If this sounds like you, this article is for you:

• You are consistent with treatment, but your hair loss or baldness still progresses.
• Minoxidil and/or finasteride helped at first, then results slowed or stopped.
• You have “dandruff” or scalp irritation that keeps coming back.
• A hair transplant result was disappointing, unpredictable, or did not last.

If you are doing “all the right things” for your androgenetic alopecia or pattern baldness, but results are stalling, read this.

Androgenetic alopecia (AGA), also known as male pattern baldness (MPB) or female pattern hair loss (FPHL), is common, visible, and emotionally heavy. Many patients do everything they are told: minoxidil, finasteride (or dutasteride), devices, shampoos, supplements, and still find that progress slows, stops, or becomes unpredictable.

When that happens, it is not always “bad luck,” and it is not always “you waited too long.”

The study titled “Perifollicular Inflammation and Fibrosis in Androgenetic Alopecia: Implications for Diagnosis and Treatment – A Comparative Histopathologic and Clinical Study with Normal-Appearing Scalp” was published in the peer-reviewed Clinical Cosmetic and Investigational Dermatology journal. There, we describe a specific histologic pattern that can live quietly under the surface and help explain why some AGA and pattern baldness patients stop responding as expected, progress faster, or respond unpredictably to both medical therapy and hair restoration surgery.

It is called PIILIF, short for Perifollicular Infundibulo-Isthmic Lymphocytic Infiltrates and Fibrosis.

Quick takeaways

• PIILIF is a low-grade, immune-type inflammatory and early fibrotic pattern found around the upper portion of hair follicles (infundibulo-isthmic region) that can coexist with AGA and pattern baldness.
• It can be easy to miss clinically and can be mislabeled as “seb derm” or “just dandruff.”
• It may help explain why finasteride or minoxidil alone may not be enough for some people over time.
• It supports a dual-pathway strategy: address the hormonal pathway and the immune-fibrotic pathway, not one or the other.
• This is exactly why I created the Inflammatory AGA Screen Program (PIILIF Track).
• Important classification insight: the paper proposes that what has been described as fibrosing alopecia of patterned distribution (FAPD) aligns with a later stage of AGA-PIILIF, and recommends staging AGA-PIILIF by the degree of perifollicular fibrosis to support earlier recognition and intervention.

The missing link for AGA medication non-responders

This section is for the patient who is not planning surgery (or not yet), but is frustrated because the standard plan is not delivering what it should.

If the scalp environment is immunologically active and early fibrosis is already present, “more of the same AGA routine” is not always the answer.

The answer is:

• better biology control
• better targeting
• better timing

Here is the practical point

If PIILIF is present, “DHT control only” can leave a second driver running.

Standard AGA treatment often focuses on androgen signaling and follicle cycling support (for example, finasteride and minoxidil). That can be appropriate, but in a subset of patients, there is an additional layer: a perifollicular inflammatory and early fibrotic process that may continue even when DHT is addressed.

That is why some patients report:

• good early improvement, then slow decline again
• a stable period, then sudden acceleration
• “I’m consistent, but the response does not match the effort”

What this changes in real life

For the non-responder, the best move is not to guess harder.

It is to confirm what is actually happening in the scalp environment, and then treat the relevant pathways when indicated.

That does not mean every patient needs a biopsy.

It means:

• for non-responders, ambiguous cases, or high-stakes decisions, it is worth considering early diagnostic confirmation, not late.

What is PIILIF, in plain language?

PIILIF describes a subclinical perifollicular inflammatory pattern that concentrates around the upper follicle and is associated with early perifollicular fibrosis.

Key idea: it can be present even when the scalp looks “quiet,” and it can be present even in areas that are not yet visibly thinning or bald.

This matters because once fibrosis progresses, it can reduce the predictability of regrowth and restoration. That is why early recognition is the whole game.

Seeing PIILIF makes the concept clearer.
The short video below illustrates how PIILIF can exist beneath visible pattern baldness and why scalp biology matters when treatments or hair transplants stop responding.

Where FAPD fits: why this paper matters beyond “routine AGA”

If you have heard the term FAPD (fibrosing alopecia of patterned distribution), you already know it sits at the crossroads of two worlds:

• pattern hair loss that looks like AGA or male pattern baldness, and
• fibrosing/scarring biology that behaves more like early scarring alopecia

The key contribution of the paper is that it proposes a unifying framework:

• FAPD may represent a later, more fibrosing stage within the AGA-PIILIF spectrum, rather than a completely separate diagnosis.
• The paper recommends staging AGA-PIILIF by the degree of perifollicular fibrosis, which supports earlier recognition and more informed management decisions.

For patients, the takeaway is not to panic about “scarring.”
The takeaway is precision: if inflammatory and fibrotic drivers are present, it changes what “optimal care” looks like and why durability sometimes requires more than growth stimulation alone.

Why PIILIF gets mislabeled as seb derm or “just dandruff”

Many people with PIILIF report flaking, scale, or irritation. So it is easy to default to seborrheic dermatitis (“seb derm”) or “dandruff.” Whatsmore, the trichoscopic features of PIILIF may show similar findings associated with seborrheic dermatitis

But in our cohort, true seborrheic dermatitis on biopsy was rare compared with PIILIF.

Even when anti-dandruff shampoos temporarily improve scale or redness, that does not necessarily address the deeper perifollicular inflammatory process.

If you are treating “seb derm” aggressively and hair outcomes are still slipping, it is time to consider whether the label is wrong.

Why this matters for hair transplant planning

If the scalp environment is immunologically active and early fibrosis is already present, “more grafts” is not the answer.

The answer is:

• better biology control
• better planning
• better timing

In higher-risk candidates, pre-transplant control of PIILIF and biopsy-informed planning are advisable.

That does not mean every patient needs a biopsy. It means that for non-responders and high-stakes surgical candidates, diagnostic confirmation should be considered early rather than late.

Who should consider PIILIF screening?

You should at least consider PIILIF screening if you relate to one or more of these:

• You are not responding as expected to a well-run AGA regimen (meds, topical plan, lifestyle, compliance is solid).
• You have been told you have “seb derm” for years, but hair continues to miniaturize.
• You have advanced AGA or you are a complex case (including prior surgery, donor depletion, body hair follicular unit excision (FUE) or beard hair FUE reliance).
• You are planning a transplant and you want to reduce the risk of disappointing yield, ongoing thinning, or unpredictable healing.
• You are 44 years or older.
• You have perifollicular scale, redness, itch, tenderness, or shedding that does not match the clinical look of “routine AGA.”
• You developed overt features of scarring alopecia or severe inflammation after a hair transplant.

The Inflammatory AGA Screen Program (PIILIF Track)

I created this because too many complex patients with hair loss and baldness were being managed with a one-pathway playbook.

Program name: Inflammatory AGA Screen Program (PIILIF Track)
Format: Virtual first (with in-person follow up when needed)
Deposit: Required to protect quality, reduce no-shows, and allow proper time allocation

What the PIILIF Track helps us do

• Identify whether a patient’s AGA is likely “standard AGA” alone, or AGA plus PIILIF biology.
• Decide when a biopsy is appropriate and where it should be taken to improve diagnostic yield.
• Build a personalized plan aimed at:
  • controlling the inflammatory axis when indicated
  • reducing progression and improving durability
  • planning surgery only when the scalp biology is optimized

Long-Term Care Matters Long-term

Sustainable treatment matters because AGA‑PIILIF is a long game
When PIILIF is present, the goal is not a short burst of change. The goal is long-term stability of the scalp environment. PIILIF is best understood as a chronic, genetically influenced tendency toward follicle‑centered inflammation and early fibrosis that is not “cured” once and for all. It is managed. That reality changes how we choose treatments.

Control, not cure, means the plan must be livable for years
If control may need to be maintained for the long term, the foundation of care should be something a patient can realistically sustain. This argues against building the core plan around high‑burden or high‑risk approaches, especially because AGA‑PIILIF can be subtle compared with overt primary scarring alopecias. The biology may be meaningful even when the scalp looks “quiet,” but the management must remain practical and tolerable over time.

What we evaluated in our cohort
Because the working model involves long-term control, the study emphasized steroid-sparing options that may be suitable for longer-term use, with short-course therapies used selectively. Selections were informed by peer-reviewed literature on steroid-sparing management in primary cicatricial alopecias. Treatments used in the cohort, often in combination and individualized to the patient, included:

• Dutasteride and finasteride
• Oral minoxidil
• Topical calcineurin inhibitors
• Minocycline or doxycycline (typically as a time‑limited course)
• A selected phytoactive approach: Gashee topical and Gashee oral

What showed the clearest statistical signal in our analysis (and what did not)
In this retrospective cohort analysis, only some interventions showed a clear statistical association with improvement. In order of p‑value significance, the strongest signals in our dataset were observed with:

1. Topical and oral phytoactives (Gashee)
2. Topical calcineurin inhibitors
3. Minocycline
4. Dutasteride

Other treatments used in the cohort (including finasteride, oral minoxidil, and doxycycline) did not show the same level of statistical signal in this dataset. This may reflect sample size, duration, selection bias, combination regimens, dosing, or when and how an agent was deployed, rather than proving a treatment has no role.

The practical takeaway
The point is not that every patient needs every component. The point is that when AGA‑PIILIF biology may require long-term management, the strategy should prioritize approaches that are realistic to sustain, steroid‑sparing when appropriate, and matched to the level of inflammatory and fibrotic activity.

How this relates to Phytoactives
Within a long-term, steroid‑sparing framework, a phytoactive topical or oral option may be considered as supportive care as part of a broader plan, particularly when long‑term tolerability is a priority. In our cohort analysis, the use of Gashee in both topical and oral forms showed the strongest statistical signal among the steroid‑sparing measures evaluated, but this study is observational, and larger studies are needed to confirm and refine these findings. Gashee is not a substitute for diagnosis and is not positioned as a cure. It may be one tool within a clinician‑guided program when it fits the patient’s overall plan and risk profile.

Where a phytoactive product like Gashee fits (and where it does not)

Important points of clarification.

What Gashee is not

• It is not positioned as a “cure” for AGA, hair loss, or baldness.
• It is not a replacement for diagnosis.
• It is not a substitute for physician-directed therapy when stronger interventions are warranted.

Where Gashee can fit logically in the PIILIF conversation

PIILIF changes the strategy from “only push growth” to “optimize the scalp environment and protect follicle viability.”

Because AGA is a long-course condition, and because PIILIF (when present) can behave like a persistent, low-grade inflammatory process, long-term tolerability matters. That pushes smart clinicians toward steroid-sparing approaches whenever feasible.

In our PIILIF work, the practical takeaway is that some patients benefit when care includes scarring alopecia or PCA (primary cicatricial alopecia)-style anti-inflammatory and anti-fibrotic measures alongside appropriate androgen management.

In that context, phytoactive support can be part of a long-term maintenance philosophy, particularly for patients who need a plan they can sustain.

Gashee exists in both topical and oral forms. In my practice, when it is used, it is used as part of a broader plan, not as a standalone promise.

Important note: Gashee is designed to support the scalp environment as part of a broader hair loss program. It is not intended to diagnose, treat, cure, or prevent disease. Individual results vary.

The bigger point: stop guessing. Start staging.

If the biology is wrong, the plan will be wrong.

PIILIF gives us a clearer framework for:

• earlier detection
• better durability
• better surgical planning
• fewer “mystery non-responders”

If you are a patient who feels stuck, or a clinician managing difficult AGA cases, the PIILIF Track is built for you.

Next steps

Patients: Request a PIILIF Track evaluation
Start the PIILIF Track Intake

Clinicians: Refer a complex AGA case for PIILIF screening
Clinician Referral: PIILIF Track

Medical and product disclaimer

1. Gashee is designed to support the scalp environment as part of a broader hair loss program. It is not intended to diagnose, treat, cure, or prevent disease.
2. This article is for educational purposes and does not provide medical advice. Diagnosis and treatment should be individualized and guided by a qualified clinician. Product statements have not been evaluated by the FDA. Products are not intended to diagnose, treat, cure, or prevent any disease.

FREQUENTLY ASKED QUESTIONS

PIILIF, FAPD, treatment resistance, and what to do next

1) What is PIILIF?

PIILIF stands for Perifollicular Infundibulo-Isthmic Lymphocytic Infiltrates and Fibrosis. In plain terms, it describes a low-grade immune-type inflammation and early fibrotic change occurring around the upper portion of the hair follicle. It can coexist with androgenetic alopecia (AGA), also known as male pattern baldness or female pattern hair loss, and may be present even when the scalp looks “normal” on casual inspection.

2) Is PIILIF the same as FAPD?

Not exactly. FAPD (fibrosing alopecia of patterned distribution) is a term typically used when patterned hair loss shows a more advanced fibrosing or scarring-leaning biology. The key insight from this publication is that FAPD may align with a later stage within an AGA-PIILIF spectrum, rather than representing a completely separate condition.

From a practical standpoint, this means that earlier recognition of inflammatory and fibrotic drivers matters. Identifying AGA-PIILIF before extensive fibrosis develops allows clinicians to plan care with durability in mind, when the biology may still be more modifiable.

Waiting until the histologic features associated with FAPD are fully established may correspond to a more treatment-resistant stage. For this reason, the authors emphasize the value of recognizing and addressing AGA-PIILIF earlier, rather than deferring evaluation until later stages when fibrotic changes are more entrenched.

3) Do I need a biopsy to know if I have PIILIF?

Not everyone needs a biopsy. A biopsy becomes more relevant when your provider finds signs of inflammation on magnified (trichoscopic) examination of your scalp. The threshold is reduced if you are already a non-responder, your presentation is ambiguous, you have symptoms that do not fit “routine AGA” (itch, tenderness, burning, persistent scale), or you are making high-stakes decisions like hair transplant planning. The goal is not to biopsy everyone, it is to confirm scalp biology early when the stakes or uncertainty are high.

4) Why did my finasteride or minoxidil stop working?

There are several reasons treatments may stop working, and not all are about the medication itself. The main concept here is that AGA or pattern baldness is often treated as purely androgen-driven, but in a meaningful subset of patients an inflammatory and early fibrotic process may be operating in parallel. If that second driver is active, “more DHT control” alone may not fully stabilize the situation, which is why biology-aware evaluation and a dual-pathway strategy may be needed in selected cases.

5) Can PIILIF affect hair transplant outcomes?

It can. Hair transplantation is not just about graft numbers or technique, it is also about the health of the recipient scalp environment and long-term stability of surrounding native hair. If inflammatory-pattern biology and early fibrosis are active, predictability and durability can be affected, which is why scalp optimization and biopsy-informed planning can be important in higher-risk candidates.

6) What are phytoactives, and where do they fit in a long-term plan?

Phytoactives are plant-derived compounds that may support the scalp environment as part of a broader hair loss program. In a long-term maintenance context, many patients and clinicians prefer steroid-sparing approaches when appropriate, especially when scalp inflammation behaves as a chronic, low-grade process. In that framework, a phytoactive topical or oral product can be considered as supportive care, but it is not a replacement for diagnosis, and it should be used as part of a clinician-guided plan when stronger interventions are indicated.

7) Does PIILIF require lifelong treatment?
PIILIF, when present, may behave like a chronic, genetically influenced inflammatory tendency around hair follicles. The practical goal is long-term control and stability, not a one-time cure. Some patients may need ongoing maintenance for years, with the plan adjusted over time based on symptoms, exam findings, and overall risk profile under clinician guidance.

8) Do I need strong steroids or immunosuppressants to control PIILIF?
Not necessarily. AGA-PIILIF can be subtle compared with overt primary scarring alopecias, so aggressive therapy is not automatically the default. In our cohort, the emphasis was on steroid-sparing strategies that can be considered for longer-term use when clinically appropriate. Treatment choice and intensity should be individualized and supervised by a qualified clinician.

9) What kinds of long-term, steroid-sparing treatments were used in the study?
In this cohort, patients were managed with a steroid-sparing approach tailored to clinical context and often used in combination. Treatments used included dutasteride or finasteride, oral minoxidil, topical calcineurin inhibitors, and time-limited tetracyclines (such as minocycline or doxycycline). A selected phytoactive topical and oral option (Gashee) was also used as part of the broader scalp-care plan when appropriate.

In this retrospective dataset, the clearest statistical associations with improvement were observed in regimens that included: Gashee topical, Gashee oral, topical calcineurin inhibitors, minocycline, and dutasteride. Because many patients received combination regimens, these findings do not establish that any single component alone caused the observed outcomes. Observational findings do not prove cause and effect, larger studies are needed, and individual results vary. Gashee is not intended to diagnose, treat, cure, or prevent disease.

Important note: Products and supplements are not intended to diagnose, treat, cure, or prevent disease. Individual results vary, and medical decisions should be individualized with a qualified clinician.

The post VIDEO: Read This If Your Hair Loss Treatment or Hair Transplant Has Stopped Working. What Science Shows appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

Scalp Micro-Pigmentation VS. Head Tattooing

While SMP and head tattooing may seem similar, they have different purposes and will give patients distinct results. Head tattooing employs traditional tattooing methods, and the results are more decorative and artistic than realistic. It employs standard tattoo ink applied deep into the dermis, and it could discolor to blue or green, migrate on the skin, and can be difficult to reverse without the use of laser tattoo removal.

Meanwhile, SMP is a clinical technique performed by trained practitioners to simulate the appearance of natural follicles. “We use specialized ink and a specialized technique,” said Dr. Umar. “Usually very superficial, to impact this look of scalp, creating the effect of stubble on the head in a pattern that mimics the natural distribution of hair.” Ultra-fine needles are used to deposit pigment into the upper dermis, resulting in a natural-looking hairline and density.

Why Patients Choose Head Tattoos

Many individuals seek head tattoos to reclaim confidence or camouflage balding. While the sentiment is valid, it’s important to distinguish between artistic intentions and clinical outcomes. SMP is tailored to restore the appearance of hair, not simply distract from its absence. Our patient Michael came into the Dr. U Hair and Skin Clinic seeking a procedure like this to achieve a fuller look while sporting a crew cut style. That’s when Dr. Umar suggested he get scalp micropigmentation (SMP) to complement his hair transplant results.

This technique is especially effective for:

• Camouflaging hair transplant scars
• Enhancing the appearance of hair density
• Refining hairlines after transplantation
• Creating a natural buzz-cut look

Patients like Michael demonstrate that hair restoration is not always about regrowth. Sometimes, it’s about recreating the illusion of density in a way that aligns with a patient’s lifestyle and appearance goals. SMP provides a subtle, impactful solution that empowers patients to wear shorter styles with confidence.

A Nonsurgical Approach To A Fuller Head Of Hair

SMP involves strategically tattooing pigment to the skin to create the appearance of stubble, making the scalp look fuller while softening harsh hairlines that were a result of hair transplants. In Michael’s case, it was used to disguise his strip hair transplant scar and give his buzzed hairdo a dense yet natural appearance. Because of his successful hair transplant with the Dr.UGraft® system, he was the ideal candidate for this procedure. “It’s the perfect use of SMP,” said Dr. Umar. “You have the hair, and then you just augment the density.” 

Subtle Yet Impactful Results Through SMP

Now, Michael can happily shave his head without worrying about bald patches and his previous scarring. The combination of FUE and SMP gave him realistic results, a softer hairline, and scalp density that he can be proud of. “I think this is the only combination of procedures that could’ve achieved this result from any doctor,” said Michael. “It looks so natural that nobody has commented on it.” These results fade gracefully within 18 to 24 months, and the procedure can be redone to achieve a fuller appearance of hair without the need for invasive surgeries.

Is Scalp Micropigmentation Right For You?

Follicular unit excisions have steadily grown in popularity, but many patients don’t realize that they have the option to complement their hair transplant results with SMP. As you have seen with our patient Michael, this procedure can render a realistic hairline and fullness that elevates your look, whether you’ve had hair transplantation surgery or not. To learn if scalp micropigmentation is right for you, book a free online consultation with Dr. Umar by filling up this form.

Individual results may vary. This story reflects one patient’s personal experience with scalp micropigmentation with Dr. Umar. Consult with a qualified physician for personalized advice.

POV: It looks cool… until you realize it’s your hairline #reels #shorts #hair #tattoo #DrU

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The post Scalp Micropigmentation vs. Head Tattoo: Which Is Right for Your Hair Loss Journey? appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

Scarring Alopecias, Immune-System Based Alopecias & Hair Transplant

Patients with certain types of alopecia, such as alopecias caused by immune system disorders, should not have a hair transplant – until the said condition is treated for and thoroughly subdued.

Why Scarring Alopecia Must Be Treated & Subdued Before Hair Transplant

In patients with alopecia or hair loss from immune system disorders, the body automatically attacks hair follicles, leading to hair fall and hair loss.

Therefore, new hair follicles transplanted to the patient’s scalp or body will be attacked by the patient’s immune system and eventually perish, resulting in a failed hair transplant.

Is Hair Transplant Possible for Those With Scarring Alopecia?

Although having scarring alopecia or immune-system-based alopecia may complicate the hair transplant, it is still possible to have a successful hair transplant with little-to-no complications once the scarring alopecia is under control.

This can be done using a combination of treatments as discussed below.

Preparing Hair Transplant for Patients with Scarring Alopecia, or Immune-System-Based Alopecia

To ensure that the patient has no underlying conditions that may complicate or negate the hair transplant, it is recommended to visit a dermatologist.

Once you visit a dermatologist, the dermatologist will ensure that the following steps must be taken:

1. Diagnose the patient to see if they have any conditions such as scarring alopecia that may complicate the hair transplant.
2. Treat the condition if any condition exists that may complicate the hair transplant.
3. Once the condition is controlled, hair transplant possibilities can be explored.

Once diagnosed, patients with previous hair loss or alopecia conditions, such as patterned baldness, LPP (Lichen Planopilaris), CCCA, FFA, or other conditions resulting in hair loss, will undergo treatment to minimize and reduce these conditions before undergoing hair transplant surgery. 

Why It is Important to Diagnose Scarring Alopecia Before Hair Transplant

Prospective hair transplant patients may not even be aware that they have scarring alopecia.

As reported in this published medical journal, symptoms of LPP may be mistaken as androgenetic alopecia, genetic alopecia, or common hair loss [1]. 

If ignored or misdiagnosed, this can lead to a failed hair transplantation, so it is best to visit an experienced dermatologist and hair expert to diagnose the condition properly.

Once you have found your dermatologist, continue below to see different ways dermatologists diagnose scarring alopecia.

How Does a Dermatologist Diagnose Scarring Alopecia? CCCA, LPP, FFA & More

To diagnose whether or not a patient has conditions such as CCCA, LPP, FFA, or other types of scarring alopecia, a dermatologist will generally take a biopsy – a small sample of the patient’s tissue.

This tissue is then sent to a lab for analysis to determine whether or not the patient has a specific condition. This is a very accurate method of diagnosing scarring alopecia.

Another way to diagnose the patient for certain types of alopecia is using a trichoscopy. Using a specialized device, the dermatologist will look closely at the patient’s hair and scalp to see whether or not there are any signs of scarring alopecia.

Once the condition is diagnosed, and if scarring alopecia is present, it must be treated successfully to a certain extent before hair transplantation is even possible.

Possible Treatments for Scarring Alopecia

Scarring alopecia is known to cause permanent hair loss. Therefore treatment should be aggressive.

Scarring alopecias that mainly involve mostly lymphocyte inflammation of hair follicles such as Lichen Planopilaris (LPP) or pseudopelade are generally treated with:

1. Corticosteroids (topical creams)
2. Steroid injections into the scalp / affected area
3. Antimalarial drugs
4. Isotretinoin

For scarring alopecias with inflammation of mostly neutrophils or a mixture of other cells, treatment generally consists of:

1. Antibiotics
2. Isotretinoin

According to WebMD, there are also new experimental drugs that are currently being used, such as [2]:

1. Methotrexate
2. Tacrolimus
3. Cyclosporin
4. Thalidomide

These treatments generally last a patient’s lifetime as scarring alopecia is a chronic condition.

This can cause concern for certain patients as specific widely-used treatments, such as repeated steroid injections into multiple areas of the scalp, may be unwanted.

Furthermore, each treatment poses possible side effects that should be considered.

Although most dermatologists have used pharmaceutical drugs to help treat scarring alopecias, new methods, such as natural botanicals (plant-based products), are also available.

One such plant-based product is Dr.UGro Gashee Natural Hair Products, created by Dr. Umar and is currently being used in Dr. U Skin & Hair Clinic for some cases of scarring alopecia.

How Does Dr. U Skin & Hair Clinic Prepare LPP Patients for Hair Transplant?

Dr. U Skin & Hair Clinic offers a unique and personalized approach to hair transplants for scarring alopecia patients.

To help prepare patients for hair transplants, Dr. U Skin & Hair clinic utilizes Dr.UGro Gashee, an original and naturally-derived hair product invented by Dr. Sanusi Umar, MD.

In some instances, Dr. U Skin & Hair Clinic also uses Gashee post-hair transplant surgery to help improve patients’ hair transplant results.

This is done using the plant-based power of Gashee’s several holistic plant ingredients studied to improve hair health. When used post hair transplant, Gashee helps increase scalp and follicle health, retaining more follicles.

This can factor in the difference between a fantastic hair transplant result and a standard one.

Gashee – Featured in Newly Published Medical Journal in Terms of Scarring Alopecia

Furthermore, a recently published medical journal has studied and highlighted the use of Gashee for some instances of scarring alopecia such as LPP. The publication reported that Gashee reduced symptoms of LPP in all patients with a history of LPP.

It is important to note that these LPP patients were previously ineffectively treated using pharmaceutical drug-based medications.

Due to the excellent results of these non-drug approaches, Gashee warrants further study in its application for LPP and other scarring alopecia and is currently used by Dr. U Skin & Hair Clinic.

What is Gashee? Natural Botanical for Hair Health

Meaning “hair” in Hausa, Gashee is a proprietary blend of natural plants and extracts based on our ancestor’s ancient medicines and healing practices. Gashee is designed to help improve hair health. 

Recently Gashee has been studied and reported as the first natural plant-based product to show a positive response toward LPP and CCCA, as reported in the journals linked below. These are significant types of scarring alopecia hair loss, currently known as hard-to-treat conditions leading to permanent hair loss.

Although plant-based doesn’t necessarily mean allergy or side-effect free, one of the advantages of using Gashee for scarring alopecia is that Gashee can be used as long as needed chronically, with a reduced side effect profile – for those who are not allergic nor possess a reaction to plant-based products.

This can be a significant point to consider for those who have previously relied on pharmaceutical-drug-based medical treatments for scarring alopecia – as a significant reason for the ineffectiveness of these drug-based treatments are their side effects profiles, which may pose unwanted side effects after prolonged use.

In summary, it is essential to consider these factors and discuss them with your dermatologist if you believe that a natural approach such as Gashee may be more beneficial for you and your goals.

VIDEO: First Botanical Reported by Peer-Reviewed Medical Study to Show Positive Response Towards LPP

Published Report, Lichen Planopilaris, LPP Responds to the Natural Hair Treatment Formula – Gashee

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Visit the YouTube video to see the before and after results of Dr.UGro Gashee Natural Hair Products as reported within the LPP study.

For more information on Dr.UGro Gashee Products, visit the Gashee website here:

Schedule a Free Consultation with Dr. Sanusi Umar, MD, FAAD

Suppose you worry that you might have LPP, other forms of scarring, general alopecia, or hair loss. Or perhaps you are in the process of figuring out whether or not you are qualified for a hair transplant.

As this published medical journal stated, a hair transplant may be viable for LPP [3] or other scarring alopecia, but certain conditions must be met.

In this case, it is best to consult a licensed and experienced dermatologist and hair expert to properly diagnose the condition and explore possible treatment options in line with your goals. Dr. U Skin & Hair clinic offers free consultations, which can be booked using the link below. Please do not hesitate to reach out with any questions and concerns.

Frequently Asked Questions – Preparing Scarring Alopecia Patients for Hair Transplant FAQ

Why is hair transplant challenging for scarring alopecia patients?

Hair transplant is particularly challenging for scarring alopecia patients because of degenerative changes and reduced vascularity due to scarred tissues around the scalp and follicle.

More so, scarring can affect the safe donor area of the scalp, possibly reducing the number of grafts available [4].

Why is it essential to diagnose scarring alopecia as soon as possible?

Scarring alopecia is an aggressive condition that can result in permanent hair loss.

Due to this, if you suspect you have scarring alopecia, it is best to visit a dermatologist as soon as possible to diagnose the condition and treat it if present.

Is hair transplantation the only way to significantly restore hair after severe scarring alopecia?

Hair transplantation is often the only way to restore hair to an area affected by scarring alopecia significantly.

Can you use the internet and highly-trusted medical websites to self-diagnose scarring alopecia?

Although plenty of information is available online regarding different types of alopecias, their symptoms, and signals, it is not recommended to self-diagnose anything.

Although you may be sure that what you have is a specific type of condition, it is always recommended to visit a licensed medical professional for a proper examination and diagnosis.

In the case of hair transplantation, a mistake in self-diagnosis for some instances of alopecia can lead to a failed hair transplant.

Further Reading

What is Lichen Planopilaris (LPP)?

What is Central Centrifugal Cicatricial Alopecia (CCCA)?

Gashee Reported By Study as First Botanical to Show Positive Response toward LPP

References

1. Baquerizo Nole, K., Nusbaum, B., Pinto, G. and Miteva, M., 2022. Lichen Planopilaris in the Androgenetic Alopecia Area: A Pitfall for Hair Transplantation.
2. WebMD. 2022. Scarring Alopecia. [online] Available at: <https://www.webmd.com/skin-problems-and-treatments/hair-loss/scarring-alopecia> [Accessed 20 July 2022].
3. Ekelem, C., Pham, C. and Atanaskova Mesinkovska, N., 2022. A Systematic Review of the Outcome of Hair Transplantation in Primary Scarring Alopecia.
4. Saxena K, Saxena DK, Savant SS. Successful hair transplant outcome in cicatricial lichen planus of the scalp by combining scalp and beard hair with platelet-rich plasma. Journal of cutaneous and aesthetic surgery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4812894/#:~:text=Hair%20transplant%20in%20scarring%20alopecia,of%20grafts%20for%20appropriate%20coverage. Published 2016. Accessed July 20, 2022.

The post Preparing Patients for Hair Transplant – LPP Patients or Other Scarring Alopecia Patients for Hair Transplant Surgery (FFA, CCCA) appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

What is Lichen Planopilaris (LPP)

What Causes LPP?

Currently, the exact cause of LPP is unknown. However, according to the National Institute of Health (NIH) [1], LPP is believed to be an autoimmune disorder where white blood cells attack skin and hair cells, causing inflammation and destruction of hair follicles. While a direct cause has not been identified, practicing healthy hair and scalp behaviors can lessen the severity of the condition.

How to Avoid LPP or Reduce Symptoms of LPP

Several hair practices can be done to help avoid the onset of LPP or to reduce the symptoms of LPP:

1. Avoid tight hairstyles that put pull or traction on the hair and scalp
2. Avoid harsh chemicals
3. Avoid harsh hair products
4. Avoid using extreme heat on hair

Generally, practices that keep the scalp healthy are good in terms of helping avoid LPP. It is also essential to gently wash the hair and scalp and moisturize the hair as necessary.

Who Does LPP Affect?

Lichen Planopilaris typically affects adults ages 30-60, favoring women over men. This may be due to the likelihood of women using more products and demanding hairstyles over men, although the autoimmune disease is believed to be triggered by genetic factors [2]. Hair loss in men and women can begin as early as the teen years or 20s, but LPP can develop later in life, even after balding begins. 

LPP Symptoms to Look Out For:

Although LPP symptoms may be similar to what may be interpreted as common genetic balding or pattern baldness, there are specific LPP symptoms that should be noted:

1. Itching on the scalp
2. Bumps on the scalp
3. Pain around the scalp
4. Redness of the scalp
5. Increased hair loss
6. Patchy hair loss

It is essential to look out for itching, bumps, pain, or redness on the scalp, mainly if hair loss appears patchy and less patterned, as this is a signifier of LPP (Lichen Planopilaris).

How is LPP (Lichen Planopilaris) Diagnosed?

Dermatologists usually diagnose LPP after performing a biopsy, meaning they’ll take a small scalp sample and have it tested and analyzed in a lab. Furthermore, a trichoscopy can also be done to confirm the diagnosis of LPP for the patient.

LPP may be more challenging to diagnose, so inform your doctor of your symptoms in detail. Visiting a licensed and experienced dermatologist and hair expert is always recommended to diagnose the condition properly.

What Treatments Are Available for Lichen Planopilaris (LPP)?

Once diagnosed, several treatment options for LPP are available:

1. Steroid injections to the scalp
2. Pharmaceutical drugs, blockers
3. Botanicals

Generally, LPP (Lichen Planopilaris) treatments consist of steroids such as corticosteroids, antibiotics, and retinoids. All are meant to lessen the symptoms of inflammation and prevent the further spread of the condition.

A commonly prescribed treatment is long-acting steroid injections (Typically triamcinolone) to the patient’s scalp, combined with pharmaceutical drugs (e.g., hydroxychloroquine, doxycycline, methotrexate, JAK Inhibitors like tofacitinib and naloxone) to inhibit specific pathways within the body to reduce the symptoms of LPP.

However, these treatments have potential side effects, so patients may desire a more natural approach to treatment. 

Although the above treatments are the traditional industry approach, they are often ineffective or unsustainable due to the patient’s discomfort with repeated scalp injections and potential side effects from pharmaceuticals and drug-based products. Due to these possible side effects, many patients may desire a more natural approach to treatment, such as studied and tested botanical products that may help reduce symptoms of LPP through natural means.

One example of natural botanical products studied for LPP is Dr.UGro Gashee Natural Hair Products, featured in this published medical journal, “Lichen Planopilaris Responsive to a Novel Phytoactive Botanical Treatment: A Case Series,” published in Dermatology and Therapy.

Treating LPP with Botanicals – Published Medical Study of Botanicals on LPP Patients

Dr.UGro Gashee, Natural Hair Products have recently been studied and reported in the journal Dermatology and Therapy.

The study, titled “Lichen Planopilaris Responsive to a Novel Phytoactive Botanical Treatment: A Case Series,” reported how all 4 out of 4 LPP patients had “consistently showed a significant improvement in [LPP symptoms]” such as “reduction in inflammation, complete resolution of symptoms, and signs of hair regrowth.”

As reported in the study, compared to pharmaceutical or drug-based treatments for LPP, such as corticosteroids, hydroxychloroquine, and scalp injections, Gashee’s natural ingredients and properties pose few side effects for patients. In addition, they were used repeatedly for the long term due to these natural ingredients that are holistically compatible with normal human physiology.

Some of Gashee’s quality botanical ingredients include green tea, turmeric, aloe vera, and more. The word “botanical” is derived from plants. Dr.UGro Gashee’s products were expertly forged from ingredients grown in nature. As many plants are known for their naturally-occurring medicinal and healing properties, Gashee utilizes botanicals to safely and holistically help strengthen scalp conditions.

Before and After – Dr. UGro Gashee Natural Hair Health Products & LPP Research

See below for more before and after results of patients from the Gashee – LPP study.

VIDEO: Gashee LPP Study Before & After Full Patient Results

For slides of more patients before and after the Gashee LPP study results, visit the YouTube video below.

Published Report, Lichen Planopilaris, LPP Responds to the Natural Hair Treatment Formula – Gashee

No Description

If you are interested in Gashee Natural Hair Products, use the button below to visit the Gashee website and online store at www.ugro.com. Suppose you suspect you have LPP (Lichen Planopilaris) and are interested in possibly using Dr. UGro Gashee Natural Hair Products to treat it. In that case, it is recommended to consult a dermatologist before using this product. To do so, you can use the free consultation button below to schedule a consultation with Dr. Sanusi Umar, MD, FAAD, the creator of Dr.UGro Gashee Natural Hair Products.

Frequently Asked Questions

Can Hair Grow Back After Lichen Planopilaris?

Hair regrows after Lichen Planopilaris – due to LPP scarring alopecia, typically left untreated, LPP can leave the user with permanent scarring, which leads to permanent hair loss – but if treated early enough, there may be the possibility of hair growth. However, this is based on the treatment and conditions of the patient’s hair and scalp.

Does Lichen Planopilaris Ever Go Away?

Typically Lichen Planopilaris (LPP) does not go away on its own – it will persist until the patient has no more hair for the body’s autoimmune system to attack.

Can You Dye Your Hair if You Have Lichen Planopilaris?

It is not recommended to dye your hair if you have Lichen Planopilaris (LPP) because it can aggravate hair follicles and scalp inflammation, worsening LPP symptoms and conditions.

What Causes Lichen Planopilaris of the Scalp?

Currently, there is no certainty on what causes LPP (Lichen Planopilaris). Only the mechanism of LPP is understood, in which the autoimmune system mistakes the body’s hair stem cells as a threat, therefore attacking and destroying it.

How Long Does Lichen Planopilaris Last?

There are no actual measurements of how long LPP lasts, but it often persists throughout a patient’s lifetime until there is no more hair for the patient’s immune system to attack.

How Common is Lichen Planopilaris?

LPP, also known as Lichen Planopilaris, is a rare disease and the most frequent cause of adult primary scarring alopecia [3].

One study states that LPP incidence varied from 1.15% – 7.59% [4].

Further Reading 

• For more in-depth scientific reading on Lichen Planopilaris, visit this NIH article. 
• For more information about the botanical ingredients used in Dr.UGro Gashee products, visit ugro.com.
• Visit this DermNet article for additional information regarding LPP basics.

Consult with an Experienced Dermatologist on LPP

If you are interested in Gashee or would like a free consultation with Dr. Umar, schedule a consultation with Dr. Umar using this link: 

References

1. 2022. [online] Available at: https://rarediseases.info.nih.gov/diseases/3247/lichen-planopilaris [Accessed 17 June 2022].
2. Dermnetnz.org. 2022. Lichen Planopilaris — DermNet. [online] Available at: https://dermnetnz.org/topics/lichen-planopilaris [Accessed 17 June 2022].
3. Cdn.mdedge.com. 2022. [online] Available at: https://cdn.mdedge.com/files/s3fs-public/issues/articles/vol28_i1_Lichen_Planopilaris.pdf [Accessed 18 June 2022].
4. Brankov N, Conic RZ, Atanaskova-Mesinkovska N, Piliang M, Bergfeld WF. Comorbid conditions in lichen planopilaris: A retrospective data analysis of 334 patients. International Journal of Women’s Dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6116820/. Published June 7, 2018. Accessed June 17, 2022.

Further Reading:

What is central centrifugal cicatricial alopecia aka CCCA ?

The post What is Lichen Planopilaris AKA LPP? appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

The concept of hair cloning is the same across the board. It focuses on the ability to use existing hair strands to create new follicles that multiply and grow. Another focus is on the hair follicle stem cells. In the same vein, the ultimate promise of hair cloning is unlimited hair. In other words, the concept of hair cloning, theoretically, there are no limitations to the number of times a hair follicle can be multiplied.

The Hair Cloning Claims

While there are a number of practitioners and institutions, primarily overseas, alleging they’ve cracked into the innovative technology of hair cloning, it’s not true. Despite the deceptive claims, there is no new treatment for hair loss.

Because the laws are loose or nonexistent in some of those countries, their allegations of multiplication of any form are erroneous and misleading. Meanwhile, in the U.S., the Food and Drug Administration, FDA, and the Federal Trade Commission, FTC, actively monitors and prosecutes false and fraudulent medical claims, Dr. Umar explained.

“There are a number of hurdles researchers have to overcome before hair cloning becomes available to humans,” Dr. Sanusi Umar of Dr. U Hair and Skin in Manhattan Beach, Calif. said.

Is Hair Multiplication a Reality?

Many hair loss sufferers are interested in knowing whether or not hair multiplication offers a legitimate form of treatment of not. In this video, Dr. U offe…

Popular Ways to Treat Thinning and Balding Hair

There are three ways to treat thinning hair and balding heads:

1. FDA approved medication like Minoxidil and finasteride.
2. Hair tonics and other natural hair products like Dr.UGro Gashee.
3. Hair transplants, which has provided patients with long lasting results.

Anyone claiming hair multiplication, cloning or restoration outside of the current treatment options is unscrupulous and lying.

“Beware,” Dr. Umar said. “People have been swindled.”

Partial FUE Hair Transplant is Not Hair Multiplication or Hair Cloning

Patients undergo a hair transplant hoping to have hair. Willing to try anything in the name of  their precious locks, some are eager to buy into the science of hair cloning with expectations that it will produce new hairs that no longer exist or existed.

Dr. Umar shared he was skeptical when learning about the claims of some centers in achieving hair multiplication through Follicular Unit Extraction, FUE. Once he reviewed the publications from such institutions, he determined they were practicing Partial Follicular Unit Extraction, PFUE.

“A PFUE is not considered hair cloning,” he explained.

According to Dr. Umar, some practitioners practicing PFUE are merely using very small FUE punches to split hair into two longitudinally. The small FUE creates smaller wounds that heal better and quicker. This also results in getting a two hair follicle, sometimes even a three hair follicle, to grow in donor areas as a single hair and another in the bald area. The problem is that there was no “new” hair follicle created. In other words, no hair multiplication has happened.

A PFUE is a blind process and increases the risk of follicle damage and no growth in either of the donor or recipient area. Consequently, a patient could lose a substantial amount of donor hair and end up with very thin, poor coverage in the recipient area.

“When you do small punches like that, ranging at the 0.6 0.5 millimeters,” Dr. Umar explained. “You’re going to have very thin coverage on your head and you’re going to have premature and severe donor depletion.”

One of Dr. Umar’s patients came to him after two unsuccessful FUE procedures with small punches. “The donor area was depleted and the coverage was insufficient,” he said. “We had to look into body hair transplantation to make up for what was not necessary and should not have happened.”

Hair Multiplication 2020 Status

In early March, Japanese company, Shiseido’s lead researcher, Dr. Ryoji Tsuboi, from Tokyo Medical University, released the latest clinical study on the safety and effectiveness of cell therapy technology or cell-based therapies using autologous or allogeneic cells used clinically for thinning hair.

Stem cell hair transplants are similar to current hair transplant procedures. The striking difference is that the follicles are replicated in a lab and then transplanted back onto the scalp in the balding areas. Furthermore, the transplanted hair as well as the donor hair follicle will grow.

According to Tsuboi’s open statements to the media in native Japanese language, the study treated male and female pattern hair loss between ages 33-64. In Tsuboi’s report he said the research entailed injecting using autologous cell based therapy (a patient’s cells) and dermal sheath cups, DSC, cells that surrounds the dermal papilla, DP.  The results were positive, but only lasted six to nine months after treatment.

“The result of our study was very encouraging,” Tsuboi said. “We were able to show that the study could help develop a new treatment for hair loss.”

As to “when the technology will be available to practice” – there’s no official timeline or date.

“We don’t know when hair cloning will become a reality,” Dr. Umar said. “but it’s coming.”

Free Hair Consultation

FAQ – Hair Multiplication 

When will hair cloning be available and how much will it cost? 

Nothing is set in stone. Hair cloning is still a technology in its research phase. Though there have been some advances, there hasn’t been a reliable breakthrough.

What if I have severe baldness with limited donor hair and need something like hair cloning, can I still restore my hair? 

Since there is no established practice of hair cloning/hair multiplication, it wouldn’t be an option. But there are current FDA and FTC treatments that can help with severe baldness and thinning hair. There are medications like Minoxidil and finasteride and as well as a variety of natural hair products and tonics. In more severe cases, some patients have opted for hair transplants. At Dr. U Hair and Skin Clinic, Dr. U uses the advanced hair transplant systems – Dr. UGraft Zeus , which has the ability to extract hair from anywhere on the head, beard and body transplanting. Because of the advanced Follicular Unit Extraction hair transplant devices, Dr. Umar is able to tailor the hair’s growth, density and shape – and still provide patients with a the most natural look.

Further Reading

Learn more about Follicular Unit Extraction performed with Dr.UGraft Zeus technology 

The post Is hair multiplication a reality? Self explanatory video: appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

Names of Fillers for the Face

Magazines and beauty sites mention often discuss various dermal filler brands, such as Juvederm, Restylane, Perlane, Belotero and more. Sometimes, these articles may not provide background information on the properties of each filler and their general applications. It will be important to learn these basics and then consider how well the characteristics of a particular product can solve a particular issue.

What are the Best Dermal Fillers

Dr.U recommends acquiring a basic understanding what each dermal filler is made of, and how the ingredient behaves under the skin to produce a particular outcome.

This level of knowledge will help provide more clarity on goals and priorities when you speak to an actual doctor. For example, are you aiming for very subtle results, or a more aggressive and noticeable form of improvement? Is the longevity of the dermal filler product an important priority to you, over other criteria?

The Three Main Types of Dermal Fillers Los Angeles Patients Should Know

The names of different filler products can seem numerous with a vast amount of information to learn. However, by understanding a basic categorization system, it will be much easier to gain a grasp on the different options available and know which dermal filler is best for your area(s) of concern.

In the Q&A video, Dr.U mentions that there are three main types of dermal fillers, which are based on the substance they are made of.

Hyaluronic Acid Dermal Fillers

Hylauronic acid is a sugar molecule naturally found in our bodies which holds large amounts of water. It not only adds volume to the treated areas, but also provides hydration which contributes to rather natural and subtle looking outcomes.

The actual hyaluronic acid used to formulate injectable fillers is actually derived from bacteria for a more sterile end result.  It undergoes a series of extensive purification and refinement processes to reduce the risk of allergic reactions in patients.

Our bodies are able to recognize the basic molecular  structure of HA allowing us to assimilate dermal fillers made from this substance without incurring severely unwanted complications.

One of the benefits of using hyaluronic acid dermal fillers is that it can easily be dissolved using an enzyme known as hyaluronidase. Thus mistakes  and unwanted outcomes can easily be corrected right away. With other types of fillers, patients have to wait until the product is completely metabolized by the body, which can take months.

Dermal fillers made of hyaluronic acid include:

• Juvederm
• Restylane
• Perlane
• Belotero

Hyaluronic acid dermal fillers are generally used for filling in cheek depressions as well as nasolabial grooves which develop around the nose and mouth.

They can be used to treat various forms of wrinkles. However, in these cases, it is recommended that the injections are placed deeper in the skin. Hyaluronic acid is a clear colored substance, making it prone to a light bending phenomenon called the Tyndall effect. When light shines on the treated area, the rays will bend as they pass through the clear colloid gel and produce a bluish coloration which can resemble a bruise.

A relatively newer form of hyaluronic acid dermal filler is Belotero which undergoes a more advanced form of processing in the making of the final product. This form of hyaluronic acid has a very different set of characteristics as a continuous substance, rather than a clear suspension.

Because of Belotero’s properties, it can be injected more closely to the skin’s surface without the risk of incuring the Tyndall effect. This hyaluronic acid dermal filler is quite ideal for lifting very fine superficial lines and wrinkles.

Before Belotero became available, it was very difficult for older generations of hyaluronic acid dermal fillers to correct fine lines on the skin without clumping or producing discolorations. Now patients are able to solve issues like static crows feet lines, etched frown and forehead lines, slight vertical cheek lines and even wrinkles around the lips.

Calcium Hydroxylapatite Dermal Filler

Calcium hydroxlapatite is a compound that helps comprise our bone tissue. This molecule (in the form of tiny microspheres)  is used as the active ingredient of a dermal filler known as Radiesse.

The main advantage of calcium hydroxlapatite is that it offers a versatile and adaptable firmness to the area of application. The microspheres within Radiesse will cluster together tightly or more diffusely to mimic the nature and density of the surrounding tissue environment.

This property allows the  dermal filler to provide more structural support when it is needed for specific treatment applications.

In terms of cost, Radiesse is less expensive than hyaluronic acid dermal fillers. However, it cannot be used for lip augmentation since it will create lumps and granules.

Radiesse can be used for filling large volume areas, such as the cheeks. It is commonly used to for other areas of applications in non-surgical facial contouring, including the nose, chin, nasolabial folds and jowls.

At the Dr.U Skin Clinic in Los Angeles, Dr.Umar often uses Radiesse as his dermal filler of choice for the under eye area to solve issues like dark circles and puffiness. Since Radiesse is an opaque, whitish substance and not a clear colloid gel, it will not produce the Tyndall effect. Since the skin the tear trough area is very thin, this property of calcium hydroxlapatite makes it an ideal choice.  

Dermal Filler Made of Poly-L-Lactic Acid (PLLA)

Poly-L-Lactic acid is a compound used to make dissolvable sutures which can also stimulate the production of the skin’s collagen.  It is also the ingredient used in the dermal filler known as Sculptra.

Sculptra is often used for large volume filling applications that result from aging or illness.  For example, this dermal filler is commonly used to treat the manifestation of sunken cheeks which occurs in HIV patients.

Sculptra is also used to lift deep creases, lines and folds, such as those which form around the mouth..

One of the main advantages  of Sculptra is that outcomes can last up to two years.

Since Poly-L-Lactic acid readily absorbs water, the final outcome of Sculptra procedures usually take time to become fully apparent.  Therefore, the enhanced volume achieved at the time of the treatment only reflects a fraction of the actual end results.

Which Dermal Filler Is Best?

A qualified doctor can certainly evaluate different types of dermal fillers and recommend the optimal one for your treatment areas. But it is best to do your own research to understand how different products work to solve specific issues.

The quality of your dermal filler results will depend on the skill and experience level of your provider. Due to the popularity of dermal fillers, they are now being offered by aestheticians and even as products that regular consumers can buy online for DIY treatments. But these practices are not advised.

Instead it is recommended to choose a medical specialist who is board certified in plastic surgery or dermatology, like Dr.U.  Dermal fillers are not to be considered in the same category as ordinary beauty services, like getting a facial or a manicure. The Australian Society of Plastic Surgeons insightfully comments, “with the increase in use has been associated downgrading of the risks that come with hyaluronic acid fillers.”

Injections must be administered by experts who understand intricate anatomical details such as the location of specific blood vessels, nerves and muscles. Accidental injections into the wrong area can lead to serious consequences.

Cosmetic fillers have been known to cause blindness, and at worst, facial deformities. While no one wants to consider the chances of permanent damage, when they are looking to improve their appearance, these risks do happen. However, as noted, they can be prevented by choosing a service provider with the right credentials, who has extensive experience performing successful procedures on actual patients.

If you are in the greater Los Angeles area and would like to speak to Dr.U about choosing from different types of dermal fillers for a particular concenr, sign up for a complimentary consultation through our online form.

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Further Reading

Learn how Dr.U’s Radiesse procedure for the laugh lines helped this female patient look younger by 15 years. 

Discover how it is possible to apply Juvederm to avoid duck lips while producing extremely natural looking lip enhancement results.  

The post Which Filler is Right For You? Dr.U Discusses the Different Types of Dermal Fillers and Their Applications appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

What Is It Like to Get a Hair Transplant?

If you are just starting to consider hair transplantation, you may find yourself wondering what the experience is like. According to Dr.U, a good starting point to help you find your answers is by visiting hair transplant forums and seeing what actual patients have to say. Also, take some time to review blogs, vlogs and articles posted by men and women who want to share their experiences with others.

Research the Hair Transplant Process By Asking Relevant Questions

To find the answers that are most relevant and useful for your needs, you must clearly define what you would like to achieve. Here are some examples of questions you may want to consider. Are you trying to reverse your hairline recession? Is your goal to fill in the crown area? What stage of the Norwood scale are you at? Would you like to achieve full coverage or partial coverage?

See if you can find examples of hair transplant patients who most closely fit your profile and your set of goals.

After you have defined what you want to achieve, start asking, how a particular doctor’s skills and techniques can help you attain your vision? Does your case require a more specialized technique?

Start examining different tools and technologies. It will be extremely important for you to learn
how each one works, their limitations and how they would contribute to your final coverage

How to Evaluate the Work of Hair Transplant Doctors

If you just starting out on the hair transplant journey, don’t feel that your own questions, opinions and insights hold no weight.

Quite truthfully, you are perfectly capable of critiquing the work and methodologies of hair transplant providers and making the best decisions for yourself. This is perhaps one of the most important steps you’ll need to take during the overall the hair transplant process.

In the Q&A video above, Dr.U advises taking some time to look at the before and after photos of past patients that specific surgeons have worked on. Ask yourself whether or not the results appear genuine and are presented authentically. Are you able to compare and contrast the patient’s before and after images at different views and angles?

Besides photos, videos can provide an even better source of information. With video footage, it is possible to capture movement of the hair and patient testimony in their own words.

Dr.U also advises that patients become clear on whether or not the actual results were achieved with FUE (Follicular Unit Extraction) or strip surgery.

Sign up for an initial consultation to meet providers in person. These meetings will be a very important part of your hair transplant process. It will be in your best interest to have your questions answered by the actual surgeon who will be performing your procedure. In some clinics, consultations are performed by sales representatives. However, in these contexts, the primary incentive is often to get patients to commit to surgery. An opening on the same day as your consultation may indicate a big red flag, although it is a normal proceeding at many clinics.

If you’ve decided on FUE, find out what punch instrument of choice the provider uses. This is the best time to learn about the technology that will be used. Avoid finding this information out on the day of your surgery.

Ideally, you should be given the opportunity to go home, review what you had learned and evaluate the pros and cons of different clinic providers before making a decision that will affect the rest of your life.

In some cases, it may even be possible to speak one-on-one with actual patients of the clinic.

Once you have made your final decision and have committed to a specific date, be sure to review the information on all your consent forms so that you are aware of the full scope of what will be involved in your procedure.

What to Expect From a Hair Transplant On the Day of Your Surgery?

In learning about the hair transplant process and what happens during surgery, patients often want to know if the procedure is painful and whether or not they will be awake during the excisions and insertions. And they may be curious about other aspects of their operation. Here is a general summary of what happens on the day of your surgery.

Right before your procedure, you will be able to meet the team members who will be performing your procedures. Before your operation, you’ll have photos taken of your hair and scalp areas.

You may want to sit down with your doctor and review your goals once again. Many surgeons will mark the outline of the new hairline and temples. Be sure that the design is aligned with what you want. And go over other specific details you hope to achieve so that there are no misunderstandings.

Once the operation begins, you may be positioned face down for your donor graft extraction phase. Hair transplant surgery is usually performed with local, not general, anesthesia which is administered through injections.

Patients are able to remain awake during their procedure. They can therefore take breaks, use the restroom and even watch television. The local anesthesia helps prevent sensations of discomfort. Sedation may be prescribed when it is not contraindicated. The ability to fall asleep can help make the time pass faster. It also helps the overall experience feel more tolerable and comfortable.

The hair transplant process for the actual operation starts with numbing the donor area (where the hair follicle grafts will be removed) with lidocaine and epinephrine.

After this phase, the operator proceeds with the donor extraction phase. This involves excising and removing the necessary follicular units which are then placed in an aqueous storage medium.

Following the extraction phase is the insertion phase. The surgeon creates slits in the recipient area to reflect very specific hair growth patterns, such as angles, densities directions and orientations. Technicians then place the individual grafts into the slits.

At the end of the surgery, the staff will review post-op care instructions with the patient. A written copy is usually provided as well. It will be important to follow these instructions carefully for successful healing and recovery.

Hair Transplant Results Month By Month

In most cases, patients can expect a timeframe of about 18 months to see the full extent of their results in the course of their hair transplant process. Understandably, most people are eager to start enjoying a brand new chapter in their life with their renewed coverage. This may cause individuals to feel anxious as they wait to see the first signs of growth and continued improvements thereafter.

As mentioned earlier, understanding the typical milestones associated with the hair transplant process and knowing what to expect ahead of time will help make the entire experience feel smoother and easier.

Hair Transplant Growth Chart

Here is a visual representation of the average progress of hair transplant results month by month.

In the first two months, the patient’s original hair shafts will start to fall out. Many people nervously fret when they notice this occurring, thinking that their grafts have been dislodged and are actually coming out of their scalps. But this is not the case.
The hair shafts are being shed because the follicle grafts are producing new hair. So losing hair during the first couple of months is a very positive sign.

New growth usually starts to appear around the third to fourth month. In months, 5-6, patients can expect to see continued improvements, although it will appear patchy. More even and uniform coverage usually develops around the 7th to 10th month. This is usually when patients can start to proudly show off their progress to friends and family. In some cases, it may take up to 12 months to see full growth. However, at this time, the hair has not fully matured. Between months 12-18 is when the patients can start noticing a more desirable texture and thickness start to become apparent.

If you are in the Los Angeles area and would like to speak to Dr.U about undergoing a hair transplant procedure, you may fill out our complimentary online consultation form here:

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Further Reading

Learn how this patient of Dr.U was able to defeat his crown baldness and receded hairline through an FUE hair transplant that transformed his onscreen appearance.

Read about his gentleman whose Dr.UGraft procedure with nape, scalp, chest and beard hair restored his appearance and the quality of his life.

The post Dr.U Shares an Overview of the Hair Transplant Process and What To Expect appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

Article Update July 2022

Things to Watch out for After Your Hair Transplant

In summary, hair transplant results take several months to show full results.

Redness and formation of scabs are expected within the first few weeks, and the present hair shaft will most likely fall within the first 2 months of surgery to make way for new healthy new hair.

Suppose you experience redness or cobblestoning after more than a few months post-surgery. In that case, you should get checked by an experienced dermatologist immediately, as this is a strong indicator of complication.

For more detailed information regarding low growth yield following a hair transplant and what you should expect or consider for a successful hair transplant, continue reading below.

Reason for poor growth after a hair transplant

For more information on Dr. Umar please visit: http://www.dermhairclinic.comLearn more about his specialty in Advanced Follicular Unit Extraction here: http:…

Is Your Progress Aligned With a Normal Hair Transplant Timeline or Poor Hair Transplant Growth

Hair transplant results take time to manifest. And without a basic understanding of the average course of events following a procedure, it becomes easy to mistake the slowness of average growth progress for hair transplant graft failure. Understanding the basic timeline for hair transplant growth will help clarify whether or not a patient should come to terms with the possibility of poor hair transplant yield.

In the first couple of weeks following a hair restoration surgery, patients will notice redness and the formation of scabs which then fall off as the skin heals. Within the first two months after surgery, the hair shafts that were present will also fall out. Many people also mistake this for graft failure. But in truth, this is a very usual and positive sign that new hair is forming.

Signs of new hair sproutings become evident between two and four months. The growth initially looks patchy and even but will start to appear more uniform over time. More desirable-looking results start to manifest between the seventh to tenth months. In some cases, patients may not see the growth even ten months past their surgery. This still is not necessarily an indication of failed grafts. Some late bloomers can achieve the results they want in the end. Dr. Umar recommends that patients wait until month 12 before considering the possibility of poor hair transplant growth.

Causes of Failed Hair Transplant Growth – What Los Angeles Patients Need to Know

Hair implants, or grafts, cannot produce growth if they have been severely damaged. Each follicle is a tiny organ, like the heart or liver. Damage to such structures will impair or even destroy their ability to perform typically.

Many factors can lead to low growth yield following a hair transplant. However, a standard set of causes is still attributed to most cases of low growth following a hair transplant.

Poor Selection of Follicular Unit Grafts

Most patients undergo hair restoration procedures because they suffer from androgenic alopecia. This means that hair loss and thinning are caused by hair follicles that have miniaturized and can no longer produce normal hair as they did before. Those who qualify for hair transplant surgery where the head hair is used will have miniaturized follicles and a supply of non-miniaturized follicles that can produce long-term growth.

Surgeons must be careful to only select grafts that have not been affected by miniaturization. But errors can still happen when it comes to choosing suitable grafts. If miniaturized follicles have been included in the donor pool, patients can have poor growth yield.  

Poor Handling of Hair Transplant Grafts

Dr. Umar emphasizes that the extraction and overall handling of the follicles need to be as gentle as possible, avoiding factors that will affect the survival of the graft, such as pulling, tugging, and use of force. Follicular damage due to harsh handling is perhaps the most prominent cause of low growth yield following a hair transplant. 

Mechanical Damage From Surgical Instruments

When using general cylindrical Follicular Unit Extraction (FUE) punches, standard forms of damage may be inflicted on the follicular unit grafts. A few examples include:

Punch Misalignment with Hair Follicle Orientation

This damage can occur when the surgeon has to guess the location and positioning of the hair follicle beneath the skin. With the basic FUE punch, they must rely on the visible hair shaft to make these determinations. But it is possible to make inaccurate assumptions and cause damage to the graft by misaligning the punch.

Inaccurate punch alignments may also occur if the patient moves, making it harder to encompass the grafts safely.

Torsional Damage

Torsional injuries may occur when the follicle ascends into the punch lumen and adheres to the internal wall of a rotating punch. The graft becomes stuck and rotates with the punch, as the lower portion is still attached to the skin. This results in breaking the graft.

Lack of depth control

Follicular units, which define individual hair transplant grafts, may consist of more than one hair follicle bundled by a tissue sheath. The ends are often splayed or spread at the lower portion. If the surgeon advances the punch too profoundly, there is the risk of severing these endings.

Impacted grafts

With more expansive follicular units (due to having multiple hair follicles), grafts can become stuck or impacted within the punch’s interior once thoroughly extracted. The surgeon often has to use forceps to retrieve them. When used with excessive force, the graft can become damaged.

Hair Transplant Graft Failure Due to Air Drying and Extended Time Out of Body

The time the grafts spend out of the body must be kept at a minimum. Dr.Umar recommends a maximum span of no more than six hours from when the follicles are extracted until they are implanted into the recipient’s bald regions. This includes the amount of time after they are excised, placed in a fluid storage environment, and retrieved to be placed in the bald or thinning areas.

Since the hair follicles are very tiny structures, small amounts of water loss due to evaporation will have enormously detrimental effects. Once the grafts are removed from their original site, they must be hydrated right away and placed in a chilled aqueous storage medium consisting of physiological fluid.

Also, the time lapses must be minimized after they are removed from their storage environment and inserted into the recipient area. According to Dr. Umar, this should last a few seconds.

Patient Mistakes That Result In No Growth After a Hair Transplant

Hair transplant grafts can also permanently damage a patient’s choices and actions.

The Risks of Wearing a Hair Piece After a Hair Transplant Procedure

Dr. Umar explains that hairpieces can exert an occlusive, frictional effect on the inserted grafts. This may be worsened by adhesives such as tapes and glues, which cause traction and pull on the hair at the skin’s surface. Similar to traction alopecia, when tension is constantly applied to the hair, this may cause tears in the follicle to permanent damage.

Dr.Umar advises patients to avoid using hairpieces as best as possible following their hair transplant procedure.

The Effects of Chemicals and Inflammation on Hair Transplant Grafts

According to Dr. Umar, patients need to avoid or protect their scalps from anything that might lead to irritation or inflammation of the skin until their hair growth yield has fully manifested.

One example includes harsh chemical products such as dyes, bleaches, and relaxants which can irritate the scalp’s surface. The deeper penetration of these chemicals can harm the grafts. But the effects are often worsened when individuals are allergic to them.

Also, if patients notice the first signs of dandruff following their hair transplantation, they must immediately start following a dandruff care regimen recommended by their doctor. Dandruff is usually caused by a fungus that the body tries to eliminate through inflammatory reactions to attack these microbes. However, these processes can also damage the implanted hair transplant grafts.

Unknown Causes of Poor Growth Yield After a Hair Transplant

In infrequent instances, it is not clear what factors were responsible for failed growth. There are no apparent indications. Or the actual causes may have been outside the range of standard variables described above.

Before choosing a hair transplant provider, patients must understand that these surgeries involve a high degree of skill and experience. The basic premise of these procedures may seem simple enough, as they only involve the transfer of hair follicles from one location to another. But there are many ways for them to face the risk of damage. It would be imperative to select a doctor with a strong track record of successful outcomes in many patient cases.

Following the surgery, the implanted grafts are still vulnerable to being permanently injured or harmed through styling and grooming choices such as using hairpieces and harsh chemicals.

By understanding what causes low growth yield following a hair transplant procedure, patients are in a much stronger position to avoid these factors and experience the results they had planned.

If you are in the Los Angeles area and want to speak to Dr.U about repairing poor hair transplant growth from prior surgeries, submit your information through our complimentary online consultation form.

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Reason for poor growth after a hair transplant

For more information on Dr. Umar please visit: http://www.dermhairclinic.comLearn more about his specialty in Advanced Follicular Unit Extraction here: http:…

If you’ve questions about how to prevent low growth yield in the wake of your hair transplant surgery, click the button below. Our Ask Dr. U for allows you to send your inquiry directly to the doctor himself:

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Further Reading

Discover how this patient of Dr.U overcame the issue of failed growth through a life-changing repair surgery performed by Dr.U

Learn more about the timeframe of hair transplant growth developments by watching this Q&A discussion by Dr. Umar.

The post What Causes Low Growth Yield Following a Hair Transplant? appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

Begin With The Basics:

Patients can begin by logging on to the Internet and doing some basic research on what different hair transplant methods entail. Reading journalistic articles on procedures and finding patient testimonials can best equip a potential patient. Videos and images also can help explain the way a surgery method works. They also explain what to expect in the way of results.

Finding The Right Doctor:

As with any surgical procedure, finding the right doctor helps guarantee success. Potential patients should research a doctor’s education, how long he’s practiced, and how many patients he has treated. In the same regard, most doctors will allow potential patients to view case histories of other men and women he has treated. Viewing case histories helps a patient better understand results. Some physicians will tap former patients to meet with prospective patients to explain their experiences.

Taking The Plunge—Understanding Hair Transplant Through Research:

Before undergoing any surgical procedure [1], a patient should meet with a doctor to develop a treatment plan. A good doctor will always schedule time for a patient to return for surgery and never perform a procedure on the same day as a consultation. Discuss the length of surgery and how long the scalp will take to heal. Find out when to expect results to show. A good doctor will also advise a patient in preparation for surgery and on proper aftercare.

Since each surgical procedure uses different methods, a patient should learn about the mechanics of surgery and understand any risks. Some procedures carry higher risks for failure, complications, or scarring. A wise patient will discuss these factors with a doctor and learn to gauge expectations in his case. Ensuring the best results begins with understanding and researching the procedure. A wise patient will take the time to do both!

Q&A Video: Understanding Hair Transplant Surgery Through Research

Watch the video below to learn more about hair transplant surgery from Dr. U in Los Angeles.

What is the FUE hair transplant surgery process like?

If you are considering FUE for your hair transplant surgery you may be curious to know what the overall experience is like. In this video, Dr. U provides a s…

If you want to consult Dr. Umar for free online, use the button below.

For Further Reading:

• Basic information regarding hair transplant
• Understanding FUE Hair Transplant

References:

1. “Surgery.” Wikipedia, 16 July 2022, en.wikipedia.org/wiki/Surgery#:~:text=Surgery%20is%20a%20medical%20specialty. Accessed 22 July 2022.

The post Understanding Hair Transplant Surgery Through Research appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.