splitting hairs

Thanks for posting those pics spex. I can see what Bill was saying about the styling, however, your second set of pictures definately clears up any question marks as to whether there is any improvement. In my opinion, there is a tremendous improvement. What I would really like to know is: who is/isn't a good candidate? Should I send my pics to you/ Dr Feller?

Never heard of Neograft, But ultra refined follicular unit transplantation is the gold standard atm, and from what I've seen of Dr Ross, his work looks ok. He's been recently added to the coalition so take a look at this thread - there's lots of pics in it. http://hair-restoration-info.c...=918102033#918102033 $2.5 per graft seems very reasonable, some clinics charge double that. I'm sure Dr Ross will go through everything we have mentioned to you, has he recommended you start Propecia?

It Looks fine. You're in good hands with Dr Feller and you just have to wait it out now. Have you noticed any benefit from the PRP yet? It's hard to tell from your pics, but it looks as though the back half of your scalp (behind the transplant) looks a bit thicker compared to your before photos.

nyny12, It's ironic that most anti-dandruff shampoo's can as a side effect cause dandruff. I have dermatitis of the scalp and have used Nizoral in the past. However, it is an antifungal and can be quite corrosive on the skin. I developed itching/burning after about a week of using the nizoral. As a result I stopped using it. I'd go with Bill's advice and try reducing your use, and if it doesn't work, stop it altogether. Such irritation of the scalp itself can be associated with extra hair shedding. I do not use Rogaine as I expect that it would cause a similar effect. I wouldn't worry about not using Nizoral shampoo as part of your hairloss regime, as it's not approved for hairloss and also since any DHT inhibitory effect is likely to be small. It sounds like you may have a sensitive scalp - have you had any scalp issues in the past. I asked Joe Greco on another Forum if PRP would be suitable for people with scalp conditions and he said that due to its anti inflammatory properties they have seen improvements in scalp conditions post PRP and that it would not be contra-indicated.

My advice is to spend at least six months doing your research. Use the search function on this site (at the top of the page) and find out about hair loss and hair transplants. Look at lots of before and after pictures for your surgeon and compare it to other top docs. Have a look at patients weblogs here aswell. Even though you may not have a family history of hairloss, it would be a good idea to get on some propecia to prevent further hairloss. Please understand that a hair transplant is not a quick fix, and as Bill says, you need to be committed to the surgical route once you go down it, otherwise if hairloss progresses, you may be left with a tuft of hair at each temple, resulting in an unnatural appearance. It is best if you do your research and think this through - then you can make an informed decision. As long as you know what you are getting into, hair transplants can be one of the best decisions a guy can make - provided its with the right doc. Good luck.

Hi Dougster, Armani charges way more for FUE than any other doc, yet his ethics are a massive issue ( giving low aggressive hairlines to young guys who will never have enough donor hair to cover the rest of their head when hairloss progresses in 5 years time), also his results are very inconsistent. FUE isn't for everyone, with some people the grafts get damaged as they are extracted and simply won't grow. With others, they get very good growth from FUE. If you live in the UK like me but are considering FUE, consult online with a top doc recommended on this site eg Dr Devroye in brussels and Dr Feller in New york. Spend at least 6 months researching it and don't jump into it without a lot of consideration. Listen to the top docs, they look out for your long term best interests - be sceptical of anyone else - they will tell you what you want to hear to get your money.

If you are referring to BHT as hair taken from the body and transplanted to the head, then you should know that body hair transplants at present are very poor. Body hair follicles are less resilient and are often damaged during transplantation and very few actually grow. Of the ones that do, they are usually curly in appearance and only grow to a certain length. Hence they tend to look like pubic hair. Your best bet is a Hair transplant, which you can get from any coalition doc on this site. Do your research. If you are asking about body hair transplants because you cannot get strip surgery, then consider Follicular unit extraction (FUE). Again, speak to a coalition doc on this site. Good luck.

I don't think that doing FUE first reduces your yield (other than the 5%, since strip has 95% yield and FUE 90%). Think of it this way, doing FUE first, lets say - 1000 grafts. Generally, that's over a LARGER area, however, as a result, your donor density is reduced. Doing strip afterwards would mean you remove grafts in a small 1-2cm strip across the back of the head, but get less grafts because some have already been removed (lets say you get 1600 vs 2000). So essentially, you've got the same number of grafts(other than the 5% and those extra grafts outside the strip region). Except you've had an extra procedure which costs way more. So as long as you don't mind spending the extra cash, it should be OK. Plus it has the advantages you guys have already mentioned.

I would imagine that most Dr's would be reluctant to prescribe proscar or similar instead of propecia, reason being because it is not licensed for hairloss. Therefore the Doc has to take reponsibility for it, which most aren't wiling to do. Get a private prescription from your Dr for propecia and pay it. Don't buy drugs online, you don't know what you are getting!

I think baby shampoo is generally recommended.

Good luck man - You're in the best hands with H&W.

My advice is to get in touch with a top hair transplant surgeon/ dermatologist - or better still Dr Jerry cooley - I believe he is both! It sounds as though you have dry/ sensitive skin. You can contact your general practitioner who can put you in touch with a dermatologist in your area - although most gp's might just want to prescribe you a topical steroid. You could try a tar based shampoo, like t/gel, or salicylic acid based one for sensitive skin, also by t/gel I think.

TomR, thanks for posting this thread. Your situation (stopped proscar and rogaine, but getting PRP) is a real test of PRP's effectiveness. I hope it works well and maintains your hair. By the way, how much of your hair is transplanted? (front half?)

London's good for me spex, Where abouts?

Great stuff aj, keep us posted.

Great result Dr Cooley, especially for only 2800 grafts.

nyny12, no one really knows how PRP works for hairloss. It is thought that since PRP contains growth factors that are responsible for angiogenesis (the formation of blood vessels), it is believed that when PRP is injected, and the scalp injured, growth factors are released to amplify the normal healing process, where blood vessels form to the injured site. This increases blood flow to the hair follicle. Infact some studies have shown that growth factors cause an increase in the size of the hair folicle and the thickness of the shaft. Dr Feller wrote some stuff about what he believes to be the mechanism on page 3 of this thread. He explains how he believes hairloss is caused by DHT and devascularisation (blood vessels being destroyed). But this is only a theory.

The reality about propecia is that 2% experienced side effects. Of those who stayed on the drug despite these, a lot of the sides resolved. After stopping the drug, sides went away - although it can take 3 months. Merck had to conduct randomised clinical trials, which will have been reviewed by the fda prior to approval. Thay cannot lie about the results, they could bias them, but a good thorough analysis by the fda would have found that. I prefer not to look online about sides from propecia - I prefer to stick to the evidence based data. We know however, that with anxiety and OCD, there can be effects on libido and other similar things. My concern is that if you go on propecia again, you will experience these side effects because you are anxious about the prospect of getting them. This happened to me when I started propecia - but after I learned to stop myself from becoming anxious, I've never had a problem. Good luck.

50-100 a day is normal.

The dosage of propecia I am taking is 1mg daily, as this is the tried and tested, clinically proven dosage for hairloss. If I had sides, I would reduce the dose (bearing in mind what Dr cooley has written). Propecia is generally not as effective for the front as it is for the back. However, I've seen pics of some guy that had good regrowth at the front.Propecia will only help. But keep your expectations realistic - aim to maintain your hair. Good luck.

nyny1, I have also heard about some people who have sides after stopping propecia. But as you said, it is most likely a result of them being anxious about such problems. In the clinical trials, all those experiencing sides had them resolved on discontinuing. Sides will most likely take 3 months to go. I've been on Propecia for 13 months. I'm 23 and approaching a Norwood 3 (but my crown is ok). In terms of hairloss, the drug has stopped it for now. I think I may have even got some fine hairs in at the hairline. With regards to sides, I thought I was experiencing some about a week after taking propecia, but realised I was just getting really anxious. After I learned to control this they went away a few days later. Never had a problem since. My plan is to continue with propecia, but I'm hoping to do PRP soon also, just to see if I get any improvement.

To be honest Finasteride is finasteride whether it's propecia or generic. Only the strength is different. My advice to you is not to buy it online. You don't know what you are getting and many fakes really do look like the real deal.

I agree with hdude, you really need a starting point. Start at 1mg/day, get your propecia from a doctor who can monitor you for sides. If you get sides, then you can start lowering the dose. There's no point in potentially limiting the drugs effectiveness unless you are actually experiencing sides with the normal dose.

losing up to 100 hairs a day is normal. Don't worry about it (and certainly don't count them!). The best thing you can do is to get on some meds. The white bulb may indicate a dryish scalp/ dandruff.

nyny12, The result Dr Feller posted on page 4 of this thread was for a guy that was on no meds if I remember correctly. Dr Rassman, as are many other Dr's, right to be sceptical. PRP as yet, is unproven. Large scale randomised clinical trials are the standard for all therapies for all illnesses, but NO ONE will fund a Randomised clinical trial for PRP unless they can patent it. Merck only spent hundreds of millions of dollars developing propecia and proving its effectiveness in trials because they could get a ten-year patent on it, which means only they can sell it until 2013, and charge whatever they want for it. What I am saying is that we don't have the usual top standard data we usually do, but for PRP the only way to find out how good it is, is for docs to actually treat loads of people. This is why Dr Feller is encouraging all Docs to Start it - so we can guage how good it really is. It's easy for other docs to sit back and say - "there's no data". If all docs had that approach to PRP then you could guarantee it would never become a mainstream hairloss treatment, no matter how good it could be.