Post Hair Loss Questions and Get Answers

This important discussion was written by Dr. Ricardo Mejia of Jupiter, FL who is one of our recommended hair restoration physicians.

Before any woman with female hair loss proceeds with hair surgery, she should properly be evaluated for medical and other conditions that can mimic female pattern baldness. Be sure not to ignore this as I have seen many women have surgery only to find out later there was a medical reason for their hair loss.

I generally do not initially recommend a hair transplant for women unless they have had a proper medical workup. I found too many cases of underactive thyroid, low ferritin / iron and causes of telogen effluvium or shock loss due to other factors mimicking androgenic alopecia. I have also found two cases of diffuse alopecia areata, an immunological condition where the hair transplants would not work.

We deal with a lot of women and it is our standard practice to assure this is done. These are some of the basics. For a woman’s perspective on hair restoration results see below:

Video: Womans Perspective on Hair Transplants

Dr. Ricardo Mejia

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Bill – aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: female hair loss, hair surgery, female pattern baldness, hair loss, hair transplant, telogen effluvium, shock loss, androgenic alopecia, alopecia areata, hair transplants, hair restoration

This question was posed by a female hair loss sufferer seeking hair loss help on our hair restoration forum and answered by  Dr. Humayun Mohmand of Pakistan who is one of our recommended hair restoration physicians. His professional answer is below.

Can you tell me what the difference between these two hair transplant methods are: Follicular Unit Transplantation (FUT – Strip Surgery) and Follicular Unit Extraction (FUE)

FUE stands for follicular unit extraction.  In this hair restoration method, the surgeon extracts one follicular unit at a time with a punch ranging from 0.7mm to 1 mm leaving a small little mark.  The advantage of FUE is no linear scar, but scarring in the shape of small round pits.  Know that there is always a scar, but the visibility is different.  There is also minimal pain during the FUE healing process, though it’s significantly more expensive in some cases.

Follicular unit transplantation (FUT) or the “strip” method is where a hair restoration physician will harvest a strip of tissue creating a liner scar from one ear to other.  These days, most surgeons are using the tricophytic closure technique to minimize the visibility of the scar in most cases and if done correctly.  Many surgeons do the tricophytic closure, but their method could vary and hence so does their result.  It’s a bit more uncomfortable than FUE, but you can get it for a very competitive price.  There are either stitches or staples to be removed in 10 days time.

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Bill – aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Knowing what’s causing your hair loss is the first step to developing a long term hair restoration treatment program. Some of you may already be aware that male pattern baldness is genetic and caused by dihydrotestosterone (DHT). However, what other contributors exist that facilitates or expedites hair loss?

Hair styling products which have been traditionally identified with women are now very popular with men. But do these styling agents contribute in any way to male or female hair loss? Join this hair loss forum discussion between patient and physician members who offer their input on this highly important topic.

Bill Seemiller – aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: hair loss, hair restoration, male pattern baldness, dihydrotestosterone, DHT, female hair loss

I have been experiencing dizziness after a month of using Rogaine (minoxidil) 5%.  I woke up a few times from it and felt my heartbeat racing for a few seconds. Anyone know about this type of side effect?  Should i discontinue use?

This hair loss question was answered on our hair restoration forum by Dr. Paul Shapiro of Bloomington, MN who is a member of the Coalition of Independent Hair Restoration Physicians.  His professional answer is below.

If you are having dizziness and heart palpitations on Rogaine, I would advise you to stop it right away.

Minoxidil is a vasodilator which means it relaxes the veins and arteries in the body. It was first used as an oral medication to lower blood pressure. The fact that minoxidil stimulates hair growth was an accidental finding. In fact, it is no longer used to lower blood pressure, partly due to this side effect.

When used topically (applied directly to the balding scalp) usually the amount absorbed into the blood stream is minimal. In most hair loss sufferers, it does not cause systemic (affecting the body ) side effects.

Dizzy spells and heart palpitations are known side affect of minoxidil and you may just be extra sensitive to the medication. But there also may be a medical reason why the minute amount of Rogaine absorbed into your blood system cased palpitations. I would see your primary care physician and/or a cardiologist to do some simple testing to evaluate your heart. Another possibility is that you have a skin condition on your scalp which allows more of the hair loss treatment to be absorbed into your body, (i.e. bad psoriasis) but I think you would know of such a condition.

I am losing hair at a very fast rate and don’t know which hair loss treatment I should use to stop it.  Please advise.

There are a number of possible causes of hair loss, the most common of which is androgenic alopecia (female and male pattern baldness). 

The only two non-surgical treatments of any viable effect in my opinion, are Propecia and Rogaine, both FDA approved for the treatment of male pattern baldness. 

Propecia comes in a pill form and contains active ingredient finasteride.  Finasteride works to inhibit DHT, the hormone responsible for androgenic alopecia.

Rogaine is a topical solution containing active ingredient minoxidil.  Minoxidil is a vasodilator originally used orally to lower blood pressure by relaxing the veins and arteries in the body.  An accidental side effect of hair growth was found and then later tested topically and FDA approved to stop hair loss.

A number of other non-surgical hair loss solutions exist, but the proof of their efficacy are lacking.  Be sure to research all products you are considering and speak to your physician about Propecia (which requires a prescription).

Bill Seemiller – aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: hair loss treatment, hair loss, androgenic alopecia, male pattern baldness, Propecia, Rogaine, finasteride, minoxidil, hair growth, stop hair loss, hair loss solutions

I began taking Propecia (finasteride) a little over 6 months ago and my hair shedding seemed to slow down significantly within the first month, but has increased again over the past two months. Is this normal? Will the shedding slow down again?

Even though finasteride has a high success rate in treating male pattern baldness, unfortunately, it’s impossible to predict whether or not your hair loss will slow down again or stop.  However, in my experience, it is best to give Propecia at least one full year before making a determination as to whether or not it is effectively treating your baldness.

Bill Seemiller – aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

Technorati Tags: Propecia, finasteride, hair shedding, male pattern baldness, hair loss, baldness

I’ve been on Rogaine since January of 2004.  Within 4 months the frontal pattern baldness stopped and I couldn’t see my scalp anymore.  But last summer I noticed scalp appearing on the temple regions so I went on Proscar in 2007.  I’m still using the Rogaine 5% but no hair is coming back.  Will a Proscar (or Propecia) and Rogaine combination help regrow hair in the temple region?

Propecia (finasteride) and Rogaine (minoxidil) are FDA approved and proven for a balding crown but many hair loss sufferers also swear by their efficacy in the hairline and temple areas.  Everyone responds differently to these medications. Though they might restore a good amount of hair in some, others may experience lesser hair growth, or maybe none at all. Typically, these hair loss treatment solutions, especially when combined are pretty good at stopping the progression of male pattern baldness, but only a select few have significant hair regrowth.

The unknown factor here is – where would your hair loss be without them? Though Propecia and Rogaine may not be regrowing all your lost hair, your allopecia could be much worse without these medications. Of course, there is also a possibility that your hair would be in the same condition if you weren’t using them, hence, the unknown factor.

In my opinion, unless you are experiencing side effects, you may want to consider continued use as they will give you the best chance of preventing future balding.

Selecting a world class hair transplant surgeon is probably the most important factor to ensure your hair restoration results are ultra refined and natural looking. That’s why only physicians who perform highly evolved hair transplants with superior results are recommended on the Hair Transplant Network.

Recently, we invited our hair loss forum community to offer their input on the Potential Recommendation of Dr. Damkerng Pathomvanich of Thailand, Asia. Learn more about how we recommend hair transplant surgeons.

Dr. Pathomvanich has received a number of glowing reviews by his patients on our forum for years and has impressed world renowned surgeons such as Coalition member Dr. Jerry Wong and Dr. Bill Parsley who have visited his clinic in Thailand. Dr. Pathomvanich is a super star in Asia with extensive experience in performing world class hair transplants with impressive ultra refined results.

After extensive research and receiving an abundance of positive feedback from his patients and physician peers, we are excited to present Dr. Pathomvanich as our new recommended surgeon on our online community. Due to his highly evolved ultra refined follicular unit procedure, we believe in time, that he should be considered for the Coalition of Independent Hair Restoration Physicians. To see the standards for the Coalition, click here.

Be sure to congratulate and welcome Dr. Pathomvanich to our community by visiting the “Potential Recommendation of Dr. Pathomvanich of Thailand” thread.

I am 3 weeks out from a hair transplant and I will be going to Florida in a few weeks. I will be wearing a hat most of the time but during the times I’m not I want to wear a sunscreen that is safe for my transplant, follicles etc. Do you have any suggestions? Thanks.

This question was posed by a hair loss sufferer seeking hair loss help on our hair restoration forum and answered by Dr. Ricardo Mejia of Jupiter, FL who is one of our recommended hair restoration physicians. His professional answer is below.

At 3 weeks, the follicular unit grafts are properly rooted and the skin is healed. You should be fine using any sunscreen as they will not cause any damage to the hair follicles. Look for sun blocks that have zinc or titanium dioxide although if you have a lot of natural hair this could be messy. Spray sun blocks are easier on the scalp where you have hair.

It is best to use hats, seek shade and use sun block and reapply frequently. The sun is intense here in Florida. More sunburns increases the risk of skin cancers which if they occur on the scalp or hair bearing areas will cause hair loss and graft destruction with subsequent hair restoration surgery and or radiation treatment.

Cover up and protect!!

Dr. Ricardo Mejia

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Bill – aka Falceros
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
View my Hair Loss Weblog

How soon can I return to work after a hair transplant? 

This hair loss question was answered by Dr. William Lindsey of Reston, VA who is one of our recommended hair restoration physicians.

It depends on many things including whether you are doing a small or large hair transplant megasession, how long is surrounding hair (can you comb it over balding recipient area), does your doctor shave recipient area (like we do), and what do you have to look like when you go back to work.

We do a fair amount of “frontal triangle” work and although I shave the recipient area, if we can get the hair restoration patient to grow the forelock a bit, then they can kind of “bushy it up” and have it cover the transplanted area after just a few days. Thus, we do a lot of Friday or Saturday surgeries and people like this tell me they go back on Wednesday, but that is a guideline–not a guarantee. It is however a good argument for doing a smaller case (1500-1800 grafts) in the triangles if there is a pretty good forelock, rather than doing a 2500+ follicular unit graft session and getting a change that would be hard to conceal upon returning to work in a few days.

So we do a lot of frontal triangles, let it grow for a year or more, and then if there is thinning hair in the forelock, that can be done and will be hidden behind the previous work so guys can often pull off the entire hair transplant procedure without too many people knowing.