Boards Exam Oral Examination
Greetings,
I just returned from being an oral examiner for the American Board Of Hair Restoration Surgery board exam in Houston over the weekend. It was my first time participating as an examiner and it was extremely enjoyable. It was nice to gather and reconnect with my colleagues. It was also intellectually stimulating and great review to discuss and formulate new questions for future exams. I look forward to continuing my active participation in this valuable organization.
All the best,
Marc Dauer, M.D.
Rogaine and Propecia For Hair Loss
Greetings,
Today I will discuss the usage of Rogaine and Propecia for treating hair loss. Rogaine is an over the counter medication that comes in a liquid form and a foam form and comes in 2% and 5% strengths. For male patients I typically recommend Rogaine foam 5% twice a day after showering and before bed. Rogaine typically works only in the crown region and is best at slowing down the rate of hair loss and in some cases taking the miniaturized hair (hair that is on it’s way out for good) and turning it back into healthy hair. The exact mechanism of Rogaine is unknown, but it is thought to promote increased blood flow to the scalp by relaxing the small blood vessels that supply the blood flow to the scalp. Rogaine 5% is approved for men, and only the 2% formulation is approved for use in women. The 5% formulation may have better efficacy in women, but it can cause hair growth on the face that is reversible when discontinued.
Propecia is an oral medication that is taken once a day. It works by blocking the conversion of testosterone into DHT which can cause hair loss. The effect of taking the medication is that it can regrow hair in some instances and can also convert miniaturized hair that is on the verge of falling out forever into healthy hair, that is cosmetically significant. Propecia is not indicated for use in women.
There have been many claims about Propecia recently, and various side effects it may cause. I typically have all my patients that are considering Propecia read a detailed explanation of all the benefits and possible side effects prior to beginning to take the propecia. I have seen excellent results with patients using propecia, and in my experience younger patients tend to respond the best to this medication.
There is also anecdotal evidence that propecia and rogaine together produce a more significant effect than either medication independent of the other. The exact cause is unknown, but there seems to be some sort of synergy between the two medications.
In summary, it is always important to examine each patient and presc
Causes Of Hair Loss in Women
Greetings,
On the heels of my appearance on “The Doctors” TV show discussing Hair Transplants for female patients, I have decided to write about different causes of hair loss in women. Common causes of hair loss in women can be traction alopecia, which results from constant pulling on the hair as in braiding or tight pony tails. Alopecia Areata, which is an autoimmune disease which results in smooth round patches of hair loss. Medications such as blood thinners, seizure medication, anti inflammatory medications, Beta blockers, prednisone, mood altering drugs, chemotherapy, oral contraceptives, thyroid medications, and illicit drugs such as cocaine, can all be causes of hair loss. Anemia, which is a low blood count can also cause hair loss. Other causes include thyroid disease, connective tissue diseases such as lupus, crash diets, stress, and post general anesthesia. Major events where big hormonal changes occur, such as childbirth and menopause, can also cause hair loss in females. Scars caused by trauma or other surgical procedures can also cause hair loss in those areas. Probably the most common cause of female hair loss is a genetic form of hair loss that is an inherited trait that can come from either the mother or father’s side of the family. This typically manifests as diffuse thinning in the scalp. Often the hairline can be preserved in these cases. Some of these causes of hair loss may be treated with medications or a hair transplant procedure but it is important to have a thorough medical work up and examination to determine the exact cause, and then we can determine the treatment.
All the best,
Marc Dauer, MD
Dr. Dauer Discussing Female Hair Loss on The Doctors TV Show
Greetings,
Here is a clip of me discussing Female Hair Loss and different reasons why women seek out Hair Restoration procedures.
All the best,
Marc Dauer, MD
Hairline Design In Hair Transplantation
Greetings,
The hairline design is probably the most important facet of Hair Transplantation. It has the power to make a Hair Transplant look completely natural or completely unnatural. It is crucial that the transplanted hairs are oriented in the proper angle and orientation. You should not be able to tell the difference between the transplanted hair and any native hair that is present in the area. In addition, the hairline should be placed in a location that takes into account future hair loss and the patients eventual donor reserve. This means that in younger patients with more extensive hair loss, it is imperative to not place the hairline too low, as you could create the problem of running out of donor hair in the future. Every millimeter that you lower the hairline requires an exponentially large number of hairs to fill in behind it. I always tell my patients we can lower the hairline in the future if the continuing hair loss allows for more aggressive hairline advancement, but once the hairline is too low, it becomes a big problem that can be fixed, but requires a fair amount of intervention to do so. It is better not to create the problem in the first place. Also, keen attention must be paid to the patients facial symmetry, hair color to skin contrast, and hair type (curly hair versus straight hair). The new hairline must be created in an irregular pattern so that there are no straight lines at any point in the hairline. With all of these factors taken into consideration, combined with the artistry of the Hair Restoration Surgeon, a completely natural hairline may be achieved.
All the best,
Marc Dauer, MD
New Hair Transplant Video Patient Testimonial
Greetings,
Here is a new patient testimonial discussing his experience before, during, and after his hair transplant procedure. It is very informative for anyone considering the procedure.
All the best,
Marc Dauer, M.D.
New Hair Transplant Patient Testimonial
Greetings,
Here is a brand new video patient testimonial of one of my patients. His story is touching and personal, and his results dramatic. This is after a single procedure so the hairline is very conservative, but in additional procedures we may lower the hairline slightly. I prefer to be conservative in the placement of the hairline on the first procedure, giving the patient a higher density of hair, as opposed to a lower hairline and lower density of hair. My patients are very happy with this plan and the results it affords them.
All the best,
Marc Dauer, M.D.
Norwood 3V Question From A Patient
Here is a question I received from a prospective patient and my answer.
Question: My wife keeps telling me that I need a hair transplant so here I am doing some research. Here’s my situation, I am 31 years old and seem to be a 3V on that baldness scale. One of my friends is taking propecia a says it’s great stuff, but I am afraid of the side effects that I keep reading about. Is it even worth having a hair transplant if I don’t take Propecia to stop the rest of my hair from falling out? I’ve also read that once I start this process I might have to go through several surgeries and if I don’t take Propecia I can still look bald in time. Please advise. Thank you.
Answer:
This is an excellent question. Firstly, there have been reports of sexual side effects with Propecia, but the vast majority of people taking Propecia report no adverse side effects and the benefits of taking Propecia, especially in younger patients, are significant. In my practice, I have all patients read and sign a detailed Propecia consent form that discusses in depth the benefits of Propecia as well as all the possible side effects and any associated risks. I let the patients know if they start to feel any of the adverse side effects to discontinue the medication. In addition, to patients who are thinning in the crown region, which it sounds like you are, I also recommend Rogaine 5% foam twice a day. Studies have shown that patients who use Rogaine and Propecia together experience a synergy between the 2 medications which show more positive results than either medication taken independent of the other. I routinely perform a video microscopy on the scalp with my patients and if I see a large amount of miniaturization of follicles I may also recommend low light laser therapy. I have become a fan of the new LaserCap which, with it’s ease of use, provides excellent compliance among patients. I have seen great results with it low light laser therapy in patients who have a large amount of miniaturization. Finally, in order for me to determine if you are a candidate for Hair Transplant surgery I would need to see you in consultation or look at your photos, but if you are a 3V it sounds like you likely could be a candidate. I always tell my patients that you will definitely have between 2-4 procedures in your lifetime to keep up with continuing hair loss. The number of procedures is affected by the rate of your future hair loss, which Propecia, Rogaine, and Laser Therapy can markedly slow down. I hope this answers your questions.
All the best,
Marc Dauer, M.D.
Hypothermasol- New Storage Media For Hair Transplant Grafts
Greetings,
I have just begun using Hypothermasol which is a new storage media for storing hair grafts while they are out of the body and awaiting transplant. In the past we have had excellent results storing the hair grafts in saline or lactated ringers solution, but recent studies have shown that there can be an increased growth yield of the transplanted hair grafts by storing them in hypothermasol. Hypothermasol has been used for a number of years to store organs awaiting transplantation. It is thought to keep the cellular mechanisms more stable while the organ is out of the body, thus decreasing any cellular degradation. Applying the same concept to hair transplants, some new studies have shown that this storage media can lead to possibly better growth rates. Even though the hypothermasol is much more expensive than the traditional storage solutions, in my quest for the best hair transplant results that can be achieved, I have decided to incorporate this into my storage process of the hair grafts. I will check in with an update on this topic in 6-9 months with the results that I am seeing in clinical use.
All the best,
Marc Dauer, MD
An Exciting New Device To Measure Hair Mass- The HairCheck
Greetings,
I have just added an exciting new device to my hair restoration practice called the “HairCheck”. This revolutionary device allows us to measure hair thinning and breakage in quantitative terms. Usually once hair thinning is noted you have already lost 50% of the original density of hair that existed in that area. HairCheck allows us to measure the “hair mass” in any region of the scalp and gives us a numerical value. HairCheck also allows us to measure damaged or broken hair. For the first time, we now have a tool to give us a quantitative analysis of the exact amount of hair mass present in any given area of the scalp. We can take measurements before beginning non surgical hair restoration treatments (low light laser therapy, propecia, rogaine, PRP), or prior to hair transplant surgery, and compare the measurements after a period of time to see how well the treatments have worked. We can also take measurements in the donor region (this is the area of the scalp that is not supposed to be affected by hair loss in most individuals) and compare these measurements to the affected areas of the scalp to determine exactly how much hair density has been lost. Photographs will always be very important, but the ability to quantify the exact amount of hair in any given region of the scalp is incredibly valuable. Please don’t hesitate to inquire about the HairCheck when you come to see me for a consultation. For more information about HairCheck visit www.HairCheck.com.
All the best,
Marc Dauer, M.D.
