I examined my scalp with a microscope: findings

[Prof101]

I got it because I am contemplating going for a HT. I have many findings to share. I bought it mostly to be able to get an idea of the density, but I will keep that for a follow-up post. By the way these are cheap online microscopes (digital) but work very well, and I wonder why more people are not getting self-examined this way. 

Yellow Dots:

I am seeing strange yellow dots around the follicles in the balding area. The only thing I found online (pretty useful actually) is about exactly this,

Yellow Dots under trichoscopy (2017): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674712/

"In androgenetic alopecia, in turn, yellow dots are seen in more advanced stages of the disease with a sebaceous component predominance"

"It is believed that, in this condition, yellow dots result from the presence of engorged sebaceous glands that remain functioning despite the progress of the miniaturization process of the follicles, leading to the formation of intraepidermal sebaceous lakes"

Now I am starting to wonder the (1) I wonder whether they raise concerns about FUE success rate  (2) To what extent is baldness actually directly related to these engorged sebaceous glands. 

I do not see this much in the donor area (see 2 attached, named donor). But I see it quite frequently in the thinning area, particularly on the crown, but also zone 2-3 (the rest of the attached). 

The paper shows few pictures and mine look even more pronounced then the ones in the study. 

 

Any thoughts? I wish some doctor can comment on this. 

Updated: 

- After some search yes it seems this is the hallmark of seborrhoeic dermatitis. There is a whole debate about the relation between this and baldness. Don't want to start it here.

- On realself suregons responded to this question saying that there would not be an issue with transplant. But being who I am, I want to test out a small transplant and study the success rate. 

I will post a follow up on my hair density. 

 

 

Edited December 25, 2020 by Prof101

[UnbaldEagle]

WOW. Great thread. I hope some docs will chime in.  

[Westview]

You really need to post more info, like:

1.  How long ago was your transplant.

2.  Was it FUE or FUT

3.  Name of surgeon/clinic

[DenverBuff1989]

@Prof101 more than anything I'm just curious how you took pictures of a microscope pointed at your scalp? I would be interested in doing the same but not sure how you accomplished it. 

[Westview]

11 minutes ago, DenverBuff1989 said:

@Prof101 more than anything I'm just curious how you took pictures of a microscope pointed at your scalp? I would be interested in doing the same but not sure how you accomplished it

Thats easy.  You get one of these and simply point it at your scalp:

https://www.amazon.com/Jiusion-Magnification-Endoscope-Microscope-Compatible/dp/B06WD843ZM/ref=sr_1_3?dchild=1&keywords=microscope+digital&qid=1608931048&sr=8-3

I bought one last year as well.  Cheap and very effective

 

 

Edited December 25, 2020 by Westview

[DenverBuff1989]

@Westview nice thanks! 

[Prof101]

@Westview @DenverBuff1989 is correct. This is what I used. 

Now here is my disappointing density. The area is 0.2cm2.  I have an average of 60FU/cm2 to nearly 100FU/cm2 in some areas (surprisingly, just below the donor area and nape area is the most dense). It appears I have a decent number of 3s and 4s. 

I will follow it up with an attachement of a regular picture of my donor area from my iphone. One thing I can't do on my own is to measure the hair thickness, going to ask Dr. Mohebi to do that for me. Hoping he would be willing to do a test transplant on me soon. 

I also measured my donor area surface: What is considered as safe area is around 120 cm^2. If I proceed to NW6, I am far from that now, the recipient area is 150cm2. So all this does not look good at all. I am very disappointed with the outcome of the measurement. I hope more of you will do such measurements, I was about to go under the knife just a month ago, with a doc (not Mohebi) who looked at my pictures only online and said let's do 3K. He evaluated my hair as being high density but thin. I think if anything it could be the other way around. Anyway, had I done this, I would have completely depleted my area. 

If I assume an average of 70U/cm2, and that I need to keep 40FU/cm2, and assuming I won't touch the area below the safe zone (which is denser and looks very thick and healthy) then I only have around 3600FU to donate. I need to measure the below the safe zone and see how large it is. Neither side of my family lost hair from below the donor area.

First Photo: Side donor area (above ear: worrisome density) 

Second: Back donor area (sample 1: worrisome density) 

Third photo : Back donor area (sample 2: OK density) 

Fourth: Nape area (good density) 

Fifth: Below the "safe zone" but above the nape. (highest density) 

 

Thoughts? 

 

 

 

 

 

 

 

 

 

 

Edited December 26, 2020 by Prof101

[Prof101]

Here is how my donor area looks like in a sun-lit room. 

[Westview]

I'm not trying to be rude, but does anyone have any clue what Prof101 is trying to say???

[thetdog666]

I have them yellow/brownish dots at temple area where my hair is miniaturizing also. Is it bad and can anything be done about it?

[hairlossPA]

so great thread. unfortunately i’m not sure/confident enough doctors do this before performing a HT. please keep this thread alive

[Prof101]

@hairlossPA Your hunch is right, I was told on this forum most surgeons don't. The more curious we get, the more diligent they will have to become.

So yes it would be good to keep this thread alive.  I linked a study below about fibrosis in the donor region and its impact on a HT. 

 

Evaluation of Perifollicular Inflammation of Donor Area during Hair Transplantation in Androgenetic Alopecia and its Comparison with Controls 

 

[DenverBuff1989]

are any hair doctors local in your area? even if you don't want to have surgery with them, I would schedule an appointment so they could look at your scalp themselves. If you don't have any local HT docs, I assume you have at least one decent local dermatologist who could do the same. 

I admire your focus and drive in this issue, but this is a lot of analysis and -quite literally, a lot of microscopic observation- for not have even seen a doctor about this yet. 

[Prof101]

I managed to schedule an appointment with a doctor in the region. It was hard to find one who does scalp analysis. I bought this kit before I scheduled with him and definitely was not going to rely on my observations alone. Agreed. But pictures don't lie, so I am more informed now and prepared for the conversation. 

I will in addition contact a dermatologist. 

Thanks for the comment. 

[thetdog666]

Would tretinoin help? Iv read online an anti-inflammatory shampoo or cortisone cream should be used for seborrhoeic dermatitis. 

Edited December 28, 2020 by thetdog666

[Prof101]

I going to ask a dermatologist, will circle back on this. 

[thetdog666]

Have you seen a dermatologist yet?