To that end, they urge a reform of the FDA process to ensure routine safety testing, generation of risk/benefit data, and improved labeling for over-the-counter medications. The study authors have disclosed no relevant financial relationships. Califf reported serving on the corporate board for Cytokinetics and as the board chair for the People-Centered Research Foundation and receiving consulting fees from Merck, Biogen, Genentech, Eli Lilly, and Boehringer Ingelheim. Shinkai has disclosed no relevant financial relationships.
No, what you are seeing is normal thickness ‘terminal’ hairs. The small hairs are vellus hairs and they are normally present in high numbers.
https://www.sixthtone.com/news/1004217/report-exposes-chinas-unlicensed-hair-transplant-industry
This is similar to many clinics in Turkey where almost 500 clinics have FUE surgery performed by minimally trained personal. I believe that these people can learn how to do it as they practice more and more on patients, but the problem is what happens when there is a side effect from anesthesia, or a cardiac arrhythmia? Then the patient has a risk of death, something that has been reported in countries from around the world. These ‘on-the-job’ trained people certainly can’t respond properly to any emergency. In the 16,000 surgeries we have done in our practice, we have seen such events almost every year, but we NEVER had a problem addressing the problem when it appeared because we are skilled in Emergency treatments and we are physicians who know this as a result of years of speciality training.
Hair transplant market in China reached US$1.4 billion in 2017 (In comparison, US hair transplant market accounts for US$1.74 billion in 2017, per Global Market Insight Inc. https://www.gminsights.
Undercover reporter took a 3 day course with 3 other trainee (a breast specialty doctor from Xinjiang, a salon owner, and a freelancer) trained by a non-physician instructor and practiced hands-on on a live patient. It is easy to find 3 day training course online: one center charges around US$1,000 and will not provide a certificate, but said such certificate can be easily purchased for about US$10 online. Another center charges around US$1,200 and will provide a hair transplant professional certificate, which is the course the undercover reporter attended. The 3 day training course only took two days to complete.
Hair transplant price in China depends on the client, the instructor recommended charging between US$0.75 to $6 per hair based on the client’s income. $6 per hair for rich client, $1.5 to $1.8 per hair for middle class client. The instructor, who originally studied psychology, never worked in a hospital, learned hair transplant from others, claimed she had trained more than 100 students and told them they can tell their clients that the saline used as graft holding solution is a special culturing fluid and charge an extra US$300-450. The undercover reporter later went through training to “work” as an online sales consultant for a hair loss center that was a Chinese Medicine Hospital several years ago. Her commission based job was to lure clients in by first earning their trust with knowledge in treatment protocols and impressive results from the treatments, then giving the clients a preliminary diagnosis but acting as if she is not very certain so that she can refer them to the hair loss center.
I’ve had issues with hair loss cause my ferritin was very low. I know that you ferritin levels need to be around 70 for regrowth. I’ve been taking iron supplement and now my levels are currently at 66 and my question is how long does it take for for your hair to regrow again after raising your ferritin levels and what can I do to make sure my ferritin
It might take a year to see the value of correction
I am 22 years old. I have been balding a lot since I was sixteen. This made me depressive from time to time and fucked up my confidence. I started Fin eight months ago. No sides yet, but there are moments in which it scares the fuck out of me. After thinking for years about it, I finally took the plunge and went for a hair transplant. Iwent to Turkey to have 4000 Grafts transplanted. Hair line with 50 grafts/cm2 and behind 30 grafts per cm2. It was a FUE. I am very happy with the transplant itself, I think the doctors made a good job. What kind of scares me now is that I definitely have to take Fin for the Rest of my time and do not really have a choice anymore. At least the clinic highly recommended me to continue taking fin. Moreover, I do not want to care that much anymore and not constantly thinking about future transplants and possible sides and also somehow think I might have been too young. Dunno, there are doubts now and all of this would not be such a big problem if some company would finally perform and bring me an alternative to fin, but I guess it will not happen. Oh man. Maybe, some of you can relate. Regarding Dermarolling, I start to lose hope because I think it only works for some people and before the hair transplant, I really hoped it would also help maintain. ust want to have my youth now and not constantly feel depressed anymore. Feeling lower than before. I feel like it might have been a stupid choice cause I am only 22. If you could contribute something, I would love to hear honest words from you what to do.
Clearly you seem to understand that hair loss is a progressive process. Now that you had 4000 FUE grafts, you most probably have reached the limit for FUE grafts in the future (see here: https://newhair.com/resources/#tab-id-4. Keep in mind that the donor hair you have left will have to manage all of the hair loss you have in the future. That is why I continually discuss two points (1) never rush into a hair transplant especially if you are under 26 and (2) always have a Master Plan for your future hair loss like how are you going to manage it. Hair transplants can’ cure depression nor cure hair loss because it is a changing process. Get a plan going forward. I would like to see some photos of you now and maybe I can help you plan your future course.
https://www.telegraph.co.uk/science/2019/06/28/hair-grown-skin-using-stem-cells-breakthrough-could-cure-baldness/
Based on what I understand about their technology, the article significantly overstates things. Several other big skin groups are trying to make human hairs from cells, but it is very hard and hairs are not desirable scalp hairs.