Post Hair Loss Questions and Get Answers

Hundreds of hair loss questions are answered on our  discussion forum and received in our inbox on a weekly basis. Below, we’ve collected some of these hot topic questions of the week and posted responses by veteran hair transplant patients and leading hair restoration physicians.

You can also ask your own questions and get answers on our hair restoration forum or privately by using the contact form.

Is Finpecia (Generic Finasteride) as Effective as Propecia?

Can Doctors Predict Future Hair Loss?

Dealing with Hair Restoration Complications (Dr. James Vogel)

What is the Difference between Rogaine and Minoxidil?

How Many Grafts are Needed to Restore a Balding Crown?

Bill
Associate Publisher/Editor

Technorati Tags: hair loss, hair transplant, hair restoration

This insightful article was written by a  Dr. Michael Beehner  of Saratoga Springs, NY who is one of our recommended hair restoration physicians.

Over the past few years Bill Seemiller   and Pat Hennessey have asked me to share with the reading audience my rationale for using multi follicular unit grafts (MFU) grafts (multi-follicular grafts, 4-6 hairs each) in the hair transplant planning for some patients. I will try to do so here.

First of all, in order to get our terminology straight, the difference between a “minigraft” and a MFU Graft, is that the minigraft is cut with less magnification, usually with “loupes” and are “cut to size” and often have a little transection in the cutting process. A MFU graft is cut, at least in our practice, under a 10x stereoscopic microscope and the nurse in our practice who specializes in cutting them each case that we use them, under high magnification dissects out a graft that encompasses two (or sometimes three) follicular units (FUs) that are in close proximity to each other. Incidentally, MFU grafts can be placed into either a small slit (usually made in what we call a “parallel” orientation) or into a small, round hole (usually 1-1.3mm in diameter; about the size of pencil lead)

ADVANTAGES:

This hair loss question was answered by  Dr. Robert True of New York, NY who is a member of the Coalition of Independent Hair Restoration Physicians.   His professional answer is below.

I had a hair transplant 2 weeks ago and my scalp is still red.   Is this normal?

For hair loss patients with medium to darker complexions, pinkness or redness of the scalp following hair restoration suture removal is rarely an issue. However for fair complexion patients, a visible pinkness may persist for 3 to 6 weeks and for a small percentage of these patients, even 2 -4 months.

Hypoallergenic flesh toner concealer cosmetic can be used to safely hide the pinkness. The doctor may also prescribe a cortisone cream to speed resolution.

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Bill
Associate Publisher/Editor

Technorati Tags: hair transplant, hair loss, hair restoration

This hair loss question was answered by  Dr. Robert True of New York, NY who is a member of the Coalition of Independent Hair Restoration Physicians.   His professional answer is below.

I just had surgical hair restoration and my hair is starting to fall out.   Is this normal?

For almost all hair transplant patients,  the transplanted hair falls out gradually from two to four weeks following transplantation.

During this  short period of time, some of the hairs actually grow before falling out. Sometimes the hairs come out when the crusts/scabs fall off the skin (attached to the crust) or they may remain to fall out later. Rarely, some of the hairs may not fall out and will continue to grow without interruption. (This is not a problem – you can cut the hairs if you want)

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Bill
Associate Publisher/Editor

Technorati Tags: hair restoration, hair transplant, transplanted hair

This hair loss article  was written by  Dr. Ron Shapiro  of Bloomington, MN who is a member of the Coalition of Independent Hair Restoration Physicians.  

When Hair Restoration Surgery (HRS) was first popularized by Orentreich, the primary graft used was the “standard” 4 mm round punch graft.   However, over the past 10 years we have seen the introduction of much more diversity with respect to the size and shape of grafts. Grafts used today vary significantly and can be described with respect to a number of different variables including:

• Number of hairs
• Number of follicular units (FU’s) per graft
• Graft shape (linear, rectangular, round, chubby, skinny)    
• Size and type of the recipient site used (i.e. slit, slot or punch incisions).   Although  technically this last variable refers to the recipient site and not the graft, in clinical practice, grafts are often described in this manner.  
• Process of graft production (i.e. cut “to size” vs. deliberately cut to contain a specific  ”number of hairs (or FU’s)”.

The reality of the situation was that for a long time a great deal of inconsistency and lack of specificity existed   when grafts were   described in the literature or at conferences.     Often in the past all that was stated was   that “Micrografts” or “Minigrafts” were   used.   This lack of specificity contributed to much of the confusion that existed when trying to compare different techniques that have developed over the years.  

Non-surgical hair loss treatments like Propecia (finasteride) and Rogaine (minoxidil)  are typically pretty good at helping men slow down, stop, or even reverse hair loss. However, in order to receive optimal benefits, proper application is important.

For men and women using Rogaine  twice daily as recommended, knowing when to apply it can be difficult between showering and applying hair styling products. To learn how other members apply minoxidil, what’s optimal for maximum benefit, and to join in the discussion, view this hair loss forum thread.

Bill Seemiller
Associate Publisher/Editor

Technorati Tags: hair loss treatments, Propecia, finasteride, Rogaine, minoxidil, hair loss, hair styling

When is it safe to color or dye my hair after a hair transplant?   Can I do this as early as 10 days post-op?

This question was posed  by a hair loss sufferer seeking hair loss  help  on our hair restoration forum  and answered by  Dr. Steven Gabel  of  Hillsboro, OR who is an elite member of the Coalition of Independent Hair Restoration Physicians.  His professional answer is below.

There is no magical answer to when hair transplant patients can start dying their hair. The reason for this is that each patient heals at a different rate. I have some patients who come back 10 days after their hair replacement procedure  and their incision and recipient sites look like they have healed.   I have others that need a little more time to heal.

The postoperative  instructions I give patients are to wait until the transplanted hairs have gone through their initial shock period – usually four to six weeks.   By that time, I know that the grafts are firmly in place and exchanging their blood supply. The problem with hair coloring and the dying process is that different hair stylists will use several chemical compounds to dye the hair and I don’t want any risk of injury to the hair follicles with outside chemicals. My advice is always: be patient!

I’ve been taking finasteride for about 6 months.   For the first few months, I was taking 1/4 tablet of Proscar daily however, due to severe dryness of the skin on my face after taking finasteride for only a few months, I now take it every 3 days.   can you please let me know whether taking 1/4 tablet of Proscar every 3 days is still effective to stop hair loss?

According to the Propecia website, dry skin is not a reported side effect of  finasteride.   However, you are the second person I’ve heard claim this in the last 2 months.

The recommended FDA approved dosage of finasteride is 1mg daily.   However, in the event side effects occur, many leading hair restoration physicians have suggested their hair loss patients try taking 1mg every other day.   In my opinion, consult with a qualified hair loss doctor  and get their recommendation on an appropriate dosage for you.

Bill
Associate Publisher/Editor

Technorati Tags: finasteride, Proscar, hair loss, Propecia, hair restoration, hair loss doctor

This insightful information was posted on our hair restoration forum by Dr. Timothy Carman  of La  Jolla, CA, who is recommended on the Hair Transplant Network.

Recently, I lost about 40 pounds of  muscle and fat due to a crash diet.   I know they’re not good, but I was very overweight and was tired of being laughed at.   A few months after my diet, I started noticing hair loss, including brittle hair on my legs and scalp especially around the nape.   I went to a doctor but am still waiting for the blood test results.

During the crash diet, I severely limited my caloric intake and didn’t eat much if any protein.   Also, afterwards, i had two intestinal infections and thinning hair.   I don’t know if my hair los has anything to do with the crash diet or infections.   I am very worried about my hair, please help.

What you are describing is classic for symptoms of telogen effluvium –  which refers to a temporary hair shedding related to some type of “stressor” – in your case, caloric restriction or “crash diet”.  

This hair loss article  was written by  Dr. Ron Shapiro  of Bloomington, MN who is a member of the Coalition of Independent Hair Restoration Physicians.  

What is Follicular Unit Extraction (FUE)?

Follicular Unit Extraction (FUE)  is a method of obtaining donor hair for Follicular Unit Transplantation (FUT), where individual follicular units are harvested directly from the donor area, without the need for a linear incision. With the FUE technique, a .8mm to 1 mm punch is used to make a small circular incision in the skin around the upper part of the follicular unit, which is then extracted directly from the scalp.

Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) are sometimes mistakenly viewed as being two totally different hair transplant procedures. FUE, in fact, is a sub-type FUT where the follicular units are extracted directly from the scalp, rather than being microscopically dissected from a strip that has already been removed. To say it another way, in Follicular Unit Transplantation, individual follicular units can be obtained in one of two ways; either through single strip harvesting and stereomicroscopic dissection, or through FUE. Therefore, when comparisons are made between FUT and FUE, what is really being compared is the way the follicular grafts are obtained (i.e. strip harvesting and dissection vs. direct extraction). The process in the recipient area is the same.