alopeciaphobia

7 minutes ago, Fue3361 said:

My diet and fitness has always been on point.  

That likely helped making those insanely densely packed grafts take hold.

Probably another reason why your specific case isn't achievable for everyone!

16 hours ago, Melvin- Moderator said:

I’m scheduled to talk to Dr. Longaker on the 1st. We’re hoping to schedule a podcast. Let’s hope we can get him on the podcast. 

Another interesting thing to ask would be if there are any other human (case) studies going on (that he's allowed to disclose). The internet is a big place. Perhaps someone who isn't posting on a high-traffic forum had useful findings.

Just a totally random thought. This makes me wonder if regular cardio or whole foods plant-based diets would improve graft survival rates after surgery. Because both are really effective in making/keeping arteries healthy.

8 minutes ago, Fue3361 said:

Yeah.  My results are even better now that we're almost 2 years in.  It's looking great.

 

As for protocol, was just one pill a day, for 3 months.  The pill, if I'm not mistaking had 2.5mg of Cialis, 2.5mg of Viagra, and it also had 5mg of minoxidil + arginine.  If you really want to know, I can look for what the Arginine dosage was, although I think it was 5mg.

Thanks so much for responding. Did you start taking the medication on the day of the surgery?

Also if you can look up the exact dosage that would be amazing. I think it would be great to have that kind of information "eternalized" on this forum for perfectionist folks like us who like to give themselves any possible edge. Or doctors who are looking to get even better results for their patients. Even if there's no empirical data showing effectiveness, it's nice to know the exact amounts so it may be iterated upon in the future.

I think most of us are very familiar with native density being ~85FUs/cm², and that ~60% of that native density (~50 FUs/cm²) being a very strong illusion of density (depending on other factors of course).

However, what really creates visual density are individual hairs, not FUs. So with 2.3 hairs/FU being average, ~200 hairs/cm² would be native density, and ~120 hairs/cm² would make a very strong illusion of density.

But what about the transition zone right behind the hairline (as described here, or here), where it's predominantly, but not exclusively singles? If you would place 50 grafts/cm² there, with say half of them being singles and half of them doubles, you would have 50 FUs/cm², but only 75 hairs/cm², which is actually pretty low density.

So I suppose my question is: in a non-balding person, is the area that's say, 1cm or 1/2" behind the hairline also ~85FUs/cm² and thus naturally much thinner in terms of hairs/cm², or is there naturally an increased amount of FUs/cm² to make up for the lower amount of hairs/FU?

From my experience, looking obsessively at hairlines of non-balding people, most (but not all) have just a millimeter or two of "softness", after which it becomes extremely dense already. Perhaps hair transplantation surgeons just make this transition zone much wider than it is natively to save grafts and blend it in better with a lower-density midscalp?

What an incredibly unique case, and an extremely aesthetically pleasing, dense NW1 hairline. If donor supply wasn't finite, I think many people would aim to get results like you. Perhaps if future verteporfin trials prove to be effective in regenerating donor hair, results like this may become more achievable for more people.

@Fue3361 I'm very curious to hear the full protocol, including dosages and times taken per day. I'm surprised that you were on both Cialis and Viagra. Their mechanism of action is pretty much the same, and Viagra lasts much shorter. So I'm wondering why the doctor didn't go with Cialis alone.

3 hours ago, Square1 said:

I am not able to tell.

Would, if true, this finding impact the preliminary conclusion about the effectiveness of the doses? 

I think (and hope) its just the photo in the first post with the red marker saying T 0.4. But if one got mixed up it's probably best to triple check all the others.

I was just pixel-peeping the results so far and I'm getting the impression that some of the conditions may have been mixed up? It looks like two different areas have both marked as 0.4mg T.

In this image here it's the leftmost square (since no excisions are visible to the left) marked as 0.4mg T.

On 7/22/2022 at 8:17 PM, Melvin- Moderator said:

Whereas in the image here it's not the leftmost square (as there is another square of excisions very close to it on the left side) that's marked as 0.4mg T.

On 11/17/2022 at 2:43 PM, DrTBarghouthi said:

A couple of other surrounding features of the scalp also seem not to match up.

I believe that the first photo I quoted (with the red marker) is the first square on the photo below, and the second photo I quoted (with the blue vertical line drawn in it) is the third square on the photo below:

On 7/22/2022 at 8:17 PM, Melvin- Moderator said:

If I had to guess, based on having just reviewed all of the photos, the conditions are from left to right: 0.32T, 0.32C, 0.4T, 0.4C, 0.24T, 0.24C, and the first photo I quoted (with the red marker) is the incorrectly marked one and is actually 0.32T.

Is this correct, or am I tripping?

45 minutes ago, Melvin- Moderator said:

Dr. Mike Longaker, emailed me back. He’s setting up a time to call me. Will report back when I have more news.

Just as I thought your contribution to the verteporfin experiments was already at maximum awesomeness, you went yet another step further! Simply amazing. Thank you, Melvin!

Folks, keep it real. These high profile celebrities aren't going to stick their neck out for this in a million years. Even if they were interested in this, they'd do in privately. We need surgeons and researchers. I don't think aiming to get the attention of a podcaster infamous for pseudoscience or a billionaire megalomaniac is going to help that.

1 hour ago, Fox243 said:

It wouldn’t be too expensive. A couple grand at most for the brand name visudyne. If you got the generic, probably under a thousand. 

Generic verteporfin exists? I thought Visudyne was the only commercially available kind.

On 6/12/2023 at 7:44 AM, Nikoni said:

@DrTBarghouthi thank you for the great job !

Do you think this can work on old FUE scars also ? Surgeon will cut the scars and inject Verteporfin ?

This still needs to be tested. No experiments planned currently, but it could be very interesting indeed. Maybe with the right dosage and injection technique some hair will regrow in place of where the scar was.

Only testing will tell. This could be a flat out cure, so I really think it's worth trying out!

On 4/20/2023 at 12:58 AM, BaldV said:

I really dont get why anyone would go for a hair transplant with such a high hairline and low density, it literally looked better when he was bald, I just hope the patient himself is happy.

I disagree completely. Hair transplants will never look perfect unless the patient is a NW2 or NW3. You can't compare this patient to those guys, or even a NW7 with thick hair. In this patients case, there was so much bald area to cover with low diameter donor hair it's kind of incredible what the Dr did.

Sure it's not super dense and the hairline is high, but that's quite literally impossible with current technology.

What the patient did get was a head of hair good enough to frame his face handsomely and that makes a great difference regardless.

The response in here is great, although I have to say that I'm concerned that with the whiteboard picture the Dr. has leaked serious personal information of the patient (age, surname and what medications he uses). The patient registered on this forum without his full surname, so clearly he prefers not to be fully identified.

Thats not right.

Absolutely amazing, Melvin. Just amazing. So many of us without the network and the connections have been wondering that there must be a couple of courageous doctor's out there who are as intrigued by this as we are. But we couldn't do much about it, no matter how much we wanted.

But you did it! And I'm just so thankful for that, because quite frankly there aren't many others who could've!

Really really really hope this one goes through, so we can learn more about the ideal dosage. Once the ideal dosage has been established, I'd like to take the plunge and get the treatment myself. I'd fly back and forth across the world a few times for checkups if I have to.

Agree with the people above that getting a doctor with a large following, like Linkov, on board could be key to skyrocketing awareness of this. Haircafe and hairliciously etc can post about this all they want, but if someone with professional credibility would start talking about this, other doctors will be less likely to brush this off as yet another broscience miracle cure.

So did all of the interest in verteporfin experiments shift to FUT?

I'm getting a bit lost in this topic, and apparently, that's as the 2nd most frequent poster 😅.

I remember during the live stream Dr. Barghouthi said the long-awaited second FUE case study was happening in late April or early May. Are we to conclude that this has been postponed again?

Is Dr. Mohebi planning on using verteporfin with FUE, FUT, or in balding areas?

I'm very interested as to how @DrTBarghouthi is going to dose verteporfin for FUT. Applying it to a sutured FUT site would be linear, rather than an area, so the dosage would have to be in mg/cm rather than mg/cm².

1 hour ago, Hairgain said:

You know if it really came down to this, we'd know we've got the real deal for a cure. If though one has to first damage an area only to repair it I don't think this is so good, likely not a suitable cure. The other thing that needs to be figured out is how well does the repaired area get repaired? Some say it grows back 50% normal hair density. Is this good enough for a satisfactory cosmetic effect? Perhaps what might be interesting is just simply do the wounding with Verteporfin to barren areas of scalp without hair transplant surgery. Maybe this alone is suitable. The idea of removing grafts just to put them somewhere else just doesn't make sense to me. It's not a solution. Plus it's a lot of work and transection of some hair is nearly guaranteed. 

A better solution is to get something to regenerate it structurally. That and get something placed to grow new follicular units without it causing cell proliferation that becomes cancerous.  Rather than cloning hair and adding the grafts, I think the best solution is injection of hair forming cells because every time a hair needs to be grafted can damage or transect another hair organ beside it. 

I think the bigger questions are if the process can be repeated infinitely, and if we even need to take out an existing (healthy) follicle to have a chance for a new follicle to start growing?

For all we know we can keep punching out skin in between healthy follicles and inject verteporfin, and every time that happens there's a chance for a follicle to regrow. Rinse and repeat. Not saying this is the case, but it's something worth considering to try.

I was shocked to hear Dr. U actually has some verteporfin in his clinic just sitting on a shelf.

Anyone courageous with, say, 20 ish grand to spare who lives near LA? 😁

4 hours ago, Melvin- Moderator said:

 

Very cool that you did this, Melvin!

I was shocked to hear that Dr U has some bottles of it in his clinic!

4 hours ago, Hairgain said:

 

 

Folks,

   I'm brand new here on Hair Restoration Network with an account (this is my first post) although I've been following this particular thread for months. 

   In terms of the ideas and comments you folks are relaying in my view are definitely on the right path. 

   So here's a bit of news from behind the scenes. I've been in discussion with Dr. Bargouthi about doing a scarring alopecia study. I was not the first either to suggest that according to him. There is another group or individual involved in this prospect. I tried contacting the email address Dr. Bargouthi gave me to collaborate but so far haven't heard back. I recall Dr. Bargouthi telling me that the cost of this study would be US $15,000 roughly. In this we are looking to do a study of microneedling with Verteporfin applied, another with incision wounding of an old scalp scar injecting Verteporfin into it. I will add that doing a microneedling and Verteporfin study of a scarred area too would also make sense, not just to an area which has been subjected to the effects of androgenetic alopecia.

  So this is another factor involved and perhaps a fundraiser can be done through this online forum to get the study to take place? I am trying to contact multiple hair loss web sites now to find out what can be done to raise the capital needed to get this underway. 

   Recently I have contacted someone at scarringalopecia.org about trying to fund the study mentioned above, maybe doing a fundraiser through their organization but surprisingly the reply to me was no interest on their end! They did a costly survey months ago about people having scarring alopecia but this is not even something that had potential to cure the problem. I kind of think this organization doesn't like me much because I am outside of the groupthink and offer suggestions to them that are not standard, outside of the orthodoxy they espouse in diagnosing and dealing with scarring alopecia. I am also male and the group is made up of nearly all women, so I feel especially alienated given this by them. Any advice they offer is from what I've found not the right approach but then I have nothing against them either and am glad they are a resource that helps people find local hair loss specialists and their web site shows pictures of what scarring alopecia conditions look like. They post medical articles too related to scarring hair loss but nothing that has the real prospect of a potential cure. I tell them about technologies in diagnosing hair loss that they never heard of and when I ask for their opinion about my findings they take note and don't reply. I feel they aren't doing as much as they could at least for me. They look to raise revenues but so far am not excited about their programs or research. 

  I believe I have scarring alopecia but no hair related professional has diagnosed me with it. So far they say I've got androgenetic alopecia, telogen effluvium, natural hair parting and early on it was seborrheic dermatitis (an early clue it really is potentially a scarring alopecia). I did not do a biopsy but have gone through many other non-invasive tests. I say no to biopsies as in all cases it leaves scarring, which is what I am looking to prevent. The only time I may consider it is if a YAP or FAK inhibitor is injected after the wound in that there is potential for it to heal with normal tissue and follicle unit neogenesis. Not only that but let's face it, a scalp biopsy hurts and maybe can lead to permanent nerve damage as with any hair transplant procedure done incorrectly. I've seen the results of people who've had scalp biopsies and are left with a big bald spot. I think a new standard protocol must be if a scalp biopsy is administered, Verteporfin must be applied to the wound or a FAK inhibitor such as VS-6062. 

  What is on my wish list is for Dr. Bargouthi to find a way to get the FAK inhibitor, VS-6062 tested in human subjects. The results shown in the red duroc pigs looked quite promising and as the video posted pointed out the healing process occurred quicker than with YAP inhibitor Verteporfin. I suspect but cannot prove that the VS-6062 may even grow more dense hair. The VS-6062 may have more pathways towards healing than Verteporfin. It is my opinion that use of VS-6062 is the better choice yet maybe harder to obtain.  

  Basically, in America, what has been holding the researchers back is approval to use this VS-6062 in human subjects. If it's worked in porcine models without issue then why not go on to test in human subjects next? How will we know if we don't try? It is these gatekeeping agencies like the FDA that are delaying and tying the hands behind the work these scientists are looking to accomplish through a slow and costly bureaucratic process. This should not be the case and the FDA needs to step aside regarding this and should a volunteer get hurt let the legal process sort this out. Almost as bad is many American doctors refuse to do safe procedures on patients unless the FDA has approved them first. I think the FDA needs to take on a much more passive roll as a body of suggestion rather than dictator of what is and isn't allowed. We need a libertarian design to get ahead regarding medical progress for people. Also mice are lousy test models for anything skin and hair related in regards to people. I and every hair loss sufferer is so sick of hearing that something regrew hair in mice because it never translates to working in humans. The new pre-clinical model should be the pig first, not the mouse or rat.

  It is at Stanford University, the Longacre Lab that pioneered the research behind Verteporfin and VS-6062. Here are the individuals behind the research: Dr. Michael T. Longaker's Profile | Stanford Profiles and Researchers find drug that enables healing without scarring | News Center | Stanford Medicine and please read FAK Inhibitors, Cassiopea and Drew Brees | Hair Loss Cure 2020.   

  Getting back to the VS-6062 compound, I've learned that it doesn't even need injection into the skin for it to work. Topically applied it seems to do the job. Although Verteporfin is a workable solution, the VS-6062 seems better, easier to use and perhaps more effective. It is my suggestion we go with this instead if it is possible to obtain from a reliable source. It would be great if Dr. Bargouthi could experiment with this FAK inhibitor, VS-6062 and compare the efficacy between the two. This is best as we will know which one has the preferred outcome. 

  Another avenue to explore is multi-therapy. Perhaps combining this with implanting cloned follicles may produce even greater hair coverage and density, that is assuming there is enough vascularity to accommodate the new hairs being introduced or perhaps the steps might have to be done separated by time to allow new blood vessels or capillaries to form. First say the wounding and drugs are used then a few months later cloned follicles can be added if density isn't quite satisfactory. 

  So I've composed many of my thoughts. I'd like the users of this group's input as we go forward with ideas behind Dr. Bargouthi's research. If perhaps enough have thoughtful or shared opinions it could be decisive in where Dr. Bargouthi will focus his energies and funding into future research. 

  Above all I am very appreciative of Dr. Bargouthi's research and outreach to the community of hair loss sufferers. He is someone that sadly few doctors today emulate. Most just follow the standard, the rules of the powers that be and simply want to make a comfortable living. The people/doctors/scientists though who contribute their time and funds to make positive change are the ones though who will be remembered, truly loved and that is people such as Dr. Bargouthi.  

   

Getting an official diagnosis first might make it a lot easier to find funding.

On 4/2/2023 at 10:28 PM, takuma said:

If it regrows the hair, then there really is no reason why it shouldn't regrow all of it, it's the mechanism of the drug to do so, so I hope Dr Barghouthi can find the ideal dosage and other factors that leads to 100 percent regrowth, then it would just be a matter of getting enough hair transplants to take give anyone a full head of hair.

Many ways in which the human body works are still a mystery. While we of course are all hoping for (something close to) 100% regrowth, it's not sure whether that's possible with verteporfin. However, on the bright side:

• If regrowth is "just" 50%, imagine having 7000 available donor grafts. That's now 14000 grafts. More than enough to cover a NW6 with glamrock level hair density.
• Perhaps at the locations at which hair didn't regrow, if the skin is punched out again in a later transplant with a decently wide punch, maybe it gets another chance at regrowing? Maybe all we need to do is repeated sessions of punching out skin in between follicular units and inject until the desired density is reached. Whether that's in the donor region or not.
• Any decent percentage of regrowth would mean we would have a way to increase the net terminal scalp hair count in a human for the first time in history. That is revolutionary and a breakthrough in and of itself. If the donor area has been overharvested for example, maybe all one would need is to transplant grafts within the donor area, just letting the chance for regrowth increase the net amount of hairs each time.

17 hours ago, Fox243 said:

Would also love to hear about possible ways to improve upon the first trial, i.e. higher dosage, more uniform injection, computer imaging/tattooing to better see potential regeneration, etc. I think it’d be especially interesting if you extracted ALL follicles in a small (say 5 mm) area so we can see if any follicles undoubtedly grow in that area after injecting Verteporfin.

It's an interesting point, but one runs the risk of having had follicles in exogen/kenogen phase showing up as "false positives". The bigger the meaured area, the more you cancel out the probability of randomness like that.

The most ideal way (other than increasing subject count) that I can think of would be a temporary tattoo demarcating one or preferably multiple areas, and doing a phototrichogram before and after.

On 3/4/2023 at 7:47 PM, DrTBarghouthi said:

I’m looking at the 18th of March as a possible date for the second trial. I’m looking at either an FUE or at the possibility of injecting into the recipient area. 

@DrTBarghouthi Did the second trial happen on the 18th, or has it been planned on a another date?

It's an interesting point. For those unfamiliar, basically the benefit of scarring is supposed to be faster healing. Although aesthetically displeasing, it's an evolutionary advantage to recover faster from lacerations and such. Verteporfin may "remove" this evolutionary advantage in favor of an anesthetic advantage, so to speak.

A whole bunch of pages back, it was discussed that with verteporfin, skin elasticity improves slower after injury, i.e. from a mechanical standpoint, the skin seems worse during the first few months, but catches up and improves compared to placebo after a couple months. That makes sense given the purpose of scarring.

Edit: just realized it was probably you who mentioned that @MrFox