Posts Tagged: Bernstein Medical – Center for Hair Restoration

Which Hair Loss Treatment is Better: Minoxidil with Retin-A or Minoxidil Without Retin-A?

November 9th, 2009

Q: Is using Minoxidil combined with Retin-A better than regular Minoxidil for Hair Loss?

A: Minoxidil has been prescribed (off-label) in combination with other medications, such as topical retinoic acid (Retin-A), to enhance its penetration into the skin and thus increase its effectiveness. This combination of medications, however, can significantly increase the absorption of minoxidil into the bloodstream and may increase the risk of potential side effects, including changes in blood pressure and severe scalp irritation that has, on occasion, led to scarring.

If person wants to add Retin-A to the minoxidil regime, the Retin-A should be applied only once a day, since the Retin-A will bind to the skin and will last for at least 24 hours.

Applying Retin-A more frequently will not increase its effectiveness (in facilitating the absorption of minoxidil); it will only increase the incidence of side effects. Retin-A can be applied to the scalp at the same time as Minoxidil, or by itself.

Retin-A should not be compounded with minoxidil (mixed together by your pharmacist or your doctor) for the following reasons:

  1. Minoxidil works best when used twice a day. Retin-A is best used once a day.
  2. Using Retin-A twice a day wastes money and increases the incidence of side effects
  3. If you develop side effects from the Retin-A, it is best to stop only the Retin-A. If they are compounded, you would need to stop both and will lose the benefit of minoxidil.

Explore the pro’s and con’s of Minoxidil — also known by its over-the-counter product Rogaine — at the Rogaine/Minoxidil page on the Bernstein Medical – Center for Hair Restoration website or by viewing minoxidil-related posts on the Hair Transplant Blog.

Topic: Drugs & Medications

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Posted by bwerner at 1:50 pm

Is Lgr5 Gene Discovery a Hair Cloning Breakthrough?

October 21st, 2009

Q: I heard about the Lgr5 gene being a breakthrough in hair cloning. What’s the latest on that?

A: Many scientists feel that adult stem cells house the answer to cloning (regeneration) of hair follicles. One of the problems of hair cloning, however, is that the cells, once duplicated, “forget” that they are hair follicle cells.

It has recently been discovered that the Lgr5 gene, located in stem cells, appears to contain the “global marker” present in all adult hair follicles. If Lgr5 gene is the “calling card” of the cell, it may carry the cell lineage and shoulder the responsibility of signaling to surrounding stem cells what they are actually supposed to do as they multiply.

Recent experiments have shown that these Lgr5 cells maintain the cells ability to differentiate as hair follicles after many generations of being multiplied in the test tube and, therefore, have the potential of serving as the building blocks of entire new hair follicles. The successful exploitation of this gene would eliminate a major barrier to cloning hair.

Reference
Haegebarth A, Clevers H: Wnt signaling, lgr5, and stem cells in the intestine and skin. Am J Pathol. 2009 Mar; 174(3):715-21.

For more on how hair cloning works, visit the Bernstein Medical – Center for Hair Restoration page on hair cloning.

Topic: Hair Cloning

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Posted by Robert M. Bernstein M.D. at 11:46 am

What are Options for Fixing Wide Donor Scars?

October 5th, 2009

Q: I would like to have the donor area from an old hair transplant repaired so it does not show the scar when I cut my hair shorter. What are my options?

A: Widened scars can be improved in two ways: they can be re-excised to make the scar finer, or hair can be placed into the scar to make it less visible.

Excising a scar works best when the original incision was closed with poor surgical techniques. In this case, using better closure methods can improve the scar. When the scar is the result of a person being a naturally “poor healer,” a wide scar will be the result – regardless of how the incision was closed.

I often approach the problem by excising a small area first, to see if I can decrease the width of the scar. If so, I would then proceed to excise the rest of the scar. If not, I would obtain hair using follicular unit extraction (FUE) — extracting hair in follicular units directly form the scalp — and place this hair into the scar. The hair placed in the scar can also be obtained from the edges of a partially excised scar.

If a wide scar that is thickened (called a hypertrophic scar) is also excised, it will usually reoccur and may result in an even worse scar. Because of this, thick scars should be flattened with injections of cortisone prior to removing. This will decrease the chance of a recurrence.

Flattening the scar is also important to permit the growth of newly transplanted follicular unit grafts.

For more on this topic, please see the Bernstein Medical – Center for Hair Restoration web page on fixing scars.

Topic: Repairs

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Posted by Robert M. Bernstein M.D. at 10:21 am

Is Platelet Rich Plasma (PRP) a Viable Hair Restoration Treatment?

October 5th, 2009

Q: There has been a lot of talk circulating on the internet regarding the use of Platelet Rich Plasma (PRP) for the treatment of hair loss. Would you be able to comment on whether or not you think this will turn out to be a viable treatment for male pattern baldness (MPB)?

A: It is a bit too early to tell. My sense is that it will not have any practical long-term benefits for the treatment of hair loss (MPB), since it doesn’t get to the cause of androgenetic hair loss, i.e. DHT. Treatments such as copper-peptide, saw-palmetto, laser therapy, have all been promoted for male pattern hair loss, but have not really turned out to have any significant long-term benefits. Further studies need to be done on PRP to get a better sense of its value in combating hair loss.

On the other hand, PRP can have a significant impact on wound healing and it is possible that it may be useful in promoting healing after a hair transplant in both the donor and recipient areas of the scalp.

For further reading, see the Bernstein Medical – Center for Hair Restoration web page on Platelet Rich Plasma (PRP).

Topic: Platelet Rich Plasma (PRP)

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Posted by Robert M. Bernstein M.D. at 9:54 am

Dr. Schweiger Discusses LaserComb for Hair Loss in Women in Wall Street Journal

September 29th, 2009

Dr. Eric S. Schweiger, an Associate at Bernstein Medical – Center for Hair Restoration, was interviewed recently for an article in the Wall Street Journal.

The article — Can Lasers Stimulate a Hair-Growth Spurt? — discusses the efficacy of the HairMax LaserComb and low level laser therapy (LLLT) and also touches on Dr. Schweiger’s main area of expertise, the diagnosis and treatment of hair loss in women:

Eric S. Schweiger, a clinical instructor of dermatology at Mount Sinai Medical Center in New York, says the LaserComb helps grow hair, but adds that effects are often modest, typically take at least six months and aren’t seen in all patients.

The only home laser device cleared for hair growth by the Food and Drug Administration is the LaserComb, which claims to increase hair growth in men. While used by Dr. Schweiger and others for women, the device isn’t FDA cleared for them; a clinical trial is continuing, the company says.

Read more about low level laser therapy (LLLT) and the HairMax LaserComb on the Bernstein Medical – Center for Hair Restoration website. For further reading you can explore the Laser Therapy topic on the Hair Transplant Blog.

Topic: Laser Therapy

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Posted by Robert M. Bernstein M.D. at 8:40 am



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