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I just heard a story from another doctor of a young girl (let’s call her Shirley) who went to a beauty school to get highlights in her hair. The student beautician put strands of her hair in aluminum foil and “painted” them with a bleach. Shirley’s head was then put under a hot hair dryer. After about 15 minutes she developed severe pain in the crown of her head. The student beautician then pulled the hair dryer away and shampooed Shirley’s hair. Later that night, she noticed swelling in back of the head. Over the next few days the pain got better, but after about a week she saw something horrific happen. As Shirley brushed her hair, part of her scalp peeled off (along with the hair in the brush). The area measured approximately 1 1/2 inches round, and when it eventually healed, it was scarred and incapable of growing hair.

Injuries in beauty parlors are not uncommon, especially chemical burns. I have seen quite a number in my own practice. In most cases the operator who did the damage just didn’t really understand what he or she was doing, and applied bleach and heat together. If Shirley is lucky and the depth of the defect does not go to the skull, then transplants may work just fine (usually the case), but she may require a special type of plastic surgery where a balloon will be placed under the scalp and inflated over a period of time to stretch the scalp. This balloon expander stays in for usually 5-8 weeks, depending upon the size of the scalp defect. The defect in the scalp can then be repaired.

The purpose of this post isn’t to necessarily steer people away from going to beauty schools to get your hair done, but really I want to just remind people that when you go to someone that is still learning about using chemicals on your hair/skin, you could run into major issues. Perhaps this could’ve been avoided with better student supervision — I don’t know, as I wasn’t there — but Shirley put far too much trust in a student and it ended up costing her in the end.

I have a few questions about ACell…first of I know it’s in early stages and a lot needs to be done but it it works I want to know this…

1. From my understanding it will involve plucking hairs from the donor hair putting into the top and then wait a few months for new hairs to sprout from the plucked areas to keep transplanting?
2. If that is the case how is not a cure where you once said somewhere? If plucking out hairs and they keep regrowing won’t you have an unlimited donor supply!?

Yes, the hair is plucked from a donor area and placed in a bald area. It is not a cure, because you are still genetically bald. You just added hair to look non-bald. If that was the definition of cure, then Propecia and hair transplant surgery could be considered a cure. If you are referring to the “theoretical” unlimited donor hair supply as a cure, then I suppose that would fit. But theory and practicality (of multiple surgeries) does not always work out in the real world.

There are a lot of unanswered questions here. I do not have all the answers, and the proliferation of information on the Internet makes it difficult to keep ahead. In other words, we are BEGINNING our clinical study. We can all speculate what the study will show, but as far as we are concerned, it is all hopes and dreams at this point. We promise we will keep you all up to date.

I have a question about the donor area scar. It seems like most donor area scars begin over the ear and proceed to the back of the head. Wouldn’t it be better to remove the donor hair from the nape of the neck where the skin is more elastic and the scar would be less noticable? Is this a viable option? Thank you

Your theory may be valid, but the hair on the nape of the neck is not considered permanent hair. Let’s assume that hypothetically the hair at the nape turns out to be permanent — you’d still run into the problem of scar visibility. A wound scars readily at that location. Many men like to keep their hair short and faded (cut short) at the nape of the neck, so having a scar there would really be a problem for them.

Finally, most donor area scars do not begin over the ear (at least not my patients).

Hello doctor. I was wondering how long eyebrow hair takes to regrow from overplucking? I know that in some cases it may never grow back, but I have read that the time frame in some cases can be from a few months to a couple of years. So, can a follicle possibly still regrow hair years later? Thanks for your insight.

I would say it takes a few weeks to months for eyebrows to grow back after plucking. If you haven’t seen growth after a year, I would think your chances for regrowth are very low, though anything is possible. Continuous plucking is the most common cause of hair loss from the eyebrow.

One of my favorite BaldingBlog contributors (who shall remain nameless) sent in some great insights about FDA advisory committees. We’ve previously posted his thoughts on the LaserComb, clinical trials, and FDA trials. This post will be used in the future as a point of reference:

—

Dr Rassman,
Given the many questions related to consideration of FDA expansion of the finasteride label for prevention of prostate cancer, your readers may wish to access the data themselves and better understand the process (which becomes more transparent and less “conspiratorial”).

 
The recent finasteride and dutasteride opinions noted in the Dec 3 Balding Blog posting are not from the FDA, but are from an independent group termed the Oncologic Drugs Advisory Committee. The committee is composed of 18 voting members (and several non-voting members) – mainly oncologists, with some statisticians, epidemiologists, and a patient representative, the former mainly from academic institutions.

The FDA eventually considers the committees opinion in approval or withdrawal of drugs (or “expansion” of a drug label for a new indication). The FDA usually follows the recommendations of advisory committees, as the committees’ recommendations are presumably “data-driven” and the FDA typically comes to similar conclusions. However, as in the case of many decisions that are split or where significant differences in interpretation of risk-benefit exist, the FDA has occasionally approved or rejected a drug against the recommendation of an advisory panel. Examples of split Advisory decisions (where a majority vote did occur) are the opinions this year related to several weight loss drugs.

The Oncologic Drugs Advisory Committee voted 17-0 against expanding the label for finasteride to include prevention of prostate cancer. A unanimous vote by FDA Advisory Committees is rare. I have no special knowledge of the meeting. This decision was based in part on data from the 19,000 patient Prostate Cancer Prevention Trial and the belief that the data did not support the risk benefit profile (i.e. possibility of increased aggressiveness of tumor did not outweigh reduced risk of low-grade tumors). As with all such committee meetings, which are open to the public (including listening via live webcasts), the transcript will be published and available within a few weeks at the FDA’s web site.

However, interested readers can go to the FDA web site now and access the Briefing Document and presentations given to Committee members from the drug company seeking approval. This information is public and typically posted several days before the meeting. The meeting was held on Dec 1, but the date of posting was Nov 26 (see under Oncologic Drugs Advisory Committee). The info can be found at the following links [note - all are PDF files]:

1. Draft Agenda for the December 1, 2010 Meeting of the Oncologic Drugs Advisory Committee
2. Briefing Information for the December 1, 2010 Meeting of the Oncologic Drugs Advisory Committee
3. Draft Questions for the November 30, 2010 Meeting of the Pediatric Oncology Subcommittee of the Oncologic Drugs Advisory Committee
4. Merck Briefing Information for the December 01, 2010 Meeting of the Oncologic Drugs Advisory Committee
5. FDA Briefing Information for the December 01, 2010 Meeting of the Oncologic Drugs Advisory Committee
6. GlaxoSmithKline Briefing Information for the December 01, 2010 Meeting of the Oncologic Drugs Advisory Committee
7. Draft Questions for the December 1, 2010 Meeting of the Oncologic Drugs Advisory Committee
8. Draft Meeting Roster for the December 1, 2010 Meeting of the Oncologic Drugs Advisory Committee
9. Webcast Information for the December 1, 2010 Meeting of the Oncologic Drugs Advisory Committee

My question, before you start reading my situation, is simply and purely “what should I do?” I’m a gay, 18 year old male who in the last six months has noticed his hair considerably thinning and then, about two months ago, considerable amounts falling out. My hairline near my temples has receded about an inch a month, the rate is staggering. With my fringe covering my hair, however, it is not at all noticeable and my hair at the back (although thinner) has produced no visible bald spots as of yet, though that is inevitable.

My problem is my mood. I have been to my GP for blood tests and tests on my thyroids, all of which came back as fine (worse than fine, optimum!) So, alas, I have to accept it is baldness. However, I’m struggling to accept it. It turned me from the hip socialite to the withdrawn type who has not only considered suicide, but actually planned it now. I’ve always had a problem with my own face with short hair (having had long hair from a very young age!) and do not find men with short hairstyles or shaved heads attractive in the slightest, so why should I expect them to find me attractive?

I spend every day miserable, and angry. I have fits of rage, and fits of tears and it simply can’t continue. I’ve lost over 50lbs in weight through not eating and I have no interest in doing so. The advice of most is, “that’s the cards you’ve been dealt, you HAVE to deal with it.” However, this is not an option for me and, realistically, I know that if that’s all there is, I will most likely end up killing myself. What do I do?

I am concerned about your mental health, as you should be. People who seriously entertain suicide for hair loss need professional help. You should understand there are many young men in the world in your exact situation, and there are many things you can do about treating hair loss.

There’s no easy answer to the question you posed in the opening sentence of your email. Any hair loss you’re seeing could be attributed to your extreme diet or genetics, but there’s no way for me to know without an examination. I would suggest you see a doctor about hair loss and treatment options, but more importantly consider discussing your issues with friends or counselors. Losing hair is not the end of the world. You should really seek out someone who will help you deal with life.

Snippet from the non-hair-loss health article:

Long-term use of a daily low-dose aspirin dramatically cuts the risk of dying from a wide array of cancers, a new investigation reveals.

Specifically, a British research team unearthed evidence that a low-dose aspirin (75 milligrams) taken daily for at least five years brings about a 10 percent to 60 percent drop in fatalities depending on the type of cancer.

The finding stems from a fresh analysis of eight studies involving more than 25,500 patients, which had originally been conducted to examine the protective potential of a low-dose aspirin regimen on cardiovascular disease.

Read the full story — Daily Aspirin Linked to Steep Drop in Cancer Risk

For years, there has been a suggestion that low doses of aspirin daily (75 to 81mg) can reduce the risk of death from a variety of cancers and vascular diseases. With increasing evidence like this, perhaps its time to consider taking one baby aspirin every day (talk to your doctor, of course).

Hey Dr Rassman i hope your day is treating you well.

Being a hairloss sufferer myself i can relate to the extraordinary anticipation and hype surrounding the new buzz word in the field of hair restoration ”Acell”. However i also realize that this is far from establishing itself as a practical solution to genetic alopecia(if it even makes it that far). As a hair restoration physician i imagine you grow tired of those ”cure” type perennial questions. In my opinion readers need to recognize that when the hairloss community is equip with innovators like yourself Dr Rassman it provides us with the best chance possible of making the most out of these types (Acell) situations.

Being a daily reader of this blog i have nothing but good things to say about it. There is not a doubt in my mind that Dr Rassman and the other physicians that contribute to the blog will be efficient at posting occasional updates. So for a lack of a better term just ”chill out” time will tell…..

Thank you for your support! I don’t mind the large amount of emails I’ve received with ACell questions, as I kind of expected that… but I don’t want to give anyone the wrong idea about what it can do (we’re still trying to figure it all out).

We will most definitely update the readers of this site on our progress as we can.

Dr. Rassman, this is in regard to body hair and propecia.
I have been taking propecia for about 1 year now, and I definitely have more body hair. I even get a little hair growing around my ears which I did not have before and I have to trim my nasal hair frequently. The Hair on my arms, legs and chest is definitely longer. I am okay with it though (even though it is rather unusual for black people).

Propecia (finasteride 1mg) is taken for the treatment of male pattern baldness on the scalp. There aren’t official statements or side effect reports that indicate that Propecia affects body hair. I do hear on occasion that Propecia decreases body hair, and some of our readers have commented that they actually lost body hair from Propecia use. Your case would be the opposite.

If I had to make a guess, I would tend to think Propecia decreases body hair since it decreases DHT (dihydrotestosterone) levels. DHT is responsible for genetic hair loss in men with the genes that predispose them for balding, but DHT is also responsible for some of secondary male sex characteristics like the growth of body hair, nose hair, ear hair, etc. Thus, it makes sense that decreasing DHT will decrease body hair… but this seems to be an uncommon effect.

In a private communication with a doctor that will remain nameless, he told me he saw a set of identical twins, one on finasteride and the other not on the drug. The twin on finasteride had distinctly less body hair than the twin who wasn’t taking it. Not that this conclusively proves anything, since obviously your situation is the opposite and you’re seeing increased body hair growth, but it is food for thought.

I have had a HT 10 days ago and wondered as a female what else i can do to help the hair i have grow apart from minoxdil. What foods can i eat and will hairmax and biotin work? Is aloe vera good to put on the scalp as it helped with the transplant pain.

There is really nothing you can do to make your hair transplant grow (this goes for both men and women). If the hair transplant was a success, then only time will tell. Women’s hair transplant surgery is a bit different then men’s for a number of reasons, with a main one being that the donor hair for women may not be permanent like it usually is for men.

I’ve written about Hairmax many times before (I assume you mean the LaserComb) and here’s a post about biotin that you may find interesting. I don’t know what kind of surgical techniques were used during your procedure, so you should be asking your surgeon what he/she recommends you do going forward.