DermMD

It is growing in exactly how it was placed (go look at your first week, it looks exactly like the grafts were placed). that marker is not exactly where the grafts were placed. You can see the micro-irregularities intentionally put in the hair line so you would not have a unnatural straight line. this a home run man, be happy.

I prescribe accutane often. I have not in this situation (just has not come up), however, the most common association is telogen effluvium. There are studies analyzing this, with patients being on higher dosage of the medication, and for longer durations potentially contributing towards it. In my opinion, with treating thousands of patients for acne with accutane, it is not a common occurrence. I would make sure though a patient in this setting was on medical therapy for hair loss. This is not medical advice to you, this is just how I would look at this situation.

No one is going to change your mind, and your statement will not change mine. And as I said in the other post, go get a real report and post it, not some crumby test.

You do not have DUPA. end of story.

I am a board certified dermatologist. I do not do hair transplants, but discuss them with patients often. I feel compelled to write a strong disagreement here with Dr. Rassman, and the assessment. If you had true DUPA, it would show even with long hair. The photos attached of your hair being wet are still not consistent with DUPA. My assumption is your overt concern for DUPA, when your hair is the way it is swayed a statement from him. A concern for DUPA with your volume of hair is a giant red flag when doing cosmetic procedures, and personally would scream do not proceed, as any physician would not be able to meet your expectation. You have zero deficiencies in hair density of your crown, occipital, parietal, posterior vertex and temporal scalp, and no evidence of DUPA. This can not be magically hidden. And as a expert in dermoscopy (trichology is a component of this field), I would not anticipate the donor density having any true deficiencies as you're stating. Also, the test he instructed you to do is garbage. If you really want to have a true assessment, see a Board-Certified Dermatologist, or hair transplant surgeon using something like Fotofinder (no COI, just a good product for dermoscopy). https://www.fotofinder-systems.com/technology/hair-consultation/

Absolutely not. https://dpcj.org/index.php/dpc/article/view/1921/1599

Is this really well articulated in the literature? At 6 months the transplanted hair should be present at the recipient site, however, it might only minimally visible to the naked eye, but with loops, or trichoscopy it would be evident. therefore, a surgeon should be able to conduct another hair transplant at that time (regardless if its in the same area as the previous HT or a new area) as they would be able to place new follicles appropriately spaced from recently transplanted hair and native hair in the thinning region. I believe that the reason it is suggested to wait 9-12 months is to evaluate the hair transplant at full maturation, as opposed to the midpoint when results may not be fully appreciated.

Correct. Board certified dermatologist here, agree. You need both.

Correct. Simply put, once you start getting your PsA testing your primary needs to know you're on finasteride or dutasteride as it can decrease the value of this test (missing early changes). if they know this, they should essentially double the PsA number to put it more in line with possible changes seen not on the medication.

See an allergist to have this tested (amide and ester anesthetics). it's unlikely you're allergic to both (I am a board-certified dermatologist), and this is how I would test a patient in this setting. just my two cents.

So, this comment needs a little clarity. what is the most common side effect with topical minoxidil (link below)? Its not hypertrichosis (thats with oral minoxidil, see that study 27% compared to 4%). The common reason topical is d/c is it change to hair texture, pruritus and perceived lack of efficacy. I am a board-certified dermatologist, just trying to point out some facts. cheers, https://www.jaad.org/article/S0190-9622(19)32666-0/fulltext#:~:text=Premature discontinuation of treatment commonly,to be effective for FPHL. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10149432/

What makes you make this statement? can you provide references/rationale? The placement of grafts are the same regardless if its FUT or FUE (I am a board-certified dermatologist), so why would it be different?