This question, asked by a member of our hair loss social community and discussion forums, was answered by a representative for Coalition hair transplant surgeon Dr. H. Rahal:

I’m undergoing hair transplant surgery next month. The clinic said to stop minoxidil (Rogaine) one month before the procedure. Why do I need to stop the medication? Is one month before surgery the recommended time period for stopping minoxidil?

RogaineRogaine/Minoxidil promotes blood circulation and flow to the scalp (to promote healthy hair growth to your native hairs). We ask that you stop using it a month prior to your procedure to minimize bleeding on the day of your procedure. Since we’re making several hundreds to thousands of incisions to our recipient area, we don’t want you to bleed any more than you need to. In addition, it makes it easier to continue to make the incisions during the procedure and allows for easier implanting.

-Robert, Senior Patient Adviser
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Blake Bloxham – formerly “Future_HT_Doc”

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

Follow our community on Twitter

Watch hair transplant videos on YouTube

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This question comes from a member of our hair loss social community and discussion forums:

I’ve read about females using spironolactone for hair loss. Can men use this medication as well? Any side effects?

Spironolactone-Bottle-SandozSpironolactone is a serious medication. It isn’t recommended in male hair loss sufferers for two reasons:

1) It’s properties as a diuretic (“water pill”). Spironolactone (Aldactone) causes significant reductions in blood pressure, dehydration, and high potassium levels (hyperkalemia). For those who don’t need lower blood pressure or a reduction in body fluid, these are serious side effects. These effects are lessened when used as a topical treatment. However, this is still an issue for men because …

2) Spironolactone’s anti-androgen properties. It may halt the androgenic alopecia process at the scalp, but it also blocks androgen hormone activity all over the body. This means spironolactone will halt and possibly reverse hair loss, but it may also cause other “feminizing” effects like breast development, loss of body hair, and fat re-distribution. This probably isn’t a big deal for females, but male patients may find it concerning.
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Blake Bloxham – formerly “Future_HT_Doc”

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

Follow our community on Twitter

Watch hair transplant videos on YouTube

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kytheraLast week, Kythera pharmaceuticals purchased the rights to “setipriprant,” a prostaglandin D2 (PGD2) drug for the treatment of hair loss.

The PGD2 theory of hair loss was initially proposed by Dr. George Cotsarelis at the University of Pennsylvania in 2012. Cotsarelis and his team found elevated PGD2 levels in bald scalp compared to non-balding scalp. Cotsarelis believed this finding demonstrated a connection between PGD2 and hair loss, and began devising treatments for PGD2 enzyme blockers, PGD2 receptor blockers, and direct PGD2 blockers.

Work on PGD2 treatments remained quiet over the next few years. Kythera changed this last week when they announced the purchase of the setipriprant drug, a blocker – or antagonist – of the PGD2 receptor, and the intellectual work of Cotsarelis.

According to Kythera:

“The University of Pennsylvania’s discovery and associated intellectual property assets, combined with access to the PGD2 antagonist setipiprant, provide KYTHERA a strong foundation for this novel approach to hair loss,” said Frederick Beddingfield, III, M.D., Ph.D., KYTHERA’s Chief Medical Officer. “These observations are potentially the most innovative new thinking in hair loss over the last two decades. Setipiprant is believed to directly affect this hair loss pathway, and our own preclinical and in vitro human hair models confirmed this effect. It is a well-characterized molecule with a large safety database and we believe we can quickly initiate a development program to study it in hair loss. Putting these two pieces of the puzzle together is ideal and represents an example of our approach to scientifically sound and efficient drug development.” 

This below response from our Hair Loss Social Community and Discussion Forums was written by recommended hair restoration surgeon Dr. Ali Emre Karadeniz.

I had follicular unit strip surgery (FUSS) at the hairline two years ago. I’m in consultations to get a 2nd pass for more density (follicular unit extraction this time). I have curly hair.

In one of my recent chats with a hair transplant surgeon, I was inquiring about the higher risk of transection during graft extraction on curly hair. He claims that transection does not result in a dead graft, just one that cannot be used in the current session. The root remains unharmed and will grow a new hair. How true is this?

Obviously, it’s possible for a root to be accidentally severed, but is it likely since the root is so tiny?

Dr_Kardeniz_PhotoThe fate of a totally transacted graft is not clear, however I don’t think we should be very optimistic about it. A partially transected graft, that is a graft with an intact follicle and transected follicle(s) beside it however, is different.

I am currently on a scientific study that has currently shown me that at least half of these transected follicles beside an intact follicle can yield a fully grown hair (at the recipient area). I don’t know what happens at the donor area. Further studies are of course necessary.

This question, asked by a member of our hair loss social community and discussion forums, was answered by “Garageland” – a clinic representative for Coalition hair transplant surgeons Dr. Victor Hasson and Dr. Jerry Wong.

It’s been almost 5 years since I had my follicular unit strip surgery (FUSS) surgery. I still think it was one of the best decisions of my life. I never stress about my hair anymore as compared to the pre-op days when I looked in the mirror constantly worrying.

That said, if there’s an opportunity to improve my hair transplant I want to know about it. I’ve come across talk about “Ultra Refined Grafting”. Is that a recent enhancement? I’m wondering if it’s possible to add density into my transplanted area.

0_6181Sure it’s possible to go into the same areas of transplanted hair to add further density, as long as the clinic is experienced. Take my case as an example. I had a further hair restoration session at the end of 2013 to add density into the frontal third. This has grown in very well despite it being the fifth time work has been carried out in this area and that includes three sessions of mini and micro grafts which caused a significant amount of scar tissue, pitting and ridging.

Of course there are factors involved that need to be judged on a case by case basis. It is not so much the implanting that is the key here, it is the incisions which you need to make sure are part of the surgeon’s role.

This question, from a member of our hair losssocial community and discussion forums, was answered by Coalition hair transplant surgeon Dr. Glenn Charles:

Can anyone wear their hair short after a hair transplant? It seems a lot of people who have had hair transplants wear their hair long. A lot of what I see is a curtain of hair or come over look.

Dr. CharlesIt really depends on the patient’s current hair situation heading into the procedure, what they feel comfortable with and if they intend on trying to camouflage the hair restoration post-op  as much as possible.

Some patients are lucky and work from home, can take time off work or can wear a hat for 7-10 days.

Dr. Glenn Charles
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David (TakingThePlunge)

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community.

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Dr_Dua_PhotoThe Hair Transplant Network recommends only hair transplant surgeons who perform cutting edge hair transplant surgery with excellent results. Thus, we are pleased to announce that Dr. Kapil Dua of India has been approved for recommendation by our community. To see how we recommend hair restoration physicians, click here.

Dr. Dua, his technique and results were carefully reviewed by our hair restoration forum and social community in consideration for recommendation. While the feedback we received at first was mixed, Dr. Dua won over the majority of the community. To see what our members are saying, visit the “Potential Recommendation of Dr. Kapil Dua of India“.

Given Dr. Dua’s dedication to state of the art hair transplant surgery and the feedback we received, Dr. Dua has been approved for recommendation on the Hair Transplant Network. To view Dr. Dua’s recommendation profile, click here.

Thanks to everyone who provided their valuable input regarding Dr. Dua’s potential recommendation. You are encouraged to congratulate him by clicking on his featured potential inclusion topic above.

For hair loss sufferers considering hair transplant surgery in India and beyond, we strongly encourage you to consult with and consider Dr. Dua for your next procedure.

Onwards and Upwards,

Pat, Bill, Dave and Blake – The Hair Restoration Team for the Hair Transplant Network, the Coalition Hair Loss Learning Center, the Hair Loss Q & A Blog and the Hair Restoration Forum and Social Community

This below response from our Hair Loss Social Community and Discussion Forums was written by recommended hair restoration surgeon Dr. Ali Emre Karadeniz.

Say, you are quoted 14K for a two day follicular unit extraction (FUE) between 3000 and 3500 grafts. Then the doc is like we can do this in one day. Should you still expect to pay the same amount for a two day procedure that is done in one day?

Dr_Kardeniz_PhotoI think this is an excellent question. I believe time and graft number are both important. 5000 grafts offered in a single day is not to the patients benefit, however the hair transplant surgeon cannot charge 5 days if this is how long it takes him to do 5000 grafts.

The per graft pricing is the most modern however it does not solve all the problems. Is doing a rushed 4000 grafts in one day more valuable than a carefully done 2500 grafts? I don’t think so. Do all 2500 graft procedures require the same effort by the surgeon? No, sometimes a 2000 graft procedure takes more working hours and effort than a 2500. Is it always to the patient’s benefit to have more grafts done? No.

This question comes from a member of our hair loss social community and discussion forums

I’m interested in hair transplant surgery. When I first started my research, I had no idea two separate methods of the procedure existed. I visit online hair loss discussion forums, and see a lot of people arguing about which technique is “better” – follicular unit extraction (FUE) or strip surgery (follicular unit strip surgery). Now, I’m confused; which procedure is better for me?

FUE v stripThe “fue vs strip” debate does stir up quite a bit of controversy online. Frankly, I think it comes down to two points: accepting more consistent growth yield with strip surgery, but also accepting the linear strip scar; or forgoing the traditional strip scar in favor of less consistent growth.

So, which procedure is “better” for you? Which one should you chose?

In my opinion, there are patients who are better suited for strip procedures and those better suited for FUE. These strip patients MUST understand the reality of the linear scar. But if they do, I think they will simply receive more “bang for their buck” with strip.

The best way to figure this out is by consulting with trusted hair restoration physicians. Discuss FUE versus strip thoroughly with several of these doctors. They should be very comfortable with both methods. Share your goals and what you see as the “pros and cons” of each procedure. Lastly, come up with a solid – and personal – answer to this question: would I rather shoot for increased yield in one pass and deal with a variable linear scar? Or, is the scar a “deal breaker” and I’d prefer more variable yields with less visible scarring?

This question comes from a member of our hair loss social community and discussion forums

I’ve noticed several small bald patches on my teenage son’s scalp. I’m concerned my son is losing his hair. We have some hair loss in our family, but he seems far too young. What should I do? Is my teenage son balding?

mom and childHair loss in males occurs for a number of reasons. The most common, as you pointed out, is “male pattern baldness” or androgenic alopecia. This type of hair loss occurs in over 80% of males at some point during their lives, and creates classic “thinning” patterns in the scalp.

Androgenic alopecia is very common, but not in teenagers. Baldness in this age group may be caused by something else. This could be caused by another type of genetic scarring or non-scarring alopecia, infection, or an acquired ailment. Many of these conditions are treatable, but the cause of the hair loss must be determined first. To do this, we highly recommend a consultation with a trained hair loss doctor.
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Blake Bloxham – formerly “Future_HT_Doc”

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

Follow our community on Twitter

Watch hair transplant videos on YouTube

Technorati Tags: hair loss, , , , hair loss doctor

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