Doctors on Hair Loss & Hair Transplant surgery.

It is really unknown what causes shock loss.  Shock loss is hair loss resulting from a hair transplant procedure.  There are many theories, however.  Shock loss most likely is due to an inflammatory response as a result of physical trauma.  It is really quite uncommon in the donor area.  It is more common in the recipient area.  The density of incision sites may play a role as high density incision sites tend to produce shock loss more commonly.  Shock loss will occur only in the area where the incisions are made.  It will not occur in adjacent regions.

Shock loss begins about 2 to 3 weeks after a procedure and it will continue over a period of a few weeks.  If you experience hair loss months after a procedure, it is not due to shock loss, but rather due to progression of hair loss or some other factor unrelated to the hair transplant procedure.

Some feel it is due to the injection of epinephrine, which is commonly added to the anesthetic.  This is most likely untrue as you will not see shock loss in areas where anesthesia is given, but rather only in areas where the incision sites were made.  You also more commonly see it in the recipient area while epinephrine is also given in the anesthetic given in the donor area during a hair transplant surgery.  Even though the same anesthetic with epinephrine is given in the donor area, you do not see shock loss in the donor area when it occurs in the recipient area.

The inflammation might result from physical trauma, but it also might be due to the free radicals that accumulate in tissue that continues to metabolize outside the body in an anaerobic state.  Free radical scavengers in the storage fluid along with cooling of the tissue outside the body might help reduce the amount of free radicals produced by the grafts.  One might also limit the free radical load by limiting the recipient area density during a hair transplant.

Shock loss is uncommon in the donor area with both strip harvesting and with FUE or FIT.

When shock loss occurs, the hair will generally begin to grow back after a hiatus of 3 months.  It is only the fine wispy baby like hair that seems most prone to remain dormant following shock loss.  This sort of baby fine, short, lightly pigmented hair produces the least amount of coverage, however, so it will not be missed as coarser, darker, longer terminal hairs will take their place when the hair transplantation produces new hair growth beginning three months after the hair transplant.

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What are the ways to camouflage strip hair restoration scars?

Camouflaging Strip Scars

Scars in the donor area from strip harvests may be problematic for many men. They may be short or run from ear to ear. Sometimes they widen over time, occasionally to more than two centimeters, which is deforming. This is usually due to an overly tight scalp, too low a placement, or poor surgical technique. They also change the direction of hair growth below the scar, relative to above the scar, which may cause a “shadow” of the linear scar to be evident even with the hair grown out somewhat.

IN order to minimize the appearance of scars, several strategies are available. There are cosmetics such as Dermatch, which may help disguise the scar. The hair may also be grown out fairly long to attempt coverage. This, of course, may not be an option for those with an over harvested donor region.

Surgical scar revision may be attempted, often without success. This consists of excising the scar and them suturing up the wound, hoping that the resultant scar will look better than the original one. This can work in some instances; however, if the condition that led to the scarring is not remedied, then even the best revision may fail.

Grafting into the scar is another option. Because yields tend to be lower in scars, this may take more than one surgical procedure over many months to have a significant cosmetic effect. Either body or scalp hair may be used; scalp hair is generally a better choice if it is available.

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Do you recommend Zinc to treat hair loss

is a Zinc whitish metal that acts as an essential nutrient in humans. Its deficiency leads to a number of biochemical and physiological problems; it is required for hundreds of different biochemical reactions, so not having enough can affect many different systems in the body. Zinc helps the immune system stay strong so we can fight infection; it helps with growth and healing, and keeps our senses of smell and taste intact!

Some of the causes of zinc deficiency include chromic alcoholism, malnutrition, malabsorption (problems absorbing nutrients from the gut), vegetarianism (because plants provide much less zinc than animal products like meats), high intake of iron, and diarrhea. Dietary sources of zinc include meats, some seafood, dairy products, and nuts; people with meat/seafood in their diets absorb more zinc than people with largely plant proteins. Oysters have the highest zinc content of any food. Since zinc is known to have an effect on sexual function and fertility, perhaps this is where the age-old reputation oysters have as an aphrodisiac!

Supplementation of zinc may be necessary in some people prone to low zinc levels. Some people believe that in modern times our foods are so low in nutrients, that supplementing is always needed (although this is not the opinion of the scientific community as a whole). The recommended daily allowance (RDA) of zinc is around 10 mg per day for healthy adults. The upper limit considered safe is 40 mg per day for healthy adults. High intake of zinc (150 to 450 mg per day or more) may cause a number of health problems. Among these are low levels of copper, depressed immune system function with increased susceptibility to infection, retarded growth in children, loss of appetite, sexual dysfunction with erectile dysfunction in males, hair loss, diarrhea, delayed wound healing, slowed mental function, and altered taste and smell.

What scientific evidence is there for treating problems with zinc? There is strong evidence for using it to treat children in developing countries that have severe diarrhea, for treatment of stomach ulcers, and in the blood disease sickle cell anemia. There is good, but less strong evidence for the following:

• Acne

• ADHD (attention-deficit hyperactivity disorder)

• Down’s syndrome associated problems

• Fungus infections of the scalp

• Herpes virus infections

• High cholesterol

• Immune system boosting

• Plaque on teeth and gingivitis of the gums

Wilson’s disease, which causes abnormally high copper levels (remember how we said that too much zinc lowered copper levels in the body?)

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My mother had esophageal band surgery a couple of years ago due to her excessive weight problem. Following this she has noted progressive hair loss and a change in her personality. I’ve read that band surgery and stomach stapling can cause hair loss. Is this true?

Bariatric (Weight Loss) Surgery: Metabolic, nutritional, psychological and physiological Consequences Bariatric or weight loss surgeries have become commonplace in the USA and in other countries, in part due to an ever increasing incidence of obesity in the context of a societal standard of beauty that emphasizes a thin, shapely physique. Lobbying by various organizations, as well as medical studies detailing the present and future consequences of untreated obesity, has led to insurance coverage for these surgeries, which were previously deemed “cosmetic”. This article will detail some of the physical and mental aspects of the often rapid weight loss which occurs after bariatric surgery.
The bariatric surgery community utilizes a number of procedures to promote rapid and hopefully permanent weight loss. Some of the earlier methods have been abandoned or modified due to unacceptable morbidity in the post-operative period, both immediate and long-term. Currently used techniques most often decrease absorption of calories or promote early satiety (feeling of fullness), or some combination of the two.

Unfortunately, the decreased absorption of calories is accompanied by decreased absorption of macro- and micro-nutrients. This often leads to nutritional deficiencies of varying degrees of severity. Sometimes these deficiencies may go undetected for some time, until they have had a profound effect on the patient. Many of these deficiencies can be very difficult to treat (refractory) once established. They may cause significant derangement in the patient’s physical, mental and emotional health.

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I had hair transplant procedure a week ago and I’ve note that the hair is still growing in the grafts. Does this mean the hair has been accepted and that it will continue to grow?

Following hair transplantation hair in the grafts will continue to elongate for about 10 days. Some of this may be continued hair growth, but it also reflects a move toward anagen effluvium. In anagen effluvium the dermal sheath begins to contract and move toward the surface of the skin much like an accordion. This shortening of the dermal sheath will push the bulb of the hair shaft toward the surface of the skin. Therefore, some of the elongation of the hairs is not due to growing, but rather due to a contraction of the dermal sheath toward the skin surface.

Once the dermal sheath contracts, the hairs will either begin to shed on their own beginning in two to three weeks after the transplant. Some of the hairs will continue to rest on the surface of the skin for a prolonged period of time. Eventually the scalp skin will either begin to form a wall around the resting, non-growing hair, or the scalp will form a pustule or pimple like reaction that will eventually burst and the non-growing hair will exit the skin with the exudate from the pimple or cyst like structure.

It is probably a good idea to minimize the number of the cyst like structures that you get because they represent unnecessary inflammation. Inflammation may not always be a good thing. In theory inflammation might sometimes lead to an autoimmune response toward one’s own hair and this in turn may compromise future graft growth.

In order to minimize inflammation, we generally recommend that patients begin removing non-growing hair fragments beginning three weeks after the hair restoration procedure. The best way to manage this is to aggressively wash the scalp with soap and a wash cloth. Non-growing hair will come out easily like removing a pin from a soft stick of butter. Growing hairs on the other hand must be plucked and it takes a good bit of force to accomplish this.

Sometimes hairs do continue to grow following a hair transplant without ever going into the resting phase, but it is unlikely that you will see more than 10% go into the resting phase. It is far more likely that the hairs will shed. Occasionally hairs almost shed, but then continue to grow. We can easily recognize these hairs because they have a dark tip that is coarse followed by a narrow constriction that is of lighter color. This is followed by a gradual darkening of the hair shaft and increase in hair diameter once again. We call these hairs that exhibit signs of this trauma pol pinkus hairs and they are a sure sign of recently transplanted hairs that have continued to grow.

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