Vascularization grafts and medication (vasoconstrictors)

[alex85]

5 months ago I had a hair transplant. From that point on, I stopped taking my medication for ADHD. This because I had read that Methylphenidate (type of amphetamine) is a strong vasoconstrictor. I had reasoned that continuing to use it might reduce or worsen the blood supply to the grafts.

I have done research, but I can't find an answer (only found the photo below). I imagine that even now it could be harmful to some grafts (which are not growing yet) if the blood supply is obstructed. Many grafts are already growing, and every now and then one pops up again. So the process is still going on, I don't want to affect it negatively. Of course I have asked my doctor this question but really didn't get a clear answer.

I use a fairly high dose or ritalin (=methylphenidate); 70mg per day (4x 15 mg 1x 10mg). I would very much like to take my medication again (haven't used it for 5 months), it really affects my daily life. Can I or could I still harm my grafts?

Edited April 2, 2021 by alex85

[Curious25]

Interesting. One for the docs on here to answer for sure 

[Britanium]

@DrTBarghouthi might be able to help here. 

[Curious25]

3 minutes ago, qui bono said:

Id ask your doc but id assume by this stage it would be ok.

Like minoxodil is a vasodilator and docs say you can resume usage 2 weeks - 1 month post-op without adverse effects. The grafts are technically anchored by 3 days post op, and you cant really do much damage to them by 10 post op. The stage youre at its really about your hair going through the different hair cycles until you notice the growth. 

But this is just conjecture and im just some guy on a forum, maybe some of the docs that frequent this site can chime in?

Based on logic and what I know about hair transplants, I would also agree with this consensus, and that it likely wouldn’t do them any harm at this stage - but I’m not trained in this field, nor a doctor,  so have zero credibility to offer you with this hypothesis I’m afraid ! 

[ciaus]

Every HT doctor has pre-op and post-op instructions that include activities and medications to avoid to optimize results, and there's no mention of yours in any that I've ever read or even heard about. If there was a chance that their work, and reputation, could be compromised by these it would be at least in the top doctor instructions and we would have heard about it on forums like this.

It's the initial days when the transplanted follicles were connecting up with their new blood supplies that was the questionable time. Starting back up weeks or a few months later might delay some of your results in the worst case scenario.

You should consider taking Minoxidil, if not now then after all your results have come in. It has the opposite effect on your blood vessels, so it could neutralize or at least help to minimize the constricting effect of your medication. Just be aware that if you start now it could possibly trigger an initial temporary shedding of some of your hair -that's just the hairs cycling out to get ready for the longer growth cycles you benefit from when taking minoxidil. But if you think that a shedding like that would freak you out, make you worry more, I'd recommend not bothering with the minoxidil for now and take it easy.

At 5 months post op the only way to destroy these grafts would be the same way you'd destroy any other hairs on your body -like through burning accidents etc.

[alex85]

Thank you Claus! I am already using minox for a while so I think I am gonna resume my medication :). 

[Britanium]

@Dr. Suhail Khokhar would you be kind enough to chime in too ? Thanks 🙏 

[alex85]

Thank you @JohnAC71! Really curious what the doc thinks about this. Especially because the quite high dosage and strong vasoconstricting capability.

[Curious25]

3 minutes ago, alex85 said:

Thank you @JohnAC71! Really curious what the doc thinks about this. Especially because the quite high dosage and strong vasoconstricting capability.

Hair transplant aside , did you/do you have to take any other meds to counteract the vasoconstriction you are exposed to from this medication? 

[alex85]

Nope, nothing. But using finasteride (and topical minoxidil) for 17 years now. 

Edited April 2, 2021 by alex85

[Future Hair Doc]

Great question.

Methylphenidate is a NDRI (norepinephrine and dopamine reuptake inhibitor). The vasoconstriction is mediated mainly by the norepinephrine (dopamine causes vasodilation at low doses and vasoconstriction at high doses but its effect isn't as potent as norepinephrine). The vasoconstriction is central (B1 receptors which are in the heart) and peripheral (A1 and A2 receptors which are in the smooth muscle cells of our vasculature) in nature. However, I don't think this vasoconstriction will impact your grafts. I'm assuming you're using minoxidil too which is a potent vasodilator. I looked up the literature on methylphenidate and hair grafts and there hasn't been any study on this. You should be fine using ritalin for ADHD.

As always, consult with your doctor on this as well.

Edited April 3, 2021 by Dr. Suhail Khokhar

[DrTBarghouthi]

I agree with Dr. Khokhar and his elaborate explanation. There should be no effects at this stage. New vascularisation of the transplanted follicles happens after around a week from surgery. Always follow your surgeon’s advice ofcourse but I also see no concern there. 

[alex85]

Guys you are great, thanks for your opinions!

[Britanium]

@DrTBarghouthi & @Dr. Suhail Khokhar thanks for responding. 🙏

[Melvin- Admin]

Awesome input from physicians 👏🏼

[champybaby]

I take adderall. Usually about 10mg daily. I've been an early grower, so just my friendly two bits, but you may be overthinking it.

[augustya]

5 hours ago, DrTBarghouthi said:

I agree with Dr. Khokhar and his elaborate explanation. There should be no effects at this stage. New vascularisation of the transplanted follicles happens after around a week from surgery. Always follow your surgeon’s advice ofcourse but I also see no concern there. 

Hello Dr ! Have left a DM to you. Hopefully you have read it, and will respond to it at your earliest convenience.

Thanks !

[DrTBarghouthi]

5 hours ago, augustya said:

Hello Dr ! Have left a DM to you. Hopefully you have read it, and will respond to it at your earliest convenience.

Thanks !

I just did. Sorry It was overlooked by me.