The Natural Health Blog

Nobody considers undergoing surgical hair restoration only to experience more hair loss. However, “shock loss” is a real risk when transplanting hair in between and around existing natural hair. Thankfully in most cases, shock loss is temporary and may only be permanent to hairs on their way out anyway or if your surgeon transects (cuts through) the hair follicles killing them.

Thanks to leading hair transplant surgeons in the field, new ultra refined tools allows a surgeon to place grafts into tiny incisions, minimizing trauma to the scalp and minimizing the risk of shock loss. Permanent shock loss due to transection is also next to impossible using these newly refined techniques.

In this hair loss discussion, real patients share their experiences with shock loss, when you are likely to experience it, and how long it lasts. You are encouraged to share your own personal experience and how shock loss may or may not have impacted you.

Bill - aka Falceros
Associate Publisher/Editor

This insightful information was posted on our hair restoration forum by Dr. Timothy Carman of La Jolla, CA, who is recommended on the Hair Transplant Network.

I have been doing some reading about a topical hair loss treatment called Fluridil that may help block DHT and stop hair loss.  What can you tell me about this drug?

Without going into too great a detail, topical Fluridil preparation acts topically to inhibit the effects of DHT on the hair follicle. Current studies show that, similar to finasteride, there is an increase in the total percentage of hair in the active (anagen) verses resting (catagen) stage (from 76% to 87% at nine months).  I happen to personally know the clinical investigators (Dr. M Sovak, UCSD) and the clinical research facility (UCSD). Their results are clinically significant, and their research work and ethics are highly respected in the scientific research community.

At this time however, Fluridil is not licensed for use in the US. 

The main advantages Fluridil boasts of what is referred to as a “hydrophobic” compound; that is, fat soluble. In addition, it is deactivated when coming in contact with water (a “hydrophilic” environment). This last fact makes so that if it is absorbed into the bloodstream from the scalp, it is deactivated as soon as it hits the blood (an aqueous or “hydrophilic” environment). Hence, since it doesn’t enter the circulation, there reportedly are none of the (normally low incidence anyway, 5%) sexual side effects.

Dr. Timothy Carman

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Bill - aka Falceros
Associate Publisher/Editor

This hair loss question was answered by Dr. Robert True of New York, NY who is a member of the Coalition of Independent Hair Restoration Physicians.  His professional answer is below.

When can I get a hair cut after hair restoration surgery?

It’s important to wait at least 5 to 7 days after your hair transplant suture removal to get a haircut. It is best to keep the hair at the level of the donor incision 1/2 inch or longer with your first 3- 4 haircuts.

It takes 8 to 12 months after the procedure for the donor incision to reach its final stage of healing and for all the hair to grow back around the incision. For some skin types it is common for the incision line to be pink for several weeks to a few months before fading to normal skin color.  For some hair transplant patients, there may be temporary hair loss and shedding adjacent to the donor incision. It takes 6 to 12 month for full hair regrowth and recovery of these shed hairs. 

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Bill - aka Falceros
Associate Publisher/Editor

The internet is rich with hair loss information almost to a fault. How will you handle the contradictory information on what causes hair loss and available and effective treatments?

Thankfully, our hair loss community is designed for balding men and women to review, critique, and challenge marketing hype and learn the most effective ways to restore your hair.

Below we’ve listed answers to some of the “hot topic” hair loss related questions asked this week through our forum, blogs, and email. Follow the links below to a topic that you find interesting and read what our Associate Publisher and Physician experts have to say about each topic.

How to Stop Hair Loss without Surgery: Men and women with minimal hair loss may be more interested in stopping its progression than restoring hair through surgery. Read this blog to learn how to stop baldness with legitimate treatments.

HairMax LaserComb Makers Warned by the FDA about Illegal Sales of Non-FDA Cleared Devices: Great controversy centers around whether or not laser therapy is an effective hair loss treatment, especially after the recent FDA clearance. Read this blog to learn why HairMax was warned by the FDA about selling Non-FDA Cleared devices and what this means for HairMax LaserComb consumers.

Can I Take Propecia Every Other Day with the Same Effectiveness? Read Dr. Jerry Cooley’s thoughts on the most effective dosage of finasteride (the active ingredient in Propecia)

I’ve noticed that some hair transplant surgeons use .7mm custom blades while others use .9mm to 1mm custom blades. Is it logical to follow the intuition of “the smaller the better”?

A doctor’s skill always reigns paramount when discussing something like this, or loupes verses microscopes. But assuming the hair restoration physicians are of equal ability, is there any reason why smaller blades/incisions are not optimal? Are there actual attributes for using the larger blades I referenced, other than that it’s easier for a doctor?

This hair loss question was answered on our hair restoration forum by Dr. Paul Shapiro of Bloomington, MN who is a member of the Coalition of Independent Hair Restoration Physicians.  His professional answer is below.

The answer to your question is that sometimes smaller blades are more optimal, and sometimes not. It depends on many factors. What is more important then the size of the blade is how the follicular unit (FU) fits in the incision. The graft should fit snugly, but not too tight to cause compression. Also, the incision size should be such that the follicular unit grafts can be planted into the skin with as little trauma as possible. The texture and thickness of ones skin and the size of the graft determine what size blade should be used to make the incisions. Some patients have tough, non-forgiving skin that does not have much stretch to it.  In these hair transplant patients I would usually cut my blades a bit larger. Some patients have follicular units which splay at the bottom. I find they get squashed a bit if the incision size is too small and I have to use larger incisions for this type of follicular unit. A person who has thin blond hair will have much smaller follicular units then a person who has thick, black hair. Persons with very curly or kinky hair will have a curve to the follicular unit and will need larger incisions. Also, a FU with 4 hairs will be larger then a one hair FU and will need a larger incision to fit properly.

At Shapiro Medical Group we cut our blades and they usually range in size .6mm to 1.2 mm. On average we use a .7 or .8 mm blade when we are making incisions for the one hair FU in the hairline. For the 2 hair FU we usually use .8 to 1.0 cm. For 3 and 4 hair FU we usually use .9 to 1.2cm blades.

What I do is estimate what size blade I will need for a 1,2,3, and 4 hair FU. Then I make about 10 incisions and place some follicular units into the incision.  Sometimes the fit is perfect.  Sometimes I need to increase or decrease the width of my blade.

The smaller blades are great. We can make incisions closer together when we want to do hair transplant dense packing. In patients with existing hair in the area of the transplant, the smaller the blade the easier it is to get between the existing hairs. Also, the smaller the blade, the less trauma there is with each incision. But also the smaller the blade, the more chance it will be difficult to place the follicular unit without any trauma.

So as you can see, one size does not fit all.

I hope this answers your question.

Paul Shapiro, MD

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Bill - aka Falceros
Associate Publisher/Editor