Magic City

Your results are fantastic my friend, congratulations. I'm sure he's told you but I had my second procedure with Dr Lorenzo last week on the same day as your brother. When he described that his brother had also had a transplant the year previous, and with the scalp conditions, I put the pieces together and realised he was speaking about you. Such a small world! You were in the surgery room whilst your brother and I were waiting for our head washes/post op assessment by the Doctor a few doors away. I remember reading your results posts last year from October onwards, as I had my first procedure in December, and it's been great to follow. Been a great read and I look forward to following more of your progress. For the record, your results are already top notch and I'm sure the small touch up will knock it even further out of the park. Anyways, it was a pleasure meeting your brother and I wish you both the very best. Thanks for posting!

It would be interesting to see if the scientists studying it for more 'mainstream' purposes are intending to trial some scar revisions. I imagine the clinical utility of being able to minimise the appearance of prominent scars with more 'normal' skin and associated structures would be a major advancement for doctors, patients, and medical science in general. This would, in theory, spill over to our hair restoration interests too. Keen to see what the future holds, but I for one have been intrigued with these trials for over a year on this thread along with many other members on here. Here's to whatever the future holds!

Does anyone know when we can expect updates from Dr. Bloxham?

Have you heard about Dr Bloxham's FUT trial with Verteporfin in the US? He injected it on 3 patients who underwent FUT and said he'd document progress on his YouTube channel. Exciting stuff

@Gatsby Your story is an inspiration for hair loss sufferers far and wide. Do you ever look at the pictures of you, slick bald norwood 6, and compare it to your hair today, and smile at how far you've come? I'm also an individual who had a HT at age 18 at a hairmill (big mistake, I know), but now I'm in my mid 20s and have been on dutasteride for 2 years and have had a HT repair from one of Europe's best surgeons. It's not perfect and I'm having a touch up in November, but I know that I would be slick bald now without medical therapy and the HT intervention. Thanks Adrian, for being so open. You've helped me to not feel so guilty and ashamed about having a HT at 18, which I regret so much even to this day.

Thanks @Melvin- Moderator Please can you ask Dr. Longaker what he sees may be the potential widestream uses of verteporfin one day? Like, what does he see as the potential outcome of his research? Reducing scars in surgery, scar revision, regrowing normal skin structures i.e. sweat glands/hair follicles?

Very encouraging to see Dr Bloxham trialling this. He seems very informed on the treatment and very enthusiastic, which is a positive. What do people see as the potential outcome of these trials? If verteporfin proves successful at either minimising scarring or regrowing hair (or both), do you think it may eventually be used off label in hair transplants, given that it is an FDA approved drug with safety data backing it up? I appreciate there is a long way to go and many other hyped treatments have flopped, but the trialling is necessary with this drug I think to really understand its potential uses

x3! Been an interesting one to follow, bet the hair's looking awesome now

This whole journey has been nothing short of inspirational, start to finish. I remember first hearing your story on Baldcafe's channel, and to see you now is so damn satisfying. Thanks for sharing the highs and lows of hairloss in its raw and often heartbreaking form, glad this is the outcome and we're not even past 2 months of the 2nd procedure yet

Filling in nicely! I had 2202 grafts with Lorenzo, and I'm about 77 days in so this has been a good progression for me to see. Thanks for the update

Do you think it’s worth putting some guidance on sourcing verteporfin (including rough costs) and some details for the protocol that Dr Bargouthi is using in this document? Or should we just direct HT surgeons to Dr Barghouthi for these questions?

Possibly, but what if you were on finasteride or dutasteride?

Does anyone know of any other examples of scar revisions using verteporfin? Hopefully cases like this (albeit not 100% scientific) inspire Dr B and other HT surgeons to trial the drug on existing HT scars

1. This is a verteporfin thread 2. This is a mice study with no human results 3. Assuming this works in humans, it is at least 5 years away. Verteporfin is here now

At present, this doesn't seem to be known/very well understood. The theory (and what has been happening in practice) is that verteporfin will block the usual scarring pathways when wounds are created which generate collagen rich, inelastic skin without sweat glands or hair follicles. In it's place, normal healthy skin seems to be regenerating. What is yet to be seen and researched is whether excising an existing scar (e.g., an FUT scar or an FUE scar) and then injecting verteporfin will cause the wound to heal like normal skin including with sweat glands and hair follicles. It would be interesting to see if the body 'remembers' what was there originally from birth in the DNA and regenerates back the skin to that, with hair follicles, or if it just comes back as scar tissue as that was there before the excision took place for the verteporfin to be injected. This is a priority area for research as there are many that have bodged donor areas, keloid scars they want to try and improve, or just over harvested donor areas in general. Alternatively, some have suggested that one way of improving FUE/FUT scars could be to extract normal hairs grafts from elsewhere in the donor area, inject the excisions with verteporfin and implant these hairs into the scars. The scars will have more hair coverage, and the new FU extractions should regenerate with hair and more normal skin than scar tissue.

Also, would be good to assess what affect excising existing FUE scars from previous surgeries and then injecting with verteporfin would have. This individual anecdote, regardless of how unscientific it is, brings up this important potential use for the treatment. I reference an earlier comment on this thread made by MrFox which summarises this really well: MrFox: 'So I wanted to comment on this post because I feel it has come up multiple times in the discord chat as well as on this forum. There is a lot of speculation around what efficacy this drug will have on existing scars, and there are definitely those that are solely interested in verteporfin for scar revision. I think the only credible information we have at this point is from the lead researcher on the Stanford studies, Dr. Michael Longaker. I am highly skeptical of anybody saying it won't work, because no one has tested it in that capacity! I personally believe the researchers at Stanford have a much better understanding than all of us on the underlying mechanisms involved, and until there is proof to the contrary, I will continue to default to the research and information coming from them. I have posted quotes directly from Dr. Longaker below: Quote from New York Times article: "His imagination soared. He might be able to prevent scars with a few quick injections of verteporfin. And there was no reason to think he couldn’t go even farther. A patient who had a disabling and disfiguring scar could go to a surgeon who could dab the scar with lidocaine to numb the skin, cut open the scar, inject verteporfin around the edges, and close the wound. Would it reheal without the scar?" https://www.nytimes.com/2021/04/22/health/surgery-scar.html Another quote from an interview on radio health journal: "This person lives a long time. Some people have many scars. So this would not only be an injection of Verteporfin when the surgeon is closing the incision at the end of the operation, but now you can say, oh, what about all those other scars that have existed for a long time? So one could imagine lidocaine cream being put on the scar, or injection of lidocaine, come back in about 20 minutes and the surgeon excises the scar under local anesthesia in the office, and then injects Verteporfin and the closure, and then it's closed. So there's many, many, many millions of existing scars that could be revised." https://radiohealthjournal.org/advances-eliminate-scarring/ From Dr. Longaker's quotes, I think it is a reasonable to assume that he believes that excising existing scar tissue and injecting Verteporfin would cause the wound to heal in a similar manner. If we continue to have positive results, I definitely feel that is worth trying to excise a smaller existing scar, such as an FUE scar, and injecting Verteporfin.'

If more surgeons get on board now with the testing and protocol refinement, I bet that it would be ready quicker than 2 years. I’m in a similar situation but haven’t yet booked my HT. Just need more doctors to get involved with this research and testing I think…

I initially thought that the zoomed out pictures of the donor areas in the recent 4 month update were all the test areas and I thought that verteporfin wasn't as good as we expected based on the left hand side images in the grid of pictures. But now Dr. B has confirmed that the test sites are in fact on the right and controls on the left, I think the visuals of the donor areas of verteporfin compared to control are unbelievable. The test area looks like there's less scarring, more uniform, and like there's more coverage which suggests hair regeneration, in my opinion.

Couldn't agree more. Great write up document too.

Thanks for the update, continues to look very promising. In the zoomed out pictures, is it the control sites on the left and the test sites on the right? If so, the results like good so far in verteporfin areas compared to control.

I am also trying to tame expectations and am also thinking that this is an incredibly promising treatment so far. I'm just very surprised that, seemingly, no other HT surgeons or hair researchers have jumped onto verteporfin yet despite it being FDA approved and the recent research papers showing that it yielded promising results in pig studies. Not to mention this telling human HT case study about the efficacy of the drug in hair regeneration and scar reduction. I appreciate this brilliant patient trial hasn't yet concluded and I know Dr Barghouthi wants to do a biopsy of the verteporfin area versus a control area for more objective results, but I wonder why there hasn't been more interest in verteporfin for hair restoration surgery. Even amongst the hairloss community online I'm not seeing stacks of interest in this treatment although I appreciate not everyone needs a hair transplant to get a good outcome. Hopefully more Doctors start to become interested in this treatment soon. I'm grateful that there is at least one doctor who has taken the bold step to do a trial and hopefully more will follow.

Very interested to see what happens if an existing FUE scar is excised and then injected with verteporfin. Hopefully Dr Barghouthi will be able to try this if one of his patients is willing. Also, I know he mentioned during the latest chat with Melvin that he would be discussing verteporfin and sharing protocols with other doctors attending a conference soon so I wonder if we'll have more verteporfin trials from other doctors soon too.

It would be really interesting to see if old FUE/FUT scars can be treated with verteporfin (wounding the scar tissue) and if the skin 'remembers' what was there before the scar tissue formed from an FUE or FUT procedure, healing with the original skin and possibly hair. There's some interest in scar healing from verteporfin amongst individuals outside of the hairloss community who have scars from other causes like injury, other surgeries, acne etc.

I wonder how long it will be before more doctors start trialling this in their practice. With each update, verteporfin is looking more and more promising. Sure, there may need to be some dosing adjustment and the exact protocol needs to be worked out, but this looks like it has real potential. Also, good for doctors as well as patients as more grafts available which could mean more potential surgeries if required.

Hey Dr Barghouthi, just want to say that it is very refreshing and encouraging to see a doctor willing to take the bold step of trying this in actual patients. Thank you. The initial results are looking promising. In terms of follow ups with the patients and updates, I think I remember in your chat with Melvin that the patients would be followed up post surgery for 6 months and possibly longer if you can. Is the next follow up and update at 90 days with the first patient? Thanks again for your efforts and looking forward to see how this develops!