Bizymoms.com, the premier work-at-home community on the Internet with more than 5 million visitors per year, has interviewed Dr. Robert M. Bernstein in order to answer readers’ common questions about hair restoration and hair loss.
Dr. Robert M. Bernstein was interviewed by The Today Show on eyelash enhancement and the eyelash medication.
Q: What is your take on hair tattoos?
A: I don’t think that it is a good idea since, as the pigment is absorbed deeper into the skin, the tattoos tend to change color over time, developing a bluish hue. This gives a distinctly unnatural appearance. However, techniques are improving and there is increasing demand for Scalp Micropigmentation (SMP) procedures.
Q: When can patients go in the sun after a hair transplant? — S.M., Glencoe, I.L.
A: Following a hair transplant, patients should protect their scalps from the sun for about a month.
This does not mean one needs to stay indoors. It just means that after a hair restoration surgery you should wear a hat or a good sunscreen when outdoors.
Sunburns on the scalp should be avoided, not just for persons having a hair transplant, but for everyone.
Q: I know that Propecia works in only about half of patients. Are younger people more likely to be helped by this medication? — V.C. Greenpoint, Brooklyn
A: The main studies by Merck looked at men between the ages of 18 and 41. The five year data (which, in my view, is most important) showed that 48% of men had an increase in hair growth and 42% had no change over baseline. Thus a full 90% held on to their hair or had more over a 5-year period. This compares very favorably to the placebo group where 75% lost hair over the 5-year period.
Q: Do patients need to wear a bandage after the surgery and for how long? — L.H., West University Place, T.X.
A: In a properly performed follicular unit hair transplant, the patient can remove any bandages the day after the procedure and gently shower/shampoo the transplanted area. The bandages do not need to be reapplied. The reason the dressing can be removed so soon is that follicular unit grafts fit into tiny needle-size incisions that heal in just one day.
Q: Why is hair loss in women harder to treat with hair transplants than hair loss in men?
A: The majority of women present with diffuse hair loss (i.e. thinning all over) rather than the patterned hair loss seen in men (where the hair loss is localized to the front and top of the scalp).
Diffuse thinning presents two problems for a potential hair transplant candidate.
The first is that there is no permanent area where the hair can be taken from. If hair is taken from an area that is thinning, the transplanted hair will continue to thin after the procedure, since moving it doesn’t make it more permanent.
The second problem is that since the areas to be transplanted are thin, rather than completely bald, the existing hair in the area of the hair transplant is at some risk to shedding as a result of the procedure.
When women have a more defined pattern (i.e. more localized thinning on the front part of the scalp with a stable back and sides), they can make excellent candidates for surgery. This pattern occurs in about 20% of women. A small percentage of men have diffuse thinning and are, therefore, poor candidates for a hair restoration surgery as well.
Q: It has been over a month after my hair transplant procedure and I am starting to get nervous. When can I expect to see some growth? — J.N., Winnetka, I.L.
A: Transplanted hair begins to grow, on average, about 10 weeks after the procedure, although this number can vary. Hair tends to grow in waves and occasionally some new hair may start to grow as long as a year after your procedure. In general, growth is a bit slower with each hair transplant procedure, although the reason for this is not fully understood.
Q: Why does a hair transplant grow – why doesn’t the transplanted hair fall out? — J.F., Redding, C.T.
A: Hair transplants work because hair removed from the permanent zone in the back and sides of the scalp continues to grow when transplanted to the balding area in the front or top of one’s head. The reason is that the genetic predisposition for hair to fall out resides in the hair follicle itself, rather than in the scalp. This predisposition is an inherited sensitivity to the effects of DHT, which causes affected hair to decrease in diameter and in length and eventually disappear – a process called “miniaturization.” When DHT resistant hair from the back of the scalp is transplanted to the top, it will continue to be resistant to DHT in its new location and grow normally.
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