Hi Dr. Wrassman, I had a quick question regarding microneedling. Can it cause a hair transplant to have a lower chance of success?
Microneedling has no impact on having a hair transplant or the success of the hair transplant. The needles with microneedling go only through the epidermis and not deep enough to negatively impact the dermis or the existing hair follicles.
Amazing change. The use of microneedling is most likely the stimulus for the speed of change that you saw.
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Syphilis Soars in the US |
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Syphilis cases in the US have risen to the highest level since the 1950s, according to new data on sexually transmitted infections released yesterday from the Centers for Disease Control and Prevention.
The US saw 203,500 syphilis cases in 2022 (the last year for which data are available), up 17% from 2021 and nearly 80% from 2018. The data also showed 3,755 babies were born with congenital syphilis in 2022, a nearly 31% change year-over-year and a 183% change since 2018. See an overview of syphilis here.
Meanwhile, new cases of gonorrhea in 2022 declined for the first time in a decade, down 8.7% from 2021. Health experts are not sure of the reason behind the decline. Cases of chlamydia, which accounted for roughly two-thirds of the more than 2.5 million total cases of sexually transmitted infections in 2022, were up 0.3% year-over-year but down 6.2% since 2018. See all CDC data here (w/charts). From 1440 Daily Digest |
I put this in my baldingblog because this blog is read mostly by men and many sexually active men should be aware of this epidemic, something that is not discussed as openly as it should be.
Microneedling should have a needle length of 1.25mm and the highest number of needles, like Dr. Pen’s system, with 36 needles. Keep the microneedling in the same place for 10 seconds. Move from place to place until you covered the area. Do this once a week. The purpose of the depth and the frequency is to produce a healing cascade from the microneedling wounds. This stimulates the stem cells close to the scalp surface and along the upper part of the hair shaft. They are located between 1-1.5 mm from the scalp surface with a good population of stem cells just under the sebaceous gland of the hair shaft.
I have seen microneedling reverse what we often think is irreversible hair loss. It is worth trying.
Yes. Minoxidil, orally, is a hypotensive medication, and taking it at varying times in the day may inadvertently increase the effective dose. Minoxidil can produce lightheadedness, which could be a sign of hypotension (low blood pressure).
I never considered that fin could make the individual hair follicles thinner. (Can it?) I’ve noticed after the one month mark that the density of my hair has gone drastically down.
Finasteride doesn’t cause hair follicles to become thinner. Finasteride will help reverse miniaturized hair to become thicker. If you believe to the contrary, purchase a micrometer from Amazon (only $22) and measure your hair thickness. This is the one I use: https://www.amazon.com/dp/B09964YBMF?ref=ppx_yo2ov_dt_b_product_details&th=1
I take Dutasteride .5mg daily. Oral min 2.5 daily. Also do topical min twice daily. Multiple times a week I dermaroll. Never draw blood. I’ve done RU588. Not much lately. I’ve got the keto shampoo that maybe I remember to use once a week. I get the meds from my regular doctor. Got a cheap dermaroller on Amazon. The RU I got on eBay. Not a hair transplant. Can’t afford one and I have thin hair on the nape of my neck and above my ears.
This is very impressive for a 40-year-old male. Doctors often wonder when the scalp is slick bald, as the back of your head showed, whether the stem cells are still alive. Using you as an example, in your case, the stem cells were kicked into action with a good anagen response. I believe that the microneedling had a lot to do with it.
Cannabis and THC may have an effect on reducing the effectiveness of anesthetics used in hair transplants and other anesthetic procedures. This observation has been made by many hair transplant surgeons and substantiated by Anesthesiologists and the peer-reviewed article below.
So the biggest issue with going to a hair mill is that you dont know who the doctor will be? It’s just some random technician?
byu/SunilaP inHairTransplants
“I have a friend who went to NOW HAIR CLINIC, loved his results. But the more I google them I see a lot of negative reviews. I understand this is a hair mill clinic, you basically roll the dice. There is a chance you will get an amazing result or a bad one.
But this search is stressing me out. I dont think I can spend over $4,000 USD. I’ve gotten several consultations, many of these clinics said I need 3500-4000 grafts.
Can someone please just list out the top three choices in Turkey. I am coming from USA”.
It is more than just picking a clinic, possibly without or without a doctor. Even many of the doctors in Turkey and even many in the US, don’t know much more than to perform an FUE and stick the hairs in the recipient area. They always seem to quote too many grafts, showing no respect for the donor area reserves in the real case of failing to achieve your objectives. Also, understanding donor reserves addresses the likely progressive balding that occurs in every balding man. I visit clinics often, and I am amazed at what I see; failures to understand quality control mean poor graft survival and poor training that seems evident everywhere; placing the grafts in the wrong direction is more common than I imagined and finding in clinics everywhere by doctors or technicians who make the site’s produce poor directional control. I can continue, but more of these comments will not help you. Go to a really good doctor in the US and see what a good consultation is about and how it prepares you for a personalized Master Plan for now and your future hair loss. You ended your comment by asking for 3 recommendations, but I doubt any three recommendations will solve your problem.
Is reversing premature greying possible with Palmitoyl Tetrapeptide-20?
It seems to have value, according to what I have read.
I am scheduled for an upcoming hair transplant, and I am worried about having Diffuse Unpatterned Alopecia (DUPA). The surgeon didn’t understand when I asked him about DUPA in my donor area, and I don’t want to go forward if I have DUPA. Please help me with the diagnosis. Here are four pictures from my donor area.
The first picture qualifies for DUPA as there are many hypopigmented hairs in the field of view. The other photos show a much more straightforward case of DUPA. I define DUPA as miniaturization over 20% of the hairs in the donor area. The third photo shows well over 20% miniaturized hair, which you can count easily. I would want a more extensive evaluation of the donor area before tackling a hair transplant, but what is here strongly suggests DUPA. He met face-to-face with three doctors before speaking with me by phone. Shame on the doctor for (1) not understanding his concerns about DUPA, (2) not listening to his concerns, and (3) not making the diagnosis when he was before them. Some doctors just do this for the money and really don’t care what happens to these patients after the surgery. I tell the patient to ask himself the question: “Is this a doctor you trust?” This is a critical question everyone should ask before allowing them to work on their scalp.
I outlined in a circle (the third picture is the same photo as #2) with arrows and circles showing the hairs in the field that I think are miniaturized. As this is part of the donor area, it would worry me a great deal if a hair transplant was on the agenda unless, that is, a better and more comprehensive assessment of the donor area is performed. Click on the photo to enlarge it.
Dr. Robert Bernstein and I discussed DUPA and concluded that Finasteride works in most men to some degree. It is worth trying this for a year and then reassessing the patient’s situation as having great before pictures is invaluable.
I’m thinning in my crown area so it’s not easy to see the progress I’m making. So I decided to purchase a microscope for inspecting the scalp. I didn’t know I could get these on Amazon for couple of bucks. It was pretty fun looking at my scalp so close. The picture shown here is my crown area that’s thinning. I can definitely see a lot of things going on there. I’m on fin and oral min so I’m hoping those drugs will reverse the process I am seeing.
The picture of the crown shows significant hair loss, with many follicular groups having only one thicker and one thread-like hair (a remnant of the hair that used to be there). Some of the follicular groups have both hairs impacted and threadlike. This single photo shows almost all of the stages of the hair loss process. This active balding process will eventually lead to the remaining hairs thinning and possibly falling out.
I’m 25M I made a post a long time ago talking about my nonfin hair loss stack. It was actually working decently well for me but I got tired of using so many topicals so I just switched to Fin + min only. Ive been on that stack for about 6-8 months now. I don’t have a before or after because there’s been no drastic changes really. I’m maintaining but I’m way more carefree about my hair now. I used to not style it for years or blow dry it because I was scared it would make me lose hair faster. I was trying to change my lifestyle & do things like avoid coffee to try to slow or stop my hair loss
Now I just take my fin & do what I want with my hair. I actually style it when I go out now and I like how I look. I still have my insecurities but fin has definitely helped. I love the drug. It’s given me more confidence and that’s all I could ask for. I do have some side effect, which are quite manageable. The are: 1) Watery semen (by a little), 2) Nipple sensitivity, 3) I had an increase in sex drive at the start, slight decrease in sex drive now but I’m also cutting weight so that could be a contributing factor
This is not an atypical story. Most men with good results, just don’t talk about it, but bad results is like the news, everyone wants to hear about bad results from medications or even hair transplants.
Will Minoxidil stop irreversible hair loss if I stop taking Fin when trying for a baby?
The mechanisms of action of these two drugs are very different. If you had a successful experience with finasteride, stopping will cause you to lose all of its benefits, and I would not expect minoxidil to rescue you. Minoxidil can produce hair, but certainty and timing are two variables that might not coordinate with your desire to conceive a baby.