David Josephitis, DO

Often hair loss meds are taken by patients to try to regrow their hair.  Many times patients are thus disappointed because after a year they may look about the same as they did when they started the meds.  Usually we consul patients to take meds as preventative treatment.  In my mind, the goal of meds is to slow down or stop future loss.  That is the main goal.  Sure, there is a certain percentage of people who will also have some small regrowth, but that is not the rule for all. 

Hair transplant surgery is what is necessary usually to improve the situation where hair loss has occurred.  That is why it is often important to do both together.

In your case from the photos sent, you have some miniaturized hair in the vertex.  Often minoxidil and or PRP can help stabilize and sometimes improve this area.  The miniaturized hairs can possibly slightly improve.  No improvement will take place wihere the hairs are completely gone though.

It is worth a trial of one or both of the treatments you mentioned.  Remember, that hair regrowth or improvement takes time.  I usually recommend trying the med for at least a year before making a decision about whether it was effective or not.

This is a common question that patients ask after surgery.  Patients are rightly concerned about damaging the newly planted hairs and the sight of hairs falling off their head is a big concern.  The fact of the matter is that hair and scabs that fall after the first week are perfectly normal.  After day 5, the follicle itself is actually quite difficult to remove by pulling.  As physicians, we are overly concerned about the grafts so we ask patients to be extra careful the first week with the hair washing.  Still, after day 5-7 the grafts are held in very well.

All the hair that falls after that time is either a fragment of the hair follicle that was transplanted or a "shock loss" hair.  Remember these shocked hairs most likely will return in a number of months.  The scabs and hairs that fall are perfectly normal and a great majority of patients have this occur.

There is nothing that needs to be done.  Continue washing the hair as you have been doing.  Eventually, all the scabs and transplanted hairs will fall.  In 3-4 months you will notice the start of new hair growth.

At a month, you can get back to your normal routine.  There are really no limitation as to what you can do activity-wise.

I do counsel patient to listen to their bodies though.  When undergoing an activity weeks or months after a transplant, they may feel tightness or pain when doing certain activities.  I encourage patients to lay off of those activities if you body is telling that it is still tight.  One may technically be fit for all activity, but I like to be extra cautious when it comes to this.

Remember that post op shedding of the transplanted hair is perfectly normal and anticipated.  Most if not all of the transplanted hair will shed within the first month or two.  Many patients examine the hair as it falls and worry if the whole hair and follicle actual fell out.  This is rarely the case.  The window of losing transplants this way is really the first few days.  When this happens, there is also usually some associated bleeding.

The shape of the hair that is shed doesn't have any bearing on the outcome.

Grafts will grow back as expected even if you have seb. dermatitis.  It is appropriate to keep this disease under control though.  Severe Seb. dermatitis has been know to cause hair loss, and it may also slow down or decrease the yield of your transplants if it is not kept under control