I, as a first year medical student, am curious as to the reasons you went into hair reconstructive surgery. Too personal??

As a surgical specialty, hair restoration has got to have the greatest patient satisfaction of any (at least in my opinion). It is supreme for helping people solve a problem that bothers them. Some people are quick to say that “it’s just hair” or look at hair transplants as strictly a vanity issue — and while those people are certainly entitled to their opinions, I would disagree with this notion. Hair loss can be a nightmare for many, and the injury to one’s confidence can be substantial. As I’ve said before, hair can be as important to men as the lion’s mane is to the lion. It is what creates his majestic look.

I also recognized that there was a need for a better technology. I entered the business when plugs and scalp reductions were the ‘standard of care’ and immediately determined that this was not an acceptable standard of care for my patients. So I analyzed what had to be done and on the very first day, the very first surgery, I created a new standard. My practice’s personal standard of care (large session surgeries of small follicular unit grafts) has now become the industry’s standard of care. So satisfaction came not only from patients I directly treated, but also from thousands of other patients who I know benefited from what was then a revolutionary change in the art of hair transplant surgery. I take great personal satisfaction in knowing that I have made a difference and this industry has been good to me. It was uniquely backward and unrefined when I entered the field and I contributed to its modern day evolution. You can see my professional history on my CV for a full look at what I’ve done. I apologize in advance if this answer seems like a big pat on the back to myself, but hey, you asked. There’s no magic or myth about it — nothing too personal to share.

Could an LLLT laser brush be used to treat skin damaged by the sun, liver spots or moles, as well?

I would doubt that it would give any benefit.

For the past six or seven years, I’ve been getting folliculitis on the back of my scalp only during the winter. My new dermatologist claims that I have ‘sterile folliculitis.” Apparently, when I get haircuts, the hairs regrow skew and my immune system attacks them as if they were foreign. I have two questions 1) why does this only happen in the winter and 2) why is there a time lag between the emergence of the hair from my skin and the onset of inflammation (my hair is already 1-2 inches long when pus starts to form around the follicle…I would expect the pus to form just as it was emerging, not a couple of inches later). Thanks for your help.

P.S. I’m a medical student and would love technical details about the inflammatory response against my hair because I find the whole thing sort of mystifying, assuming the diagnosis is correct.

A good friend of mine has the same problem that you mentioned whenever he gets a haircut, and I have a similar problem around the winter months (when I am in colder weather).

As a medical student you should know that this is the “practice” of medicine… and not the “science” of medicine. There is no solid scientific explanation, but doctors are keen to ‘describe’ what they see and give it fancy names (sterile folliculitis sounds good, and I am supposed to be an expert in the field).

My personal theory is that in the winter months, your skin is more dry; dry skin promotes irritation to the skin. I suspect your neck/back of scalp is more sensitive to dry skin.

With respect to haircuts and folliculitis, I suspect that the short haircuts irritate your skin (the same way dry air/weather does).

You must remember it is not all about the diagnosis, but what you do with it and how you treat it. We can all try to be intellectual and talk about the immune system and the mediators such as IL2, IL4, TGF, B cells, T cells, etc, etc (immunology), but in the end it seems cold weather and short haircuts just don’t agree with you. Avoid short haircuts and try moisturizing cream.

I’m getting a little tired of doctors saying there are no studies that demonstrate the effectiveness of LLLT on hair regrowth. They need simply do a medline search. A recent study of alopecia areata using intra-subject controls found regrowth on over 90% of the treatment bald spots and 0% regrowth on the control spots. Granted, they don’t understand why and the positive results come from studies using 308nm xenon-chloride excimer lasers to 904nm pulsed diode lasers. The doctors thaat don’t understand the significance of these results simply don’t understand experimental design.

Remember the birth defects from thalidimide that doctors endorsed and prescribed? Recall 20 years ago doctors said megadoses of vitamin C did nothing. Sometimes doctors are wrong and sometimes they are right, but opinions from individuals who have not read the research are of no value.

As I’ve said, the medical field is often referred to as the “practice” of medicine and not “science” of medicine. Thus, sometimes doctors do not know why certain treatments work and sometimes they are wrong in prescribing a treatment.

With respect to lasers, you can approach it from either a scientific perspective or a capitalistic perspective. From a scientific perspective, you mention a very important bullet point: the “experimental design”. Look behind the research method and the sponsors of said research and you may find conflicting sources of interest. With respect to the capitalistic perspective, it boils down to making money. It sounds harmless and it may be worth a try to many individuals, especially with these research papers, but you also forget how many research papers have gone scrutinized (as your thalidomide example). Research papers endorsed medications such as Celebrex (COX2 inhibitors), but in recent years controversy arose from risks associated with heart attacks.

You are correct in stating that sometimes doctors are wrong, but sometimes research papers are wrong. You can see this as a stalemate. You can see it as buyer beware. We all have choices and opinions.

Inversion Therapy: What is your view of this i.e hanging upside down for a few minutes each day to increase blood flow to the scalp. Any benefits to slowing hairloss or re-growth ?

Thanks

The theory of baldness being due to lack of blood is outdated now. In fact there is no evidence to prove the scalp blood supply in balding people is less than in non-balding people, but when the balding happens, the blood supply goes down as a response to the hair being lost. Hair has a very high metabolic rate, so when it dies off from genetic balding, there is no real need for the blood supply that once bathed the hair follicles.

One of my patients actually had this type of therapy for 6 months, haning from his feel for a few hours each day. Guess what? No news is not good news! It did not work!

Early humans shed their body hair thousands of years ago to be differentiated from their ancestors. According to a new theory, humans lost their body hair to avoid being infested by blood-sucking insects such as biting flies and other disease carrying parasites, which live in fur. Presence of facial and head hair can be explained by their continued importance in sexual attraction.

• Read the article at CBC.ca — Early humans shed hair to avoid bug bites: biologists