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I am planning to have a second FUT procedure in September to boost the density in my hairline. Any recommendations, experience stories, lessons learned etc. from those of you who have had a second HT in the hairline area? Was it a success?

We have discussed this before: http://www.hairrestorationnetwork.com/eve/158620-oily-scalp-after-hair-transplant.html How long have you been on Finsasteride btw? My greasy scalp and hairloss even in transplanted area seems to correspond with taking Finasteride. The more I took, the more greasy my scalp was (like someone poured cooking oil on my forehead while I was sleeping) and the more hair I lost. I have stopped the medicine and now it's not so greasy. Please consult with your doctor about the situation.

No one mentioned Dr. Rahal. Is he still doing transplants?

I would say my scalp is more oily since being on finasteride. However the hairs I lose are thick and dark (my hair is naturally lighter brown) so I believe the fin is at least keeping the hair cycle healthy, because I am not seeing miniaturazation of hairs or major hair loss. Levrais, I am hoping the hairs will grow back as they are not miniaturized as I mention above. The ones I lose recently all have a large whitish sebum plug attached to the inner white hair bulb. I think if I could keep those longer in the hair cycle without fallout then my hair would be reasonably thick for my age. Seems scalp health for those of us originally prone to oily scalp and hairloss is a delicate balance. My hair, scalp and HT in general was rocking after first using Nizoral, but you have to be really careful not to overuse the stuff. I am using these 2 shampoos now: Kerium intensive anti-dandruff treatment shampoo which works great in treating my SD and the milder Kerium oily dandruff shampoo for more everyday use. These are dandruff shampoos so my hair is not looking great but the intensive treatment has made my scalp healthier. Just doesn't seem to be removing the sebum plugs like Nizoral did, because it is less harsh on the scalp.

It dried out my hair and scalp, because it was the only shampoo that worked in treating my seborrheic dermatitis condition and I had to use it quite frequently. This was after Dr. Lees Regrowth shampoo of course became unavailable. My hair was literally falling out after about a year on Nizoral. After getting off Nizoral though my hair grew back. My issue now is the sebum plugs, as I am now using a milder shampoo. Thick otherwise very healthy hair coming out with sebum attached at the root.

Anyone out there have luck with shampoos or treatments for sebum plugs? Nizoral almost ruined my HT, so I cannot use it as much as before. I am losing thick healthy hairs with sebum plugs attached at the end. I wanna save and maintain my remaining hair....

This shampoo really does work, been on it since Feb. Kerium intensive anti-dandruff treatment shampoo Anyone thinking of getting off Nizoral should give it a try for a few weeks. My hair that I lost to SD has grown back thank god!

Be careful not to overuse Nizoral or its other variants, as other posts have mentioned on this forum. I was in a situation where I had to use it for dandruff issue (SD), and it nearly ruined my hair. Became brittle and just thinned out after a very amazing life-changing HT by one of the top docs.

Is it a mild shampoo gentle to the scalp? Or is it one for treating seborrheic dermatitis (dandruff)? What are the active ingredients?

Always had problems with hairline dandruff and plaques on my scalp my whole life, but was only finally truly diagnosed with SD at the time of my HT. Luckily live where there is soft water so the plaques are not as hard as when I was younger. Hard water and SD are a nasty combination.

Tried Regenepure, but didn't work out with my oily scalp. Left some buildup in the hairline and also was a little drying if I remember correctly. The only shampoos I have ever been able to use that didn't leave a scalp buildup caused by the oil on my scalp reacting with the shampoo ingredients, have been (1) Dr Lees, (2) Nizoral (don't ever overuse this stuff!!!) and now (3) this Kerium Intensive dandruff relief. Really wish someone would get hold of the formula for Dr. Lees shampoo and re-brand / remanufacture it. Seems to be more than just simply mixing 2% Nizoral with 3% Salicylic acid.

I never did find a good alternative, so I had to use 2% Nizoral (actually 2% Sebizole) to combat my Seborrheic dermatitis (crusty dandruff). My HT was from one of the Top 3 docs and was really rocking for a while, I was a new confident person!!! However the Nizoral (Sebizole) overuse eventually weakened my hair. So I stopped using it. Then the thick nasty dandruff came back and weakened my HT further. After a lot of crap and suffering in general --> hair thinning out for the third time in my life.... I have finally maybe found a dandruff shampoo that is seeming to work. I know a lot of folks suffer from SD and related hairloss, so am just posting what has been working for me recenlty. It is Kerium intensive anti-dandruff treatment shampoo (have on Amazon) Your mileage may vary as everyone's scalp is different but it has improved my condition.

Dandruff issue: Dandruff is referred to as seborrheic dermatitis, and is a condition that can be controlled but not cured. It is important to try the various recommended active ingredients that work in treating seborrheic dermatitis, and find the 1 that best works for YOUR particular scalp and physiology. These include: Ketoconazole Selenium Sulfide Coal Tar Salicylic Acid Zinc Pyrithione I had suffered from some dandruff-related hairloss before, and use of a 2% Ketoconazole shampoo has fully taken it under control. Actually to the point where I worry more about dry hair (side effect of dandruff shampoos) than dandruff now. I agree with the other poster, your hair looks great as far as the pictures show.

I definitely agree with Janna, stay calm and ask for a private room/area if that's possible. It happened to me and that's how I handled it....

I have recently started taking it twice a day, once in the morning and once at night, in an attempt to see if it would help reduce the oilyness / sebum production issue I've experienced after my HT. (Proscar 1.25mg each time) So far it seems to be helping a little. Forehead is not so oily when I wake up in the morning now. Not sure of the DHT reduction or hair growth benefits though.

Thanks Dr. Charles! I'll have to give Regenepure DR a try, looks to have all natural ingredients too in addition to keto. Do you or any of your patients use the Regenepure NT btw? (treatment / conditioner ?) My biggest issue recently is not so much SD, but dry and tangled hair that is difficult to style. The HT is finally kicking in nicely so I'm trying to grow it long, but if the tangles continue I might be forced to buzz it down. :rolleyes:

Hi Gillenator, I've ordered the product and will let you know after it arrives and I've tried it a few times. However looking more closely at the ingredients it appears to have SLS and also parabens:rolleyes: I should've looked closer before purchasing. Ketoconazole 1% , Salicylic Acid 2% Water, Sodium Laureth Sulfate, Ammonium Laureth Sulfate, Sodium Laureth Sulfate/Glycol Stearate, Cocamidopropyl Hydroxysultaine, PEG-150 Distearate, Propylparaben, Methylparaben, Polyquaternium- 10, Diazolidinyl Urea, Propylene Glycol, Peppermint Essential Oil, Polysorbate 20. Also: I tried out Free & Clear conditioner for sensitive skin after the Nizoral and the conditioner seems to make my hair smoother with no itch or irritation so far (fingers crossed).

This oily scalp / sebum issue is driving me crazy. My HT has come in really nice but I occasionally lose a few hairs with sebum balls (plug) attached. Well within the normal daily amount, but it's kind of unnerving.:confused: I'm on FIn and also wash with Nizoral, still very oily. What are the other options available? topical spiro?? low doses of accutane?? there's gotta be some way to deal with this as it appears to be a very common issue that many experience. Once again, any advice from the Doctors here?

Looks like I found an alternative in terms of main active ingredients: "Hair Regrowth Stimulating Shampoo" by Perfect Image Solutions. They have it on Amazon. Same ketoconazole and salicylic acid ingredients as Dr. Lee's shampoo, but not sure about it yet as I haven't tried it. Anyone use any of Perfect Image Solutions' products?

3-4 months if nobody is supposed to know you had it done and if the doctor requires shaving. Or grow your hair long behind the transplanted area and do a comb down until the shaved hair/new hair grows in. Still best to think in terms of months not weeks. It's realistically not possible for most people to take months off from work though of course.

I had been using Dr. Lee's Regrowth shampoo with 2% ketoconazole & 3% salicylic acid successfully to treat my seborrheic dermatitis. As you know the FDA has apparently shut his site down. Regrowth shampoo was the only shampoo that both helped my SD and also left my hair manageable and tangle free. Other dandruff shampoos like Nizoral always leave my hair dry and almost unmanageable. Is there an alternative keto shampoo available that is hair friendly? Or a conditioner that anyone uses which doesn't cause scalp irritation or exacerbate seborrheic dermatitis? Thanks.

A lot of folks take MSM up to 3,000mg daily to speed up native hair growth after a HT as well as Biotin to strengthen hair. I think Vitamin B complex, MSM and Biotin are the big 3 supplements but here are probably others. I think this site has a FAQs on this topic if you google it (??)

I have noticed this as well after my HT. I'm on Fin and use a Keto based shampoo and it's still very noticeable.:rolleyes: Would it be possible for Dr. Charles or one of the other Dr.'s here to comment on whether an oily scalp affects the results of a HT as well as its affects on hairloss in general?

Among those mentioned, what is the recommended method for a second HT into the hairline to boost density that does not require shaving? Depending on how things turn out I'm considering a second one after I see the final results.

The red/itchy/scaly skin is probably due to SD (seborrhoeic dermatitis). Shampoos like Polytar AF or Dr. Lee's Regrowth Shampoo etc. may help in treating this part. Probably best to see a dermatologist. Hopefully the experienced guys here can give you some advice on what to do for the pitting. Hang in there!