Sunday, February 21, 2010

Can I use the wig for some time after transplant? I will quit once the hair grows.

You may use hair piece after 15 days of transplant with some care when the wound have healed and then remove it once the transplanted hair grows. You must know that transplant will never give you as much density as the hair piece or wig can give and there for it is better that you get the hair piece trimmed to lighter density serially before you finally quit it . But still better method s shave the head completely during the transplant and maintained like that for 4-6 months and after that and let the transplants grow with other hair thereafter.

I read about the side effects ; should I stop Medications?

Every thing you read on internet may not be written in the right perspective. Minoxidiil may be very rarely a possible cause of hepatic ( liver) damage but when it is consumed orally and not when you apply it on the scalp. Same way Finasteride side effect is mainly reduced sexual libido ( a psychological manifestation) and not really impotency or sterility ( organic manifestations) more over this is very well studied to be experienced by only 1% of those who use it and majority of the time that is experienced in initial few weeks. Most important and interesting is the sexual symptoms are reversible on stopping the medication and it has been seen that many of those who have continued in spite of the experience of initial sexual symptoms had observed that the said side effect disappeared. By not taking this you lose a chance of falling in to 99% of those who do not have such side effect and have benefit of medication. for more ref to:

http://goodbyehairloss.blogspot.com/2010/01/medications-used-for-hair-loss.html

http://goodbyehairloss.blogspot.com/2010/01/hair-loss-medication-minoxidil.html

http://goodbyehairloss.blogspot.com/2010/01/hair-loss-and-medications-finasteride.html If you have been using this medications for long time and you already had benefit if improving your the thickness and length of your miniaturized hairs you may start rapidly losing those hairs which are supported by the medications if you suddenly stop the medications. Minoxidil is better used as 5% instead of 2% for more efficiency and use twice instead of oncee a day. In my experience Instead of plain Minoxidil as you have been using; use the combination with Reti-A which is more effective and have to be used once a day. check: http://goodbyehairloss.blogspot.com/2010/01/minoxidil-with-retin-or-minoxidil.html Finasteride is better than Minoxidil in effect when used alone but since both medications have different mechanism of action there is more benefit when used in combination.

Saturday, February 13, 2010

Transplant of Hair from others or animal : is it possible?



Each follicular unit of hair has blood vessels, glands, nerves, skin, and fat. It takes all this plus a growth center and the right genes and nutrition to make hair grow. Since by definition hair is an organ, transplanting the hair from someone else is like transplanting a heart, kidney, lung, etc.
One may tend to think that a person (a Family, friend or well wisher) with same blood group if willing to donate hair to another person should be an easy solution for people with hair loss but it is not that easy a solution!
Generally hair transplantation from one person to another (called Allogenic or Homologous Transplant) who could be living person or a dead person (Cadaveric Transplant) carries the similar risks as organ (liver, heart, kidney) transplants.
Transplant from the animal fur to human head is called Heterogenous or Xeno Transplant. There is a
1. Risk of rejection and failure
2. Wastes money and effort of surgery
3. Lifelong use of anti-rejection medication that could lead to further health complications
4. Transmission of some diseases.
5.It involves surgery on the donor as well
6. There are medico legal aspects to it besides ethical issues: such as possibility of people selling their hair for money in future.
Such experiment has been done before without success (http://www.hairsite.com/hair-loss-articles/article308-person-to-person-hair-transplant.htm)
Hair from a newborn baby or identical twins (they have same Genetic Blue print) might be immune privileged (it seems to work for a heart transplant), but again, who would endorse such a donor? Incidence of transplant from one identical twin to another has worked in the past but the problem is that when one twin has balding, so does the other.
There are some research indicating that Anagen Bulb part of Human hair follicle is Immune Privileged (i.e. protected from Host Rejection)
http://www.nature.com/jidsp/journal/v8/n2/full/5640115a.html ). More research may open a new vista in this field in future.
Rosati et al. reported the case that the bone marrow transplant patients could undergo an allotransplant of hair from the same bone marrow donor. Jahoda et al. (http://www.nature.com/nature/journal/v402/n6757/full/402033a0.html)

Wednesday, February 10, 2010

Where is our Location?


Our address: Dr. Bishan Mahadevia Dr. Mahadevia's Hair Transplant Clinic 3/A New Bhramakshatriya Society Nr. Pritamnagar Akhada Pritamnagar, Paldi Ahmedabad- 380006 Gujarat, India We are 14 Km or 45 to 60 minutes drive from Ahmedabad International Airport ( Known Sardar Vallabhbhai Airport) We are 12 Km or 25 to 30 minutes drive from Ahmedabad Kalupur Railway station



How to reach us:        If you are coming to India for the first time you need to take the visa from Indian Embassy in your country. Ahmedabad has some direct international connections from, Dubai, Sharjah, Singapore, New York, London. You can otherwise get the connection from Bombay (Mumbai) or Delhi.
For International flights: http://www.expedia.com/, http://www.globester.com/ ,  http://www.ezeego1.co.in/
Tourist Information:
Teperature43 - 23º C in summer and 36 - 15 ºC in winter
Average Rainfall 93.2 cm
Official Language Gujarati
Languages spoken Gujarati, Hindi, English
Visa:     check at              http://www.visatoindia.com/
Where to stay:                      
Hotels at walking distance: (N.B. Pick up and drop, on prior request can be arranged)

1. Hotel Chicago: Nr. V S Hospital, Ellis bridge Ashram Road, Ph: 079- 26578126, 26577225
Fax : 079- 26577226 http://www.hotelchicago.in (Rooms around 1500 -2500 per day)
email: chicago@icenet.net ( Sp. Note: This is closest to our clinic, reasonably priced, clean, comfortable, give good services, accepts credit cards, provide airport pick up and drop services.)

2. Hotel Maruti : Next to Hotel Chicago mentioned above (Rooms around 700- 1500 per day)
Ph: 079-26589871 Website: www.hotelmaruti.com

3. Hotel Apex: Phone: 079 26578101, 26579660 . (Room around 500 - 1000 per day). Sahjanand Trade Centre, Opp. Kothwala Flats, Ashram Road, Paldi.

4. Inder Residency: Opp. Gujarat College Ellisebridge, Tel: 079- 26560407
email: inder-residency@egujarat.net or inderad1@sancharnet.in web: www.inder-residency.com ( Higher price and facilities,)
5. Hotel Royal Plaza:
Hare Krishna Complex, Opp. Kothawala Flat, Pritamnagar, Ellisebridge, Ahmedababd-380006 Ph: 26576708, 26578235. Room rates from Rs. 600 to 1500
6. Hotel Dev Residensy:
7. Fortune Land Mark:  (about 4 Km from the clinic and rates and luxury facilities) http://www.fortunelandmark.com/  Address: Usmanpura Cross Roads,
Ashram Road, Ahmedabad - 380 013, INDIA. Phone+91 (79) 3988 4444 Fax +91 (79) 3001 4445 Email info@fortunelandmark.com
8. Taj Residency Ummed ( 5 star hotel near Air port ) http://www.tajhotels.com/Business/Taj%20Residency%20Ummed,AHMEDABAD/default.htm. Address Taj Residency Ummed
International Airport Circle, Hansol, Ahmedabad - 382 475,
Gujarat, India.
Phone:(91-79) 6666 1234 / 2286 9999
Fax:(91-79) 6666 4444
Email: residency.ahmedabad@tajhotels.com

 

Galeatomy what is it?

SCALP has 5 layers (S: Skin C: Cutaneous Tissue A: Apponurosis (Galea) L: Loose Areolar Tissue P: Pericranium) According to one theory it was believed that 3rd Layer Galea or Apponurosis which is a a tough sheet like layer under the skin tightens over the blood vessels passing through it to the skin and does not allow enough blood to pass through it to the skin. This leads to hair loss. Well this theory is never been proven. Galeatomy as a procedure is there for many years now and not new; is deviced with the hope that by cutting this constricting layer blood vessels will carry more blood to the skin and will therefore control the hair loss. This theory was never been proven and those who have performed this surgery in the past have never substantiated this belief. This procedure which I have no personal experience of has never been supported by even international association like ISHRS where hair loss specialists from around the world are active. It is also important to note that most of the scalp blood supply come from front and back of the head and not from the underneath the Galea and those vessels above the Galea and they do not have to cross the Galea. There are few surgeons in Belgium who rpomote this but have perhaps never presented their results in ISHRS.

Sunday, February 7, 2010

Does FUE have less hair in the same number of grafts than that by strip method?

well there is view like that because in FUE some of the grafts (about 8-10%) can have partial extraction of the grafts due to the nature of the procedure this may extract less number of hairs. As against the in FUE we have a freedom of choosing follicles with 3-4 hairs unlike the strip method therefore total number of hairs extrcted at time may be same or even more than the same number of grafts by strip method as in strip we do not have any choice but to harvest whatever is available in the strip area.

Tuesday, January 26, 2010

Flakiness due to Minoxidil liquid- Is Foam better?

Propylene Glycol is often the cause for this dryness, irritation, itchiness and flakiness. Daily thorough shampoo wash and application of say Johnson’s baby oil at nighttime on alternate days on the scalp is usually beneficial. Conditioner for the dry scalp or hair can be used. Foam based preparation has no PG (Propylene Glycol) For more details check: here

Monday, January 25, 2010

Hair Transplant in Young age

The hair loss started in young age is usually due to strong genes and at times is very rapid and if you go for early hair transplant you may lose more of non transplanted hair in near future and that can make you unhappy very soon. We cannot predict your future hair loss and its extent and time. If you begin surgery when you are young, you may find your hair loss exceeds your donor capacity. Since the hair loss is recent the desire to look as it was just a few months ago is intense and it is prcticlly not possible with transplant because can not achieve the normal density.

Most medical treatments such as Minoxidil, Propecia, Avodart, etc. do not grow a significant amount of hair in most individuals. What they do often though, is slow or even stop hair loss. This is very important to you. You are buying time until we have a better solution and perhaps limiting the amount of hair restoration you will require over the course of you lifetime. This may ultimately save you money and preserve you coverage for a longer period of time. You may also slow your hair loss until such time that you become more comfortable with your degree of hair loss.

Well having said that it is equally true that having hair loss at young age also creates great mental stress because that is the age when everyone wants the best of the looks.

On the other hand if you have a good donor area and also the awareness about possible hair loss and reasonable expectation out of HT and can control the hair loss medically transplant can give you happiness although you do have possibility of hair loss and further transplant in near future. If you do consider surgery at a young age, I recommend FUE. This is the only true stand alone procedure. In other words, you can elect to shave your head down and still appear natural because you will not have a linear strip scar in your donor region. Hair Line placed in a conservative fashion in a younger male.

Sunday, January 24, 2010

Minoxidill Liquid application

As for the Minoxidil with Retin-A 1ml is the dose.The best time is in the morning after bath on dry scalp. so that the effect lasts for 24 hours till the next hair wash. Do not apply on hair from the top but use it on the skin. Look skywards and allow drops to fall on the hair line area in the front the liquid will roll over to the back on the skin till the crown rather than hair. That way your hairs may not remain sticky. One of my patients taught me this.

Sunday, January 17, 2010

Medications used for Hair Loss

There are host of medications used for hair loss only Finasteride and Minoxidil are FDA approved for Hair Loss prevention: some of them are Minoxidil Group (eg Avacor, Procede, Folliguard, Hair Advantage, T-Flavanone, Scalp Med; The Herbal/Biologics group (eg Saw Palmetto, Hair Genesis, Soy, Nuhair, FNS, Procerin, Folligro, Emu Oil; The Vitamin/Mineral group (eg Folligen, Hair Vitamins, L-Lysine, Hair Zx, Triaxin, copper peptides; Home Made Group (eg Oz-Brew); Miscellaneous (eg dutasteride, Nioxin, Kevis, Revivogen, Spironolactone, Procyanide, Nizoral, Fluridil) many aurvedic, Chinese and other traditional medcations area alos promoted but it may not be safe to use the ones that are not well studied.

Saturday, January 16, 2010

Hair Loss and Laser Therapy/ cold Laser/ LLLT

Laser Therapy

Low-Level Laser Therapy (LLLT) or Cold Laser in hair restoration utilizes cool lasers to stimulate hair growth and reduce shedding of hair. LLLT is based on the scientific principle of photo-biotherapy. Photo-biotherapy occurs when laser light is absorbed by cells and stimulates cell metabolism and protein synthesis. Although the exact mechanism by which laser light promotes hair growth is still unknown, it appears to stimulate the follicles on the scalp by increasing energy production and by reversing miniaturization (the process leading to thicker hair shafts and a fuller look).

Laser light is in the visible red light spectrum and is generated in a laser diode. The energy level is far below that of laser beams that cut or burn tissue. The low-level red laser light has a very low absorption rate in human tissue making it safe for use in the treatment of hair loss. The Revage laser emits 670nm of visible red light.

Low energy lasers have been used for over thirty years to accelerate healing after wounds or burns and to reduce pain. In 1992, Pontinen published the first paper discussing its possible use in promoting hair growth. Since then there has been much progress is defining the exact parameters necessary to accomplish this, In 2007, the FDA cleared for marketing the use of low-level lasers for the treatment of androgenetic hair loss in men. This clearance was based on the device’s safety, and not on its effectiveness in treating hair loss.

The HairMax LaserComb, cleared by the FDA as a Class II medical device in January 2007, is a compact version of the larger laser therapy units used by hair clinics in other countries to stimulate hair to increase in thickness and make the hair appear fuller. This home product has teeth that part the hair to potentially enable the laser light to reach the scalp in areas of existing hair.

The Revage Laser System, from Apira Science, utilizes Rotational PhotoTherapy (RPT). The Revage 670 is a Class IIIA diode laser approved by the FDA for cosmetic use. It is a low-level laser system that contains 30 laser diodes that rotate 180 degrees around the scalp. This dynamic process increases the contact of the laser energy with the hair follicles and is potentially more effective than a static system in delivering the laser energy to the scalp. It also eliminates human error and variability in self administration. A potential limitation is the fact that existing hair may interfere with the laser beam effectively reaching the scalp.

The unit may prove to be useful for hair loss in women where the thinning tends to be diffuse or those experiencing telogen effluvium. LLLT can be used safely in conjunction with other medications including Propecia and Rogaine and there are no contraindications which would interfere with hair transplant surgery.

While these cool laser treatments have been approved for use, their long-term effectiveness has yet to be determined. A 12 month program can require treatments from 3x per week tapering to one treatment per month and the results and satisfaction from patients thus far have been sporadic.

How Effective is Hair Loss Treatment with Laser Comb?

It is difficult to tell since there are no long-term studies using the LaserComb.From the data we have available, it seems to be about as effective as Rogaine (Minoxidil). As most who have used Minoxidil know, it only works in areas where there is a fair amount of miniaturized hair and over time loses its effectiveness. The HairMax LaserComb is not as effective as Finasteride and, of course, is not a substitute for surgical hair restoration.

Which Laser Comb Works Best ?

I have been trying to find some evaluation of which laser combs work best for “hair restoration”. I have seen some dermatologists speak about the Hair Max laser comb and its effectiveness (considering patient compliance, the amount of time the patient has been losing hair, the amount of total hair loss at time of treatment, etc.). I have also seen reference to the Sunetic laser comb which claims to have a superior technology to the Hair Max and offers a changeable head to allow treatment of the skin for healing, wrinkles, etc. A company in Michigan also offers a laser comb called the Hair Rejuvenator which it claims is superior to either of the other combs but I have not heard of any dermatologist who recommends this comb. A firm in Australia also offers a laser comb (Aculas) which it claims is the most effective; however, the makers of the Hair Rejuvenator comb say it is too powerful and dangerous and could cause blindness. Amidst all these claims, the consumer (patient) is left wondering which best option is and which is merely hype or fraud.

There are no comparative studies thus far. For a hand-held device, I would stick with the Laser comb for now since it is the only one that has cleared the FDA.Some others may work as well (and are less expensive) but we just don’t know at this time – and how useful any of them are long-term is also still not known.

How is Rogaine for Women vs Rogaine for Men

How is Rogaine for Women Different from Rogaine for Men?

Rogaine for men is 5% minoxidil and Rogaine for women is 2%. Another difference is that the 5% solution has propylene glycol in it whereas the 2% is alcohol based. The propylene glycol helps the minoxidil penetrate the skin better and makes the medication more effective. Although both the alcohol and propylene glycol based preparations can irritate the scalp, propylene glycol can cause actual allergic reactions in those who are sensitive.

Propylene glycol is greasier to have on the scalp than the alcohol based formulation. For patients who complain of the greasiness, we advise Minoxidil 5% at bedtime and 2% in the AM.

A side effect of minoxidil specific to women is increased facial hair and this is seen predominately with the 5% propylene based formulation. Women are also more likely to experience lightheadedness or dizziness from the medication.

Minoxidil with Retin-A or Minoxidil Without Retin-A?

Which Hair Loss Treatment is Better: Minoxidil with Retin-A or Minoxidil Without Retin-A?

Minoxidil has been prescribed (off-label) in combination with other medications, such as topical retinoic acid (Retin-A), to enhance its penetration into the skin and thus increase its effectiveness. This combination of medications, however, can significantly increase the absorption of minoxidil into the bloodstream and may increase the risk of potential side effects, including changes in blood pressure and severe scalp irritation that has, on occasion, led to scarring.

If person wants to add Retin-A to the minoxidil regime, the Retin-A should be applied only once a day, since the Retin-A will bind to the skin and will last for at least 24 hours.

Applying Retin-A more frequently will not increase its effectiveness (in facilitating the absorption of minoxidil); it will only increase the incidence of side effects. Retin-A can be applied to the scalp at the same time as Minoxidil, or by itself.

Retin-A should not be compounded with minoxidil (mixed together by your pharmacist or your doctor) for the following reasons:

  1. Minoxidil works best when used twice a day. Retin-A is best used once a day.
  2. Using Retin-A twice a day wastes money and increases the incidence of side effects
  3. If you develop side effects from the Retin-A, it is best to stop only the Retin-A. If they are compounded, you would need to stop both and will lose the benefit of minoxidil.