Hair Falling Out Near Scar from Scalp Injury a Decade Ago

/by William Rassman, M.D./0 /

Hello, I was in a car accident in 2002. When it happened my scalp was pulled from my head and I am left with a U-shaped scar on the side of my head. The hair around the sar fell out and then grew back. But now my hair is getting thinner an falling out around the scar. It ha been almost 10 years and it is starting to fall out now. I was going to get scar revision to make he scar less noticeable but now that the hair is falling out around the scar I don’t know what to do.

You need a good examination from a doctor that can give you a better assessment of your condition. Maybe you are losing hair around the scar (as part of genetic balding), or a change in your hair thickness has occurred and you are noticing the scar even more. I really couldn’t say, as I haven’t seen the scar.

Scar revisions in general do not completely get rid of scars, but how much improvement depends on where it is and the direction of the scar. Scar revisions in the scalp may reduce the scar by 25 to 50%, but sometimes they can make the scar worse. Speak with your doctor.

Tags: scarring, hairloss, hair loss, scar

Scalp Scar After Motorcycle Accident — Will Hair Regrow There?

/by William Rassman, M.D./0 /

I recently had a motorcycle accident about a month and a half ago. unfortunately i was stupid and wasnt wearing a helmet causing a minor injury on my head. i went to the hospital and was told by the doctor that i would need plastic surgery to make sure my wound closed. however throughout the whole process of taking care of paper work and insurance to cover the plastic surgery my wound closed out perfectly fine. even the doctor told me i didnt need the surgery anymore.

however i have a scar about the size of a quarter, a little bigger id say, and i have no hair there. but people say i am gonna grow hair being that everything closed out normal no stitches or anything. i just wanted to clarify that. thanks

I would wait about 6 to 12 months to see if hair will regrow. If not, you can have that scar dealt with, either by having the scar revised or perhaps hair transplanted into the scar. At this point, you’re going to have to wait and see, and if the hair doesn’t return you can meet with your doctor to determine the next step.

Tags: accident, wound, scar, hairloss, hair loss

2011 ISHRS Meeting Review, Part 2 – Female Hair Loss

/by William Rassman, M.D./1 /, ,

ISHRS 2011

Note: The annual meeting of hair surgeons was in held in Alaska this past week. The following review is very selective and is biased by the things that were interesting to me and what I (Dr. Rassman) thought could be interesting to the readers.

This is part 2. More to come…

***

 
What is the role of immunity in the development of androgenic alopecia in women?

    In men and women, it was suggested that there is an immune response in genetic hair loss that could either trigger the process or be an early sign that hair loss is about to start. Dr. Neil Sadick of New York has been following female hair loss for years. He showed his results from scalp biopsies of the scalp in women with hair loss. What he saw were findings that were similar to the conditions found in diseases like lupus (an autoimmune disease). He believes that female pattern hair loss is attributable to immune driven inflammation and he believes that this interferes with hair stem cell activity as they enter into the growth phase of the hair cycle.

    The earliest symptoms of many women and some men start with pain and itching of the scalp, a set of symptoms that reflect the inflammatory response that he believes is always present, but often ignored. He raises the issue that if the connection is correct, the scalp may respond to the use of steroids in the earliest phases of the hair loss process.

Read more

I Had Multiple Brain Surgeries and the Scarring is Causing Depression

/by William Rassman, M.D./0 /,


I’m 26 I had 3 brain surgeries 5 years ago and have a large scar the shape of a horse shoe on the left side of my head. this is causing severe depression. I’d like to know who can I see and what I can do to cover this scar. my hair is no longer thick enough to cover the bald spot and I simply can’t wear a hat all the time. I’m looking for information on doctors in the boca raton area or near palm beach that can help.

thank you so much. this is my prayer to look normal again.

Scars from brain surgeries, as you describe, can be addressed with a hair transplant surgery or with Scalp MicroPigmentation (SMP). Treating brain surgery scars take some experience, as hair that is transplanted into the scar tissue may not fully grow. Be sure that the doctor you see has experience with transplanting into scars.

I would recommend that you not limit yourself to just your immediate area. See as many doctors as possible to get a good idea about what is possible and what the expectations should be. There are many hair transplant surgeons in Florida, and you can find doctors in your area by using the physician search at ISHRS.org. Just be sure to do your research and meet with doctors to form your own opinion on who has the best results.

Tags: brain surgery, scarring, hairloss, hair loss

Repair: Old Plug Removal, SMP Into Hair Transplant Scar

/by William Rassman, M.D./0 /, , , ,

This is a Norwood 6 patient who had a hair transplant done at a clinic in Europe in the 1990s with the old pluggy technique. He wanted to shave his head, but the old hair transplant donor scar and the visible plugs were a problem for him.

This patient chose a combination of (1) SMP to camouflage his old scar, and (2) the surgical removal of his old plugs. The hairs that were in the plugs were redistributed into the crown. We also transplanted a few hundred FUE grafts taken from the donor area and used them on the top of the scalp. As he does not live in the United States, he will return at his convenience on another visit for the needed touch ups. He will likely go on to cover his entire head with SMP, may also undergo more FUE grafting into the frontal hairline, which will make it appear even more natural.

At the point I last saw him, the patient was very satisfied with removing his old plugs with FUE and having SMP done into the old scar. He can stop here if he is satisfied with the result, but I anticipate more work to be done. The after photo shows the temporary redness common just after surgery. We will keep you posted when he returns to the US.

The before (left) and after (right) photos show a work in progress. Click photos to enlarge.

 

Tags: smp, scalp micro-pigmentation, pigment, hair transplant, repair, hairloss, hair loss

Scar is Still Red a Year After Trichophytic Closure

/by William Rassman, M.D./0 /,

I had a trichophytic closure performed on a scar just over a year ago. I think it is healing well but the area is still red not pink and some hairs have grown through accordingly but not nearly as much or what I was expecting especially after a year. Is it normal for the area to still be red? If the area is still pretty thin or still has bald areas can it still be improved? Thank you for your feedback.

Some patients have persistent redness at the donor scar area, even after one year. Follow up with your doctor and get a formal opinion. Sometimes the redness may subside over time (1-2 years).

Tags: hair transplant, scar, scarring

Scars from Strip Harvesting Surgery

/by William Rassman, M.D./0 /,

I have a terrible scar from a previous hair transplant in the donor area. What can be done about it?

If you find that you have a scar from your donor harvest that you find is unacceptable, these options need to be discussed with a competent doctor. The scar often has ridging from the nature of the closure and that will be determined by the doctor who evaluates you. Scars from the donor area are not uncommon and when the surgery is done by a competent surgeon doing standard of care work, scars may still form and be the result of the way your body heals. The treatment of scars are as follows:

  1. Do nothing
  2. Perform a scar revision with a surgeon who can do trichophytic repairs and use ACell in the wound to give you the best opportunity to heal it.
  3. Have FUE into the scar. This can fill in the scar, but hair direction may not be controlled by the surgeon, making the results often disappointing. Two sessions into the scar may be needed.
  4. The use of Scalp Pigmentation has been a significant breakthrough in our hands. Risks include change of color (unusual for the back of the head where hair covers the pigmented area protecting it from the sun). This will not address any ridging in the scar area.
Tags: scar revision, scarring, hair transplant, smp

Short Haircuts with Strip Surgery vs FUE?

/by William Rassman, M.D./1 /,

I like to to have a buzz cut during the summer months. How short can someone cut there hair if they go with a traditional hair transplant vs a FUE?

The visibility of the linear scar from the strip surgery partially depends upon how you heal. Some people heal with a fine line scar that will allow the very short hair cut (not a buzz cut) while others will develop a wider scar that could, at worst case in a single surgery, get to 1cm in height. If the worst case happens, the haircut must be longer to cover the scar.

Tags: haircut, short hair, hair transplant, follicular unit extraction, strip surgery

SMP to Disguise Scalp Reduction Scars?

/by William Rassman, M.D./1 /,

I have had in the past scalp reduction and hair transplants which has left me severely scarred and with and unnatural look. It has also caused my hair to start falling out and thinning rapidly as I am now 51. My scalp is often irritable, hot and prickly.

My life is more than ruined as I am in a senior management role and frequently have to deal with people who are too embarrassed to look at me. I am at the point where I may have to leave a company that I helped build and find a job where I can wear a hat. My last chance would be to disguise the scars and create throughout my scalp and cut my hair shorter with perhaps your method of SMP?

Could you please be discreet when returning my email as this is my work computer, although nobody actually uses it, however you never know. I hope that you can restore some normality back to my life!!

In general terms, Scalp MicroPigmentation (SMP) is a great method to disguise scarring from previous surgeries on the scalp, but you would need to keep your hair shaved. Another option would be a hair transplant to disguise the scars.

A consultation would be best at this point so we can see what you’re dealing with and come up with some treatment options. If you would like a consultation please contact us at (800) NEW-HAIR or use our consult form.

Tags: hairloss, hair loss, smp, scalp reduction, scarring, scalp micro-pigmentation

Hair is Regrowing In a Scar On My Arm That I’ve Had Since Childhood

/by William Rassman, M.D./0 /

As a child I suffered an accident in which a chunk of flesh was torn from my forearm. This resulted in a nasty scar. Later, as an adult, I noticed several hairs growing from this scar tissue. These hairs are similar in size and color to the rest of my arm hair. This makes me wonder if hair follicles can develop spontaneously.

I would think the existing hair follicles on your arm are somehow now re-growing out of the scar, because hair follicles do not develop spontaneously.

Tags: scar, hair growth

How Can I Eliminate My Linear Transplant Scar?

/by William Rassman, M.D./0 /,

Hello Doctor,

After 2 hair transplants of 1000 grafts and then 1800 grafts, I think investing 30-45mins every morning to gel and blow dry my hair and still be worried about wind speeds outside is probably not normal. My hair loss was rated at 5A/6.

Long story short, I am thinking of shaving my head but am concerned about the big scar left on the back of my head from the 2 surgeries. Can you please let me know the options I have to reduce/eliminate this scar?

Thank you for your time and your teams contribution to this blog.

There’s no way to completely eliminate all donor scarring. You can’t undo a transplant. You might be able to have a scar revision, but even then there will still be visible scarring to some degree.

There is a way to camouflage the scar, as long as you didn’t mind keeping a very closely-cropped hairstyle. At New Hair Institute we have been addressing hair transplant linear scars with Scalp MicroPigmentation (SMP) (see example). For more information about SMP please visit scalpmicropigmentation.com.

Tags: pigment, smp, scarring

Removing Scalp Moles Without Leaving Scars?

/by William Rassman, M.D./0 /

I am 24 and unfortunately well on my way to total hair loss, despite having started a Propecia regimen eight months ago.

I´m slowly coming to terms with the prospects of being bald, but one thing bothers me in particular: I have a large number of moles all over my body, including my head. As I lose my hair, these will become visible. Are there any proven methods for removing moles from the scalp without leaving scars? More specifically, would a small surgery to remove the moles make a future hair transplant less likely to be successful? Thanks so much!

I have many questions that could be answered with good pictures of a shaved head. For starters, what are the sizes of these moles? Small moles probably will not leave a noticeable scar, but larger ones might. I would have to evaluate you and determine where you are going and what you want to do about it, your hair loss, and the moles.

Tags: scar, mole, hairloss, hair loss

How Do I Know if My Donor Area is Depleted?

/by William Rassman, M.D./1 /, ,

How can someone figure if their donor region has been depleted? Is it evident by the appearance and volume of the donor region; would someone who has a depleted donor region have somewhat of a see through look in that area? I have had two FUHT both around the same size, 1350 grafts each, totaling 2700 grafts. Both of the strips were about six inches long and 5/8 of an inch wide and were remove from the exact same region of my scalp, second strip removed from the previous scar. My doctor says he could easily get another strip totaling 1300 grafts if not more from on top of my now existing scar. I’m a little skeptical of this. Although my donor area still appears just as thick as it ever was, that seems like a lot of grafts from just that small region. I would have totaled 4000 grafts and barely even touched either of the sides of my donor region, having just used the back region. Is this plausible? Side note my donor density is slightly above average

Usually 2700 grafts will not deplete the donor area. You need to have expertise in examining a donor area to make that assessment. If you do not trust your doctor’s opinion, get a second opinion. The depleted donor area usually has a see-through appearance, especially when the hair is lifted up.

Tags: donor area, hair transplant, hairloss, hair loss

Scalp Micropigmentation (SMP) for Scar Camouflage (with Photos)

/by William Rassman, M.D./1 /, ,

This patient came into the office with a widened scar from a hair transplant we did over a year ago. The photo at the lower left is following his second transplant procedure (the first was with another doctor). The widened scar risk increases with each additional procedure. Only the central 2 1/2 inch portion of the wound stretched 1cm (as seen here), while the two 1/2 inch wounds on either side didn’t stretch. Donor scarring is a real risk of strip harvesting for FUT but usually the scar is under 3mm in width. After the second surgery, the scar may widen as in this man.

We suggested scalp micropigmentation (SMP) for camouflaging the scar and these photos below were taken 10 minutes after his SMP session was done. This is a typical scar treatment for SMP. Sometimes a second treatment is needed. Click the photos to enlarge.

BEFORE SMP (on left); IMMEDIATELY AFTER SMP (on right):

 

Tags: scalp micro-pigmentation, smp, hair transplant, scarring, pigmentation, pigment

Scalp Lacerations Required Staples — Will Hair Regrow There?

/by William Rassman, M.D./2 /,

About a month ago, I sustained two lacerations to the scalp on the back of my head. They were closed with seven staples. The area was not shaved at the emergency room. The largest of these lacerations is about 20 mm long and 1 mm wide. However, the resulting bald area exceeds the wound width by approximately 5 mm (making the width of the bald area 6 mm). I know no hair will grow again within the wound parameters. So I ask you:

1.) Is the prognosis good for full hair regrowth outside the wound?
2.) How many weeks (or months) must pass before I could justifiably believe there would be no more significant hair regrowth?
3.) What are the potential surgical corrective measures (e.g. cutting open the scar and running hair from one hair bearing edge up through the scar tissue)?

Hair loss with laceration repairs is common around the wound. The size of the bald area will vary depending upon the direction of the wound. The scars will be less significant in the normal Langer lines direction (see here).

The regrowth will usually occur within the first 4 months or so and any hair that has not grown in 6 months may probably reflect some permanent hair loss. Scars from scalp lacerations that form are not easily amenable to excision, as they tend to recur (I am assuming that the scars were properly closed and that there were no unusual circumstances present at the time of the closure, such as dirt in the wound).

Tags: laceration, wound, hairloss, hair loss, scarring