Some Concerns..Help

[Bill - Seemiller]

Hi all...a couple of concerns that I need advice and/or thoughts on:

 

1. I am 4.5 months post op, and more than occasionally, certain places in my donor area are itchy. When I look at it, it's sometimes a bit red, maybe a little bumpy in some areas. Anyone ever experience this or have a solution to make it go away?

 

2. Crown Area Vs Front Area: I am happy with the progress of the front area and hairline, but the back area (although hairs are growing), are still very light in color and aren't progressing the way the front is. Is this normal? What do you all think? I do use Propecia for about 3.5 months, and I use 2% minox twice a day.

 

3. About Propecia: How long should I be using it until I know whether or not it's helping? I mean...the back of my hair, below the crown has been getting thin since before my surgery, and I'm hoping Propecia will preserve that area, maybe even regrow some hair there...how long should I wait to know whether or not that is working?

 

Thanks all...I appreciate it.

 

Bill

[Bill - Seemiller]

Hi all...a couple of concerns that I need advice and/or thoughts on:

 

1. I am 4.5 months post op, and more than occasionally, certain places in my donor area are itchy. When I look at it, it's sometimes a bit red, maybe a little bumpy in some areas. Anyone ever experience this or have a solution to make it go away?

 

2. Crown Area Vs Front Area: I am happy with the progress of the front area and hairline, but the back area (although hairs are growing), are still very light in color and aren't progressing the way the front is. Is this normal? What do you all think? I do use Propecia for about 3.5 months, and I use 2% minox twice a day.

 

3. About Propecia: How long should I be using it until I know whether or not it's helping? I mean...the back of my hair, below the crown has been getting thin since before my surgery, and I'm hoping Propecia will preserve that area, maybe even regrow some hair there...how long should I wait to know whether or not that is working?

 

Thanks all...I appreciate it.

 

Bill

[Robert_]

Bill,

 

Your concerns are very legitimate but pretty easily answered. I'll do my best.

 

1) The donor area can be a bit itchy for a while post-op. Mine was kind of itchy too. Think of it kind of like any scar that is healing. It has been my experience that any time a scar is healing (a scratch, cut, etc) that it itches slightly. I have always chalked this up to the increased activity of the healing process but I am no doctor - that is just my guess. Can you describe the bumps a little more?

 

2) The crown does typically take longer to start growing in and mature than the hairline. This is completely normal.

 

3) Most physicians (that I have heard) advise to give Finasteride at least a year before determining as to whether or not it is working for you. The thinning you are experiencing in the crown can very well be chalked up to some shock loss and should return.

 

Hope this helps.

 

-Robert

[Bill - Seemiller]

Hi Robert,

 

Thanks so much for the quick reply. I'm glad to hear that these things are normal.

 

In response to your question about the bumps. I don't know if I can describe what they look like because i really can't see em, but it just feels like a slight tiny little bump right on one area of the scar line. Looking at it, it almost looks like a litle cut, or a little red mark, etc...perhaps even a little scab? I am not sure. Is there anything you suggest putting on it? Some kind of cream etc? I thought maybe itchiness could be because of dry skin, so I have tried skin moisturizers, and that doesn't really have any effect.

 

About the crown: I am glad to hear that is normal...any statistics on when the crown hair normally develops/matures, etc?

 

I will definately be using Propecia for at least a year, as it is my last medical hope of stopping hairloss. I have tried minoxidil (still using 2%), but no luck on it's own. I have also tried Revivogen....no luck there, just an oily stick scalp. I don't know if I can attribute the thinning due to shockloss, because it was there even before the surgery. Take a look at my pictures and you'll see some of the back of my head where the lower part of my crown and back of the head area are thin...I'm trying to prevent that from balding by using Propecia, and maybe even grow a little back.

 

Also, what do you think of my recent pic post? How am I coming along? Thanks again for your help and post soon.

 

Bill

[Mike1651]

Bill:

I had similiar symtoms, in the donor area, after my HT...my doctor explained that the deep sutures, used internally, are dissolvable & sometimes react with our system creating the bumps your descriping...in my case, after a number of months the bumps disappeared permanetly...as Robert said, I've heard/read numerous times from the surgeons & patients that the crown grafts grow at a slower pace that the hairline...regarding your progress, it looks good--congrats!

 

Mike

[Smoothy]

First, your ichy donor area is normal. Try using dandruff shampoo that will help control the itching. The hairline will regrow faster than the crown-- sometimes crown area takes 6 months to start growing and continues beyond a year, unlike hairline which regrows at a faster rate.

Propecia will not start seeing results until 12 months-- the literature say 6 month, but for me personally it took 12 months and I've been on it for 7 yrs now. Continue with 5% rogain 2x a day and take your propecia at night before you go to bed. ALso, add MSM 3,000mg a day to your supplements which is good for hair growth-- I've been VERY impressed after 4 months on MSM. Best of luck,

[Bill - Seemiller]

Thanks guys,

 

Mike,

 

It's good to hear that others have experienced the same thing, however I did not have dissolvable stitches, BUT, thankfully, the last week or so, it hasn't been as itchy, and the few little bumps in one area have gone away, although it still looks like a little tiny scratch or something, like somehow the area got irritated or something, but it's fading away, so this is good. Yeah, the more I am researching, the more I hear that the crown could take longer to grow too...so thanks again!

 

Smoothy,

 

thanks for your comments. Thankfully, the itchiness has gone down a lot, although not completely. So the question is...how long will this itchiness last? Like I said, it's diminished and beyond tolerable, but I am just wondering if I will experience that from time to time forever, or is it a matter of the more it heals, the better it will be? I've been on Propecia for about 4 months now, and I don't know if there is any difference or not, however, the one thing I can say is that I am noticing less shedding which was much more common before using Propecia. Just running conditioner in my hair on the top and crown used to produce a number of hairs in my hand, even before the HT, and now there is a huge reduction, so that is good. I'd love to see Propecia regrow some crown hair, but I think that's a low percentage...but who knows...maybe I'll be one of the "blessed" few right? Has propecia regrown any hair for you? If so, do you have pictures of any propecia regrowth?

 

Also, in regards to the crown, you can tell from the pics that there is definate growth taking place even on the crown, however, what concerns me is that there is some spots of the crown that are growing in nicely, whereas, there are other parts where I am seeing some tiny white hairs, but nothing more...and I'm wondering if these hairs will develop? What do you think?

 

Thanks again.

 

Bill

[gillenator]

Bill,

 

Possibly you have also read that hair follicules fulfill a three-phase cycle throughout our lifetime. The first phase is anagen (growth) and averages approximately six years or so in duration. The second is telogen (rest) phase and typically lasts three to four months. Then the hair sheath disengages from the root and dermal papllia which is the catagen phase (shed) before the follicule re-enters the anagen phase all over again.

 

It is true that re-growth in the crown can be slower. That can be related to the resting phase taking a little bit longer or the anagen phase coming in a little slower in the crown area. The blood supply in the post-anterior area (crown) may not be as rich as the frontal zone. The mid-anterior area (vertex) can be the same way and also can be more subject to shockloss as a result. Possibly these mid and post areas of scalp re-act more acutely to the trauma caused by the incisions.

 

The finer white hairs you are noticing may be some weaker natural hair that are coming back or it's the beginning of terminal hair growing in or a combination of both. Either way, the pigmentation should begin to resume as the new growth matures.

 

The area below the crown that you mentioned is starting to show thinning is the coronet area and can recede lower on those men transforming from a Norwood 6 to 7 in that specific area. Now it's a great thing you are on finasteride and I especially was happy to read your last post that the higher rate of shedding has stopped. You probably are aware that we shed hair on a daily basis which is normal. Yes finasteride can slow down the thinning in the post-anterior area and that is where finasteride is the most effective for genetic hairloss. However the chances of it growing back what you already lost are not very good. I wish I could say the opposite.

 

Through the years I have noticed that approximately 40% of men between 19 and 25 years of age have "re-grown" hair in the post-anterior area. Patients over 25, the re-growth is almost non-existent or very minimal. Even those cases over 25, the re-growth appeared very fuzzy and typically did not achieve the length and caliper that it originally did before the ill effects of DHT causing miniturization. So from what I have seen from a clinical standpoint, finasteride helps more to "maintain" what is left. Are there exceptions? Of course, but far and few between. So if you do realize some favorable re-grrowth, take it to the bank!

 

Give finasteride one full year to evaluate stabilization of hairloss and eighteen months to evaluate any re-growth. Just keep in mind that what is working today may not be effective over the long haul. I have been ingesting finasteride for about eight years and still quarter Proscar into four pieces. To date it has still been efficient for me so that is promising. Everyone reacts a little differently to meds especially over the long haul so it is prudent to plan restoration from a perspective of life-time planning, keeping some reserve for any future loss.

 

Also glad to hear the bumps are going away which does take time. Soon you will notice the redness going away as well. Do not be surprised should you notice a few red bumps in the recipient areas as the new growth comes in. In-grown hairs which appear as pimples can be common especially at the stage of post-op that you are at. Hey, best wishes Bill!

[Bill - Seemiller]

Hi there Gillenator,

 

First of all, thank you so much for taking the time to write all of that. You were very thorough in your answers and gave me a lot to think about and a lot of comfort as to where I am in this stage. At 4.5 months, I am thinking and wishing I was at 12 months and that every hair was already fully mature. There still seem to be a lot of immature hairs, and the thickness of the new hairs don't seem to be as thick as my other hairs, so I hope they will continue to grow thicker, longer, and fuller.

 

Yes, I will be continuing Propecia for at least a year, and honestly, if there is no change in my hairloss, I will probably keep using it for a long long time.

 

I'm not sure about the white hairs growing in. I don't know if they are a result of the minoxodil, or if they will mature and develop like the other hairs. It's difficult to tell at this point, but there do seem to be a number of them in the crown area on the one side.

 

At 4.5 months, do you suspect I should see a lot more growth? It's hard to tell when looking at the pics of other members just how much more hair they've grown between 4.5 months and 8 months. What are your thoughts? I guess I get discouraged when looking in the mirror and I don't see the results I'm hoping for...yet, at the same time, I know that ultimately, I probably won't be fully happy until I have a close to full head of hair, and I know I'll need a few more surgeries for that. But I do hope that I see a lot more out of this surgery...but oh well.

 

Anyway, thanks again for the response. Please post any more thoughts you might have.

 

Bill

[HairBeThere]

Bill,...

 

hang tight man!! don't judge anything yet!

[gillenator]

Hi Bill,

 

You are doing fine and yes there is more to come both in new growth and caliper development.

 

At 4-5 months post-op you have approximately 50% new growth and then add another 10% for each month that passes thereafter.

 

But it does take as long as 14 months post-op to achieve full maturation. Since caliper is the single most important factor in achieving the illusion of coverage, you really won't see the full visual benefit for a year or so. I went through it myself, especially after my third and largest procedure of 2400 grafts. I also had been using Toppik until that time. All the while though, I kept looking in the mirror and saying to myself "this should look like more coverage" and I could still see a little scalp until 14 months later. It was like one day I realized that I could no longer see my scalp once my hair was dry and groomed in place. That is when I truly could visualize the full benefit.

 

You said you are noticing the new skinnier hairs, not as fat as the other ones. But a year or so later those new transplanted hairs will be as fat as the others and that's when you will notice the full benefit too.

 

That is why I always advise patients to wait at least one year before their subsequent procedures. I mean who knows, one year later maybe you won't need as many grafts that you thought you might need looking in the mirror at say nine months post-op and trying to assess future needs. And everyone is a little different in their rate of growth, coarseness of hair, and hair characteristics like wave.

 

One thing I know for sure is that you have more comin' your way!

[Bill - Seemiller]

Hi Hairbethere and Gillenator. Thanks so much for your comments. Yeah, I was looking at before after pictures (up to now of course), and I have noticed just how much of a difference it has made from then until now. But I am excited to hear that I should be expecting more growth, and more caliper. I'll keep everyone up to date with pics. In the meantime, thanks for the encouragement!

 

Bill