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I saw this patient last week for a follow-up and he had a wonderful result from a single session of 1807 grafts in the frontal area. When I looked for the scar to see how well it had healed, I could not find it. The scar was closed with an upper and lower trichophytic closure and the results of doing this make strip surgery more than competitive to follicular unit extraction (FUE). This type of closure allows hair around the wound to grow through the scar, making it extremely difficult to see once it heals. To learn more about this, see Techniques to Minimize Donor Area Scarring. I have been routinely getting this type of healing from trichophytic closures.

The after photos were taken about 22 months post-op. Click the photos below to enlarge.

Before on the left; After 1807 grafts on the right:

Donor area - After. Can you find the scar?

I have been taking a generic finasteride for 2 years now,with good results. I am paying about $600.00 Canadian for a one year supply.I recently saw an advertisment on line for finasteride for about half that price. My question is what do you think about me alternating every other day the two different genertic finasteride,just in case the cheaper one is not as good as the one I am already taking?

Assuming this other generic is really finasteride, it should be the same. There may be different filler ingredients, but as long as both contain 1mg finasteride, alternating shouldn’t be a problem. Be sure that the manufacturer is reputable and that they are approved for sale by the FDA which will provide some assurance of purity in what you are buying.

Keep in mind that this is your body you are dealing with, so if you don’t trust the cheaper unknown brand, you may consider not buying it. I can understand if it is a car or a house or anything else and you’re looking for a great deal, but I wouldn’t recommend skimping on medications. Online prescription drug sales are also suspect in my eyes, particularly when they’re imported from other countries and violate various laws.

Here’s an interesting theory about your skull expanding, causing hair loss. Anything to this? Big Head, Bald Head- Is Hair Loss Caused by Skull Expansion?

It might be a humorous hypothesis, but there’s nothing to it. The site that is mentioned in that press release states that, “Skull expansion is now being recognized as the true cause of androgenetic alopecia through its publication in the Medical Hypotheses journal“.

A hypothesis is simply what someone (the author of that journal article) supposes. It is certainly not proven or even recognized by the medical community at large. So when they claim skull expansion is recognized as the true cause of hair loss, because it was published in a journal that discusses hypotheses… wow, what a complete joke.

I am noticing much more hair loss during my illness. i have tonsilitis at the moment. is there some connectiong between hairloss and imunesystem ?

Stress can sometimes cause hair loss, though usually, it would take an extreme case of stress (medical or emotional). While there are instances of hair loss from immune system issues, the immune system as you are implying is not likely the cause of hair loss. To make it a bit confusing, alopecia areata is thought to be hair loss related to immune system issues.

Tonsillitis does not cause hair loss.

hi dr,
i just have a question about dutasteride. ive heard that the half life of the medication tends to persist longer then propecia. why cant we just then take it on a bi weekly basis or something instead of taking it daily like propecia which half life is 6 hours? wouldnt this be something to try? just thought id get your opinion. thanks for your time and answer in advance

Bi-weekly dosing makes sense, but it is not what I recommend today. Remember, the medication is still not FDA approved to treat hair loss at this point. Some people suggest taking 2.5mg, some suggest 0.5mg. Once the formal clinical trials are made public, many questions will be cleared up. I am not experimenting on patients, so you will have to find a doctor willing to do what you are asking. The half life of dutasteride is measured in weeks.

About 2yrs ago I started getting an itching and burning sensation on the back of my head on the scalp around the hairline up about 2inches. I noticed my hair thinning, I went to see a Dermatologist he gave me a couple of steroid shots. He told me to come back for a follow-up, when I did he said it hadn’t helped but not to worry about it, with time it should grow back. It hasn’t and seems to be getting thinner on my right side. It still itches and hair falls out more than on the other side. Can you help or suggest any solution?

I’m not sure how long it was between the time you received the steroid shots and your follow-up visit. You’re under the care of a dermatologist, and if you feel you’re not getting adequate treatment for whatever reason, you should consider trying a different doctor. Without examining you, I can not help you. Sorry!

I would like to know that the hair which are growing after the chemotherapy are healthy , should they be kept or should it be discarded and let the new ones grow after sometime , i am really confused . also the hair which are growing are all grey , what to do , pls answer my query. waiting for the reply. thanx

All the hair that survived the chemotherapy should continue to grow. The hair that is in your hands that has already fallen out is not worth keeping, but new hair should grow to replace what has fallen out in less than a year.

Hi,

1. Does Hair Body transplant works? I mean I have a lot of hair in my chest, I could use it instead of laser hair removal..
2. Also, do you recommend antiandrogens? I mean, what’s the difference between them and propecia?
3. Also I have read something about a Tricomin product, is rogain better than tricomin? Which should I use? Or should I use both intercalated?
4. And it’s rogain 5% better than 2%?
5. Normally I just wash my hair “day yes day no”, so that I can not have an oily scalp. So, should I apply rogaine everyday even with my hair “dirty/oily”?
6. Finally, do you recommend LLLT at long term?

Great blog and thanks for your advice!

Hi.

1. Body hair transplants should only be used if you are out of donor hair from the scalp. The growth cycle of body hair is different than scalp hair, as well as the hair characteristics themselves.
2. Finasteride (Propecia) is an antiandrogen. An antiandrogen is something that inhibits the effects of androgens in the body. See Wikipedia for more info.
3. Tricomin’s website says you can use their product with Rogaine or Propecia. I don’t know what’s in it though, but I’d doubt it’s better than Rogaine. Remember, the only 2 FDA approved and proven medications to treat hair loss are finasteride (Propecia) and minoxidil.
4. Rogaine 5% is stronger than the 2% — the 5% is sometimes marketed as “extra strength”. If you experience irritation from the 5%, switch down to the 2%. It’s good to have options.
5. You should apply Rogaine twice daily. So, yes.
6. I do not recommend low level laser light therapy (LLLT). I’ve not seen any results that are worthwhile. I even had a LLLT machine in my office for my patients to use for free and wasn’t satisfied with the results (or lack thereof).

So if I start a new regimen and regrowth occurs would it start out as thin hairs then gradually grow thicker and thicker? Kinda like a reverse minituarization?

When we talk about hair regrowth, we are talking about two different phenomena:

1. The growth of new hair that was not there prior to the use of the medications
2. The thickening of the miniaturized hairs that will make the hairs that are there, thicker

The studies on hair regrowth usually refer to hair counts that show more hair numbers after 9 or so months, but the reality is that much of the fullness that is created by medications like Propecia, actually reflects the thickening of hair shafts. I can see this when I compare the metric I get examining hair a year apart with the microscopic miniaturization mapping of the hair that I do in most patients.

About.com reviewed my new book, Hair Loss & Replacement for Dummies. Snippet from the review:

Overall, I am impressed with both the content and readability of this book. The content covers everything from causes and psychological effects of hair loss to pharmaceutical and topical treatments, styling options, diet supplements, replacement systems and transplant surgery. Hair Loss and Replacement for Dummies also discusses hair loss myths and how to avoid scams and expensive mistakes. The book gives you a fairly objective look at the pros and cons of various treatment and concealment options and will help you determine the costs and complications of such options.

Read the full article at About.com

Nice review, and I’m hopeful that it’ll lead to more feedback one way or the other. As I write this blog post, the book is #1 on Amazon.com in the Hair Loss category, so that’s good to see. If you’ve picked up a copy and have a moment to review it, I’d be appreciative. The Amazon listing is here.

In other news, I was recently quoted in a new article about hair and employment opportunities. The article can be found at Canada’s CBC website.