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I read a doctor’s web-site and he said his hair transplants did not produce scars in the donor area. Is that possible?

The FUE technique is often called a “scar-less” surgery, but that is misleading. Instead of the linear scar with conventional strip harvesting, FUE produces punctate scarring (pin-point scars about 1mm or less in size). If a doctor would state either in an advertisement or on his/her website that they perform scar-less surgery, any doctor that did this in California, for example, would violate truth in advertising rules and could be disciplined for use of such language by the Medical Board of California. Every time the skin is cut, no matter how small the cut it, it will produce a scar. FUE scars can be seen easily when the scalp is shaved or clipped closely and doctors use many ‘punch’ sizes which will impact the size of these punctate scars.

Is hair falling problem to be discussed with a Dermatologist or with a trichologist.? If a doctor like you can address this problem then what is the role of a trichologist?Iam pretty much confused with who should be approached for treatment (many universities in australia and USA are conducting trichology courses)?

A trichologist is not a medical doctor. A dermatologist is a medical doctor. You can discuss your issues with whomever you feel most comfortable. A trichologist can’t prescribe medication.

I found a listing on ebay that claims to be selling information on the “best” way to buy Propecia. This is a scam, right?

This is the description of the “information” for sale:

“PROPECIA too Expensive?” is an original narrative which WILL HELP AND INSPIRE YOU IN REAL LIFE! It follows how one person goes through life using rogaine minoxidil toppik and Propecia. The subject wants to find a way TO SAVE MONEY ON PROPECIA. He soon discovers a little known piece of information that allows him to buy a ONE YEAR SUPPLY from a particular well-respected national pharmacy chain FOR $30 A YEAR!!! This price gives him a SAVINGS OF $770 EACH YEAR!!! The person is relieved that the medication comes from a particular WELL-KNOWN AND REGULATED NATIONAL CHAIN and is ABSOLUTELY SAFE. The fictional story ends with ALL the EXACT AND SPECIFIC DETAILS revealed that should definitely help and inspire you. Shipping is .90 to anywhere in the US. There are other fictional narratives out there that are much more expensive so you SAVE MONEY when you buy this narrative! Due to the originality of the story, there will be no refunds on this auction; however, the benefits that you will receive from reading this story will more than make up for the cost of the story! Bidding is anonymous for your convenience.

How clever… this guy appears to be trying to sell a “narrative” on eBay, because otherwise it is a violation of that site’s policy to sell info on how to get cheaper drugs. Here’s the information that this joker is likely trying to sell… and I won’t charge you anything for it. In fact, I’ve written about it over and over again before. Propecia is 1mg finasteride, Proscar is 5mg finasteride. There is a generic Proscar, but no generic Propecia sold in the US due to patent laws. With that in mind:

1. Ask your doctor for a Proscar prescription and buy the generic from the pharmacy (Costco pharmacy has the lowest prices I’ve seen).
2. Cut the generic Proscar pill into 4 pieces (easier than cutting into 5 pieces) and you’ve got the same medication as Propecia, but for pennies on the dollar.

The only issue is that you will need to find a doctor that will prescribe you Proscar (a prostate medication), but as long as you explain that you will be cutting the pill and using it to treat hair loss, it might not be too much of a problem. Each doctor is different. Also, don’t cut more than one pill at a time and always store in a dry area.

Dr.,

If you’re a good responder to Finasteride, doesn’t that mean you’d have an even better result on Dutasteride/Avodart? Seems like the only guys saying dutasteride didn’t work for them were the ones that didn’t get any benefit on fin. Glaxo Smith Kline is making a big mistake if they don’t do the studies to get avodart to market as a hair loss drug.

Thanks, hope you can answer this

Some unofficial studies suggest that there is a better response to dutasteride than finasteride, but measuring this may not be very scientific. The real cost with dutasteride is:

1. We don’t know if it is safe for young men with regard to long term fertility
2. Side effects may be greater with dutasteride than with finasteride
3. The half life of the drug is 5-6 weeks
4. Most doctors will not go off-label in prescribing drugs that are not FDA approved for the purpose

Will the medication be available as a hair loss treatment? I don’t have the answer to that. If the studies show it is safe and effective, I hope it does become an option.

I’m constantly amazed by how amazing David Bowie’s hair is (and no, I’m not just referring to the wig he used in ‘The Labyrinth’!). But the guy is in his early 60s and has the hairline and fullness of hair that a guy in his early 20’s has. How can this be possible? I’m sure he hasn’t had any transplant surgery and his look is entirely natural.

Could it be that older guys such as himself are just very lucky with their genes and are able to have hair which never thins no matter how old they get?

Yep, it’s all about the genetics. 50% of the male population will develop some degree of balding, which also means that 50% of men will not lose their hair. Look at those photos of David Bowie, Ronald Reagan, and Bill Clinton. They are among those with great hair genes, and a massive number of men will actually retain the juvenile hairlines into old age (about 5% of the male Caucasian population). I guess David Bowie might just be one of them.

I’ll keep this short and sweet. I’ve been gradually losing hair for 6 years. My temple area is very thin and my crown is somewhat thin. Can I benefit from Propecia since I’ve been losing hair for 5+ years? Thanks!

I’ll keep it short and sweet as well. I don’t know the sure answer to your question, because if you don’t try it you won’t know. I would like to think it should help if you have genetic balding (it does work for treating genetic balding by slowing or stopping the hair loss). Propecia works best when the hair loss is caught earlier, but I don’t think it’s too late if your loss has been gradual. Go see your doctor and get your scalp evaluated for miniaturization so you will know for sure what the diagnosis is.

Hi what the problem is that just about a year ago i started to get seborrheic dermatitis mildly starting on my eyebrows. It has now progressed all around my scalp and has produced reasonably large flake’s all over my scalp. what i worry about is that when these flake’s fall out a hair would sometimes come out with it and what looks like the root of the hair aswell. I am just wondering will these hairs grow back if it is not part of the normal growth cycle? or may i be facing permanent hairloss if there is no true way to permanently get rid of these flakes. Thank you for your time Doc.

You may have psoriasis rather than seborrheic dermatitis. The hair that is going to fall out in normal hair cycling will often come out with the big flakes. You need to be evaluated by a dermatologist.