Not too long ago, consumer columnist David Lazarus, in a Los Angeles Times story, mentioned he had visited an open house at a hair transplant office and, to his surprise, saw that there were a lot of men who showed up. For him, it was unexpected. Lazarus said he had a conversation with the owner of the hair transplant center and learned that, in this fragile economy, a lot of men who are shopping for a hair transplant are thinking that it will better their job opportunities by having a full head of hair.

According to a CNN report, findings have shown that people who are better looking, or are slim (vs. fat), or who are of a younger age tend to have better success in the nation’s economy. These “lookers” bring in more money, have a better chance of moving up in the company, and tend to be treated more graciously. Albeit the results of this study may be a bit disturbing, it may be a somewhat accurate reflection of our society.

When we take into account these conclusions, it ought to come as no surprise that there are balding men in America who really hold fast to the idea that they can boost their chances of landing a job by sporting a full head of hair. It might just end up being a mental edge, or a self-esteem enhancer, for these adult males to give a good impression during their interviews.

All things considered, in my humble view, the crucial aspect of a job interview is a how a potential employee presents himself to his interviewer. The responses she gives, her demeanor, attitude about previous employers, and overall impression.

But, these days, some men believe it wouldn’t decrease their chances to have a full head of hair. In addition, due to the slumping economy, a hair transplant cost is at an all-time low for high-quality hair restorations. If there ever was a time to get a hair transplant for those who, under different circumstances wouldn’t get one, now is the time.

Recently, Dr. Parsa Mohebi, Medical Director of US Hair Restoration Los Angeles, gave a lecture on a new way to use the Laxometer during mega and giga-session hair transplants at the annual ISHRS (International Society of Hair Restoration Surgery) gathering in Amsterdam, Netherlands. As mentioned in other hair transplant industry gatherings, the Laxometer has the ability to make more accurate the strip removal method during a follicular unit hair transplant and, at the same time, minimizing the risk of donor scar complications.

At the 2009 ISHRS Meeting, Dr. Mohebi discussed a new manner in which to utilize the Laxometer for patients who have limited laxity of the scalp because of previous hair transplant surgeries or for people needing a max number of grafts in one session (3000+, 4000+, 5000+, etc.). In 2008, Dr. Mohebi  tried a different method by which he removed the strip in sequences for hair restoration procedures using the Laxometer before and after removal of every part of the strip. This particular way of using the Laxometer has resulted in a safer strip removal and, at the same time, has lessened the risk of donor wound complications.

The findings revealed at the ISHRS meeting proved that the Laxometer is the ideal surgical tool for increasing the number of hair grafts during a strip hair transplant while minimizing donor wound complications of a hair transplant surgery. Because of the results Dr. Mohebi found, he has been using the Laxometer at his California hair transplant offices quite often and it has resulted in a lot of satisfied patients.

Q:

Not too long ago, I had a hair transplant (using FUE). Things were OK until several months after the transplant. I spent some time having fun in the sun, and it was maybe close to triple digit degrees outdoors. As soon as I got back to my house, I noticed my scalp in the transplanted area had turned white. It looked like the skin on my head had been scorched. But I didn’t think it was a big deal and I kept on using the Minoxidil with Betaderm spray, which my doctor highly recommended.

A few weeks later, the top of my head (which had been grafted) began to peel and the skin fell off (like a sun burn). And there were a few transplanted hairs which fell off as well, with the skin. This really alarmed me. After about eight weeks, the scalp seems to have healed, although there is some redness in places; but, overall, it seems to be OK. But, I’m a bit worried about the condition of my after-playing-in-the-sun scalp. I know it was probably a sun burn, but I just hope my grafts weren’t damaged beyond repair. I’ve done some research on skin consequences of sun burn, but I wonder if the grafts can ever fully recover from the exposure to the ultra-violet rays. I know if my skin becomes more tan, it’s OK. But about my grafts, I’m really concerned about them.

I need answers, doc.

Yours truly,

A beach bum with a hair transplant

A:

Hey beach bum,

Skin and scalp which has been exposed to the sun’s rays for long periods of time damage both native hairs and transplanted hair. The consequences can be especially harmful if a person who has had a hair transplanted is not under an umbrella or is not wearing a hat of some sort. The scalp skin could be damaged that way. It is best to stay out of the sun after a few minutes, at most. For the first six months, hair transplant patients may want to use sunscreen or wear a hat to prevent hair loss and to guard against permanent damage to hair follicles.

For those who don’t like to wear hats or other types of protective head wear ought to guard their hair as if their financial stability depended on it. Make sure your hair density increases to the point in which your hair follicles cover your entire scalp and so the scalp skin is not exposed to the sun’s scorching rays (especially during summer).

I can’t give you a verdict on whether your newly transplanted hair is permanently damaged. I’m sure I don’t have to tell you this, but I’ll say it anyway in case there are people reading this blog who are in a similar situation: from now on, be very careful about your scalp’s sun exposure. And just kick-back and wait a while to see if the damaged hair grows back.

Remember, after hair transplant care is very important, if not crucial to the longevity of your hair restoration results.

In a recent email sent to our office from a recent patient, he writes in regards to his scalp evaluation and regarding Propecia (Finasteride). He asks, “Could finasteride worsen the hairline due to the rise of testosterone?” and, “if there’s any safe and minor treatments to slow the progress of maturation or reverse it that you would recommend at this stage?”

Early stages of male patterned hair loss may not always be obvious enough to be differentiated from normal levels of miniaturized hair during scalp microscopic evaluation. Propecia (finasteride) is still the most recommended hair loss medication to prevent additional balding. Some patients have even been prescribed Propecia without proper diagnosis or documentation of their hair loss condition making it difficult to tell if they have gotten better since they started or worsened.

Propecia (finasteride) is designed to block DHT (Dihydrotestosterone) which is the main cause of male patterned hair loss. With this in mind, finasteride cannot deteriorate your hair loss or cause changes in the hairline. Maturation of the hairline is normal in all men and should not be confused with balding. We also do not have any further recommendation on medications that can stop the maturation of the hairline.

In a recent article published in Dermatologic Surgery Journal, Dr. Nausbaum et Al discusses naturally occurring female hairlines. His study was based on a large panel of normal women for the purpose of comparing and contrasting hairline variables to attain the perfect female hairline. Given that male hair restoration has almost always been the focus of hair restoration this new information can help benefit women who are candidates for hair transplant surgery.

The author came up with a guide or type of blueprint to help determine the best hairline for a woman. This guide was based on the average recorded parameters in women with healthy, non-balding hair. Among a panel of 360 women, the most dominant feature found in 81% of the women was in fact the presence of the widow’s peak. In addition, around 90% of these women also showed lateral mounds.

It’s great to know that there is now a bigger emphasis in hair restoration for women with more viable information and techniques to help solve their hair loss. Our hair transplant surgical offices already specialize in female hairline reconstruction in women suffering from female patterned hair loss or male patterned hair loss. This technique has also been applied on transgender (male to female) patients to help soften and alter their masculine features.

We at our California offices of US Hair Restoration perform transgender hair transplants regularly and I personally believe that hair restoration is one of the most key procedures in sex reassignments process for transsexuals.

As with any surgical procedure, you would have to worry about certain side effects or tedious maintenance. We are asked by every potential surgical patient, “When can I go back to work after my hair transplant surgery?”

Downtime doesn’t only apply to the amount of time you would spend away from your office or how soon you can return. This all depends on the type of work that you do, whether or not you can use a hat, how sensitive the issue of your hair transplant is and whether or not you want to keep it a secret.

We have a few follow up dates after the hair transplant surgery in our California Hair Transplant Offices and each must be completed. On the day after surgery, all patients must have a hair wash done in office to best instruct the patient. We make sure to clean the patient as thoroughly as possible without damaging the hair grafts in a professional and comfortable manner. We make sure the patient understands that scabbing and redness must be dealt with as soon as possible.

Patients are most concerned about how they will look the first few days. Redness and swelling are the most common side effect of the surgery and can last 4-5 days after the surgery. Patients can choose to wear a hat to cover the transplanted area from plain site.

On larger hair transplant cases, the swelling may actually progress to the eyebrow area or even the eyelids and under eyes. 5 to 6 days is all it should take for this kind of swelling to go down, generally. The swelling is most always triggered by large (2500 graft surgery) or mega-session (3000+ graft surgery) procedures but is almost undetectable on smaller cases.

The final concern or issue after hair transplant surgery is the visual aspect of the existing hair. Most cases, we trim the hair in both the recipient and donor area (0.5 to 2cm) and it will stay at about that length for 2 to 3 weeks. In about 90% of patients that undergo surgery, the transplant hair will fall out within the first 3 weeks. This means will look like they did before hair transplant surgery. By this point, there should not be any swelling or redness. Staples and/ or sutures are removed in less than 2 weeks after surgery and the transplanted hair follicles will then go into their resting phase until they are ready to grow again.

We understand people like to pamper themselves. A patient of ours wrote to us regarding a scalp and body massage. He had his hair transplant surgery in our Encino Surgical Office almost 8 months ago and asked, “Would get a head massage risk loosening the implants?” He also wanted to know if that would help increase circulation to the grafts and improve growth.

Hair that has been transplanted over 3 months ago and is growing normally is considered permanent and cannot be dislodged from your scalp. The main concern is in the first weeks of a hair transplant surgery when the hair is still settling in. Even so, some cases where the hair is removed the active part of the follicle may still remain and a new follicle will grow shortly after. At this point, hair cannot be harmed.

However, there is no proof that a scalp massage to increase scalp circulation is proven to increase the quality of existing or newly transplanted hair. More so, it has also not been proven that lack of blood circulation or oxygenation in scalp will cause hair loss.

A patient sent us an email regarding his hair loss condition. He has male patterned baldness and it is still progressing. He already met with a dermatologist and had several studies done prior to the email and was even using Chronostim for approximately 3 months. Now that he’s used up the bottles of Chronostim, he has noticed no change is his hair loss situation. He wants to have a full head of hair and does not want to take hair loss medication for the rest of his life. Before we forget, his wedding is in 2 months.

Chronostim has not been clinically proven to correct or prevent male patterned baldness or any other form of hair loss. It should not be considered a replacement option for medications that have been both proven effective and FDA approved safe for consumption like Propecia (finasteride) DHT blocker.

We highly suggest that all patients experiencing any form of hair loss to be seen by a good hair transplant surgeon and have a miniaturization study done. If the condition is in fact male patterned baldness or androgenetic alopecia, finasteride should be a part of your everyday hair loss treatment plan.

Hair restoration surgery can restore the areas damaged by hair loss by transplanting healthy permanent hair from the donor. In this situation, however, neither of the aforementioned will make enough of a visible difference for the day of your wedding. These procedures take time to show their fullest effect. There are cosmetic options available like Toppik that can cover the balding or thinning areas of your hair through the use of microfibers. If anything, you can use that product for the wedding day while you either consider a hair transplant surgery or at least try using Propecia (finasteride) so that you may see true results a few months after your wedding.

We received a distressed email from a young patient who wrote saying he took Propecia after consulting with a doctor but it aggravated my situation and it catalyzed the hair fall instead. I was suggested that the hair fall will be temporary. I was scared so I discontinued the medicine.  He was also concerned if malnutrition may have also caused the patchy hair fall and the possible sexual side effects associated with Propecia medication.

When it comes down to hair loss, the first thing that needs to be verified is a family history of hair loss.  The reason for this is because most hair loss is genetically linked.  In this case, we can use this information to help prevent and reverse hair loss.

Vitamin deficiency can cause hair loss but generally if a person maintains a balanced diet they should be okay.  If vitamin deficiency is the issue, vitamin supplements can help correct that.

Finasteride (Propecia) has been clinically tested and proven effective for the treatment and prevention of hair loss and has been FDA approved.  You may experience some level of hair shedding during the first few weeks or months but hair growth should become evident within or after 6 months of treatment.  Sexual side effects have only been reported in only 1 out of 100 patients tested but the effects are usually temporary.  If Propecia medication impedes your libido too much, it is safe to either discontinue usage or reduce the prescription amount.

At this point, we highly suggest starting to establish a good relationship with a good hair transplant surgeon and consider getting a proper evaluation of your hair loss.  If male pattern baldness or typical male hair loss is the final diagnosis, we recommend starting a medication regimen and maybe even considering a hair transplant in the near future if need be.

We are getting another question on the Propecia use in men whom their wives are pregnant.  A hair loss patient just asked about possible side effects that finasteride (Propecia) may cause. He has read on the manufacturer’s instructions that broken tablets must not be handled by women who are or may become pregnant.

“Can finasteride cause damage to pregnant womens health or to the health of the developing fetus? Here I’d like to know also if finasteride can be found in body liquids such as men’s saliva, sweat or sperm. In such case is there any risk that a pregnant woman is exposed to finasteride? Are there any recommendations concerning taking or not Propecia before planned or during wife’s pregnancy?”

The answer to this patient’s question, which is a common question that many of young patients may ask is that finasteride (Propecia) blocks the conversion of testosterone to dihydroxytestostrone (DHT). DHT does not have any known role in adult men development, but it is crucial in development of a male fetus and child external genitalia (their penis). We at our Los Angeles, California hair transplant clinics don’t recommend taking finasteride for hair loss prevention and treatment before adulthood while maturation of external genitalia is not completed. Pregnant women should not take finasteride because of its effect on the external genitalia of their male unborn baby.

As we all know, finasteride (Propecia) is designed to block the enzyme that converts testosterone to Dihydrotestosterone (DHT). DHT does not have any real known role in an adult male but it is crucial in the developmental stage of a male fetus as well as the development of a young male’s external genitalia (penis). After reviewing the facts at our Los Angeles, California hair transplant clinics we do not recommend taking finasteride for hair loss prevention and / or treatment before adulthood while maturation of external genitalia is not completed. For this same reason, pregnant women should not take or handle finasteride because of its effects on the male external genitalia of an unborn baby.

Although the pharmaceutical company suggested that pregnant women should not be exposed to finasteride. They should not even be cutting pills that might increase the chance of inhaling small particles of finasteride. You are right about finasteride being present in body secretion such as semen and saliva. However, the amount of the medication is so small that it is considered negligible or safe for pregnant women.  So the research shows that it is safe for pregnant women to be exposed to the secretions of a man whom takes finasteride. That is why we do not recommend men to stop taking finasteride if their wife becomes pregnant. There has been no evidence of any risk to a male baby from secretion of finasteride through the father’s saliva, sweat or sperm.

They even mention cutting, ingestion or inhalation of small particles of finasteride to be harmful during pregnancy. You are right to be concerned of finasteride being present in body secretion such as semen and saliva. You can find a very small trace of finasteride in body secretions but the amount of the medication is so small that it is considered negligible or safe for pregnant women. Studies show that pregnant women can be exposed to male secretion even if they are currently taking finasteride. Studies have not found any evidence of risk to a male baby from secretion with trace of finasteride through the father’s saliva, sweat or sperm. So in short we conclude that men do not need to stop using finasteride while having their wives pregnant.