Scalp and Skin Diseases

[mister_25]

Hey everyone, in a few days I am going to see two different dermatologists to ask questions and check out my scalp for diseases/conditions that could interfere with my upcoming transplant.

What are some diseases and conditions that I should ask for them to check when I visit? Specifically ones that will compromise the growth or add difficulty to a hair transplant procedure.

[ciaus]

On the mild end scalp eczema/seborrheic dermatitis/scalp psoriasis. Generally you'll know if you have one of these, they'll produce symptoms like itchy dry red skin, flaky skin aka dandruff. They are pretty common in the general population and having them doesn't mean you shouldn't or can't get a hair transplant, but you do want to have them well under control before the surgery and to optimize healing in the important days after. Often guys can manage them with over-the-counter medicated shampoos for dandruff you can get at stores. But if its more severe you may need have a dermatologist help you manage it with more powerful medication/shampoo prescriptions.

There are some more serious and lesser known conditions where hair follicles are actually attacked and destroyed. Estimates are about 3% of population have one of these. And if you are one of the unlucky ones, you'll want to have the condition in a 'remission' state for at least a few years before considering a transplant. And even then since they have no cures and the potential to flare back up at any time, its always going to be a gamble transplanting hair. They are harder to diagnose and treat. Some can present with symptoms that are similar to the scalp eczema and seborrheic dermatitis described above, and eventually cause random 'patchy' spots of baldness if not managed properly. Sometimes referred to as 'scarring alopecias,' lichen planopilaris (LPP), Alopecia areata, pseudopelade of Brocq are some examples. 

[mcr7777]

Lichen planopilaris  - most hair doctors in the know think it is way underdiagnosed, can mimic MPB - and can cause poor HT results.  It usually but not always comes with symptoms of itching- sometimes burning or crawling too.

Edited July 10, 2022 by mcr7777

[THE TRUTH]

1 hour ago, mcr7777 said:

Lichen planopilaris  - most hair doctors in the know think it is way underdiagnosed, can mimic MPB - and can cause poor HT results.  It usually but not always comes with symptoms of itching- sometimes burning or crawling too.

Yes lichen can look similar to Androgenic Alopecia sometimes although it's more similar to a bald spot on the midscalp or crown.  It doesn't look like  androgenic alopecia at its early stages (diffuse thinning or hairline recession). 

Lichen or Scarring alopecia can definitely sabotage the outcome of a hair transplant. 

I remember a case of a guy who got a bad result from  Dr Emorane Lupanzula...he was extremely angry and upset but it turned out it was actually lichen planopilaris.  

Lupanzula and his rep didn't give a s*** afterwards. 

And also another guy  that EvansLawrence talked about. I think he also left the clinic bad reviews on google and youtube. Dude had a bad result from HLC and the guy apparently had lichen too. 

So the point is surgeons are surgeons. They are not trichologists.  They don't care about you. They want to operate on you and take your money. After all they run a business so....Sad but true. 

Therefore, you have to do your own homework before undergoing such big, risky and expensive procedure  

Hair transplant is a huge deal. 

Visit a very good trichologist before your surgery. Do a biopsy if required. 

You really wanna maximize the chances of sucess. 

Edited July 10, 2022 by Transplant ruined my life

[mcr7777]

Yes I agree with what you've said except that LPP can sometimes present at hairlines or diffuse thinning (there are variants called FAPD and Frontal Fibrosing)...this is why some people get caught out thinking they only have LPP - they assume LPP occurs only as bald spots on the midscalp or vertex - when it actually can occure in different places on the scalp. 

[mister_25]

Visiting a dermatologist in a few hours, any last minute conditions/diseases that I should get checked out?

[Gatsby]

Without seeing your scalp folliculitis is one.

[AB2000]

On 7/9/2022 at 12:16 PM, ciaus said:

There are some more serious and lesser known conditions where hair follicles are actually attacked and destroyed. Estimates are about 3% of population have one of these. And if you are one of the unlucky ones, you'll want to have the condition in a 'remission' state for at least a few years before considering a transplant. And even then since they have no cures and the potential to flare back up at any time, its always going to be a gamble transplanting hair. 

And this is the "X" factor on why some random hair transplants fail, even when going to a doctor with a good track record and the surgery done properly.  The procedure can kick up something like Scarring alopecia to those who are prone.