The US Food and Drug Administration (FDA) has authority to regulate regenerative medicine products, including stem cell products and exosome products. There is a lot of misleading information on the internet about these products, including statements about the conditions they can be used to treat. FDA is concerned that many patients seeking cures and remedies may be misled by information about products that are illegally marketed, have not been shown to be safe or effective, and, in some cases, may have significant safety issues that put patients at risk. FDA wants to help consumers be informed about how these products are regulated, and what to look for when considering treatment with one of these products.
This man used finasteride and minoxidil for 18 months with good results on restoring his hair
https://www.washingtonpost.com/health/fda-wins-groundbreaking-case-against-for-profit-stem-cell-company/2019/06/03/498373fa-864e-11e9-98c1-e945ae5db8fb_story.htm
June 4, 2019 at 8:50 a.m. PDT In a decision expected to send a chill through the booming stem cell industry, a federal judge ruled in favor of the Food and Drug Administration on Monday in a lawsuit against a Florida-based stem cell company whose treatments have blinded at least four patients. Judge Ursula Ungaro agreed that the FDA has the authority to regulate a procedure that has become widespread in the burgeoning industry — using patients’ fat to create a stem cell treatment. The judge ruled that the FDA is entitled to an injunction ordering U.S. Stem Cell to halt the procedure……………. read more
https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/consumer-alert-regenerative-medicine-products-including-stem-cells-and-exosomes
I get a lot of inquiries about stem cells and the growth of new hair follicles arising out of stem cells. These two articles addresses the problem and challenges in this field. Stem cells have yet to be approved by the FDA for hair loss treatment.
https://www.sciencedaily.com/releases/2020/09/200928125008.htm
Abstract: A team of researchers from Cologne and Helsinki has discovered a mechanism that prevents hair loss: hair follicle stem cells, essential for hair to regrow, can prolong their life by switching their metabolic state in response to low oxygen concentration in the tissue. The team was led by Associate Professor Sara Wickström (University of Helsinki and Max Planck Institute for the Biology of Ageing) and the dermatologist Professor Sabine Eming (University of Cologne), and included researchers from the University of Cologne’s Cluster of Excellence in Aging Research CECAD, the Max Planck Institute for the Biology of Ageing, Collaborative Research Centre 829 ‘Molecular Mechanisms Regulating Skin Homeostasis’, the Center for Molecular Medicine (CMMC) (all in Cologne), and the University of Helsinki. The paper ‘Glutamine Metabolism Controls Stem Cell Fate Reversibility and Long-Term Maintenance in the Hair Follicle’ has been published in Cell Metabolism.
I have an appointment at Dr XXX’s office today, and I’m wondering why people always recommend FUE? His office tells me than FUE has a lower graft survival rate and leaves the back of the head looking thin. I think I’d rather have a tiny linear scar on the back than a less dense donor area? I’m a NW2 that’s thinning and I’d probably need 2000 grafts to bring back my density and restore the hairline.
That is not true. In good hands, survival of FUE is as good as the strip surgery. In our practice we do 50% FUE and 50% Strip surgery. This is because there are good solid reasons to do a strip surgery or FUE as follows (some tips):
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Do a strip surgery if you had a previous strip surgery
- Many of the newer doctors only learned FUE and can’t perform a strip surgery so that they recommend what they know, the only surgery that they know how to do. There is a place for both.
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If you are going to be very bald. A strip surgery for a large number of grafts will not produce a see-through donor area common when FUE is over-harvested.
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FUE is good when the total short term needs is less than 3500 grafts total in a person with medium weight hair and an average donor density. Many men with class 3 balding can easily get a great FUE session with great survival of the grafts
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FUE is good for men who will not be very bald and want to keep their hair very short in the back of their head.
- FUE has a very short recovery time and very little post-operative pain. Most young men don’t look at FUE as a surgery (which it is).
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At our monthly open house events, former patients come in, some had FUE completely, some had Strip followed by FUE, and some had FUE followed by strip surgery. You can meet these patients and judge for yourself what is real and not real.
Everyone is different on how they handle hair loss. Many men put on facial hair if they hadn’t had it before
Yes, this is a classic look of the magnified donor area that you want to see with 50% or more miniaturized hairs. We actually classify DUPA (Diffuse Unpatterned Alopecia) once the miniaturized significantly exceeds 20%. Most DUPA patients have much higher miniaturization in the donor area and elsewhere on the scalp. The single best treatment is the drug finasteride which is less than 50% effective at controlling the progression and less effective at reversing the process. I don’t know of anyone who has reversed the process with any treatment.
So I’ve recently been noticing my hair looks way thinner, and is much more oily (which probably makes it stick together and look thinner). My scalp shows way much more on the sides, and its just wierd, feels like I aged 5 years in a month. I’ve always been a heavy drinker, but things that can have an effect:
• Drinking more often
• Smoking ALOT more•Using this Hemp shampoo, which is very oily (pretty sure this is the main cause)
Sounds like your stressed and stress tends to accelerate the hair loss process in men who have the genes for balding
25 yo. I’m thinking of getting a hair transplant in the next 7 months or so. I will likely need another one after that. My crown is very thin ( can see scalp) and my hairline has receded. I still have quite a bit of hair tho.
I was wondering can one get a preventative hair transplant in areas where you’re likely to lose hair in the future ( transplanting hairs in areas where there’s hair but it’s less dense).
I am strongly against a preventive hair transplant because of this: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/ A good Master Plan is needed before you go forward with the hair transplant process. Here is my explanation for the Master Plan: https://baldingblog.com/so-if-i-replace-my-receding-hairline-what-happens-in-another-5-10-years-when-i-continue-to-recede-answer-a-master-plan-with-a-good-doctor-who-measures-your-hair-bank/
The arrows show large grafts at the hairline, something that should never be done as they appear pluggy. Also growth seemed either under transplanted or this man has inadequate growth. Either way, this man should get his money back and go to a good hair transplant surgeon to fix the problem
Hi Dr Rassman, sorry to bother you but I have a question for you. I have been on finasteride 1mg/day for the past 2 years now. I have also incorporated minoxidil foam for the past year(initially twice a day, but in the last few months it’s only been once a day). Both have resulted in success of hair regrowth for me.
So in the last 1-2 months I have noticed A LOT more shedding. Before this time, I rarely had been shedding any hair at all.. but for whatever reason now I lose hair even when I run my hand through my hair.
I am unsure if it is stress/diet from the new school, perhaps a damaged minox canister or the decreased frequency of applying it, or maybe the most unfortunate which is that the finasteride has lessened it’s effectiveness on me… Anyways, just was hoping to get your insight if you have the time. Thank you
It is possible that the shedding actually is related to the genetic hair loss. Wait it out for 2-3 months and you should see reversal of the shedding if it is drug induced.
Yes, a hairline lowering surgery can cause a scar. In this example, an unusually bad scar resulted. I say unusual, because incisions that are horizontal on the forehead tend to heal well. I suspect that this man had either unusual tension as the advancement was closed by the surgeon (most probable cause) or this particular patient had scarring tendencies. This can be fixed with hair transplants, either FUE or FUT; however considering the degree of scarring, FUE might be a better choice. The surgeon who does this better have a great deal of experience when designing the hairline to repair this problem as a poorly designed hairline will just add to this man’s misery.
This man is showing that minoxidil has worked on his hairline. The reason that most say that it only works on the crown (vertex) is that the FDA only got approved for claims on the crown (Vertex) when the drug got approved. It clearly works sometimes on the hairline as many men will tell you so and it works well in the crown for many men.
These two photos show two different men responding to finasteride, 6 months on the left and 4 months on the right. This shows the value of this drug for many young men.
This young man rushed to get a beard transplant. He should have asked the surgeon to show him other patients who had it done in that surgeon’s hands. Unfortunately, that didn’t happen. Now he work in a public position and every asks him what is wrong with his face? He wants to get rid of the transplants, all 2500 of them. This will possibly produce scarring even when they are out. The use of a very small punch by the surgeon and test removals is the way to go to see what is outcome will be. There is clearly a balancing act, the removal process and the possible scars left behind, or leaving it the way it is.
