Hair Restoration Blog

Q:

Hi, My name is XX XX and I am from India. My age is 27 years. I am suffering from scarring alopecia from last 10 years. Initially I have 4-5 very small patches, but now they have increased slowly, these patches are very smooth and of red color. I never feel and pain, burn or sever itching on my scalp, but many times I feel sensation under my scalp area and on my face, it is just like something is moving. I have taken lots of treatments Dermatology, homeopathy, ayurveda but none of these worked, may be because I did not continue any one of them more than six month. One or two year back it was kind of arrest but from last one year it again starting and I can see some new small small smooth and red color patches. I am very depressed and don’t know what to do. Please tell me if you can help me in any kind of diagnose or treatment in your research center or by any other way, please help me out. I will be very grateful!!

A:

Scarring alopecia (Cicatricial Alopecia or CC) is a broad term that applied to a diverse group of hair loss disorders.  An inflammatory condition is usually present that causes destruction of the hair follicles.  Biopsy of the scalp is generally needed to establish the diagnosis. Treatment options are different based on the exact microscopic diagnosis.  In many cases the treatment of cicatricial alopecia is difficult and a complete recovery may not be achievable with medical treatments.

Hair transplant has been tried for the treatment of cicatricial alopecia for those who have a healthy donor hair with limited success.  In some cases the process of the disease may flare up and stimulate losing patient’s original hair along with the transplanted ones. I usually obtain a scalp biopsy from patients who have atypical patterns of baldness to role our cicatricial alopecia before planning for a hair restoration surgery in our Los Angeles Hair Restoration Centers.

My recommendation to you is to find a good dermatologist and stick with his or her plan. You need to understand that the treatment of cicatricial alopecia might be long and a complete recovery might not be achievable in many patients.

Q:

I have had alopecia areata since I was 3 years of age and now I’m 33. I have done as much research as I can to find the causes of this hair loss and there has not been any accurate information of the cause. But my question would be if you are cloning the hair and a patient has alopecia how successful will the procedure be if the hair growth from the patient is unhealthy in the first place?

This procedure is a billion to trillion dollar industry but the research has to be done extensively due to unknown side effects. Please keep posting more information as you go forward. There are many people waiting impatiently.

A:

Alopecia areata is one of those conditions that hair transplant, either from regular methods or through cloning, cannot help much. We have discussed the treatment options for alopecia areata on our website.  Alopecia areata is an autoimmune condition in which the immune system reacts against the hair follicles and destroys them.

If we were to transplant hair to an area with active hair loss due to alopecia areata, the chance of you losing the transplanted hair is very high due to the same mechanism in which native hair has been lost. We do not have much information on cloned hair, but the same phenomenon is likely to happen after transplanting cloned or multiplied hair.

There is just another study on a potential new medication that could be used for treatment of hair loss. Currently, there are only two FDA approved medications for male patterned baldness or typical men hair loss in United States. The two medications that we have extensively discussed on this web site are finasteride (Propecia) and minoxidil (Rogaine).

The article “Effect of Cuscuta reflexa Roxb on androgen-induced alopecia” was published in the Journal of cosmetic dermatology September 2008. The research is done in India and the authors discuss the significance of hair loss in men and the effect of androgenetic alopecia on millions of men and women. They classify typical men hair loss as androgen-driven disorder. They used Cuscuta feflexa Roxb for hair growth activity in androgen-induced alopecia.

The authors of the article used petroleum ether extract of C. reflexa for its hair growth-promoting activity on albino mice. They induced male patterned alopecia in mice by testosterone administration for 20 days. The inhibition of baldness by simultaneous administration of the extract was evaluated using follicular density, anagen/telogen ratio, and microscopic observation of skin sections. To investigate the mechanism of observed activity, in vitro experiments were performed to study the effect of extract and its major component on activity of 5alpha-reductase enzyme.

The researchers announced that petroleum ether extract of C. reflexa exhibited promising hair growth-promoting activity as reflected from follicular density, anagen-telogen ratio, and skin sections. Inhibition of 5alpha-reductase activity by extract and isolate suggest that the extract reversed androgen-induced alopecia by inhibiting conversion of testosterone to dihydrotestosterone. They concluded that the petroleum ether extract of C. reflexa and its isolate is useful in treatment of androgen-induced alopecia by inhibiting the enzyme 5alpha-reductase.

This hair loss research needs more research on human volunteers on a long period of time before it can be considered as a balding treatment. There must also be more research done on the application of the product on human in terms of medication side effects and its comparison with currently available medications for treatment of hair loss.

We at US Hair Restoration continue to follow on the most advanced investigations and researches on hair loss treatment. We keep our patients and the readers of hair restoration blog updated with the new information and medical technology to improve the quality of our hair restoration treatments at our Los Angeles hair restoration clinics.

This article was just published last month in Dermatologic Surgery Journal.  I thought the results should be interesting for the readers of this blog.  The article title is Survival of densely packed follicular unit hair grafts using the lateral slit technique.

The authors, Nakatsui, Wong and Groot, describe their experiment on densely packed follicular hair units and follow up on the rate of survival of the transplanted hair.  They use a density of 75 hairs per square centimeter which is even higher than the regular hair transplantation methods currently in use. The authors explain that the use of densely packed follicular unit grafts (>30 grafts/sq cm) is a highly debated issue with some claiming decreased survival rates.

Those who perform dense packing routinely do not believe they have seen any impaired survival. However, no prior study has rigorously analyzed densely packed areas to assess survival rates.

This is true and some hair transplant surgeons still advocate the use of lower densities which make the patient commit to multiple surgeries. These hair transplant surgeons convince their patients that dense packing can negatively affect the circulation of the skin and jeopardize the rate of growth for implanted hair follicles.

The study was only done on one patient and needs to be experimented on a larger number of patients but this at least clarifies the mechanism of hair restoration with new methods of highly dense packing. The authors concluded that 98.6% of transplanted hair follicles survived and were able to re-grow a normal hair.  Obviously, this is the first study that demonstrates high growth rates in densely packed follicular units using the lateral slit technique, even at densities of 72 grafts/sq cm.

We do perform densepacking hair transplant surgery at the US Hair Restoration clinics in Los Angeles, Beverly Hills and Orange County in California on a regular basis.

Q:

Dear Sir,

I am 27 years old now and I have the problem of hair falling, I lost 60% of hair in a period of last 3-4 years. I am basically from India and currently working in Dubai.  I heard about your treatment for baldness; I am interested in hair transplantation. I had gone through the details through internet, Can you provide more details about the transplantation.

·        What is the percentage guaranteed for the transplantation

·        What are the side effects

·        Can I do the treatment in India / UAE (mention places)

·        How is the treatment period

·        What are the pre and post procedures of treatment

·        How is the treatment done

·        What about the price for the transplanting

·        How is the growth of hair after transplanting? Gradual, Immediate……

With regards

Patient’s Name

A:

Below you can find the answer to your questions as they were asked:

·        What is the percentage guaranteed for the transplantation?
If diagnosis is done correctly with an expert eye, it can be 95-99% successful.

·        What are the side effects?
A linear scar on the back, some swelling and redness on forehead for a few days after surgery and possibility of some numbness at or around donor and recipient area.  For more you see donor scar complication post in my blog.

·        Can I do the treatment in India / UAE (mention places)?
We are in process of having regular visits to Dubai, but we don’t have a certain day yet.  Please check with our office within the next few months for the schedule of our Dubai, UAE hair transplant clinic.  However, if you are willing to travel to get your hair restoration surgery done in our Los Angeles hair transplant clinic, we do have a special program for the patients from other countries in which they can get 10% off the cost of their hair restoration procedure toward their traveling expenses.

·        How is the treatment period, what are the pre and post procedures of treatment and how is the treatment done?
Please see our website to get more information of hair transplant surgery with follicular unit transplant method.  You can also see some before and after hair transplant pictures there.

·        What about the price for the transplanting
Check the website of US Hair Restoration for cost of hair transplant surgery.

·        How is the growth of hair after transplanting? Gradual, Immediate……
It usually takes 3 months for you to see any growth, and then it will get better and better until 1 year post surgery.

Please don’t hesitate to ask any other questions by email or through Hair Restoration Blog.

Best,
Parsa Mohebi, MD

Q:

I have been diagnosed with a thyroid problem called Hashimoto’s Disease.  I am 23 and I am losing hair on head, and also developing some bald spots on my beard area on the neck and scalp too.  My eyebrow hair is also falling out on the sides.  Doctors said that I have low function of thyroid and put me on thyroid pills.  Now that my thyroid is under control, I would like to know whether or not that my hair ever grows back.

A:

Hypothyroidism or low functioning thyroid can cause scalp and eyebrow hair loss.  However the balding spots that you are experiencing are not typical for hypothyroidism.  The patchy hair loss spots are usually due to a disorder called alopecia areata.  Alopecia areata (AA) is an autoimmune disease that could be seen in association with other autoimmune disorders like Grave’s disease or Hashimoto’s disease.  Thyroid disease is reported in almost 10% of the patients who have alopecia areata.

To confirm the diagnosis and start with a treatment plan, you need to see a dermatologist.  If the diagnosis of alopecia areata is confirmed then you can choose to wait for spontaneous recovery as it is in most of cases of alopecia areata or seek treatment methods that can facilitate the recovery and re-growth your hair.

Q:
I am 24 with a strong family history of hair loss in the male members at and around early 20s. Recently, I started seeing hair in my sink and on the bed that is much lighter my regular hair. Is it normal? Am I balding and can I use a hair transplant to prevent further hair loss.
A:
Male patterned hair loss is characterized with miniaturization of hair shafts before complete losing them. In genetically prone men to male pattern baldness, hairs of an affected area gradually become thinner and thinner, before they ultimately become nonexistent.

Miniaturization hair shafts make them look thinner, because of the smaller size and then the smaller amount of darker pigments that could be seen.

It seems that you started with hair loss phenomenon and you only need to get it diagnosed by a good hair specialist who can also get you started on medication treatment if need be. A miniaturization study can give you some ideas of where you are heading before starting with the medications.

Q:

It’s been just over 4 weeks since I had my hair transplantation. I still have a few scabs. It just happened that while shampooing my hair, I ended up accidentally removing a scab and the area underneath the scab appeared red. The area that has gone red, I could not say for sure if there was any bleeding as I would have been washing it at the time with shampoo. Did I lose any graft? Its 4 weeks post op and I am not sure when I can get to my normal hair wash and I really don’t want to compromise with the results.

A:

Transplanted hair is vulnerable in the first 4 days. The most important day is the first day after surgery in which I would like to bring patients back to wash their hair professionally. You can read more on Dos and Don’ts after hair transplant in our web blog. Washing after hair transplant surgery is very meticulous, but after day 4 following a hair restoration surgery, transplanted hair follicles become part of your skin and you cannot dislodge them even if you remove hair. I usually recommend that my patients follow our washing and after hair transplant care directions on the first four days to minimize scabbing after hair transplant surgery and don’t use any other products.

In your case at 4 weeks after hair transplant, you should have been able to wash your hair in your routine long ago. At this time, you can use your regular shampoo and conditioner without being worried about losing your precious implanted hair grafts.

I am in the Detroit airport on my way back to Los Angeles from the 16^th annual meeting of international society of hair restoration surgery (ISHRS) that was held in the beautiful city of Montreal in Canada last week. This five day meeting was filled with a variety of presentation on the clinical and basic science aspects of hair transplant surgery and medical hair restoration.

I gave a lecture on psycho-social impacts of hair restoration on men on the first day of the meeting. The lecture has been prepared based on my other article on Psychology of Hair Transplant that was previously presented and published on the Hair Transplant Forum International on April, 2008. In the current presentation on psycho social impacts of hair transplantation, I explored some other social and psychological aspect that hair transplant patients experience after their hair restoration procedures based on experience we had with our Los Angeles hair transplant patients and what we found in our research last year with New Hair Institute (NHI).

Several other interesting studies were presented on the aesthetic planning and designing of the hair line and frame of the face with hair transplantation. There were many articles on the hair transplant surgery techniques that could be used for optimization of the final appearance of a hair transplant.

Few articles were presented on hair stem cell research and hair multiplication. However based on the presented evidences, there were no signs of an upcoming solution for hair multiplication or hair cloning any time soon.

One article discussed an innovative method of hair graft harvesting that can produce more hair from an existing follicular unit. The result of this study, although interesting was very controversial among the experts and the author could not release the study details on the methodology to elucidate this matter.

I will publish the highlights of this meeting on the website of US Hair Restoration soon.

The article “Surgeon Restores Patients’ Hair, Self-Confidence” was recently published in the popular newspaper of “The Beverly Hills Courier” based on the interview with Dr. Parsa Mohebi, medical director of US Hair Restoration.

Here is a summary of the article, which mostly focuses on the psychological impacts of hair restoration on men. Dr. Mohebi also discussed some of the new methods of hair restoration that is offered by the Beverly Hills Office of US Hair Restoration. Here is how he goes:

Nothing looks better than a full head of hair, and one of the best people to provide it is Dr. Parsa Mohebi, medical director of US Hair Restoration.

Mohebi specializes in several hair-transplant procedures:

• Follicular Unit Transplant (FUT) is the gold standard of hair-transplant surgery, Mohebi said, giving very natural results. A strip of donor scalp is removed and the follicles are prepared under microscopes and distributed in the bald area in the natural direction and orientation.
• Follicular Unit Extraction (FUE), also called non-invasive hair-restoration surgery, uses special biopsy devices to extract individual follicular units without having to remove a strip of skin; so there is no linear scar.

“Not everyone needs non-invasive surgery,” Mohebi says. “But people who want to shave their head in the future for any reason may consider FUE because there is no visible evidence of surgery on the back of their head. There’s nothing to suture, and the small dot wounds are not detectable a few days after surgery”.

• Mohebi also specializes in eyebrow transplants for both men and women.
• As testament to his skills, he also repairs bad or “pluggy” transplants, performed by other doctors. “We do several repair hair transplant surgeries a month,” he says.

Mohebi spends an hour with each new patient and does a microscopic evaluation of the scalp and a miniaturization study of the hair to predict future hair loss. “That way we’re not limited to the obviously bald areas, but we can transplant hair to where the patient may lose hair in the future. With the technology we have now, there’s no reason for anyone to experience hair loss.”

As a fellowship-trained hair-transplant surgeon, Dr. Mohebi continues research the latest high-transplant techniques and his writings have been presented and published in both national and international medical-society publications.

The article continues with discussing the published research on the psychology of hair transplant in men, which was finished last year: Dr. Mohebi’s latest article was the cover story for Hair Transplant Forum International, considered the most important journal in the field of hair restoration, on The Psychology of Hair Transplants. From research in Europe, we know that people with hair loss are prone to anxiety, depression and other psychological problems; we tried to see if we can reverse that with hair restoration surgery.

He evaluated 200 patients after surgery in eight criteria, and saw improvements with FUT in terms of happiness, youthfulness, energy levels, self-esteem and self confidence, future outlook and impact on their career and sex life. The results were amazing and improvements in all eight criteria were statistically significant. The authors, Dr. Mohebi and Dr. Rassman concluded that using the new techniques of hair restoration patient can drastically improve all of the psycho-social impacts of hair loss.

The reporter then set aside US Hair restoration from many other hair transplant clinics by several factors by referring to Dr. Mohebi’s comments on following the latest standards of hair restoration surgery and the fact that things have changed significantly recently in the field of hair restoration. What was done five years ago is not acceptable today. We have the most experienced technicians; and everything is done under a microscope to get the highest yield of hair.

Then there’s the customer service. “The day of the hair transplant procedure is a big day for patients,” Mohebi said, “often six to eight hours. Patients are usually amazed at how smooth and pleasant the day is.

Patients are given mild to moderate sedation and numbing medication for the donor and recipient area. Once the scalp is numb the strip of skin is removed and the wound is closed. The next step is to prepare hair grafts under microscope. While grafts are being made by experienced technicians of US Hair Restoration, Dr. Mohebi is designing the hair line and makes the sites according to the natural direction and distribution of hairs.

Since the newly placed follicles are so fragile, patients return the next day to get their hair washed professionally, given special shampoo and taught how to take care of their hair at home. “After five days, no special care is needed,” Mohebi said.

Ten days after the surgery, patients return to have the donor site checked and staples removed for those who had them. Hair starts growing after three months, and is long enough to style and comb after ten to twelve months. The third follow up is at 10 months after the procedure.

Severe baldness may require more than one surgery, usually spaced at least six months apart. “With megasession hair transplants we can do 4,000 grafts in one day. That significant number is a help to patients with a high class of baldness. We can get a higher stage of restoration with fewer sessions of transplants.”

Continuing to pioneer in the field, Dr. Mohebi is the inventor of the Laxometer, a device to measure the laxity or mobility of the scalp. Laxity of the scalp is key in determining the size of the donor strip so that enough can be removed for bigger cases, and the wound can be closed without too much tension and the scaring will be minimal.

To help people stay abreast of all that’s happening the field of hair restoration, and to answer questions (he’s heard from Europe and China) Dr. Mohebi maintains a hair restoration blog, ushairrestoration.com/blog.