Hair Restoration Blog

Previously I published an article on the Hair Transplant Forum International titled Psychology of Hair Transplant. Our study evaluated the significance of hair loss on men’s psychology. We also discuss the improvements that men experienced after hair restoration surgery.

I just read another article that was just published on the International journal of clinical and experimental hypnosis titled: Hypnotic approaches for alopecia areata. I initially got exited thinking that they have been able to treat Alopecia Areata (AA) with hypnosis. What they studied though was managing the psychological effects of alopecia areata with hypnotherapy.

Patient with alopecia areata like androgenic alopecia show increased rate of anxiety and depression. Here are the synapses of what was researched by Willemsen and Vanderlinden from Department of Dermatology of Academic Hospital in Brussel, Belgium and put together as an interesting article:

AA or Alopecia areata is an autoimmune disease leading to loss of scalp hairs. The disease seems triggered by stress. Data on the possibility of using hypnotherapy in the treatment of AA are very limited. Twenty-eight patients with extensive AA, all refractory to previous conventional treatment, were treated with hypnosis at the Academic Hospital UZ Brussel, Brussels, Belgium.

The authors’ hypnotherapeutic approach combining symptom-oriented suggestions was discussed in the article they also came up with suggestions to improve self-esteem. They are suggesting that twelve out of 21 patients, including 4 with total loss of scalp hair, presented a significant hair growth. All patients presented a significant decrease in scores for anxiety and depression. Although the exact mechanism of hypnotic interventions has not been elucidated, the authors’ results demonstrate that hypnotic interventions may ameliorate the clinical outcome of patients with AA and may improve their psychological well-being.

This article again is focusing on the significance of hair loss and hair loss treatment on patients psychology as we discussed before in our article titled: psychology of hair transplant that could be found on the website of US Hair Restoration, the Los Angeles hair transplant center.

Q:

Dr. Mohebi,

What do you think about Nioxin for hair loss treatment? Do you offer it in your Los Angeles hair restoration offices?

A:

We currently do not sell any products in our Los Angeles hair restoration offices. Nioxin makes different products such as cleansers (shampoos), conditioners, reconstructors, and other products for hair and scalp. They are in the market and could be purchased from beauty salon. Nioxin shampoos are popular, but there appears to be nothing in them that will cure hair loss. I have had many patients who used them in the past for a while and they gave me a mixed report. If they are affordable and you are happy using them as cleansers or conditioners I have no problem with that. However, by looking at what is out there on the ingredients on Nioxin products and the reports from my patients, I cannot recommend them as a treatment for hair loss.

Many people ask me on the use of hair products such as shampoos or conditioner after a hair transplant procedure in our Los Angeles hair transplant clinic. My answer as you probably have seen in this blog is that you can go back to your routine hair wash and maintenance after the first five day after your hair transplant surgery. They practically cannot damage the transplanted hair at that time by washing or shampooing it.

Q:

Hi, I have a few thousand grafts already and I am interested in getting more as well as trying to revise my scar. My donor area is still quite dense.

A:

Scar revision could be done through several different methods depends upon the location, size and orientation of the scalp scars. The scalp scars that are not aligned with the Resting Skin Tension Lines (RSTLs) generally do not respond well to the revision through simple excision of the scars. For these scars hair follicular unit transplantation is a better solution. Filling the scalp scar with follicular unit transplant can be a successful method for the scars that do not respond to the regular excision. We have treated the scars that have been previously operated with multiple simple excisions by other plastic surgeons with no significant improvement in the final size and appearance of the scar. For more on scalp scar management with hair transplantation, you can read on one of my presentations in the fifteenth annual meeting of the international society of hair restoration surgery (ISHRS) which was titled: Hair Transplant and Neurosurgical Scars. You can also check our website at www.ushairrestoration.com to get more information on the modern hair restoration procedures and possible options for repair of old surgeries or scar revision procedures. You can also browse the Hair Restoration blog at www.ushairrestoration.com/blog to familiarize yourself with the available hair transplantation methods and techniques for revision of the hair transplant scar.

Q:

I am a 40 year old man with class IV hair loss. I started taking Propecia recently with great result on the crown area only after a few months. However, it seems like I need more time to get an erection. The other problem is that I cannot maintain an erection as before. I know there is a lot of psychogenic side effect associated with this drug so I am not sure I am really experiencing a side effect or it is just in my head?

Thank you,

A:

You have been taking Propecia (finasteride) recently and have had great result from it, but you are recently experiencing erectile dysfunction. Erectile dysfunction has been reported in men who used Propecia. The comparison of its occurrence between the Propecia and placebo group showed a slight difference (1.3% in Propecia group vs. 0.7% in placebo group).

You can stop Propecia for 2 weeks to test it. If you don’t feel any improvements in 2 weeks, Propecia cannot be the cause of your problem. If your erectile dysfunction improves by stopping Propecia, then you can reduce the dose of Propecia to half and you may not experience the problem with the new dose. This method is effective in most patients who experience erectile dysfunction with Propecia.

You have to understand that erectile dysfunction may be the sign of some other medical problems and you need to discuss it with your primary physician to rule out more serious causes.

Q:

Do you recommend Finepecia for treatment of hair loss?

A:

Finepecia is another name for finasteride or Proscar. Finepecia or finasteride is a medication that blocks the production of Dihydroxytestosterone (DHT) and can stop or slow down the process of baldness. The medication is also prescribed for treatment of enlargement of prostate by physicians. You need to be evaluated by your hair doctor preferably with a miniaturization study before starting on Finepecia. For more on Finepecia or generally medical treatment of hair loss you can visit the website of US Hair Restoration.

I have performed a hair transplant surgery on this 42 year old man who had another hair transplant last year with micor- and minigraft with another office last year. I would like to assume that the era of mini and micro-grafts are over, but still every now and then I see patients who are recently operated with micrograft or minigraft techniques. This 42 year old patient had small number of grafts for a large area with less than adequate coverage.

The patient’s old hair line is lower than where it should be on the corners for his age and race. He had some pluggy hair growth on the corners and on his hairline. We restored his hairline with 400 single hair FUT grafts, removed some of the pluggy hairs on the hairline using a 1mm punch biopsy device. We increased the density of hair on the front are with total of 2293 follicular unit grafts.

The frontal area was densely packed and the some of the frontal grafts with pluggy appearance were removed. I expect great result in a few months for this patient at our 10 month follow up.

Patient immediately after hair transplant surgery with 2293 FUT grafts including 400 single hair grafts on hairline.

Q:

Dear doctor Parsa Mohebi

I have got some questions that I request you to answer them, so that I can have a better decision.

1- Is it possible to use the hair of other members of the family as donor?

2-May the transplanted hair at the fore part of the head recede again? If yes, how long does it take to begin?

3-If the hair recedes to the back of the head, the scar of the surgery appears and it is so ugly. What should we do in this case? And in the case of FIT after receding in the back, that area looks very sparse and with little hair? These make a bad appearance. What should we do in this case?

I appreciate you before and I wish more successes in life for you.

Truly yours
Patient’s name

A:

I will answer your questions in the order you asked them:

1- Is it possible to use the hair of other members of the family as donor?

No

2-May the transplanted hair at the fore part of the head recede again? If yes, how long does it take to begin?

No it will not. Transplanted hair is considered permanent and there is no chance that you lose it in regular male pattern baldness. However you may continue to lose your own hair if you have any left in and around your transplanted hair. Here at US Hair Restoration we recommend finasteride to most patients around the time of surgery to prevent shock loss that could be seen after surgery.

3-If the hair recedes to the back of the head, the scar of the surgery appears and it is so ugly. What should we do in this case? And in the case of FIT after receding in the back, that area looks very sparse and with little hair? These make a bad appearance. What should we do in this case?

Scar or the surgery should never be seen if placed properly. The only way you can see the scar is if you decide to shave your head. If you plan to shave your head for any reason scar of the strip technique hair restoration surgery will be seen and you may want to choose FUE (Follicular Unit Extraction) or as some people call it FIT (Follicular Isolation Technique). FUE transplant or FIT are the same and if done properly should remove hair follicular units evenly throughout your donor area and it should not look thinned out in any particular area. Of course the donor area will be thinner than before the hair transplant surgery, but density of the hair on the back of our head is not what makes you look bald. Not having a solid frame around your face is responsible to give you the appearance of baldness and can make you look older.

I have announced on some TV talk shows that I will be in Dubai this summer along with my all surgical staff to present our high quality hair restoration surgeries to people who prefer having their surgeries closer to their country of residence or have difficulty traveling to the United States. As I said before, I prefer to have a full photo consultation through email and then phone conversation and then book the patients who are interested to have hair transplant surgery with us in Dubai, United Arab Emirates.

We will be in Dubai from August 14, 2008 to August 21, 2008. We have already done some consultations with patients from Dubai, UAE, Iran and. If you are interested in having a hair transplant surgery with US Hair Restoration, please don’t purchase a ticket or arrange for your travel before completing your hair transplant consultation and booked your hair restoration surgery with us. We do not accept walk in patients while we are in Dubai.

The process of online consultation is very simple. You need to visit US hair Restoration online hair transplant consultation page in US Hair Restoration web site and fill the questionnaire. In the comment section, mention that you are interested in having your hair transplant surgery in Dubai, UAE. When we receive your email, we will send you another email asking some more questions and pictures that could be sent through email. At the end, we will have a phone conversation with you to answer all your questions and if you are a good candidate for hair transplantation book you for your hair restoration surgery in our Dubai office.

I hope this service can provide US Hair Restoration quality hair transplant surgery including follicular unit transplant (FUT) and follicular unit extraction (FUE) for people of Middle East, such as UAE, Qatar, Saudi Arabia, Iran, Iraq and Kuwait and other countries of the region. Our Dubai hair transplant clinic may also be easily accessible from India, Pakistan, and European countries. If you have more questions on your hair loss treatment with US Hair Restoration, please email us at info@ushairrestoration.com or call our Los Angeles Hair Transplant center at 1-818-788-8363.

Dr. Parsa Mohebi

Medical Director

US Hair Restoration

Los Angeles, California

Can shampooing affect our hair loss? Can I hurt my hair by doing too much washing and shampooing? Is there a shampoo that can help the growth of my hair? These are some questions that patients ask me in my office on a daily basis.

The answer is simple. The external factor such as shampoos and conditioners cannot really affect the growth or fall of your hair much. You can wash your hair on a regular basis with shampoos if you have oily scalp and greasy hair. You can choose special shampoos for that matter as well; shampoos that have a stronger cleansing effect for oily scalps. You cannot possibly hurt your hair by washing your hair if you are not having obsessive compulsive disorder. Not washing hair may cause you to lose your partners or friends, but it does not affect your hair strength much.

You can find many different shampoos in the market with the claim of helping your hair growth and preventing further hair loss. Unfortunately most those statements are not quite accurate. Even using the shampoos with some effective ingredients such as minoxidil or DHT blockers chemicals cannot be that effective on preventing your hair loss. The active ingredients of the shampoos cannot freely enter the skin and even if they can be absorbed to some degrees, they cannot reach the generative layers of the skin. The contact time of the shampoo and conditioner with the skin is also limited that does not allow for the ingredients to penetrate the skin.

My suggestion to those patients is to stick with whatever shampoo that they are comfortable with and not to change the shampoo because of the miracle shampoo advertisement they saw on the news paper.

Hi Dr. Mohebi,

A couple of questions for you and the blog perhaps.

Just wondering - I’ve noted that one LA area hair transplant doctor has used Vaseline on patient’s heads after surgery to prevent graft scabbing - what’s your opinion on this?

By the way I’m mentioning this as I feel I may have a greater tendency to scab as despite the twice daily washings my three grafts that you so kindly placed scabbed up and still are scabbed on this 6th day out, Sunday, but seeming to loosen up a bit now (patient had a FOX test with us to check his candidacy for FUE procedure and we implanted the three intact grafts that we biopsied to his crown). I’ve had prolonged scabbing before despite the washings and frequent wetting that I was advised with prior procedures. Also, I don’t necessarily mind the scabs other than I’d prefer not to have to return to work with them if they could be minimized with the Vaseline possibly or something similar.

Otherwise I’m wondering if Neutragena shampoo is okay post op vs. baby shampoo? Here’s a Neutragena link for reference.

http://www.drugstore.com/qxp14485_333181_sespider/
neutrogena_shampoo/shampoo_anti_residue_formula.htm

Thanks much,

Patient’s name

A:

Scabbing after hair transplant is very important and if not treated properly may affect the growth of the transplanted hair grafts. We are very meticulous on the care after hair transplant especially hair wash after hair transplant.

Many shampoo s are recommended and used by different hair transplant doctors, but we really don’t have a strong researched based proof for many of those. The only thing that I can tell you is to increase the number of washing in every day to minimize the chance of scabbing. In terms of using shampoos, I prefer using baby shampoo for the first 4 days that skin incisions area still healing, but after that you can use whatever you were using before. We know that there are some solutions and shampoos that can minimize the scabbing and crusting that is seen in the process of wound healing, but since we don’t know how they affect the growth of transplanted grafts we really cannot recommend them in our Los Angeles hair transplant centers. Not until we can have the evidence of their safety on the grafts from a medical study.

Using Vaseline falls in the same category. I prefer not using it in the first two days when the tiny incisions on the recipient area might not be quite sealed.