Doctors on Hair Loss & Hair Transplant surgery.

When and how does the new hair grow in after my hair transplant ?

Many people ask this question during and after their hair transplant; some actually think the hair will all continue to grow and they will have their “new head of hair” immediately. Unfortunately, most individuals have to accept delayed gratification as part of the transplant experience!

When the grafts are placed in the balding areas, they indeed may continue to grow for a few weeks. However, by about three weeks, the hairs begin to rapidly shed and soon most all of them are gone. The good news is that the follicle cells, the ones that make the new hair shaft that grows up and out, are still lying dormant under the skin.

At about three to four months, the first hairs begin to sprout through the scalp. At first, all new hairs will be finer, and slightly less pigmented than they will eventually be after some growth time. It is important to note that the grafted hairs do not all begin to come in simultaneously; they generally sprout in a “staggered” fashion, which means that each month some new sprouts will be noticed emerging from the scalp, until they all have grown in! Full growth will have occurred, on average, after about 10 to 12 months; full ingrowth may sometimes take a little longer on second and subsequent procedures.

Of course, the full cosmetic effect may not be apparent right away. This is because length and caliber of hair, as well as density, contribute to coverage. Once the hair has grown long enough and each shaft has become thick enough, then the full coverage will be apparent and the welcome decrease in the appearance of thinning and baldness will be noticeable.

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What is the importance of hair characteristics in hair transplant surgery?

These characteristics are significant in that they determine to a great degree how much coverage of the scalp there is, in order to block light. When light is not blocked and penetrates through to the scalp, the appearance is of thinning or balding.

The other big factor here is the density, which is another topic unto itself. The density is the number of hairs or follicular units per unit area (square centimeters or square inches or whatever unit you prefer; the centimeter is the standard for physicians). Although this density usually gets most of the attention when discussing hair loss, hair characteristics are equally, if not more, important.

First let’s look at color. At first, one might think that the darker the hair, the better the coverage. This is generally not correct. Lighter hair usually goes with lighter skin, and the tow together tend to mask thinning very well. Darker hair can cover well, but in the case of poor hair transplant work (pluggy looking, or larger graft on frontal hairline) they may stand out much worse than lighter hair. We will discuss color in more detail when we discuss contrast.

Curl is another very important factor in coverage. Generally speaking, curly hair provides coverage in proportion to the degree of curl (i.e., wavy hair gives better coverage than straight hair, curly hair better than wavy, very curly better than slightly curly, etc.). This has to do with light blockage as well. The curlier the hair is, the more it creates a meshwork of sorts (kind of like a thatched roof) which “stands up” a little bit off the scalp and keeps the light from penetrating to the scalp.

Contrast has to do with the difference between hair color and skin color. The closer to each other the hair and scalp are, the better the coverage. In a way, this “fools” the eye of the observer into not noticing the decrease in density. If a person with blonde hair and light skin loses 50% or his or her density, they may appear much less affected than a person with equally light skin and jet black hair. In this case the dark hairs of the second example are highlighted against the light skin and it shows the sparseness of the hair. The person with the blonde hair reveals very little difference between the hair and scalp, in other words, the observer cannot detect where the hair leaves off and the scalp begins.

Last, let’s consider caliber. Thicker strands of hair provide more “hair mass”, which is a term doctors use to describe the total effect of length times caliber. The more hair mass in a given area, the better the coverage. This makes intuitive sense. Imagine covering a hut with logs. If you place 20 logs as a roof, which will give better coverage, skinny logs or big round ones with large diameters? Of course, the bigger ones, so the thicker hairs do the same over the scalp. And remember, what appears as thinning or balding is simply the appearance of light shining through to the scalp.

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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.

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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.

(Read The full Article » » » »)

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I see on your website that you offer a Hairdx test, what is it and how is it helpful to prevent hair loss?

Hairdx is a genetic marker test to determine your risk for hair loss and to determine whether you might not loose your hair. The test evaluates a specific marker on the X chromosome. As you know, the X chromosome arises from the mother of the male. The marker is on the androgen receptor gene located on the X chromosome. Men who carry this gene variant are at a 60% risk of loosing their hair by age 40. Men with the less common genetic variant have a greater than 85% probability of not going bald before age 40. Ninety-five percent of bald men have the high risk androgen receptor variant.

It is known, however that androgenetic hair loss is polygenic in inheritance. One receives genes from both the mother and the father and it is felt that hair loss is not sex linked. This means that you can receive the risk for hair loss from either the mother or the father, but the specifics are still poorly understood. To date there are 4 major genes that determine your risk for hair loss, age of onset, eventual hair loss pattern, and rate of hair loss progression.

This test is only a prediction of future hair loss. It does not rule in or rule out the probability of future hair loss entirely. If you test positive, you should be evaluated for other signs of hair loss. These include miniaturization of the hair follicles and loss of hair shaft pigment. If you show signs at any point after testing positive for the marker, you might want to consider medical therapy such as Propecia or Minoxidil. You might also want to begin using Haircycle shampoo and conditioner to prolong the anagen duration, which is known to slow down the rate of hair loss progression. Instituting medical therapy at an earlier stage in life may limit the rate of your progression and the ultimate degree of loss you will suffer from.

We are happy to send a test kit to you if you like. The cost of the test is 149.00. This is the first diagnostic test to help you determine if hair loss may be in your future.

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