Celebrities – especially the men – are getting comfortable with the idea of surgical hair restoration and we are seeing more famous men embracing the concept every day. The truth is that the majority of men will eventually lose hair, so this is nothing to be embarrassed about. But most men don’t have to depend on their appearance to pay their mortgage bill, or to ensure that their career continues. Celebrities find themselves in a unique position in this respect, especially when the world is watching them grow up or grow old.

Celebrity hair loss is becoming an increasingly hot topic in the media. The continuing demands on celebrities to keep their good looks, seems to be of great interest to the tabloids. This is evidenced by the recent interest in the hairlines of stars like John Cleese, Mel Gibson, John Travolta, Kevin Costner, Dennis Miller, Tom Arnold, Johnny Depp, Jude Law, David Beckham and many others.

For example, a Google search for “Mel Gibson hair loss” has almost 50,000 entries. This attests to the amount of attention the media – and the public – are paying to celebrity hair restoration.

Many celebrities don’t mind their hair loss when it comes to their own personal life, but they realize that appearance is paramount in the entertainment industry. Celebs worry that their looks are important to the fans, and they seem to be right.

Chat rooms and fan sites are abuzz with the hair lines of the stars, not to mention the TV, magazines and newspapers which seem to always know when to get a picture at the right (or the wrong) time.

Often celebrities have hair transplant surgery only to satisfy the demands of their careers. Soap Opera stars for instance, need those wonderfully youthful hairlines, something that would not be in such demand with the general aging public. The hair transplant design required by someone in this profession, however, might not be appropriate for the average person.

As a result, actors sometimes need to make some compromises on long-term results in order to achieve short-term career goals.

In order to create the illusion that time has simply stood still for people in the public eye, secrecy is paramount. Cosmetic Surgeons for the stars are very meticulous about maintaining privacy, and understanding the special needs of their celebrity patients.

“Though the public tends to perceive celebrities as temperamental and demanding, I have not found that to be the case. Celebrities recognize the importance of cosmetic surgery to their careers and are very pragmatic about having it done – for most it simply goes with their job.” says Robert M. Bernstein M.D., Clinical Professor of Dermatology at Columbia University in New York and founder of Bernstein Medical – Center for Hair Restoration in Manhattan.

Interest in celebrity hair transplants is not just reserved for film and TV stars, but for all kinds of professions in the public eye. Sports celebrities like Tom Brady, politicians, fashion designers, musicians, and now even top business executives recognize the importance of hair to their image.

Busy celebrities often have their PR people or handlers try to discover what their treatment options may be, but often the proper research is not done. After all PR people are influenced by the media just like the rest of us. The far better route is the more time consuming one, where academic credentials and hospital affiliations are checked and medical publications are reviewed. Without this level of research, the search for a hair transplant surgeon can lead to some pretty bad results.

According to Dr. Robert Bernstein of the Bernstein Medical – Center for Hair Restoration in Manhattan, “Most Celebrities aren’t as concerned with how the process is done; they simply want it to be taken care of. One high profile patient of ours, however, was so curious about the process, that he actually left the surgical chair during his procedure so that he could watch how the graft dissection was done.”

In this very competitive society, youth and beauty are highly coveted bargaining chips.

One without the other can seem to be a considerable handicap. However, in the world of the rich and famous, where ones livelihood depends on physical image the stakes are even higher.

Fortunately, with modern medical breakthroughs, the image that is conveyed by a full, healthy head of hair is something that can be achieved, even by people who are not so genetically fortunate.

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.

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.

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).

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.