The following thorough response to a question from the Hair Restoration Social Community and Discussion Forums, was written by forum member “Gillenator”.

I know you can start normal exercise two weeks post-op, but when is it ok to do intense physical activity like martial arts after hair restoration sugery? Is 4 weeks ok? Does doing intense exercise affect how the transplanted grafts grow? Finally, what happens if you take a knock or kick to the head when training? Does it affect the hair transplant hair growth?

styles2A big part of the concern post-op is related to the strip scar if you have follicular unit strip surgery (FUSS). The concern is putting undue strain, pressure, or tension in that area. Even though the outer layer of scalp is healed, the inside dermal layer takes longer to heal; up to eight weeks on average.

Judo for example, would be a huge no-no because of the various holds and throws that are involved. Lost grafts are of no concern at this point in time post-op.

Gillenator
Supporting Hair Restoration Physicians: Dr. Glenn Charles, Boca Raton, FL – Dr. Jerry Cooley, Charlotte, NC – Dr. Jim Harris, Denver, CO – Dr. Robert True & Dr. Robert Dorin, New York, NY

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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.

Erebos Eyebrow TransplantSeveral months ago, we started a new feature at our hair loss community: the Hair Transplant Patient of the Month.

Each month, we review hair transplant cases posted by patients on our Hair Restoration Discussion Forums and select one particularly excellent result as our Hair Transplant Patient of the Month.

In October, we selected community member “Erebos,” who underwent Follicular Unit Extraction (FUE) eyebrow transplantation with Dr. Jean Devroye, as our Hair Transplant Patient of the Month.

After years of worrying about his thinning eyebrows, Erebos finally decided to “take the plunge” and undergo eyebrow restoration. Understanding the difficult and technical nature of this procedure, Erebos sought out a true hair restoration expert: Dr. Jean Devroye.

Dr. Devroye and Erebos decided to extract a small amount of grafts via the FUE method, and use these scalp follicles to conservatively rebuild his eyebrows. 12 months later, Erebos shared his results on our Hair Restoration Discussion Forums, and the transformation is dramatic!

To review his excellent 12 month results, please see the following: Erebros’ FUE Eyebrow Restoration with Dr. Devroye.

Please join me in congratulating Erebos on his excellent transformation! Although his case is unique, I think it demonstrates the versatility of hair transplant surgery and the potential of an FUE expert like Dr. Devroye. For these reasons, I believe Erebros’ eyebrow transplant meets the qualifications of a true “Hair Transplant of the Month” result!
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Blake – aka Future_HT_Doc

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

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

I recently starting taking minoxidil (Rogaine) for my hair loss. It’s been a few months now, and all I notice is an increase in the amount of shedding hair (which I know happens at first). I’m wondering, however, how long do I wait before determining whether or not minoxidil is working?

RogaineIt generally takes 6 months to determine whether or not you are a responder. This represents the time it takes for the now “resting” or telogen phase follicles to transition into an anagen – or “growth” – state (this is where the initial 3-4 month increased shedding comes into play) and produce visible hairs. However, most hair restoration experts recommend taking the medication for a full 12 months before determining whether or not it works for you. This obviously does not take intolerance from side effects into account.
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Blake – aka 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

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

I’ve been losing my hair for several years. I initially thought I suffered from androgenic alopecia or male pattern hair loss; however, members of online forums now say it may be diffuse unpatterned alopecia or DUPA. What is DUPA? Can it be fixed with hair transplant surgery?

DUPAI’m not 100% sold on the idea of “DUPA” or it’s cousin “diffuse patterned alopecia” (“DPA“).

Traditionally, non-scarring alopecia is broken down into several categories: focal, patterned, and diffuse. Focal alopecia includes conditions like alopecia areata; patterned includes androgenic alopecia and female pattern hair loss; and diffuse covers conditions like telogen effluvium, anagen effluvium, loose anagen syndrome, atrichosis, and hyoptrichosis. However, it does not – traditionally – include “DUPA” or “DPA.” Maybe the categorization is out of date, but I generally try to stay away from these terms – or at least from DPA. I do understand that “DUPA” is a good description for one clinical picture – which I will explain below.

I would classify hair loss fitting this diffuse pattern as follows:

Either: diffuse androgenic alopecia that is best described by the Ludwig and not the traditional Hamiltion-Norwood hair loss scale; OR you could call it diffuse unpatterned alopecia if you are experiencing thinning in the donor region (which is the only time I really think this term is appropriate).

I have been suffering from hair loss for the past two years. Now my condition is that my hairline is receding in a Norwood Scale II category. Should I go for a follicular unit extraction (FUE) procedure so my hair growth becomes more dense?

questionsThat is a question I cannot answer because I am lacking significant details in order to provide you with an educated opinion. In order to determine if hair transplant surgery is appropriate for you, your hair restoration physician will consider your age, the quality and density of your existing hair and your predicted future hair loss among other factors.

The best way to determine if you are a candidate for hair transplant surgery, is contacting one or more of the hair restoration physicians recommended by the Hair Transplant Network.

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

I’m a young patient – in my early 20’s – with an advanced balding pattern (Norwood Class V) interested in body hair transplantation (BHT). I would like to restore my scalp with grafts from my beard, chest, and legs. Would I be a good candidate for this procedure?

body hair transplantBody hair transplantation, according to most experts, is a procedure reserved for those with depleted scalp donor supply in dire need of hair restoration. Body hair grafts “retain their donor characteristics,” meaning they look like body hair and grow differently – even after being transplanted, and generally don’t blend well with natural scalp hairs. Now, this doesn’t mean body hair grafts can’t help camouflage scalp scars, add density to the vertex/midscalp regions, or provide adequate coverage in extreme repairs; however, a large amount of body grafts implanted diffusely in the scalp of a young patient would not – likely – look natural.

An individual in this situation should first consult with a trusted hair restoration physician. This doctor will evaluate the following: 1. if this young patient is properly utilizing preventive medications – like finasteride (Propecia) and minoxidil (Rogaine) – that may improve the hair loss and make the patient a suitable candidate for hair transplantation in the future; 2. if this patient is even a candidate for any surgical procedure; 3. if this patient does have enough scalp donor supply for a traditional hair transplant procedure; and 4. if this patient may be a candidate for a combined procedure with scalp and some body hair grafts.

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

I noticed my hair is thinning and want to start preventive hair loss medications. However, I’m afraid of using minoxidil (Rogaine) or finasteride (Propecia) because of the side effects I read about online. Are there any other proven hair loss medications available?

Rogaine and PropeciaTwo hair loss medications have been reviewed and deemed safe and effective by the US FDA: finasteride (Propecia) and minoxidil (Rogaine). Finasteride is an inhibitor of the enzyme – 5-alpha-reductase – responsible for creating dihydrotestosterone (DHT). DHT causes hair loss in androgenic alopecia or male pattern hair loss – the most common type of alopecia seen in men. Side effects of this medication include: headache, confusion (“brain fog”), and sexual side effects (ie decreased libido, erectile dysfunction, and decreased semen volume or “watery” semen). Most users are concerned about the sexual side effects; however, according to the FDA approval studies, these occur in approximately 2% of patients and cease after stopping the drug. Many doubt these figures and believe some sexual side effects may last longer, but, thus far, no conclusive data exists.

Minoxidil (Rogaine) prevents hair loss via an unknown mechanism. The drug relaxes blood vessels and opens potassium channels, so some believe it increases flow of blood, oxygen, and nutrients to the scalp. Others believe the mechanism is more complicated, and likely involves increased production of prostaglandins (PGE2) and growth factors (TGF-B/BMP), and also upregulation of important hair growth genes (BCL2/BAX and ERK/Akt).  Side effects of minoxidil include: skin irritation, low blood pressure, hair growth in unwanted areas, chest palpitations, and tissue swelling.

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

I recently underwent hair transplant surgery. I’m happy with the results, but I’m afraid they will not last. Are the follicles transplanted during hair restoration surgery permanent, or will they thin and fall out over time?

For all intents and purposes, the follicles transplanted during a hair restoration procedure are permanent.

Barry post opAndrogenic alopecia (male pattern hair loss) is caused, initially, by diyhydrotestosterone (DHT) hormone. Hair follicles in the frontal scalp, mid-scalp, and vertex are sensitive to this hormone, and contact with DHT causes the follicles to miniaturize and stop producing hair. There are some follicles in the scalp, however, that are “highly resistant” to DHT. These follicles are located on the sides (temporal/parietal) and back (occipital) of the scalp. When transplanted, these follicles retain their resistance to DHT and do not shed or thin – even when exposed to DHT in new regions of the scalp.

These follicles are “highly resistant” to DHT, but they are not completely immune. This means, in theory, they could still shed if exposed to very high levels of DHT over a long period of time. However, the thousands of successful cases of hair transplantation performed over the past 60 years prove the resistance and permanent nature of the DHT resistant follicles. Many of the “10 year plus” hair transplant cases shared on our Hair Restoration Discussion Forums reinstate this point; hair transplantation is permanent, and patients should not expect their results to thin or shed significantly over time.
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Blake – aka Future_HT_Doc

I had a follicular unit strip surgery (FUSS) back in 2003. My hair transplant result is okay but I want to shave off my hair. Will my scar be visible? If so, how can I hide it being bald?

FUSS-scar-fixedUnfortunately, once you have undergone follicular unit strip surgery, shaving your head will expose the resulting scar. You may have success camouflaging the strip scar via scalp micropigmentation (SMP) or scar revision through follicular unit extraction (FUE) hair transplantation.

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

I’ve taken an antidepressant medication without side effects for years. During this time, I also experienced some hair loss. I always attributed the thinning hair to “male pattern hair loss“, but I recently read about antidepressant drugs causing alopecia, and now I’m wondering: is an antidepressant causing my hair loss? Is it true that antidepressants can even cause hair loss?

antidepressantsIn a perfect world, pharmaceutical medications would treat diseases effectively with no adverse side effects. We, unfortunately, do not live in this world. Medications are not perfect. While many are considered “modern miracles,” and cure people of ailments responsible for significant morbidity and mortality in the past, these powerful “wonder drugs” often come with a set of equally powerful – but much less wonderful – side effects. Unfortunately, hair loss is a side effect of several trusted and proven antidepressant medications.

However, all is not lost …

Of the numerous types of antidepressants available today, two classes are (most commonly) associated with hair loss: tricyclic antidepressants (TCA) and selective serotonin reuptake inhibitors (SSRI). Both classes of drugs officially list “hair loss” as a potential side effect; however, both also report hair loss occurring only in a very small number of medication users. For example, several types of SSRIs list hair loss as a “rare” side effect that occurs in approximately 1-2% of users. Even more encouraging, many see a reversal of the hair loss after stopping the medication. This is, however, not guaranteed – as many drugs “unmask” dormant permanent types of alopecia like androgenic alopecia (“male pattern baldness“). In these cases, the hair loss is not reversible. In these instances, however, it’s important to understand that the drug only revealed or accelerated an underlying condition; it did not actually cause a primary hair loss.

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