Hair Restoration Blog

Q:

Hey there, doc,

It’s been about three weeks since my second hair transplant in Los Angeles. As of this moment, when I bend my neck, there’s a tightness and tension on the back of my head (donor area). Can you tell me if this tightness will ever go away and be back to the way it was before my operation? I really want to be back in the gym doing my jump ropes and abs.

A:

I’d say to give it about three weeks and begin more gentle activities such as jogging, brisk walking, bike riding, or push-ups. As long as you don’t stretch that donor area by looking down (this is important), you ought to be OK.

Activities to stay away from four to six weeks after a hair transplant: wrestling, flag football, basketball, boxing, abs exercises, and surfing or boogie boarding. Make sure there isn’t much strain on the donor area. It’s sensitive and requires protection and non-contact to heal.

Remember: Activities which increase tension between the edges of the healing wound in the donor area, such as lifting barbells or weights and other exercises involving intense bending of the neck are to be avoided. You should wait at least six months for this type of exercise in order to prevent reopening of the wound or stretching and widening of the donor scar.

Over the last few decades, different therapies which effect wound repair have been proposed. The connection between wound healing and hair growth was already proposed by Dr. Catsarelis at the University of Pennsylvania through the WNT pathway (some molecular process that controls would healing and hair growth). Now, we review the emerging fields of gene and stem cell therapy in hair restoration and wound healing.

Gene therapy, initially developed for treatment of congenital defects, is a new option for enhancing wound repair. In order to accelerate wound closure, genes encoded for growth factors or cytokines showed the greatest potential.

The majority of gene delivery systems are based on viral transfection (intentionally contaminating the host cells with a particular virus that insert the desired gene to the target cells), naked DNA application, high pressure injection, or liposomal vectors, etc. Embryonic and adult stem cells have a prolonged self-renewal capacity with the ability to differentiate into various tissue types. A variety of sources, such as bone marrow, peripheral blood, umbilical cord blood, adipose tissue, skin and hair follicles, have been utilized to isolate stem cells to accelerate the healing response of acute and chronic wounds.

Recently, the combination of gene and stem cell therapy has emerged as a promising approach for treatment of chronic and acute wounds. This is good news for prospective hair loss patients: the idea that similar gene therapy techniques can be used to affect the baldness gene by switching the hair loss gene off and on.

This new study was done by Branski et al. at the Department of Surgery, The University of Texas Medical Branch and Shriners Hospitals for Children.

Hair Growth with wound healing technique in animal models: Dr. Parsa Mohebi's research at Johns Hopkins Medical Institute

A new article was published in the most recent issue of the Journal of Internal Medicine Research (2009 Mar-Apr;37(2):583-6) “A very rare complication: new hair growth around healing wounds.”  This is aligned with Dr. Mohebi’s research on wound healing and gene therapy techniques on the growth of hair in animal models at Johns Hopkins Medical Institute.

The article discusses a finding on a patient who grew hair around a healing wound near Sun ZY, et al, from the department of plastic surgery, first affiliated hospital, Guangxi Medical University in Nanning, China.

The authors of this article discuss a case in which active hair growth occurred around a wound after the healing of a wound.  This is described as a rare phenomenon.  This phenomenon in humans has not previously been reported in their literature.  They proposed that after the epidermis and hair follicles have been damaged by wounding, it is possible for them to naturally heal and repair if provided with an appropriate chemical and physical micro-environment. They propose that their hypothesis may inspire new thinking in the management of hair loss, tissue engineering and the regeneration of other organs.

I did research on hair growth as an effect of wound healing when I was performing research in the wound healing laboratory of Johns Hopkins Medical Institute.  After observing the healing of a wound, some of our gene therapy techniques could stimulate the growth of hair in mice. I focused on hair growth itself and our study was confirmed with multiple studies of that kind from 2005-2006.  Dr. Cotsarelis at the University of Pennsylvania and his colleagues were the first group to publish the effect of wound healing on hair growth through activation of molecular pathway WNT.

The reports on this type are emphasizing that hair restoration through tissue engineering, hair multiplication and gene therapy might be a reality in the future and maybe even sooner than what we thought before.

Parsa Mohebi, MD
Medical Director
US Hair Restoration