Hair Restoration Blog

Q:

Hi Dr.,  I saw your TV show, and would like to ask you if it is ok for me to buy minoxidil and dissolve it in the shampoo?
Also there are products that says gradually will change the color of my hair to natural color, are they safe to use? wouldn’t they interfere with my scalp respiration?

Thanks a lot

A:

Minoxidil mixed with shampoo

Minoxidil is one of the FDA approved medications for balding prevention and hair loss treatment.  The recommended dose and method for its use is applying it topically on balding area twice a day and leaving the product without washing it off.
Although combination of minoxidil with shampoos are available commercially, I don’t believe you can get a complete result by using them because:
1.    Minoxidil would be diluted with shampoo and water and that will reduce its strength.
2.    The active ingredient (minoxidil) would be rinsed and it would not get enough time to have contact with the scalp skin.
3.    It would be less likely that it is used twice a day, which is the recommended method for its maximum result.

Hair product for white hair

To answer your second question, there are many products that are claimed to change the color of white and de-pigmented hair to a normal one.  Most of them are herbal extracts and there is just not enough long term studies that prove their safety that I am aware of.

Q:

It’s a little over 3 weeks after my hair transplant now and I’ve noticed there’s a 1inch in diameter bald spot roughly two inches to the left of my right ear (when viewed from the right side).  Though I had been keeping that area clean as instructed for the last 3 weeks, it hasn’t filled in, just appears to be the same size.  I’m pretty sure it’s not getting bigger.  It’s sensitive to temperature, too, like skin on the inside of the wrist. The last scab fell off today while washing, but it was nearly as big as the spot, .3cm x .75cm big right at the center of the spot.

There’s also numbness still concentrated right around the bald spot.  This is the first time I’ve ever seen a circular bald spot on the donor area, so it’s scary. Is there something I should do? Does trauma cause fallout even in donor areas?  I’ve been taking 1.25mg finasteride daily, prior to, during and after surgery. In retrospect, except for a few erratic glucose levels (low and high) I actually think I’ve taken better care of my head this time than the 3 previous surgeries, so I’m worried.

What’s the likelihood of it growing back granted the area isn’t scarred over? A quarter-sized bald spot doesn’t make sense to me because that makes it seem like the wound healed while gaping open. That area was sensitive this whole time, but I never noticed any infection or excess oozing after the first few days, so it seems only possible that the hair around a fixed point on the wound got shocked and fell out.

Please advise,

A:

Thanks for the email.

You are right and the hairless spot is probably due to shock loss around the donor wound area. You have had a tight closure at the donor wound. I guess the tight closure has caused some shock loss and the areas on both sides of the scalp are very typical for shock loss.

When it happens, it is usually seen on both sides. The shock loss around the donor wound is almost always reversible and hair will usually come back. Re-growth of hair that is fallen due to the shock loss may take up to 6 months and recovery may be gradual.

There is not much that could be done at this point. However, you need to be seen and examined to confirm the diagnosis. The numbness around the donor area, if it occurs, may last for weeks to months and has to do with the inflammation of the healing area that may affect the fine nerves on the area. It generally gets better on its own.

I found another interesting case report on a very unusual location for hair growth recently published in the Journal of Oral Surgery and Oral Medicine the other week.  The case study was reported by Femiano et al. at the Second University of Naples, in Naples, Italy.

He reported a woman who was found to have hair growing inside her mouth due to a medical condition.  Nasal-like hair.  Scientists said it had to do with the the high level of testosterone in her system. They called it “oral hirsutism”, which I guess should be considered a new term in medical terminology.

Numerous conditions and serious diseases can result in high levels of circulating testosterone, although the most common cause of hirsutism is polycystic ovary syndrome (PCOS).  In the future, maybe someday scientists specializing in hair follicle growth may utilize hormonal manipulations to grow hair on the scalps of men and women who qualify for  hair loss treatment.

Q:

Dear Dr. Mohebi,

Thank you for taking the time to see me on Saturday! Your correspondence providing a summary of our discussion was very comprehensive and is much appreciated!

Since our meeting on Saturday, I have done some research and would like to trouble you with a few more questions:

1) Is Alopecia the correct term to describe my hair loss pattern?

2) Would you consider cortizon shot treatment for me?

3) Would you consider laser therapy?

4) If I were to use monoxidil, does it have to be 2% or a higher percentage would yield more and faster hair growth?

5) you recommended a complete medical evaluation, could you please recommend someone that you trust?

I wish to thank you again for all your time and patience!

Best regards,

A:

Hi,

Here are your answers in the order you asked:

1) Is Alopecia the correct term to describe my hair loss pattern?

Alopecia is a general term that means hair loss. We have many different patterns of hair loss or alopecia, like male pattern or female patterned alopecia or alopecia cicatricial. Your pattern is similar to a male pattern because you lost your hair on the frontal area while you kept your hair on the donor area intact, which is why you might be a good candidate for a hair transplant procedure considering that your medical evaluation is negative for any medically treatable cause of hair loss.

2) Would you consider cortizon shot treatment for me?

No, steroid shots are sometimes used for Alopecia Areata (AA), which is an autoimmune disorder. Alopeica Areata is a hair loss condition with patchy hair loss spots. Your condition does not seem to be Alopecia Areata.

3) Would you consider laser therapy?

I do not recommend laser therapy for hair loss in the form of laser comb or laser machines because of the lack of solid medical evidence that support their effectiveness at this time.

4) If I were to use Monoxidil, does it have to be 2% or a higher percentage would yield more and faster hair growth?

You can start with 2% and then you need to be re-evaluated in six to 12 months and a treatment plan might need to be adjusted at that time.

5) you recommended a complete medical evaluation, could you please recommend someone that you trust?

Any good internist or endocrinologist could follow through with the lab works that you need.  Our letter includes the list of medical conditions that should be considered and lab works to rule out those women like you who have hair loss. You can share my letter with any good internist or endocrinologist and he or she should be able to follow through with your lab result and treat any treatable conditions that could possibly be found.

Have a great day,

The effectiveness of medical hair restoration alone with hair restoration medical options that are currently available such as finasteride or Rogaine has always been questioned.  Medical hair restoration without the surgical option (hair transplant), might work for some people, but should not be recommended to all as a cure-all solution, as you may find in some advertisements.

The available FDA-approved medications for hair loss prevention are finasteride and minoxidil.  Although both are effective, they may have different indications for male and female patterned baldness. They might not be considered a complete treatment for male patterned baldness, as pharmaceuticals may try to show.

Medical hair restoration should be seen as a preventative measure which should be considered, along with the surgical options, as part of a master plan. Most people are prone to shock loss that may happen after a hair transplant surgery and they need to be on preventative measures such as finasteride at least a few months around the time of surgery. Shock loss after a hair transplant used to be one of the biggest problems that hair transplant patients had up until the last few years. Now, most hair transplant patients go on finasteride after a hair transplant surgery.

What is Saw Palmetto?

Saw Palmetto is an extract of the fruit of Serenoa Repens. It is rich in fatty acids and phytosterols. It has been used in alternative medicine for a variety of indications, most notably benign prostatic hyperplasia (BPH).

Indications:

Prostate treatment

Saw Palmetto has also been used in treatment of benign prostatic hyperplasia (BPH), a condition known by enlarged prostate size to the degree that it makes urinating difficult.

Hair loss prevention

The role of Saw Palmetto in hair loss prevention has also been documented. Saw Palmetto is one of the few effective herbal treatments that can reverse hair loss process in some people to some degree and slow down the process of  balding in men. Saw Palmetto bio active ingredients prevent conversion of testosterone into dihydrotestosterone (DHT).

That is how Saw Palmetto helps to stop the process of balding on the hair follicle level. It can help increase the thickness of miniaturized hair and make them grow longer. The Saw Palmetto effect is comparable to finasteride or other DHT blockers by mechanism. Saw Palmetto is available in oil extract for topical use on scalp or as pills used for prostate enlargement treatment.

Q:

Comment or Question: is hair cloneing/multiplication currently available at your practice? please leave a voice mail

A:

Hair multiplication is not available at our hair transplant centers or any other hair restoration clinic for that matter because present-day technology has not yet been able to successfully multiply hair for the purpose of hair restoration.

But there have been numerous studies and publications on hair multiplication, also known as hair cloning. And there is one company, Intercytex, , which has been considered by many experts to be at the forefront of hair multiplication research.

Intercytex announced that their staff finished phase II of the study and started phase III (the stage in which scientists try their particular product and method on a large number of people and follow them for eight to 10 years and wait and see if there are significant long-term side effects and complications to take into account).

However, at the last annual meeting of the International Society of Hair Restoration Surgery (ISHRS), it was announced that Intercytex hadn’t even successfully completed phase II of the study, which means phase III hasn’t been started. We don’t know which specific obstacles impeded the progress of this work, but we are aware that it generally takes about eight years for phase III of most studies to be completed.

So, the research might get started in about eight years, maybe longer, after which we may find hair multiplication proven to be safe and effective.

Best hair loss treatment and best hair transplants are two of the most common questions of people who suffer from hair loss and want to have hair restoration surgery. Since most people understand that hair restoration surgery is a permanent procedure, they look for the best possible way to restore their hair using the most advanced technology available and conducted by the best hair transplant surgeon around. For this to happen, the person must make sure they are making the right choice when choosing a hair transplant clinic or the consequences could be catastrophic.

For those of you reading this article, we can safely assume that you are already on the search for the best hair transplant doctor who offers the best hair transplant surgery results. Hair restoration doesn’t have to start only with surgical treatment. In the process of restoration, medical treatment of hair loss still plays a major role. Here are a few factors to consider while searching for the best hair transplant surgeon and facility:

Knowledge of the most recent hair transplant technique:

• Only because a hair transplant surgeon states that he’s been practicing hair transplantation for many years doesn’t mean it’s the most recent technique or technology. Hair restoration is a relatively new science that is constantly changing and advancing almost every year.  If you educate yourself and know the facts about modern hair restoration surgery, then you can recognize the most honest hair transplant surgeon when you see one.

Artistic Talent

• This, of course, is not something you can really just study and apply. Some patients end up having hair transplant repair due to a failed or unnatural looking hair transplant. To make matters worse, some have had this situation even through the newest hair transplant technique follicular unit transplantation. Hairline design plays a crucial role in hair restoration and requires a designer’s eye to achieve a great result.

Surgical Team

• A hair transplant surgeon is only as good as his hair transplant team of technicians. It takes experience and dedication from the hair transplant team to achieve great results. To have anything less is an outright shame and almost a crime to both the patient and the industry. On top of that, quality control is essential and it is up to the hair transplant surgeon to make sure that the procedure is done accordingly or best based on the best hair trnasplant techniques.

As always, we at US Hair Restoration ask all whom are considering hair transplant surgery to fully educate themselves before they call a hair transplant surgery office and hair transplant surgeon. Read about the newest advancements in hair transplant technology and make sure that you are only getting the best hair transplant procedure using the best hair transplant technique.

Q:

HI sir, I met you today, and you suggested me to take Finasteride, but Finasteride is marketed as Proscar, Propecia, Fincar, Finpecia, Finax, Finast, Finara, Finalo, Prosteride, Gefina, Finasterid IVAX. Which one do you suggest me to buy. You said to buy it from a particular pharmacy, so could you please specify the tablet.

thankyou,

A:

Propecia is the trade name for the hair loss medication finasteride, which is the only FDA approved oral medication for male hair loss prevention or balding treatment in the United States.  Proscar is the other trade name from the company Merck for 5mg finasteride which is prepared for prostate enlargement treatment.

Some people cut Proscar into quarters to save money in the long run.  If you buy finasteride under any brand from an American Pharmacy, it should be fine as long as you take the proper dose for hair loss treatment that is 1mg or if you have to buy 5 miligram and cut it, the closest does would be 1.25mg per day.

Q:

I am a 21 year old boy and I started losing my hairs an year ago .I was preparing for my exams and i had some sort of food poisoning thing which affected my health adversely and I couldn’t had a proper diet for two months which resulted in a dull patch of baldness over my scalp.. I consulted with my local doctor and he suggested me minoxidil with some diet supplements(BIOVET-biotin and EMVIT-amino acids ,follic acid and some other vitamins).Now the hair fall is minimal but then too I suffer intense hair fall sometimes . I also took propecia after consulting with a doctor but it aggravated my situation and it catalyzed the hair fall instead. I was suggested that the hair fall will be temporary. I was scared so i discontinued the medicine.I took the medicine for 10 days specifically. Baldness is inherent in my family. What should Ii do?  Please guide me regarding the various hair treatments.  I dont wish to use propecia as I am scared about after mariage issues involved the medicine Hoping for your response as soon as possible.

Thanking You

A:

If you have a strong family history of hair loss, you may be heading in that direction already.  Vitamins for hair loss could be needed in case you are diagnosed with having vitamin deficiency.  However, a person with a balanced diet should not lose hair because of lack of vitamins.

Propecia, or finasteride, is by far the most effective medication for treatment of baldness or prevention of further hair loss.  You may experience some increase in hair shedding in the first few weeks to months, but that should not discourage you.  Hair growth with Propecia won’t be seen before six months from the time you start the medications.

You need to establish a good relationship with a good hair transplant doctor to properly diagnose your hair loss condition.  If you are diagnosed to have male pattern baldness or typical men hair loss you need to start taking hair loss medications and eventually get a hair transplant if need be.

As for “after marriage issues,” I believe you might be referring to the report of side effects associated to the use of finasteride. It has been reported that only 1 out of 100 patients (or less than 2%) have experienced some form of sexual side effect (erectile dysfunction, less desire to have sex, problems with ejaculation such as a decrease in the amount of semen released). The side effects have usually been temporary with continued treatment or disappeared when treatment is stopped.  It is a safe and proven product and should not be disregarded as a way to treat hair loss.