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I’m an African-American man, I have scarring aolpecia, especially on my crown. Will this Scalp Micro-Pigmentation (SMP) work work me?

In all likelihood, you would be a great candidate for Scalp MicroPigmentation (SMP), because hair transplantation is definitely not an option for men with scarring alopecia. SMP is also great for people with alopecia areata or alopecia totalis.

See here for FAQ and more information about SMP.

My question is about the use and effectiveness of topical finasteride. Are there any recent studies as to the effectiveness or safety of such a treatment? I have read both previous posts about “Xandrox Sales Stopped by the FDA”. From what I understand about the use of topical finasteride, it appears to me that the jury is still out and it is not so easy to dismiss altogether. Granted Dr. Lee may have had no “proven” scientific basis for claims about the effectiveness of his topical finasteride treatment, Xandrox, however that does not preclude its viability as a hairgrowth alternative to the popular propecia pill just because its effectiveness is simply not known.

Topical finasteride has already been studied. For example: 1997 JOURNAL Of DERMATOLOGICAL TREATMENT 8(3):189-192
mazzarella f; Loconsole f; Cammisa A; Mastrolonardo M; Vena GA.

The use of topical finasteride is also discussed at length in the original patent application for propecia by Merck:

[0033] For the treatment of androgenic alopecia including male pattern baldness, acne vulgaris, seborrhea, and female hirsutism, the 5.alpha.-reductase 2 inhibitor compounds may be administered in a pharmaceutical composition comprising the active compound in combination with a pharmaceutically acceptable carrier adapted for topical administration. Topical pharmaceutical compositions may be, e.g., in the form of a solution, cream, ointment, gel, lotion, shampoo or aerosol formulation adapted for application to the skin. Topical pharmaceutical compositions useful in the method of treatment of the present invention may include about 0.001% to 0.1% of the active compound in admixture with a pharmaceutically acceptable carrier.

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So the topical concept does not seem like some radical idea to me but rather more of a potentially common sense alternative. Is there some known fundamental chemical problem that prevents the drug effectiveness when it is administered topically? If not, I can see no reason to discount it. Am I wrong?

I understand the medication has not been FDA approved this way, but I don’t understand what could happen from topical use that could not already happen from taking a finasteride pill orally?

Drug delivery through the skin is not as simple as making a drug topical. I’m not a pharmacologist, and to be honest, I do not know more than you summarized for the readers.

There has been some discussion on the Hair Transplant Network about the relationship between the amount of Epinephrine used during surgery and shock loss in the following months. I know that Epinephrine is used to control bleeding and constricts the blood vessels, but is it the main culprit in shock loss?

Shock loss is prevalent in younger men who are actively (rapidly) losing their hair. In simple terms, any shock to the weak/dying hairs will accelerate the hair loss. While we can hypothesize epinephrine as the culprit, it is probably a combination of the surgery itself, the drugs that are used, and where you are in the hair loss process that all contribute to shock loss.

Young men (under 28 years old) in rapid hair loss with unstable hair in the balding area are more likely to experience hair loss than older men (greater than 40 years old), regardless of the medications used. High doses of epinephrine, when used by less experienced surgeons, increase the risk of shock loss. Men on finasteride, on the other hand, are likely more protected against shock loss than men not taking this drug.

I suppose the one way to tell would be to inject epinephrine on one side of the scalp and saline in the other side of the scalp (without hair transplant surgery) to see if that causes shock hair loss. Any volunteers?

hi
I have a serious hair loss problem and recently i came to know about kamino moto and i’ve been using it so far and i feel really good about it because it is a good solution for my dandruff but my question is now i am little bit scared to use it because it comes from japan and don’t know whether this product has been contaminated by radiation so please let me know all about this situation.
thank you

Unless your shampoo was made in close proximity to the Fukushima nuclear plant, I think you are overreacting and contributing to the hype of unfounded radiation scare. But if you are scared, there is a simple solution: Don’t use it. Does the bottle have a manufactured date on it? When did you purchase it? That might help set your mind at ease.

Also worth noting — the US FDA has been testing products imported from Japan, and other countries also considered radiation testing (the article is from right after the earthquake in Japan, so I don’t know what testing has taken place in the past couple months).

I hope you can help me…I finished chemo about 15months ago & my hair did start to grow back, a little thinner but at least it was growing..in the last 2 to 3 months it’s started to fall out again, not clumps but a few strands at a time, mainly on the top & very noticeable. I have been using Nioxin shampoo & conditioner for the last month but nothing seems to be happening…have you heard of this before??? Please can you help me.

I would need to see you and learn what kind of cancer was being treated, what medications you were taking, what medications are you now taking, etc. Your best answer to the question you posed is to have a deep conversation with you oncologist. Sorry I couldn’t be more helpful, but I’m afraid you gave me no information to work with.

In one of your answers to a post you mention that if the man had been receiving testosterone injections, that the new hair could fall out. Did I understand you correctly? I was under the impression that the hair taken from the area on the back of the head that normally never falls out would not fall out if it was transplanted as long as the surgery was successful. Can you please straighten me out on this? I have been taking Androgel for 10 years and had a HT about six months ago. Is it possible that all my new hair will fall out because of the Androgel?

Also, I’ve noticed that on the back of my head,the area that first showed balding years ago isn’t being filled in by new hair but the front of my head has,although there isn’t much thickness in front. I was given 2400 grafts.Do you think the testosterone could be causing any of this thin hair in front as well as little or no growth in the back area? Thanks once again for sharing your knowledge about hair transplants.

If Androgel (an androgen that may increase your body’s DHT levels) causes hair loss, it will only affect the genetically susceptible hairs. The transplanted hairs taken from the donor area are not affected by androgen (DHT).

I’m looking for a hair transplant surgeon who does both harvesting and transplanting. I don’t want a doctor who harvests only and lets technicians do the transplanting, as happened in my wife’s case.

In the United States, virtually all hair transplant surgery is done with a doctor and his staff of technicians. The doctor harvests the donor hair grafts and makes the recipient sites. The technicians process the donor grafts (under a microscope) and feeds it into the recipient sites that that doctor has premade. Without this teamwork the entire surgery would be too cumbersome for one doctor to accomplish. There is a misconception that the technicians are controlling where the hairs are implanted, but the direction, the angle, and the distribution of hair is predetermined by the doctor.

In short, the planning is more important than the execution and to succeed you need great teamwork. Thus, the consumers (patients) should be aware that when they choose a hair transplant doctor, they should also ask about the staff/technician and the overall reputation of the clinic (not only the doctor).

Here are some past articles that might be of interest to you, related to technicians in hair restoration surgery:

• NHI Surgical Team
• Doctors vs Technicians — Who Does More in the Hair Transplant Procedure?
• Selecting a Hair Transplant Doctor
• Hair Transplant Done By the Doctor or the Technicians?

Snippet from the article:

“I just put three or four drops on each side of my temple once a day,” said Mr. Paduda, 32, an insurance worker from Boca Raton, Fla. “The hair in that area, which was real thin and wispy — all those hairs got thick again, dark.”

Mr. Paduda is one of a growing number of men experimenting with Latisse as an antidote to encroaching baldness. Made by Allergan, the drug has already won a following among women for helping them grow long, fluttery eyelashes. It was only a matter of time before it made the leap to denuded pates.

Read the full story at NY Times - New Stratagems in the Quest for Hair

Latisse (bimatoprost) is expensive and comes in small quantities (it’s an eyelash growth medication), but people are experimenting with using it for hair growth. It’s a prescription medication, so you’ll need to find a doctor willing to prescribe it… and have the financial means necessary to keep up with the $150/mo cost for a small quantity.

The article also briefly gets into hair cloning, and mentions that my colleague Dr. Robert Bernstein believes hair cloning to be commercially available within a decade.

Hey Dr. Rassman,

Is it easier to treat a scalp with micropigmentation if the hair is black?

There is no color that is easier to apply than another. Scalp MicroPigmentation (SMP) does tend to look better on darker (black, brown, olive) skinned men with darker hair (black or brown), as the contrast difference between hair and skin color is lower than if the skin was white.

Men with red hair or blond hair still have grey follicles that you see when they shave their beard and scalp hair.

For more information see our SMP FAQ.

I recently found out that i’m pregnant, i’m about two months along now…and I noticed that about two months ago I started having hair loss more than normal. My hair has gotten significantly thinner. I went to the dermatologist and she said it’s most likely from low iron. I’ve been pregnant three times before and have never had this issue. If it is from being anemic, I was wondering what the result would be if I got an abortion, will the hair loss stop or get worse or stay the same?

Hair loss in pregnancy is relatively common and it’s generally a temporary phenomenon, usually changing course a few months after you give birth. Abortion or miscarriage can also cause added stress-induced hair loss. Please follow up with your doctor.