This study also demonstrated that the Hedgehog agonist is active in human scalp in vitro as measured by Hedgehog pathway gene expression. The results suggest that topical application of a Hedgehog agonist could be effective in treating hair loss conditions, including male and female pattern genetic hair loss.
Q: I was wondering why you chose two years as the amount of time one should wait to judge the effectiveness of Propecia. Have you had patients who only saw results after that long? Why does Merck say 3-6 months and Dr. Rassman at New Hair say 6-8 months? I know these numbers aren’t arbitrary, but I’m just wondering what the logic is behind this and how does this relate to planning a hair transplant? — I.P., Hempstead, Long Island, NY
A: The Merck data showed that over 90% of patients had peak response at 1 year and this has been my experience as well.
Most patients show the most dramatic response between 6 to 12 months with some getting additional benefit up to two years. Prior to 6 months, the results are quite variable and there may even be a net loss due to shedding during this period, as the Propecia stimulates a new anagen cycle…
Q: Can you perform a hair transplant into scar tissue? A.H. – Rockland County, New York
A: Yes, hair grows in scar tissue, but not quite as well as in normal tissue. The scar is not as elastic as normal tissue so the grafts are at slightly higher risk of being dislodged; therefore, more care must be taken to protect the grafted area after the hair transplant.
In addition, the blood supply in scar tissue is less than in normal tissue, so that area should not be transplanted as densely and the hair replacement should be performed over multiple sessions.
Q: If a second hair transplant is performed before the first had a chance to grow could the second procedure destroy the follicles from the first? — B.M., Upper East Side, NYC
A: Hair from the second hair transplant session would not damage the follicles transplanted in the first session, even if follicular unit grafts were transplanted in exactly the same spot as in the first session.
The reason to wait until the hair grows in, however, is so that you can better plan the subsequent hair restoration procedure. If two follicular units are placed on top of each other or very close together, you will essentially be creating a mini-graft and the results will not look natural.
Q: I am twenty and think that I am starting to thin. I am also experiencing a slight tingling in my scalp. Are these related? — T.N., Philadelphia, PA
A: Most likely. Early androgenetic alopecia can be associated with a slight tingling or slight tenderness of the scalp.
You should see a dermatologist for evaluation and, if you have early male pattern baldness, consider starting finasteride (Propecia).
Synopsis: This writing is the textbook version of the paper; “Limiting Epinephrine in Hair Transplant Sessions.”
Synopsis: This is the textbook version of the important 1999 paper; “The Logic of Follicular Unit Transplantation” that was instrumental in making follicular unit transplantation a mainstream hair restoration procedure.
Synopsis: This paper describes the technical and organizational skills needed for performing Follicular Unit Extraction Megasessions. It also points out some of the important long-term implications of FUE, especially regarding its inefficient use of donor area which potentially limits the ultimate donor supply.
Synopsis: This paper proposes that the old punch-graft technique may have a place in modern hair transplant surgery, particularly in patients with significant donor scarring and when further linear incisions are not possible. In these cases, punch harvesting (with subsequent microscopic division of the punch grafts) may be better than FUE, since extracting individual follicular units can be difficult in areas of scarring.
Excerpt from the interview:
Julie Chen: Dr. Bernstein, I want to go through all the options that are available for women, but what is the difference between female and male hair loss option-wise. What can we do to treat it?
Dr. Bernstein: The main difference medically is that women have hair loss often from hormonal changes and it’s due to an imbalance between progesterones and estrogens. That equilibrium can be reestablished with medication. Often birth control pills can do that.
All Fields Are Required
