Jayson1361

10-15 after a shower… I’m sure that’s probably anecdotal… unless you have a process and documented observations. I bet this has been going on for quite some time you may have not noticed or had a darker sink or your head wasn’t over the sink or… whatever variable.  My opinion for that type of shedding over time being on the strongest stuff you can be taking for hair loss is that personal opinion, how you feel, observation of aging and knowing your age… etc… influences people to pay closer attention to perceived change. I’m willing to wager that anything you’re seeing is an accumulation of time on the body and not sudden. Most people use the term shedding for acute hair loss due to a change in routine of some type. Not that it makes it any easier to observe and deal with but I bet you’ve seriously slowed your loss being on dutasteride and oral min. You could really be experiencing the periodic shed people get. 

6 hours ago, jim1973 said:

@alopie is correct in that I'm not regrowing any new hair but my existing hair is much thicker.  I'm on 5mg of oral Min and .5mg of oral Dut.  Unfortunately I still shed hair daily in the sink after showering and I'm approaching 1 year on both of these doses of each.  I think this is as good as its going to get for me.  I'm not sure how others get into the regrowth stages but it doesn't seem to be in the cards for me.  I'm also a little older (51).  

What do you mean by shedding? You towel dry your hair and then see a few more fall or you see another 10-50 hairs fall? I would think even after shampooing towel drying hair might cause a few to fall normally or even running hands through wet hair. If 50-150 hairs shed normally, daily… that’s possibly up to 6-7 hairs an hour…so I guess I’m curious what you mean by shedding after showering.  

2 hours ago, Smacias15 said:

How do you get soft water ?

Well, you buy a water softener and install it at the water supply for your home. Or, you can buy an on the go water softener and install it on a faucet at your apartment or condo, or the main water supply for your apartment or condo if you have access to it. 

18 minutes ago, TheDarkHour said:

What exactly is "soft water"? Reducing the water pressure from the shower head?

Soft water is water that has reduced minerals in it, hopefully dramatically reduced… usually achieved through an ion exchange with sodium charged resin beads in a tank. The reduced minerals exchanged for sodium creates a water that dramatically reduces the amount of minerals that build up on the hair or scalp which usually cause irritation, itchiness and drying. Soft water is significantly better for your hair and scalp and helps hair retain more moisture. The effect is immediate with good soft water vs hard water in my experience. If you wash your hair with soft water even once, you’ll be like yeah that dude was right. 
 

Edit: If your hair is dry..I’ve said it before in these forums try some Living Proof 5-1 before blow drying it’ll help smooth it out. I’m curious to, have you thought that some of the dry frizzy hair could be regrowth of terminal hairs just weaker because the follicles were dormant due to taking oral Min? It’s possible🤷‍♂️

On 8/14/2023 at 7:49 AM, TheDarkHour said:

Looking and feeling dry. It's all over.

One of the best thing I’ve ever done for my hair which has always been curly and slightly frizzy or wavy was to start washing my hair less and with soft water. Hard water makes a frizzy mess of hair pretty much especially if you’re using multiple products for texture or hold or leave in conditioner or whatever. 

What do you mean by frizzy? Looking and feeling dry or curly hair lacking pigment? Is it all over or just in thinning areas? 

His work is extremely clean and it looks great. Especially the donor. So no complete shave huh… I’ve heard he usually likes to shave the entire head. 

Melvin I’m curious, how long to you let TD Xyon dry before styling or putting other product in your hair? 

Dr Konior doesn’t do per graft more based on complexity. Id speculate 25-35k. 

3 hours ago, HelpfulFriend said:

Hello everyone, thought I'd pop by for another update. 

 

I'm at about 5.5 months, and the hair is starting to take on the caliber of my non transplanted hair. It was really quite thin up until about a month ago.

 

All in all still progressing

🤷‍♂️I mean what can you say. Damn. 

That’s as symmetrical as you can get. Damn! The tenacity of that guy. Looks very dense as well. Are you on meds? Do you have pictures with out the hair being held back and your hand covering the top? A part in the hair showing density and at the crown? 
 

Bottom line…I mean Damn! Looks amazingly clean. 

8 hours ago, MattJosh said:

Doesn't almost everyone has some inflammation to one degree or another? Even just basic dandruff or those with seborrheic dermatitis who have successful transplants and there are plenty would be considered to have inflammation

How would you define inflammation in the scalp?

I think medically, inflammation exists as a matter of verifiable fact and anyone’s definition of inflammation if they are not a medical professional, which I’m not doesn’t matter. But, obviously I’m referencing an underlying disease process or skin condition that’s currently not dormant or is manifesting symptoms. Given that injury can aggravate LPP or LP in skin tissue Id be curious to know if the OP with a diagnosed case of LPP via biopsy has micro needled and if that aggravated the condition. 

59 minutes ago, ITA said:

It may also be that a person does not know he or she has LPP until after having the transplant.  Sometimes the LPP is so called dormant, there are no symptoms, nor are the surgeons aware of it before or during surgery.

Of course. But the point of my posts are not to address the likelihood of LPP to reoccur after it has become dormant. Rather, I think it’s all reasonable to assume based upon an itchy scalp or other symptoms associated with male pattern baldness or LPP that LPP is the root cause right out of the gate. It will be the last thing that I assume absent a diagnosis.  

2 hours ago, ITA said:

If, however, to these symptoms, you add that you did one/two transplants and the hair remained on your head only 1-2 or 3 years, some doubt comes to you.

I don’t see the doubt. Don’t transplant hair into an area of active inflammation regardless of the root cause🤷‍♂️. But that’s not the question or doubt I have. I don’t think it’s right to assume that if your scalp itches etc… that LPP/FAA is the first place your mind should go. 

48 minutes ago, HairEnthusiast101 said:

Interesting yes I was worried because I’m noticing thinning but my head also itches sometimes throughout the day randomly(probably when I think about it) but also sometimes tingles/burns after showers so I assumed I have this. Which I might but I will get a check regardless. Wonder how common it is

I think it’s folly to assume one has a rather rare form of alopecia, or I’d go as far to say very rare form of alopecia because the scalp itches or tingles or whatever. I can get my hair to tingle if I push it in the opposite direction it’s trained to feel sore even in the scalp. Probability that I’ve seen from reading online, like all of us….of cases reported of LPP 1-2% are even men. Then FFA would have to develop from that which is even more rare. Especially in men. I could find the links but don’t have them off hand at the moment.  Point is it’s ridiculous to assume one has LPP/FFA from reading on a forum because your scalp itches every so often or tingle when you put pressure on it or whatever. Just ridiculous. 
 

Further, MPB androgen related pattern balding does not just go away and causes permanent fibrotic related baldness.  Lichen Planus or Lichen Planopilaris absolutely can just go away. Or significantly reduce in the presentation of symptoms causing inflammation and hair loss which is essentially what we are talking about.

1 hour ago, MattJosh said:

Very astute observations and I would tend to agree with the overall conclusion

I have to mention that the event of skin discoloration takes place quite often to one degree or another in the case of the recipient area in hair transplantation, specially when  the patient gets plenty of sun exposure before a few months go by

Biopsies are very important to detect these things but let's not rule out the human element and the different interpretations by different Dr's of the same results, as has happened far too many times, unless in cases that are extremely clear and straightforward

Very true. Further if the individual has any amount of hair on the scalp that could block UV rays there is going to be an obvious discoloration from scalp to forehead. Anyone that has shaved their head down can easily see the whiteness of a scalp vs forehead or neck post shaving. I can pull up a close up photo of skin on my arm and see small tracks of white tracing through possibly hyper pigmented skin. Could probably do it on any part of my body. I think the point is can pores from hair follicles been seen even if they are not producing hair on the scalp. 
 

Op had a history of suggesting LPP in many other posts if the thread even indicates an itching on the scalp, why I’m not sure.  Suggesting a rather rare form of alopecia can be very alarming perhaps even misleading, even though I’m sure his intentions are good. However, getting scalp checked by a derm seems it should be standard ops before getting a HT which is probably the best take from this entire post. 
 

Regardless, I have random itches all over my body all day long I scratch and they go away, including my scalp. S$&t I’ve got one right now even🤷‍♂️. Since I comb my hair and don’t care to mess it up so much I just press and release as palpitation also over whelms the nerve registering the itch. 

I’ve looked into this before. Posting twice in this thread I wanted to say I think it’s important to keep things in perspective. LPP with associated FFA is rather rare even for those who have an auto immune disorder like lichen planus or perceived symptoms that coincide with mpb. To say that allot more people have it than has been reported or diagnosed is a stretch I feel. Almost all of the normal symptoms of MPB can be associated with LPP and FFA or a patterned form of fibrosis. Itching, receding hairline, change in hair texture… thinning eyebrows, or sideburns would probably be more indicative of something but itching…meh that can be caused by so much, including folliculitis or any number of things. Discoloration on a small scale occurs in almost all skin types as well. That was my conclusion originally when looking  into this and it remains the same. Further, having dealt with lichen planus it’s not permanent on any part of the body in my experience and can flare up or not. If indeed there is hairloss due to LPP I would think that might even be a better diagnosis than MPB as symptoms can be controlled and eventually eliminated even. Further HT can take in areas where there is scar tissue as that resides on the top of skin. But, that being said Hair loss due to scar tissue is very permanent and destruction of stem cells in the bulb is also, at least for now. Healthy grafts finding a blood supply would take quite some time to be impacted by LPP as they were not impacted most likely prior to the HT on the back of the head. Obviously LPP can be localized but usually does fade with time to virtually non existent. I had an injury a scrap that was fell on my hands due to moving heavy furniture during a move. I had what I think was a version of LP that existed for 2.5 years before disappearing. Super dry skin, perceived eczema or something. Eventually it subsided to let’s say a .5 vs a 10 and has remained as such. JAK inhibitors have been shown to significantly improve LP and LPP as well…. which means that dealing with hairloss outside of androgens could have a higher probability of success when associated with HT. Personally I think drugs associated AA vs MPB have a higher chance of success of coming to market much sooner. Whose to say really, but it’s important to keep things in perspective. Sure the OP has a biopsy and diagnosis, but I bet with treatment if indeed that was the only form of hairloss… 1) The LPP will eventually subside and 2) drug intervention has a higher chance of success vs MPB drugs over time. Sure not knowing ahead of time and getting a HT without treatment of an underlying condition is alarming, but knowing ahead of time and treating and with time, and assuming that were the only cause of hair loss…I might take that over MPB. I bet treatment of LPP and another pass via HT would yield positive results. Curious as to what an ANA blood test reveals for the OP? That’s standard ops for a blood test when getting a yearly physical. 
 

There is a pub med study that shows LPP causes a positive ANA test in 84% + patients. 
 

https://pubmed.ncbi.nlm.nih.gov/30810113/

Further, when it comes to speculation on hairloss, this site is more prone to speculation vs empirical observation or evidence due to the personal nature of hair loss.  Based on that I think it would be safe to assume in the absence of  a positive ANA test or positive biopsy HT would still be the gold standard in dealing with hair loss even if LPP or FFA is suspected or even found. Obviously if either were found treatment associated with HT would be the obvious course. 
 

I think it’s also fair to note that fibrotic tissue regardless of scarring is also prevalent in MPB as well as FFA. The obvious difference being that FFA can have a skin level scarring bulb and in extreme cases a keloid that grows to be much much larger although very rare and even more so in men. Point being just because LPP is present doesn’t mean time and circumstance associated with treatment and HT can’t yield a positive result. The crux of this being that it may take longer and or preserving donors for a later date. 
 

Lets also not forget there have been many post on scar tissue from FUT being repaired as well in this forum. Which I bet is much more fibrotic than an unnoticed form of FFA associated with LPP. 

On 2/10/2021 at 7:39 AM, mcr7777 said:

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....

 

 

This is an interesting thread. I actually have oral lichen planus and had concerns about it moving to my scalp somehow. I’ve not been too concerned about it as I’ve responded to Avodart over the years and had some response to oral minoxidil. Also, I have no eyebrow thinning or white patches on the forehead that I can see. I’ve also not had all day scalp itching but have had scalp itch here and there which I always attributed to the DHT itch, drying from dandruff shampoos or product build up…etc. I don’t have any patchy balding or thinning, or symmetrical recession from the forelock back… but rather temporal thinning with what I perceive some diffuse miniaturization in the front. A few times after styling with gel and pressing down on the crown I felt a slight burning sensation which sparked my interest into this topic. I have not pursued a biopsy but after seeing this I’m going to as the bulk of my thinning is focused in the front with more aggressive miniaturization over the last two years. However, it seems that FFA from LPP doesn’t really do the whole slow miniaturization process like MPB therefore I’m still in question if this is occurring for me. But, seeing this here has sparked my concern. Thanks for the post. 

After applying xyon when can you apply other styling products? Can you blow dry your hair after applying it? What’s the norm for anybody using it? 

On 3/1/2023 at 12:31 PM, Anthropos said:

Hi everyone,

Please find pictures at Day +30.

Grafts don't seem to fall anymore despite washing my hair twice a day as per Dr. Ferreira's instructions.
I try not to look at myself too much in the mirror as I feel horrible... Hopefully in a few months my hair will cover the recipient area.

I'm starting to think about taking oral Minoxidil next year (at very low dosage 1.25mg per day) to improve density. I'm a little scared of skin aging and collagen losses. I will talk about it with Dr. Ferreira later since it's out of stock in my country right now apparently.

Have a nice day!

Looks good. You could wear a hat for a bit. Can’t say I’ve experienced advanced aging or collagen loss from oral Min. I do take care of my skin though as I’ve had some minor skin cancer removed. Can’t say I’ve heard of allot of people reporting aging or collagen loss either. 

On 3/4/2023 at 12:50 PM, newguy2021 said:

Here is another picture that I think shows the right and left density differences better.

You could try a touch up procedure. I see what you’re trying to do. But, since you’re not losing hair there anymore I’d try combing the hair to left, try a wax product, maybe even lighten the hair a touch for a different look. A different hairstyle could easily blend that in. 

On 2/8/2023 at 6:48 AM, ljpcarrera said:

Over a year on 2.5 daily. Definitely entire scalp grows quicker and is thicker. No side effects. 

On 2/8/2023 at 6:48 AM, ljpcarrera said:

Over a year on 2.5 daily. Definitely entire scalp grows quicker and is thicker. No side effects. 

Do you feel like results have peaked? If so when did you notice the effects peaking? 6 months in, 12 months in? 

5 hours ago, im_not_a_robot said:

Thanks guys, makes me feel better about the results! 

I’m not doing a product plug because I don’t care if you try it or not. But, let your hair dry apply some Living Proof 5-1 conditioner styler product, style then blow dry. Bet your hair looks amazing. 

3 hours ago, Mike10 said:

but why are you comparing oral minox to fin/dut rather than to topical minox? 

Oral minoxidil like fin and dut is dose dependent from what I’ve read. The higher the dose the higher the probability it does something for you, good or bad. The rest of what I wrote was in regard to minoxidil vs oral minoxidil. By minoxidil I mean topical vs oral minoxidil. Sorry for any confusion. 
 

Also, I’m not a medical professional. I only know what I’ve read on forums and the internet. I also have experience taking oral Min as I’m 4.5 months in. Shedding has decreased no doubt, but I’ve seen no regrowth. My hair does feel a bit thicker but I don’t really perceive a noticeable increase in density. I’m going to use it for 12 months then assess a maintenance protocol for continued use. Currently I’m doing 2.5mg every day. M-W-F I take 2.5mg in the morning then 2.5mg at night. 

12 hours ago, im_not_a_robot said:

Hi, everyone. 

I had my procedure done 22 february 2022, so it's been just over 12 months since my procedure. I had 2200 grafts implanted in temple areas and midscalp. Although there has been a big improvement overall, i'm not quite happy with the density achieved. I'm not sure if it's because of unrealistic expectations, or whether it's in fact because some issue with the procedure or growth. I would like to hear your opinion on my results. Before and after pictures are included below.

 Before:



After:


Also, a few hairs are pointed out at wrong angles, which i have to cut because they are impossible to style. Luckily there is not too many of those..

 

 

 

You’ve obviously had a good result, in my opinion. After a bit of time a minor, and I say minor 2nd pass to achieve just a bit more density on the hair line would be what I would do. But, I think it looks good. As I’ve said before and I’ll say again, now you don’t have to watch your hair line disappear if you choose to proceed with a 2nd HT to get a little more density. Bottom line, I like it. 
 

I’ll go even farther to say that, given the right surgeon and donor, you might be able to achieve a hairline that looks hmmm how do I say Hollywood/ a styled type of thickness everyday. I mean that in the sense that with another HT and the right product for styling like you see guys do (ease of use of course, such as a wax product) you could have damn near perfect living in heaven/hell (Gatsby slays it 😂😂) hair.

 The saying you get what you pay for has never been more applicable than the hair transplant industry.  However, I’d wait and leave it be for a while, at least 18 months post op to see how things progress before making another appointment.