Update on Dutasteride

Finasteride, which is the generic name for Propecia, has been approved for the treatment of Male Pattern Hair Loss since 1998. Finasteride works by inhibiting the enzyme ,5 alpha reductase type II, that forms DHT. There has been a lot of interest by both patients and physicians in dutasteride, which is a drug that inhibits both type I and type II 5 alpha reductase enzyme. Read more

Hair Transplant Strip Scar - Can It Be Repaired?

I was left with a ear to ear, 1/2 in wide scar after having a mega session in 1996. It is impossible for me to hide the scar and the company who performed my hair transplant insists that they did nothing wrong. This has been a nightmare for more than a decade. I currently wear my wife’s eyeliner makeup to camouflage the scar which works O.K. but I would really like to fix the scar now that I have a little extra money. Is this possible and how much does it cost? Read more

Difference Between FUT (Strip Method) and FUE (Follicular Unit Extraction)

What’s the difference between the Strip method and FUE (follicular unit extraction) for getting the donor hair?

First and most importantly, I make sure my patients understand the greatest limit to any hair transplantation is that there is a fixed and limited amount of good genetic hair that we can transfer to the balding areas.

With that in mind, I explain that no matter how experienced the surgeon, when I remove the donor area with either method, I am removing it blindly (i.e. – I can not see under the skin until after the donor tissue is removed). The problem is that I can not see if the follicles have been damaged or transected until after it’s been removed. So it’s best to have as little tissue as possible exposed to any device removing the tissue.

With the strip method, we minimize the amount of donor area being exposed to the risk of damaging hair follicles while obtaining the donor hair. With F.U.E., the patient no longer runs the risk of having a linear scar on the back of their scalp, but there is a significant increase in the amount of surface area being blindly dissected and with that a significant increase in potential damage to the hair follicles.

While I use both methods to obtain donor hair, I make sure the patient understands the risks and implications of both and I help the patient make an educated decision.

Paul J. McAndrews, MD
Senior Medical Advisor, IAHRS

14 Years old and Losing My Hair - Can I Use Propecia?

I’m a 14 year old high school freshman and I think I’m losing my hair. Is it possible to go bald at such a young age? Can I take Propecia or do I have to wait until I am 18?

While it is unusual to lose your hair at such a young age, I have seen a number of such cases. And usually, I have found there is a very strong family history of extensive hair loss in such situations, although this iscertainly not predictable. I am not comfortable prescribing Propecia or any other DHT blocker to a young man Read more

My 52 Year Old Mom Had A Terrible Hair Transplant

My mother had a hair transplant with terrible results. She is 52 years old was was told by her hair transplant surgeon that she was a perfect candidate for the operation. She has lost so much hair I the last year and the transplant looks very unnatural and sparse. She is very depressed to say the least and wishes she never had the hair transplant. Do you think it was the doctors fault that the hair did not take or is it my mother’s age. Can anything be done to rectify the situation. Thank you for your help.

Hello. I’m very sorry to hear you mom is disappointed with her results. I’m going to make the assumption that we are, in fact, dealing with female pattern alopecia in your mom’s case when I answer your question. However, I just want to say, in an effort to be thorough, that you mom should be checked out by a Dermatologist to rule out other causes of alopecia in women. And this might include blood tests and a scalp biopsy as well as a thorough medical history. So assuming your mom is suffering from female pattern alopecia, what could have gone wrong? Or did anything go wrong? I have found that it is quite common for women to have extreme “shock loss” following an initial hair transplant procedure, so I always advise them of this and the fact they are very likely to require an additional procedure or procedures to achieve reasonable cosmetic density.Now since “shock loss”generally affects hair that is destined to fall out anyway, the procedure did not “cause” the hair loss, but it certainly did speed it up. Assuming your mom has sufficient donor hair available an additional procedure or procedures should help your mom achieve reasonable cosmetic density. Soassuming that all the grafts transplanted did grow, my only concern would be that these issues were not discussed in advance in a frank and professional manner. Doctors can’t always tell you what you what to hear, but we can make very sure that we tell you the absolute truth.

Gregory Pistone, MD
Member, International Alliance of Hair Restoration Surgeons