(female)
I have skin cancer which required graft closures. I have had MOH’s surgery and grafts twice and once (one year ago this past March) I had hair transplantation from the nape of my neck. Approximately two months after the surgery the right side of my scalp regained feeling but the left side did not. It still hasn’t so I told my plastic surgeon and he injected a steroid thinking it was scar tissue. While he was examining my scalp (after the injection, which did not work) he touched an area of my scalp on the left side that shot pain up to the top of my head probably right on the occipital nerve (greater). He didn’t know what to do so I went to see a neurologist who told me that some of the lesser occipital nerves are not as deep and are in fact at scalp level. My scalp (at the donor site) is so tight it is difficult to move my head to the right and down. Now he says I have cervical dystonia. I don’t believe that because in my research I found nothing that even resembles what I am feeling or going through. What do you think?

Persistent pain and/or numbness is a relatively rare risk of hair transplant surgery from small nerve damage. It is always stated in our pre-surgery consent form that we go over with our patients. Tightness of the scalp is also a side effect of a hair transplant surgery. The more surgeries you have, the more risk you may have of tightness or nerve damage. As your neurologist explained to you, some of your nerves may have been cut/irritated during the surgery and this may be contributing to your problems. I really have no way of knowing, though.

Hello,

Thank you for answering my question about smoking and hair loss (posted in your archives in 6/25/09). I thought you might be interested in this link, which provides info on a medical study between hair loss and smoking: Could Your Bad Habits Be Causing Your Hair Loss? Stress - Smoking And Baldness

Summary:

Smoking has been proven to have a profound effect on hair loss by changing the dynamics of hair growth and restoration in the scalp. In essence, it works by promoting the level of DHT (dihydrotestosterone) in the hair follicles. According to a clinical study by the Harvard School of Public Health, DHT levels in randomly sampled smokers were 13% higher in smokers than in non smokers. In addition, testosterone was about 9% higher in smokers than non smokers, which means there are more levels for the enzyme Alpha-5-reductase to act upon in producing DHT. In conjunction with each other, testosterone and DHT increase the amount and rate of hair loss.

I haven’t seen the actual study that is referenced, but assuming this is true, it speaks for itself. Thanks for sending.

Hi,

I’ve been going for hair transplant surgery last 2 months and after the surgery the doctor recommend me to take propecia to maintain my existing hair as i was indicated of suffering from Male pattern hairloss. Just 3 days ago i start to apply Proscar and split it into quarter 1.25 mg as financial problem and use it daily without side effect so far. Surprisingly my hair stop to fall off immediately as only used for 3 days..

My question is now i am taking 1.25 mg of proscar daily, and i plan to switch to Propecia 1 mg after 2 years from now on. Is there any case of intensive shedding happened if switching from Proscar 1.25 mg to Propecia 1 mg? As most of the cases is only mentioned switching from Propecia to Proscar for cost saving.

Thanks for your sincere advice.

Cheers.

Proscar and Propecia are both the drug finasteride just at different doses. Switching between them is no problem at all. The difference in the 1.25mg dose and the 1mg dose is relatively insignificant.

Tomorrow is Independence Day here in the US, so we're taking today off for a long weekend. We'll be back Monday with new content, but please use this opportunity to check out our new featured articles:

1. Selecting a Hair Transplant Doctor
2. How to Avoid Dishonest Doctors
3. Why Should You Visit Us?

Snippet from the article:

The ‘baldness calculator’ - said to be the world’s first reliable tool for predicting hair loss - has been a huge hit with men in other countries.

The program calculates the exact age at which someone will go bald or have lost most of their hair or provides reassurance by predicting that they will still have a full head of hair in old age.

Read the rest at Telegraph UK

A PR firm sent me the press release and apparently the Telegraph in the UK got the same release and ran with it, presenting the article above. This “baldness calculator” is a clever way to market a caffeine-based shampoo called Alpecin, but I don’t know how this thing can claim to be accurate. It’s guessing the year you’ll lose your hair based on these factors you feed it — age, number of hairs lost daily, current hair loss pattern, scalp dryness, how often you wear a hat (???), stress, activity level, family history of hair loss, location (which apparently is limited to the UK), marital status, and career. Most of the questions are yes/no, and some have zero relevance. And surprise, surprise — when the answer is “calculated”, the solution is a special shampoo! I am completely and utterly SHOCKED (note sarcasm)!

For fun, I asked one of my employees to go through the steps of the “calculator” to see where he’d end up. It determined he’d go bald at 60 years old (though he’s not in the UK, so he had to choose a region that he doesn’t live in and probably has never visited). How’d it come up with that age? Your guess is as good as mine. He’s got miniaturization on the top of his scalp already (he’s been taking Propecia to maintain it), so clearly 60 years old may be completely wrong (who really knows).

My verdict: Fun way to try to sell you a shampoo, but to call this “accurate” is completely ridiculous. In fact, it’s laughable. Determining the age you’ll go bald is just not that simple, folks. If you want to try it yourself, go here, but keep in mind what I just wrote about the accuracy. Perhaps their claims for the shampoo are equally as accurate?

Hi Doc,

I’ve been using Minoxidil 5% for around 18 months and although results are evident they aren’t miraculous…as to be expected. My question to to you is, I’ve bought some Follicare supplement to assist with my progress. DO you know if this contains any harmful chemicals or will it cause a reaction with the minoxidil? I;ve read the chemicals are natural but to what extent? I know that follicare sells a package containing minoxidil but I wonder if it is any different to Kirkland minoxidil.

Anyway thanks for your time

I do not believe there is anything harmful in a supplement, aside from the harm it does to your wallet. If the product contains minoxidil, that’s going to be the ingredient that regrows your hair — so I’d stick to the generic minoxidil. I would not double up on the minoxidil, using the generic and the Follicare at the same time. Follicare’s various sprays and lotions also contains botanical extracts, saw palmetto, vitamins, oils, and lots of other stuff. It might make your hair shiny, but I don’t see where the treatment for hair loss is in there.

I’m looking at the Follicare website now, and I am not impressed by the tiny and blurry before/after photos. Ever notice how so many of these various hair loss products for sale are often accompanied by lots of hype, little proof, and even smaller photographs?

I have received a job offer that seams to good to be true. I responded to and add for an administrative assistant listing and at the interview they offered me a position as a hair restoration technician. I believe that I am under- qualified with a Bachelor’s Degree in Music Business. Is it customary to only hire women technicians? How do I know if this job is legit?

Training for a hair transplant technician takes considerable time and to become proficient once the skills are learned, may take a few years. If the doctor has experience training technicians and you like the detailed work that is involved, then you can embark on this as a career move. I would hope that the doctor who offered you the position does not let you loose and expect that you will become an instant member of the surgical team, making many mistakes along the learning path. It often helps if you have some medical assistant training so you understand the sterile technique process.

Can chemical relaxers applied properly by a professional at a salon cause hair loss? It seems as though every question here about chemical relaxers involve doing it yourself or messing up and burning the scalp.

Professionals make mistakes on occasion so the use of relaxers always put you at risk for chemical burns. In the hands of experienced professionals, I would think that the risks are minimal.

With that said, I just met with a nice lady who had a professional use a relaxer on her hair about a year ago, and ended up with two thumb-print type bald spots that appeared after a 6 month course of treating open burn wounds on her scalp. I will be transplanting those thumb-print bare areas shortly.

Snippet from the article:

[Shaun] Williamson and [Duncan] Bannatyne had hair transplants performed by Dr Bessam Farjo at his medical centre in Manchester. He says: ‘The biggest difference I find after the procedure is in the patients’ outlook.

‘You can see the change in their self-confidence and self-belief - they are smiling and making more eye contact. For many people, losing their hair is a burden, and then it is gone.’

Read the rest — Revealed: New techniques that may have helped James Nesbitt beat his baldness

Admittedly, I don’t know who any of these celebrities are, but Dr. Farjo got a good mention and our friends across the pond will likely find this article interesting for the celeb factor.

Hello,
I have a healthy 2 year old daughter who up until 8 weeks ago had a full head of hair. Now the front/top of her scalp is experiencing significant hairloss. There are no actual spots without hair (it is either breakage or regrowth). The dermatologist diagnosed her with seborraic dermitits, however upon reading, I’ve noticed that this is not common to cause hairloss. Neither sides of the family have any baldness. The dermatologist mentioned possible TE, but I’m finding it hard to believe that either TE or dermitits would cause this much hair loss in a child that previously had thick healthy hair. Do you think either of these conditions would possibly cause so much hair loss in a 2 year old? Thank you

I agree with you that I do not like the suggestion that this is seborrheic dermatitis. Speak with her pediatrician and get an another referral for a second opinion.