Doctors on Hair Loss & Hair Transplant surgery.

What is Maximum Medical therapy for hair loss?

People with hair loss, and certainly anyone even CONSIDERING hair transplant, may want to use a regimen of maximum medical therapy. This just means using a number of different medications that have different mechanisms of action to try to “cover all the bases”, so to speak. Attacking hair loss by targeting different aspects of the process is a way of using the synergy between various agents to maximize the effects.

Finasteride (Propecia and Proscar) is an agent that blocks the formation of dihydrotestosterone (DHT), a hormone that has been implicated in male pattern baldness (androgenic alopecia). This is a first line drug for men with thinning hair or balding. It is not beneficial for women; in fact, it can cause birth defects if a woman is exposed to the drug and gets pregnant. It has few side effects in men and has been used for about 25 years with a good safety record.

Minoxidil (Rogaine and many generic versions) is topical, or placed directly on the scalp. Side effects are few, and it has a synergy when used with finasteride. This may be used in men and women, and is considered by many to be the drug of choice in women with hair loss.

There is some evidence that an anti-fungal shampoo containing ketoconozol (Nizoral) may help slow hair loss. It can be used twice a week and has the added effect of decreasing dandruff and itching of the scalp. There are also a variety of over the counter preparations (Hair Cycle products) and internet-marketed preparations that are available. Many of these contain minoxidil and other ingredients. Some of these are topical androgen (male hormone) blockers; there is little scientific proof of their effectiveness, but many men swear by them, and they may work for some.

The most important thing one can do with these latter agents is read and read some more. Information from sources other than the manufacturers is likely to be more objective and may help one with informed decisions.

Tags: androgenic alopecia, anti fungal shampoo, balding, finasteride, hair cycle products, hair loss, hair loss solutions, hair loss treatments, hair transplant, hormone, male hormone, male pattern baldness, medical therapy, minoxidil, nizoral, proscar, rogaine

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This video demonstration was taken during live hair transplant surgery with one of Dr. Cole’s patients.  With strip harvesting or traditional FUE, the patients are very limited in their personal appearance and have difficulties getting back to normal daily activities because they are asked to shave their head.
Shaving the head allows the physician to have high visibility of the donor area which is necessary for donor hair extraction. With the new C2G technique, the patients are able to keep their normal hair style before and after the CIT technique!
Now patients can have the best of both worlds. They no longer have to put up with the pain associated with strip scars and they can still maintain their normal hair style.

 

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Tags: c2g, cit, dr. john p.cole, hair style, hair transplant, hair transplant surgery, patients, strip scar, surgery, video

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Tags: donor area, Grafts, hair transplant procedure, hair transplant surgery, high density, inflammatory response, recipient area, shock loss, transplant shock

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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.

Tags: anagen effluvium, cyst, dermal sheath, dr. john p. cole, Grafts, hair diameter, hair growth, hair restoration, hair shaft, hair transplant, hair transplant surgery, hair transplantation, inflammation, non growing hair, patients, pimple, resting phase, scalp

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Dr. Cole, what is the C2G stand for?

C2G stands for the Cole Isolation technique to go or CIT to go. CIT is a proprietary method of harvesting individual follicular units one at a time such that there is no need for a strip harvest. Strip harvests leave linear scars and no one can predict how wide the scar will be or whether it will be pale white in color or red in color. Either way the strip harvest leaves you will a linear scar that obviates your capacity to wear your hair short and leaves you vulnerable to others suspecting you’ve had a hair transplant previously. Often patients are so concerned about their strip scar that they cease going to a barber or hair stylist for fear of exposure.

In an effort to overcome this social stigma we developed the CIT procedure. The single negative to this procedure has been the requirement for patients to shave the donor area. This can result in problems blending back into society or into one’s work place. The goal of C2G was to develop a procedure that allows patients to keep their hair long so that they can return to their normal social environment within a few days.

C2G is a procedure where only individual follicular units are trimmed and the resulting individual follicular units are then transferred to the top of the scalp after harvesting them via CIT. Only the individual follicular units are trimmed so that you have a normal appearing donor area from day one and you also have the advantage of avoiding the strip scar altogether. Now there is no reason to avoid taking advantage of all the long term benefits of CIT. This includes no linear strip scar, no prolonged strip scar pain, no prolonged strip scar tightness or numbness in the donor area, more hair per graft (more bang for you buck), and a lower follicular injury rate (transaction rate).

There was once a draw back to CIT. Now there is none. C2G is the future of hair restoration surgery.

Tags: c2g, cole isolation technique, donor area, hair restoration, hair transplant, hair transplant surgery, strip, strip scar

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