Do I Have to Shave My Head Before a Hair Transplant?

do i need to shave my head for a hair transplant?

Q:

Hi Dr. Mohebi,

I am planning to undergo an FUE hair transplant to add greater density to my hair in the front and along the hairline. Do you always shave the patient’s hair before a hair transplant? Is there a way it can be performed with long hair?

A:

Thanks for the question.

It is usually not mandatory to shave a patient’s head before an FUE procedure. Both types of hair transplant (FUE or FUT/strip) can be performed with minimal or no shaving.

  • In the strip method, shaving can be limited to the area of the strip that will be removed so the patient will have long hair on both sides of the wound so it will be covered. With the FUE method, the donor shaving can be done in layers which means the longer neighboring hair can cover easily cover the shaved area. Layer shaving in FUE transplant can only eliminate the appearance of a shaved head if you leave your hair longer on the back and sides. We recommend complete shaving whenever possible since it allows us to expand the donor area to the entire permanent zone. That increases the evenness of the hair on the donor area and avoids the minimal contrast between the extracted and neighboring areas with higher density.

Shaving the donor area in layers allows us to harvest up to 2000 grafts in one day. However, it might not be possible to harvest more than that amount. For larger sessions, we need to have access to the entire donor area so shaving in layers might not be possible.

  • We offer Celebrity Hair Transplant (non-shaven FUE) so the patient doesn’t need to have any shaved areas on the donor or recipient area. This procedure is more labor intense so fewer grafts could be transplanted in each session and it is more expensive for the same reason.Celebrity Hair Transplant is popular among celebrities who do not want any evidence of a hair transplant (even in the first few days after the procedure). This hair restoration technique allows the surgical team to either excise the grafts with long hair or cut only the hair that needs to be harvested so there is no visible shaved area on the back of the head.

Do I need to shave my head for a hair transplant?

Non-Shaven FUE – FAQ With Dr. Mohebi.

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Weird and Wacky Historical Hair Loss Solutions

The techniques available to combat hair loss have evolved over the years to where many people take the current methods for granted. It might be hard to believe but there were ways to combat hair loss before the 20th century. Have you ever heard of any of these weird ways people attempted to combat hair loss in the past?

Ancient Egyptians used a variety of cures to help those suffering from hair loss. One of the oddest remedies was a mixture of fats that included tomcat, crocodile, hippo, snake and an ibex AKA a wild goat. Porcupine hair was also boiled and then applied to the scalp for at least four days. Egyptians who were not fans of those ideas more than likely chose the option of wearing a wig.

While Hippocrates is known as the father of Western medicine, he also suffered from male pattern baldness. What was his answer to his baldness? A topical solution made of pigeon droppings, spices, opium, beetroot and horseradish.  His other cure for baldness was a little more radical as he realized that eunuchs were not lacking hair on top of their heads. There are no records of how many people choose the castration solution.

Julius Caesar might be the father of the comb over. Once he started losing his hair, he turned to growing his hair long in the back and then brushing it up and over his scalp. When this didn’t work, he turned to a remedy consisting of bear grease, mice and horse teeth. When that rather unappealing solution didn’t work, Caesar finally decided on wearing a laurel wreath on his head to cover his bald area.

The phrase “snake oil salesman” is used to describe someone who is not particularly trustworthy. The 19th century saw many salesmen pretending to be doctors while trying to sell potions and products to cure baldness. Most of these tonics were simply drinks made by the salesmen that had no medical value in treating baldness or any other ailments.

These crazy ideas to combat baldness are just a few of the methods used throughout history to battle hair loss. We’ve come a long way since the days of potions made from a combination of animals found in the great outdoors. We should all be glad that we live in a day and age where modern medicine is able to provide effective hair restoration solutions.

Can a Baseball Cap Help Female Hair Loss?

Laser Cap Used for Hair LossEven though hair loss is mostly thought of as a condition that mainly happens to men, there are a number of women who also suffer from hair loss. Many women are embarrassed to discuss their hair loss in public so they don’t seek professional help. However, there is now a hair loss treatment that women can use by simply wearing a baseball cap.

The LaserCap LCPRO is a baseball cap that is operated by batteries and includes a special disc inside the dome of the cap. Once the switch is turned on to activate the LaserCap, 200 pulsed lights go to work on stimulating scalp hair growth. The pulsed light is a low level laser light that stimulates what is known as the “energy factory” of the cell as it passes through the scalp. In turn, this stimulating action brings about an atmosphere that is rich in oxygen and energy to help stimulate the hair follicles.

One of the most convenient aspects of the LaserCap LCPRO treatment process is that it doesn’t require a number of trips to the doctor’s office. The patient can take the LaserCap LCPRO home and use it for treatment multiple times during the week. The number of times the cap needs to be used in the comfort of the patient’s own home is determined by the doctor as the needs of each patient are different. However, wearing the cap is normally recommended at least three times per week in 15-minutes intervals.

While the LaserCap LCPRO has been on the market for more than five years, it has only recently received approval from the FDA as a product that can be used to stimulate hair growth. While it’s too soon to tell the long term effectiveness of the LaserCap LCPRO or other laser caps currently on the market. However, it does offer female patients another way to combat hair loss beyond Minoxidil, also known as Rogaine, which is currently the only medication approved by the FDA to combat female pattern baldness.

Parsa Mohebi Hair Restoration currently offers a special Laser Cap with 224 individual 650nm 5MW lasers. This Laser Cap is used to treat thinning hair in many patients without other medical or surgical options. Please contact our office if you would like more information.

Can New Research on Mice Hold the Key to Combating Hair Loss?

Research to Combat Hair LossWhen it comes to dealing with hair loss, the current solutions range from combovers to hair loss medications and transplants that are way too way to spot. However, research continues in the scientific community on new solutions for hair loss. Scientists have recently discovered some hair loss can be treated by blocking certain enzyme activities. In fact, in a new study bald mice underwent certain enzyme blocking treatments and they started showing new hair within 10 days.

Researchers at Columbia University Medical Center spent time last year searching for new treatments for alopecia areata. The research team studied how well certain drugs inhibit a family of enzymes that is in hair follicles. The enzymes are known as Janus Kinase (JAK). Their research showed the drugs actually turned off a signal that started autoimmune attacks. The drugs also showed potential to restore the growth of hair when given orally to some subjects as well as when it was applied to the skin. These findings indicate that the JAK drugs seemed to be preventing the autoimmune attack as well as having a direct interaction with the hair follicles.

Simply put, the research team established that the JAK inhibitors help to bring the hair follicles out of their resting state. (They normally put the follicles into a resting phase.) The act of suppressing its normal activity allows the drugs to help any hair in the sleeping state return to the active cycle. In the research on the bald mice, the JAK drugs were applied to their skin for five days and then they started to grow new hair within ten days. The mice regrew almost all of their hair within three weeks while another group of mice left untreated remained bald.

In the past, there have been some similar mice studies trying to manipulate the growth cycle.  I have done some studies on mice hair growth after electroporation (a technique used in gene therapy) in mice model at Johns Hopkins Medical Institute. However, most of these studies are limited by their focus on hair cycles and not changing the course of miniaturized hairs that are going through the process of baldness. This innovation would be great for human body hair that has a longer resting phase and shorter growth phase. If they apply it on human body hair, a person can potentially have more body hair. I am not sure if anyone wants this though.  When it comes to human scalp hair, they behave differently than mouse hair since they already have a very long growth phase. Plus, more than 95% of scalp hair is in a growth phase at any one time.  Keeping them longer in growth phase may help a person grow scalp hair longer but, if they have follicles that are falling because of male patterned baldness, they shouldn’t be affected as much.

Is There Solid Evidence to Support PRP?

Platelet-rich plasma, or PRP, has been on the radar of hair regrowth advocates for a few years. There are many proponents of the treatment but their enthusiasm is tempered by a lack of solid evidence to support the treatment as we previously discussed on our website. However, there is a newly published study that shows favorable results pointing to a promising future for the use of PRP.

The study highlights the results of a randomized placebo-controlled study that compared hair regrowth with PRP versus a placebo group. PRP was prepared for use from a small volume of blood. It was then injected on half of the patients’ scalps in the study while the other half was simply treated with a placebo. The described treatments were administered a total of three times in 30-day intervals.

The endpoints of the study were defined by hair regrowth, hair dystrophy, any itching or burning feelings and cell proliferation. A total of 23 patients were enrolled although 3 were excluded at some point in the study. At the end of the 3 total treatment cycles, clinical improvement was seen in the mean number of hairs as well as an increase in the total hair density. It’s also worth noting that no side effects were detected or recorded during the study period. Any relapse of androgenic alopecia was not studied in any of the patients until 12 months after their last treatment. According to the authors of the article, only 4 of the patients reported any continued hair loss after the 12 month period. They were then re-treated.

More information about the study group, study parameters and more total data from the study can be found here.

What exactly does this mean for the use of PRP as a treatment for hair loss? While the data does show positive effects in combating hair loss, the fact that there were only a small sample size of participants in the study means that the study group and its results might not be large enough to draw an accurate conclusion when it comes to utilizing PRP as a hair loss treatment. Also, as of now, there are no studies that have looked into the long term potential side effects of PRP scalp injections. More studies are necessary with a larger number of participants to accurately determine the validity of PRP as a hair loss treatment.

What’s So Funny about Going Bald?

In an extreme case of the pot calling the kettle black, comedian Larry David has stated that professional golfer Jordan Spieth is going to be “wildly bald”. Spieth is 22 years old and has already won two major tournaments this year (the Masters and the U.S. Open). David is the co-creator of “Seinfeld” and the creator and star of “Curb Your Enthusiasm”.  The two men have a few things in common.

larry david going baldSpieth is a professional golfer. David is not only an avid golfer but he is also a big fan of professional golf. Spieth has a rapidly receding hairline. David has already lost a good portion of his hair.

While David is a big fan of Spieth’s ability to handle himself on the golf course, he can’t wait to see how the young golf pro handles a different kind of pressure.  In the latest issue of Golf Digest, David says he is very interested in seeing how Spieth handles seeing all of his hair in the bathtub. David then makes a prediction that Jordan Spieth has only three or four years left before he is “wildly bald”.  How he reacts to the pressure of going bald is of great interest to Larry David. In fact, it sounds like Larry David can’t wait for the day Jordan Spieth loses all of his hair.

How did Spieth react to the comments of Larry David? The young golfer seems to have a good attitude and took it all in stride. In fact, he remarked that David’s comments were funny and there is nothing he can do about his impending hair loss.

We’d like to point out to Jordan Spieth that there is plenty he can do about his hair loss. He made $1.8 million dollars for winning the Masters and the same amount for winning the U.S. Open.  With that amount of money, Spieth can afford any hair transplant procedure he wants in the future.

Just remember Jordan…Your friends at Parsa Mohebi Hair Restoration are here for you.  Give us a call to set up your consultation appointment!

Do the Effects of Propecia Level Off After Three Years?

Q:

Good day Dr. Mohebi,

I hope everything is fine with you. I have a question about Propecia.  I have been taking it for few years now. I remember you mentioning in the past that Propecia effects level off after 3 years.

If this is the case, should I continue taking it ?

I look forward to your answer.

 

A:

It is good to hear from you.

The effects don’t level off but, it’s important to note, you won’t continue seeing the initial effects that had been noticeable due to the initial enlargement of some of the miniaturized hairs. You have been making DHT all along but at a lower level as time passes.

At this point, it is still slowing down your hair loss. If you stop taking it, you will see a more aggressive loss of your native hair that is prone to balding.

Does PRP Really Work for Hair Loss Treatment

Q:

Hi, Doctor.

PRP-for-Hair-Loss-TreatmentI had a quick question. Recently, I tried to grow my hair long and realized after my locks had reached the length that I like them at, my hair is noticeably thinning around my crown area. It’s been happening since I was about 18 years old, but none of my barbers had informed me that it was thinning, repeatedly telling me that it was just my cowlick, until now. I’d like to combat this hair loss, but it is my understanding that any medications you start becomes a lifelong commitment. Also, I am afraid the common side effects associated with Propecia, but I do want to know if it can help. I’ve also done some research on PRP, and it seems I would have to maintain the regimen throughout the year, how many times would I need treatment to maintain results?

 

A:

I would recommend that you seek an evaluation from a hair specialist or a hair surgeon. Make sure the initial evaluation specifically includes a microscopic evaluation, which will give you an indication of what your future pattern of hair loss may be. Only after this initial meeting and evaluation could it be determined what treatment options are best for you.

There are a few FDA medications and methods that have proven to slow down hair loss such as Propecia and Rogaine.  However, hair transplant is the only viable, permanent solution at this point to restore ones hair. PRP (Platelet Rich Plasma) and mesotherapy are among the treatments that do not have significant scientific data to support their claims of treating hair loss.