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I just had anFUE hair transplant 4 days ago in Thailand by a good surgeon who is a ABHR member also, they advised me to spray the recipient area hourly for 3 days while I was awake, but for some reason I missed that part and for the first 24 hours after surgery I didn’t do any spraying with the spray they gave me, it wasn’t till my follow up the next day when they washed it that they reminded me to spray. I am really worried I could have done damage. Is this likely to have had an effect or should I relax and stop worrying? I know I am not one of your patients but I’d appreciate the info as your website was inviting to ask questions. Thanks and kind Regards Daniel.

An FUE is treated just like a regular hair transplant with regard to the recipient area, but the donor area has open wounds which require daily washing with soap and water. Within 3 days of surgery, you can resume full activities, heavy exercises if you wish. The recipient area requires daily washes as well to keep the recipient area free of crusts. I generally recommend the use of a sponge and supply my patient with a surgical sponge to fill with soapy water and press on the recipient area daily. By repeating this daily, all crusts can be washed off without any fear of losing grafts. If any crust are present, use a Q tip and dip it into soapy water, and roll it on the crusts and that will lift them off without dislodging them, but never rub them, just roll the Q tip on the recipient crust. I like to see no evidence of any crusting in the recipient area and the crusts from the donor area gone in 7-10 days with daily washing.



It is now 5 months since my hair transplant, is it normal and I am very worried about the growth. Is the surgery a failure or can I expect more growth?

I tell my patients that hair growth often starts between three to five months and then keeps growing at a rate of about a half inch per month. By the eighth month, you should see 80 percent of the growth you expect and at 12 months you should see 95 percent of the growth. Just be patient for a few more months and wait it out. If you had a good doctor and a good surgical team, then the grafts will grow.

5 month growth


Basically I remember that I hit puberty later than my peers, when ohers grew pubic hair,etc. I had literally 0 hairs everywhere else. People tell me today that I look like 17/18 eventhough I am 20 so I am wondering if I should wait with fin or not. I haven’t been growing for almost 2 years now is this some indication? My beard has been developing pretty well in the last 2 years and now it is almost complete apart from connectors. Could fin affect my “maturing”? especially facial bone/etc. maturing/masculine appearance.

If you are not balding or losing hair, don’t take finasteride. There is not effect on facial bones once you have matured. If you take finasteride, it could reduce your beard growth.


Would you tell me what you think of this article?

I get these types of emails from many patients. I have no idea what they mean except for the rat. There is no evidence that this is a problem in humans who take Finasteride.


I have lost my libido and can’t get erections, noticing that in the morning when I wake up, my penis is not erect as it has been for almost 22 year, or at least as long as I can remember. My hair is falling out and I can now see that my hairline is almost gone.

The drug Minoxidil, when taken orally, may solve your problem. See a doctor who is willing to write a prescription for you.


This handsome young man had a hair loss consultation with me because he believed he was losing his frontal hairline.  He came to see me because he thinks he is losing about 100 hairs each day.  As part of the examination, we used the HAIRCHECK instrument to determine if he was losing hair anywhere on his head. The examination showed no miniaturization anywhere on the scalp.  The photos below show his hairline is moving to the mature position with a widows peak still present. His hairline probably moved up about 1.4 inches which left the widows peak present.  The HAIRCHECK instrument showed he had no hair loss.

handsome man with no balding


An article that appeared in the New Scientist of May 27, 2017 suggests the brain goes into overdrive in mice who are sleep deprived. We know that people with chronic sleep loss have an increased risk of dementia. Cells in the brain called Astrocytes start to break down more of the brain connections as debris builds up in chronic sleep deprivation.  Also, critical brain connections are eaten up by these Astrocytes after they are broken down. The article says this process is a one-way street. The article points out, as many other article do, that we need sleep and can’t have a healthy brain without it. Some other studies I read suggest that a human needs at least seven good hours of REM sleep each night to maintain good brain health. If you are studying for an exam or dealing with the challenges of life, you need to be able to think clearly.


Here is a link that is a good review of hair loss causes, treatments and future possibilities.


I am 3 weeks after my hair transplant and have plucked out these hairs. There are many more, should I pluck them out?

At three weeks, you can pluck the hairs if you wish, but I would rather you leave them alone because playing with your hair may introduce infections such as folliculitis.

plucked hairs


Tom decided to have Scalp MicroPigmentation but his original efforts to tackle balding started with his first hair transplant when he was 19 years-old.  Now at 47, he reports on the real price he paid for a poor decision when the technology was very primitive some 30 years ago. A hair transplant on any genetically balding 19 year-old male is considered malpractice today.  The quality of Tom’s life was negatively impacted by his hair transplant due to the terrible results.  Not only was the technology of 30 years ago poor but the doctor never treated him as a human being and never told him what he was getting into. Most of the old “plugs” didn’t even grow, left him with scars and made him self-conscious about his appearance for 30 years.

“I want to take the time and thank you for liberating me. I have been wearing hair systems for almost 17 years and the thought of not being burdened by the discomfort or constant maintenance of wearing it anymore is priceless. The hair system cost me thousands of dollars over the years. Having SMP is one of the best decisions that I have made. I no longer worry about my scalp, my hair system or the money I had to pay out every couple of years for a new hair system”.


class 6 before SMP

class 6 balding pattern before Scalp MicroPigmentation

Class 6 after SMP

Class 6 balding pattern after Scalp MicroPigmentation


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