Below are the best answers to frequently-asked questions about hair loss, hair transplantation, and medical hair restoration. All posts were rated by users of this website.

How Long After Hair Transplant Can Grafts Fall Out?

Q: How do you know if you have lost any grafts after a hair transplant and how long after the hair transplant can you still lose them?

A: Each day following the hair restoration, the transplanted grafts become more fixed in the scalp and the hairs in the grafts become more dissociated (loose). At nine days post-op, the grafts are fixed firmly in the scalp – it has essentially become part of the scalp in the new area and can’t be dislodged.

The hair, however, has totally separated from the follicle by this time, so that it can easily be pulled out without dislodging the remainder of the follicle that contains the growth center. When this hair is pulled out (or is naturally shed) one often sees a tiny bulb at the end. This is the root sheath of the hair and not the growth center. This is normal and is not a lost graft.

If a graft is lost, an event that may occur within the first 3-4 days following surgery, it is almost invariably associated with a small amount of bleeding.

For details on how to care for a hair transplant, visit the Instructions After Your Hair Restoration Surgery page on the Bernstein Medical – Center for Hair Restoration website.

Total Score: 75
Average Rating: 4.69
Rated 16 times

Do Propecia (Finasteride) and Rogaine (Minoxidil) Work on Front of the Scalp?

Q: Both Propecia and Minoxidil definitely can work in the front of the scalp as long as there is some hair in the area. Although their mechanisms of action are different, both Propecia (finasteride) and Rogaine (minoxidil) act to thicken miniaturized hair regardless of where it is on the scalp. In fact, there are published data (Leyden et. al., JAAD, 1999) demonstrating this improvement in a controlled clinical trial of men with frontal hair loss.

A: Both Propecia and Minoxidil definitely can work in the front of the scalp as long as there is some hair in the area. Although their mechanisms of action are different, both Propecia (finasteride) and Rogaine (minoxidil) act to thicken miniaturized hair regardless of where it is on the scalp. In fact, there are published data (Leyden et. al., JAAD, 1999) demonstrating this improvement with finasteride in a controlled clinical trial of men with frontal hair loss.

The source of the confusion on this topic is the fact that the FDA limited the application of the drugs to the crown on the package inserts for both Propecia and Rogaine. The FDA did this because Upjohn (the company that introduced Rogaine) and Merck (Propecia) only tested the medications on the crown in the clinical trials. Logically, the fact that DHT causes frontal hair loss and Propecia works by blocking DHT gives a reasonable explanation for the efficacy of the drug on the front of the scalp. Also, a side effect of the use of minoxidil is facial hair, so how could it not also work on the front of the scalp? It is regrettable that some doctors and many patients think that these medications won’t work on the front of the scalp. Unfortunately, many hair restoration surgeons have done little to educate the public and dispel this myth.

To reiterate, yes, both of these medications can work on the front of the scalp to prevent hair loss and thicken a thinning hairline. However, it is important to note that neither of these medications can grow hair on a totally bald scalp or lower an existing hairline. Hair follicles must exist for the medications to work. It is also important to stress that the best results come from using both finasteride and minoxidil together.

Total Score: 75
Average Rating: 3.57
Rated 21 times

How Long Are FUT and FUE Hair Transplants Visible After Procedure?

Q: How long are FUT and FUE visible after the procedures?

A: The recipient area in both procedures is visible for up to 10 days. The donor area in FUT is generally not visible immediately after the procedure. In FUE, the donor area must be shaved, so that will be visible for up to two weeks (the time it takes for the hair to grow in).

Read about what to expect after an FUT hair transplant
Read about what to expect after an FUE hair transplant

Total Score: 38
Average Rating: 3.45
Rated 11 times

Why Am I Still Losing Hair (Shedding) After 6 Months on Minoxidil And Finasteride?

Q: I have been using an increased dosage of Propecia now for around 8 months and Rogaine for about 6 months. I know that shedding can be expected for the first 3-6 months, but I believe I am now beyond that timeframe. Have you seen cases in which these products merely exacerbate hair loss without the expected regrowth?

A: It is a bit long to still see shedding, but from my experience, either the medications are working (and you are still in the shedding phase) or you are not responding to them. I have not seen minoxidil or finasteride worsen hair loss. My advice would be to continue the same course for at least a year before re-evaluating their use.

Total Score: 38
Average Rating: 3.45
Rated 11 times

Do You Use Megasessions or Very Large Graft Sessions In Your Hair Transplant Procedures?

Q: Some surgeons are doing hair transplants using 5,000 to 6,000 grafts in a single surgery. Looking at the cases in your photo gallery, it seems like your hair transplants involve many fewer grafts p…

Total Score: 33
Average Rating: 4.71
Rated 7 times

When To Assess One’s Donor Supply?

Q: I am 24 years old and just starting to thin. I was told by another doctor that it was too early to have a hair transplant, but the hair on the back and sides of my scalp seems really thick. Shouldn’t I have a hair transplant now, just in case I am not a candidate in the future? — A.S., Cherry Hill, NJ

A: The most important criteria in determining who will be a candidate for a hair transplant is the presence of sufficient permanent donor hair. When hair loss is early, it is often hard for the doctor to determine this, since early on the donor area can appear very stable. It is not until the front and/or top of the scalp has significant thinning that the donor area may also show thinning. Therefore, it is only at this time that the stability of the donor area can adequately be assessed.

Total Score: 30
Average Rating: 5.00
Rated 6 times

Should Nizoral Be Used Every Day?

Q: Should I use Nizoral every day? — L.S., Houston, TX

A: The product recommendation is to use Nizoral shampoo twice per week for dandruff, but many patients prefer to use it daily. Other than drying out the scalp, it is safe to use daily. The 1% formulation is over the counter. The 2% requires a prescription.

Read more about Medical Treatment of Hair Loss

Total Score: 30
Average Rating: 3.75
Rated 8 times

How Experienced Are Bernstein Medical Hair Restoration Technicians?

Q: I know Dr. Bernstein is one of the leading hair restoration surgeons in the country but what about his medical assistants? How experienced are the hair restoration technicians that help him during surgery?

A: My medical assistants and technicians are full time employees, and many of them have worked closely with me for many years; in fact, many of them have been with me since the inception of FUT, the procedure I pioneered way back in 1995. I do not hire, nor have I ever hired, per diem technicians.

All my hair restoration technicians are highly skilled and experienced in stereo-microscopic dissection and follicular unit graft placement. Even with Robotic FUE, being highly skilled and experienced in stereo-microscopic dissection is important since every graft that the robot harvests is examined, counted, and, when necessary, trimmed to ensure they are of the highest quality before being implanted into the scalp.

Because of the intense in-house training of our staff, we have received national accreditation from the “Accreditation Association for Ambulatory Health Care” (AAAHC/Accreditation Association) for maintaining rigorous standards in patient care.

Read more about how we train our surgical staff.


Total Score: 29
Average Rating: 2.64
Rated 11 times

What is Latest Information on Persistent Side Effects from Finasteride?

Q: I have heard that side effects from finasteride can persist even after stopping the medication. What is the most current information on this issue?

A: For the past two years I have been on the ISHRS’s Task Force on Finasteride Adverse Events and struggling to make sense of this issue. There seems to be a disconnect between the relatively low incidence of side effects that we, as physicians, see in our practices, what published controlled studies have shown, and what is now being reported on the internet. For example, a 2012 study by Sato of 3,177 Japanese men published the Journal of Dermatology, showed a 0.7% incidence of adverse reactions to finasteride 1% and no persistent side effects after stopping the medication.

That said, there has been a recent increase in anecdotal reports of side effects from finasteride as well as reports of persistent side effects after the medication has been discontinued (referred to as “Post-finasteride Syndrome”).

Total Score: 27
Average Rating: 3.86
Rated 7 times

Dr. Bernstein’s Hair Loss: Why No Hair Transplant?

Q: Dr. Bernstein, why have you not had a hair transplant? I’m sure this question gets asked a lot. Thanks.

A: Yes, all the time.

My donor area is very thin (so I am not a good candidate) and I have gotten used to being bald. It has been years.

Total Score: 25
Average Rating: 5.00
Rated 5 times

Can Hair Transplant Restore Hairline in 21 Year Old With Early Hair Loss?

Q: Hi, I am a 21 year old male experiencing the first signs of hair loss as of late. I looked at your before and after pictures of hair transplant patients and honestly right now I have a lot more hair than the patients, even in the after photos. By no means do I intend to criticize your work at all, but I noticed that they still had a receding hairline. I myself am an artist and pay close attention to detail. What I want out of a hair transplantation procedure is to basically have the full head of hair that I had even before puberty. Is it possible for this to be done?

A: Your concerns and goals, although understandable, are impossible to achieve through hair transplantation and is exactly the reason why we don’t perform hair transplants in young persons.

Surgical hair restoration can never give you your original density back since we are just redistributing a smaller amount of hair.

In addition, your original hairline should not be restored since a transplanted hairline is permanent and will not evolve naturally as you age. A mature hairline must be built into the design of the first hair restoration procedure, regardless of a patient’s age.

Total Score: 25
Average Rating: 2.78
Rated 9 times

Is Propecia Persistent Side Effects Study Reported in the Media Flawed?

Q: As a Propecia user, I was alarmed when I read headlines last year about about a new study indicating very high rates of depression and erectile dysfunction caused by Propecia, with symptoms persisting even after the drug was stopped. However, when I read the articles, this “study” appeared to be survey of 61 men who had taken Propecia and already reported sexual problems who were then asked about symptoms of depression. These rates of depression were compared to a small survey of men who had hair loss but had never taken Propecia.

Anyone with a basic understanding of statistics would know such a survey was deeply flawed. First, it is a textbook example of a bad data sample — to get sound results you have to start with an unbiased and random group of people who took the drug, not a self-selected group of men already suffering symptoms. The study also confuses correlation with causation — because these men are suffering from ED or depression does not necessarily mean it was caused by the drug. Am I missing something here, or did the media just report these “findings” with no scrutiny on what was actually studied? — Jonathan, Brooklyn, NY

A: Jonathan, I think you’re right on the mark. The way the study was conducted raises a lot of concern about the accuracy of the findings. It is really important that additional data is obtained in a controlled way, as this will be most useful for physicians in advising patients. I addressed concern on these reports on the Hair Transplant Blog last year. The issue of persistent sexual dysfunction as a side-effect of finasteride is an on-going issue that we take very seriously. I sit on the International Society of Hair Restoration Surgery (ISHRS) Task Force on Finasteride Adverse Events, so this is an issue that we watch very closely.

Read more about Propecia and Persistent Side Effects

Read more about Propecia (finasteride)

Total Score: 24
Average Rating: 3.43
Rated 7 times

Do You Recommend Azelaic Acid With Rogaine (Minoxidil) 2% Or 5%?

Q: Have you any experience with Azelaic Acid as a hair loss treatment — is this something you would recommend using with Rogaine (minoxidil) 2% or 5% solutions?

A: Azeleic acid has no direct benefit in promoting hair growth. Azelaic acid (like retinoic acid) increases the absorption of minoxidil, but also the side effects, so I would especially not recommend it in your case.

Total Score: 24
Average Rating: 3.00
Rated 8 times

Is LaserComb FDA Approved to Treat Hair Loss in Women?

Q: Is the LaserComb FDA approved for women?

A: Yes, on June 11, 2011 the FDA cleared the HairMax LaserComb Lux 9 to treat female hair loss and promote hair growth.

Read this article in the Laser Therapy section for more information on this development.

Total Score: 23
Average Rating: 3.83
Rated 6 times

Does Propecia Cause Infertility?

Q: I’ve heard that FDA added a description of reports of male infertility to the side effect labels of both Propecia and Proscar (finasteride). Is this a likely side effect in your experience?

A: Propecia (finasteride 1mg) may, uncommonly, lead to male infertility by changing the consistency of the male ejaculate as well as decreasing the sperm count.

Ejaculate is a combination of sperm produced by the testes and a viscous fluid made by the prostate. Since finasteride shrinks the prostate it make the ejaculate less viscous (more watery).

Most patients taking Propecia and trying to conceive have no issues.

If one is trying to conceive for 4-6 months and having difficulty, then it is reasonable to stop taking Propecia.

It is important to know that taking Propecia while trying to conceive will not lead to congenital deformities or issues with the fetus as long as the women does not come in direct contact with the medication.

Total Score: 22
Average Rating: 4.40
Rated 5 times

How Many Hair Transplants Will I Need?

While the first session of a hair transplant is designed to stand on its own, there are several reasons why one would want a second hair transplant.

Total Score: 22
Average Rating: 2.00
Rated 11 times

Which Handheld Laser Therapy Device Do You Recommend?

Q: I am interested in trying home laser therapy for my androgenic alopecia? Which handheld laser device do you recommend? — N.M., Northfield, NJ

A: There are several handheld lasers currently marketed as a home use treatments for androgenic alopecia. To my knowledge there has never been a clinical study comparing different laser devices. Most of the devices use diodes to emit a narrow band red light. This wavelength of light is actually similar to those that are used in hair removal lasers, except they are at a much lower intensity. The theory is that high intensity laser damage hair follicles causing hair loss, but low level laser energy can have a bio-stimulation effect and actually induce hair growth.

If you would like to try laser therapy for hair loss, I suggest using a HairMax laser comb. This is the only device that is FDA approved. They sell a few different “strengths” of lasers for different costs. They have not shown any clinical evidence supporting one laser comb versus another. The more expensive ones have more diode lights so it would be reasonable to conclude that they are “stronger” and require less frequent use. I have patients who have used the “mid tier” laser comb, the Premium Lux 9 successfully, so that is the one I recommend to other patients.

Total Score: 21
Average Rating: 4.20
Rated 5 times

Why Recommend FUT Not FUE If I Have No Linear Scar?

Q: If I have no linear scar and I can exercise right away, why would you ever recommend FUT instead of FUE?

A: I advise FUT because the grafts are of better quality (less transaction and more support tissue surrounding the follicle) and because more hair can be obtained from the mid-portion of the permanent zone –- which is where the hair is the best quality and most permanent. For the majority of patients a linear scar buried in the donor hair is not an issue. Each patient has to weigh the pros and cons of each procedure when making a decision.

Total Score: 20
Average Rating: 4.00
Rated 5 times

Compared to Manual FUE, Does Robotic Transplanted Hair Grow Faster?

Q: Does transplanted hair grow faster after a robotic FUE?

A: There is no difference in the rate of growth between manual FUE verses robotic FUE. However, with robotic FUE, the actual growth should be better due to less transection (damage to follicles during the harvest).

In general, one can expect transplanted hair to start to grow within two to five months with the transplanted hair taking on its final appearance after approximately one year.

Read more about Robotic Hair Transplant surgery.


Total Score: 20
Average Rating: 3.33
Rated 6 times

How Can I Make a Hair Transplant Less Obvious Post-op?

Q: I am considering a hair transplant and would like to have the procedure and not be overly obvious about it. What are my options in hiding or concealing any redness after a week or so after the hair restoration? — R.T., Manhattan, NY

A: There are a number of factors that can make a hair transplant obvious in the post-op period. These include the redness that you are asking about, but also crusting and swelling.

Redness after hair restoration surgery is easily camouflaged with ordinary make-up. At one week post-op, the grafts are pretty secure, so that make-up can be applied and then gently washed off at the end of the day. Since the recipient wounds are well healed by one week, using make-up does not increase the risk of infection. At 10 days after the hair transplant, the grafts are permanent and can not be dislodged, therefore, at this time the makeup can be removed without any special precautions.

Usually, residual crusting (scabbing) presents more of a cosmetic problem than redness, but can be minimized with meticulous post-op care. Crusts form when the blood or serum that oozes from recipient sites after the procedure dries on the scalp. Although it is relatively easy to prevent scabs from forming with frequent washing of the scalp after the surgery, once the scabs harden they are difficult to remove without dislodging the grafts.

Total Score: 19
Average Rating: 3.80
Rated 5 times


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