mcr7777

That's good you have no thinning at least.  TE usually affects the whole scalp but there can be localised TE sometimes but there is usually some underlying cause.  Dr Donovan (specialist hair doctor) talks about it.

  If it continues for some time you might want to see a specialist hair dermatologist - but if no thinning that is a plus.

Do you notice actual thinning of the hair? or are small numbers falling and regrowing that it doesn't appear thinner than before.  I suppose it could be a number of things e.g. telogen eflluvium?_ - but would normally affect entire scalp rather than just transplanted hairs 

Do you know why your previous surgury failed? If I were you I'd want to rule out an autoimmune condition through a specialist hair dermatologist before considering any further surgery.

I'm thinking a good thing to do is to investigate/rule out autoimmune conditions e.g. alopecia areata or lichen planopilaris (LPP). Do you have any itching/burning/crawling sensations?

On 9/5/2021 at 8:59 PM, johnfish123 said:

It was great for the first 3 years and now is failing rapidly(not just my opinion, seen several surgeons about a repair who have confirmed, don't wait to say too much at the moment) I want to give HDC every chance before I do a full thread etc but I have a full folder of pics and vids to share and will be happy to chat, answer anyones questions about my experience who is considering a transplant with them

I'm sorry to hear the hairs are thinning rapidly. Do you have any itching/tenderness/crawling sensations on the scalp? 

On 10/13/2021 at 7:30 PM, Mike Flaherty said:

Okay, I finally managed to take some photos. This is where my hair is at now. I didn't even realize my crown was thinning so harshly. It's all very thin hair with nothing near the temples to bind what hair I have onto. This is basically the state of my hair just before first transplant. 

Do you have any

On 10/10/2021 at 6:42 AM, Mike Flaherty said:

This photo actually makes my hair appear thicker than it is. I honestly believe it's getting worse by the week. 

The hair on the sides of my head have ceased growing. 

The hair around my crown will not grow to any length.

I've developed bare patches on my right front, left front where I part my hair, the area on the right side of my head near the top of of strip scar.

The hair on the front of my scalp which was always the thickest area has now become thin, wispy flyway hair that is unable to bind to any hair towards the side.

Temple recession and even slight frontal thinning/recession.

Something detrimental is occurring and my hair is regressing to pre-transplant levels to the time when I first met Dr. Rahal and he told me the hair I had wasn't going to last "much longer."

Most of these issues have occurred within the last year.

So, basically I'm freaking out.  

Do you have any burning/tenderness sensations on the scalp?  

If you have itchy scalp - you should definitely check that you don't have Lichen planopilaris -an autoimmune condition. This is what I have - it causes an itchy scalp with hair loss - which can be patchy or sometimes diffuse or other times in a vertical strip down the centre of the head. 

People with LPP are often misdiagnosed as MBP.  For this reason, you should find a derm specialising in hair loss - not a general derm - and not  just a HT doctor- as they often will miss LPP/not be very aware of it.  If you think you might have LPP i'd suggest trying to find a derm that knows about scarring alpoecia.  It's not uncommon for people with LPP to also have some MBP which seems to confuse doctors.   

I'd recommend trying to find what is causing the thinning and itchiness before doing another transplant.   Meds might help to stabilise your hair - but LPP meds are oten different than MBP mesd.  So important to find out what is going on if you've lost a lot of hair very quickly.  The itching and quick thinning makes me suspicious of LPP - but you need to see a dermatologist to figure out what's wrong rather than a HT doctor.

On 5/18/2021 at 6:40 AM, Jake003 said:

Hi

Im almost at the 7 month mark.

One side is growing very slow and not as good compared to the other side. 

I attached 1 picture to show and can see areas that are still empty and other areas lacking in density. 
 

my question is could there be many hairs that will still pop in the future And will the empty areas fill in? Or there will be no more new hairs popping through the skin?

been worrying and stressing about this but yep at almost 7 months was hoping for everything to be filled in.

 

 

 

It looks like you have red pimple type bumps on your hairline - have you been checked for some type of scalp condition e.g. dermatitis by the clinic or a dermatologist? Might be a good thing to do as it looks unusual.

7 hours ago, GrowNewHair said:

topical fin from minoxidilmax. not sure if liposomal.

yes. topical dut from fueclinic

Have you noticed any sides from Topical dut?  Do you think it's working? Any shed with it?

On 6/26/2021 at 4:02 PM, Myr said:

 

 

Yikes, just googled LPP and scarring alopecia. None of the clinics have said anything about this but those have been online consultations. I do have diagnosis of Alopecia Mucinosa in a past though which is a very rare skin disease. 

Do you think it would be worth to pay a visit to dermatologist before travelling to any HT clinic? I'm considering HLC but if I'm honest, I'm not 100% sure they would give me impartial view if I'm eligible candidate for HT.

HT clinics would not be able to diagnose LPP - certainly online - and even in person.   I saw several clinics in UK and none of them recognised I had LPP.  You could always invest in a digital microscope like I did - £18/25 USD on amazon.  You can look at your scalp and see if there are typical LPP symptoms like redness around the follicles, scaling etc.  A quick Google search will show you what LPP looks like on dermoscopy.  It's acutally probably more reliable as a first step than seeing a general derm (many who are not great at spotting LPP as many forum users go years being misdiagnosed).  

On 6/26/2021 at 4:02 PM, Myr said:

 

 

Yikes, just googled LPP and scarring alopecia. None of the clinics have said anything about this but those have been online consultations. I do have diagnosis of Alopecia Mucinosa in a past though which is a very rare skin disease. 

Do you think it would be worth to pay a visit to dermatologist before travelling to any HT clinic? I'm considering HLC but if I'm honest, I'm not 100% sure they would give me impartial view if I'm eligible candidate for HT.

I'd definitely would recommend seeing a specialist derm before going with a HT. I saw a number of HT doctors including former derms who didn't recognise I had LPP even though I had symptoms and hair loss. I ended up getting a HT and getting diagnosed with LPP afterwards - after itching/burning didn't stop and growth wasn't great.  I wish I'd known beforehand but didn't see a specialist derm - and didn't even realise LPP existed.

Do you have symptoms e.g. ithching/burning? 

It might help a touch with itching but it's not one of the main treatments I find other shampoos better for soothing the scalp.

You might want to try Euracin shampoo or head and shoulder anti itch as they helped me while I was waiting to be seen by a derm.  

If it is LPP you have or a scarring alopeia, more targeted meds are needed if you want to bring down inflammation.

3 hours ago, TrialAcc said:

Okay thanks for the information. No chance of regrowth at all? That's pretty depressing!

 No hair doesn't grow back if lost to LPP - that's why it's important to get diagnosed early if you think you might have it. A lot of people seem to be completely unaware of lichen planopilaris (like I was)  and even derms and doctors frequently misdiagnose it.  

The digital microscope is useful as there are certain details you can see only with the microscope (e.g. scale around the follicles).  Seb derm is another possible cause but I don't think this generally causes as much hair loss and maybe less intense pain/burning compared with LPP.

I am on lymcecycline and topical steroids and have just started hydrochloroquine too. No sides form these (unlike fin which made my condition a lot worse and caused sides).

I'd suggest seeing a dermatologist that specialises in hair loss - ideally one that knows about scarring alopecias.  A lot of people seem to get misdiagnosed due to ignorance of many general derms about the condition.  This means treatments are delayed and lots of hair is lost before a diagnoses is made - this happened in my case.  It wasn't until I got the digital microscope that I realised myself what it was.  You don't regrow hair from LPP loss so suggest getting diagnosed as quickly as you can if you think it might be what you have.

On 4/14/2021 at 4:04 AM, TrialAcc said:

Hmm I wonder if I should get checked for this, I have insane itch and red spots where I'm losing it. 

I'd definitely recommend getting a dermatologist/hair specialist to examine your scalp for signs of inflammation.  I had the same as you and was diagnosed with lichen planopilaris.  Treatments are needed to stop shedding (mine is finally getting better).  

You can even buy a digital microscope on amazon for about £18/less than 20 USD.  You should be able to see if there are worrying signs like redness around the hair follicles. 

On 2/6/2021 at 2:24 AM, Panamera13 said:

I have itchy scalp for many years and lost lot of hair; turns out I have LPP i.e. Lichen Plano-Pilaris and I'm NW6-7. I was wondering:

1.) Is anyone here with the same scalp condition?

2.) If I get HT, will the transplanted hair stay?

Thx.

You might want to see my recent post - I was diagnosed with LPP a year after having a HT - I basically didin't know it was LPP causing hair loss until a year after i did the HT.  The HT didn't grow great as they implanted into an area of active LPP (maybe frontal fibrosing).  I do have more hair there now but not expecting to keep them more than a year or so longer as the LPP will probably kill them.  If I want more hair I think I'll have to go down the hair system route.

Was your biopsy showing LPP in the front, (frontal fibrosing) and/or middle or crown?

1 hour ago, anotherhairlosssufferer said:

> Following a biopsy I was diagnosed with lichen planopilaris (LPP)

Is this a condition where they can definitively say that you have it (by having more chemicals of a particular kind in your scalp for example) or is it more or a "syndrome" and pretty much it's up to the subjective opinion of the dermatologist?

Also, can it be fixed?

I am sorry you had it and you potentially wasted 1200 grafts (went through your post history - it doesn't look at all bad currently imo). I definitely have itching all over the scalp and I kinda feel that's an indication of where the hair loss is progressing, but I don't know enough about it to make any claims.

 

The biopsy takes a small bit of your scalp including hair bulb. They need to take it in an area of active inflammation in order to do a proper diagnosis. 

The derm normally takes the biopsy and sends it to a specialist lab where they analyse it.  They gave me a technical report which analyses the hairs and root and whether it is growing properly.  LPP kills the stem cells so hair bulb can't regrow.

If you think you might have it (any of the symptoms I mentioned e.g. eyebrow thinning or pale patches around hair loss or forehead),  it's important to go to a derm who deals with hair loss and knows about scarring alopecia. 

 They need to take the biopsy in the right area of active LPP - as if they take from an unaffected part of the scalp the biopsy probably won't show anything and you may be misdiagnosed.

You might want to see my recent post - I was diagnosed with LPP a year after having a HT - I basically didin't know it was LPP causing hair loss until a year after i did the HT.  The HT didn't grow great as they implanted into an area of active LPP (maybe frontal fibrosing).  I do have more hair there now but not expecting to keep them more than a year or so longer as the LPP will probably kill them.  If I want more hair I think I'll have to go down the hair system route.

Was your biopsy showing LPP in the front (frontal fibrosing) and/or somewhere else on the scalp?

I thought I would update my case as I had a hair transplant 1 year ago with sub-par growth. Following a biopsy I was diagnosed with lichen planopilaris (LPP) -  most likely  the frontal fibrosing variant, a scarring alopecia  -last week.

This means after going through a HT, my transplanted hairs will likely fall out in the coming months/couple of years.  I had no idea this condition even existed until two months ago. I saw 4 different HT doctors before my procedure and none mentioned I might have this condition.  It does look similar to MBP - but now that I've read about frontal fibrosing,  I can spot some differences in the symptoms: very itchy scalp at area of hair loss, some minor eyebrow thinning which I do have - but didn't notice until I really looked back at photos of my eyebrows 5 years ago when they were much thicker. 

I wanted to warn people that if you have an  itchy scalp/inflammation, eyebrow thinning you might want to see a dermatologist before going for a HT. Another sign of FFA/LPP is paler white skin pigmentation around the area of the hair loss - that might extend a bit down the forehead- it looks unaffected by sun damage/colour and might make the rest of your forehead look darker. Although not everyone gets this.    I also have this for 5 but had no idea it was LPP/FFA and only one of the doctors spotted it (I have pale skin to begin with so may have been difficult) but didn't mention FFA/LPP. Some men also get sideburn thinning but I don't have this.

I wish I'd known about this condition beforehand.  They say frontal fibrosing is very rare in men - but I've read it's likely way under-diagnosed due to similarities with MPB - and the condition is increasing rapidly.  There is speculation some environmental factors e.g. sunscreen or moisturisers might be causing the rapid increase.  It mainly affects older women but I read more men are getting it and men tend to get it at younger ages than women.

I  really wonder how much these conditions are going undiagnosed in men as it can look a lot like MBP (whereas in women it would be very obvious something is unusual).  I also wonder how much poor growth after HT might be attributed to lichen planopilaris/frontal fibrosing.  I would have never known I had it - had it not been for lots of internet research and eventually seeing the dermatologist to get the biopsy.

Hope this might help someone out there....

Can you post one of the centre of the hairline too? 

Seems like it could be a number of things based on the bumps and inflammation -there may also be some minitaurisation too from what I can see. But don't think you would normally get bumps like that from only MPB.  It's possible there can be another condition going on in addition to MBP.

 Good idea to do a biopsy when you can - definitely before moving forward with any HT.

Yes post pics if you can...sometimes scarring alopecias can look like MPB, especially cases of frontal fibrosing.  I really wonder how many go undiagnosed.  It cause itching too.  Also sometimes you can have both MPB and a scarring alopecia at the same time.

On 10/22/2020 at 3:48 AM, jfede said:

For me is mostly depression.

As a 26 years old guys dealing with this for 4 years now I sometimes overlook my status and discover something new to worry about my hair

My real problem now is itchy scalp...sometimes like burning and red.....which really worries me

I consulted with several dermatologist but all of them is suggesting there is no problem.

 

I've had this alot too.  Have you tried Ketocozanole shampoo e.g. Nizoral?  Could be sebborheic dermatitis. Or possibly a scarring alopecia e.g. lichen planopilaris or Frontal fibrosing.  You might need a biopsy to diagnoses these.  Try going to a dermatologist that specialises in hair/scalp conditions as general dermatologists often don't know much about these conditions.

On 3/17/2020 at 3:54 PM, baalloss said:

Hi all,

In the spirit of ‘paying it forward’ here’s my review of my recent transplant with Dr Lupanzula.

Summary

Norwood 4, Aged 55. Had full head of hair till around 50.

FUE procedure, 2111 grafts, 4444 hair, on surface area of roughly 50cm2.

(Another procedure to be done in a year, for the crown and back of the head.)

Graft details :

                             FU’s       Hair

1 Hair                  443        443

2 Hairs                1086     2162

3 Hairs                509        1527

4 Hairs                78          312

Total     FU’s       2111     4444

Background:

Mid 50’s, started losing hair around 8 years ago. I had been thinking of a transplant for 3 years as my hair have been shedding with increasing speed. Now at Norwood 4 I would say and knew that this year I would have to pull the trigger. Denial, fear of pain, and the negative emotions associated with anything to do with hair loss kept me from doing it.

Anyway, I did some research – I read these and other forums. Read lots of reviews. Where are the negatives ones? There seem to be very few of those – so I wondered how many of the reviews are actually genuine?

Had a face-to-face consult with two very well know doctors. Met Dr Lupanzula in Feb in London, and I liked what I heard. Asked further questions via his assistant Scott, who was, and continues to be, very responsive and informative, without being pushy or ‘sales-manny’. A week later I signed up. They had a slot in 3 weeks’ time, and I looked forward to anxiety and sleepless nights till then.

 

The Event

My pre-op consult was the same day as my operation, and this was fine with me. Day started at 6:30am. Photos takes, hairlines drawn, blood samples taken for the blood tests, hair shaved off. Dr Lupanzula did all of these himself.

Around 9:00am is when the main event started. Scalp anesthetised, and I lie on my front whilst the doc extracts the follicles from the donor. This lasted around 2.5 hrs. Then followed the incision stage where the doc made the openings for the extracted follicles to be transplanted and this was fairly quick, maybe an hour or just over.

The final stage was the placings, which was done by two technicians and lasted for around 2.5 -3 hours.

The whole process was finished by 5:30pm, and I then joined the doctor for a chat, Q-and-A and a well-deserved baguette.

My experience

Pain – this was the ONE thing which had prevented me from taking action for 3 years cos someone ones said to me “Oh, my brother-in-law had a transplant, and he said it’s really painful”. Well, I had the complete opposite experience - practically no pain at all. The only tiny bit was when the injections were used to numb the scalp, and on a scale of 0-10 where 0 is “No pain”, I would measure mine at 2. It’s like having an injection when a blood sample of taken from the arm – there is a little prick that lasts a few seconds.

I am a real whoos when it comes to pain, so if you are like me, and have been holding back, then let me reassure you – if you pick the right doctor/clinic, then the pain is minimal. In fact, numerous times, during the day I fell asleep – at one point, both the technicians were laughing as my snoring became so loud that it even woke me up.

That night I was expecting throbbing of the head, but nope, nothing. The most painful part is having to sleep at 45% angle at night – I liken it to being on a long-haul flight in an economy seat, ie. inconvenient and fidgety, but not painful.

The next day, I was given a 1000mg paracetamol to take, but I didn’t need to take it as there was literally no discomfort at all.

Doctor/Clinic/Staff

I’m trying to not make this sound like a sales pitch, but here goes :

Wonderful. All three. The doctor is really relaxed and chilled and that calmed my nerves. We even shared a few laughs while he was drilling around my head, and I tried to impress him with my 10 word knowledge of the Swahili language. The facilities are very modern and well-equipped. The technicians are friendly, and one invited me to look through the microscope while he was separating my follicles. During the 2.5 hours of the placings stage, I was free to pick my favourite Netflix shows to watch while the technicians quietly did their job.

Support

Pre-booking : All the comms are via Scott, the client liaison chappie. He’s very responsive and provided me all the info I needed. All the forms, payments etc were done online very efficiently, and within two days  of me saying ‘Yes’, we had everything finalised.

During the day : the doctor is very open to discussion, didn’t rush at all, and answered all the questions I had in a rational manner. The support staff too are very polite, respectful, and helpful. I was of course, the only person being operated on during that day, and this was important to me.

Post-op : I asked if I could come back the next day so someone could show me how to wash my hair, and of course, they were very happy to do so. In fact, I would say, whichever clinic you use, make sure you go back the next day, so they can clean you up properly, and show you good maintenance techniques. The staff even offered to video me having my hair washed for my personal use when I return home.

I will keep in contact with the doctor and have 3 and 6 monthly face-to-face consults when he visits London.

I feel great right now. Just want the ugly-duckling stage to pass quickly, and I look forward to seeing the results.

If you have any questions, feel free to ask.

 

 

 

 

 

 

 

 

Definitely do a biopsy (don't have to wait - can do this now) - it will be worth it to rule out any scarring alopecia which generally causes bad growth (lichnen planopilaris, frontal fibrosing, etc)

Don't even think about a touch up without getting a biopsy and understanding what went wrong.  

On 10/30/2020 at 7:23 AM, Aleko said:

Hi, 

Im not on any meds. They did take grafts from a fairly large donor area but I would say the majority if not all were from the safe zone. 

Do all of the hairs cycle at the same time? How long would this take before it start thickening up if its due to this?

 

Have you seen a dermatologist?   They can examine for any signs of a scalp biopsy (e.g. scarring alopecia Lichen Planopilaris, Fibrosing Alopecia etc).  These conditions normally cause transplanted grafts to shed after 15 months- 2+ years. They can sometimes be mistaken for MPB.

Definitely worth doing especially if you're considering another procedure.

3 hours ago, Egy said:

In fact, it would be enough for surgeons to request a scalp examination from patients before undergoing the procedure, but they would lose too much money, because many would not have the transplant.

Yes - I agree - I am concerned myself about having frontal fibrosing/lichen planopilaris - already nearly a year into my transplant and waiting to have a biopsy now.  Wish I'd known about these conditions before and had one before my transplant so I could have had more peace of mind.

I think some HT doctors aren't very aware of frontal fibrosing (FFA) and how much it can look like normal MPB - and certainly general public don't seem to be very aware of it.