In this episode, Dr. Sanusi Umar discusses the case of John, a patient who came in with severe acne keloidalis nuchae (AKN) affecting the back of his scalp.

Many patients with acne keloidalis first notice bumps on the back of the head or irritation along the neck hairline. Over time, these bumps can become thicker, inflamed, and sometimes lead to scarring if the underlying inflammation continues.

For John, the condition had progressed enough that surgery was recommended to remove the diseased follicles and scarred tissue.

After the procedure, John’s sister Cheyenne immediately noticed the improvement. When she saw him, she reacted with excitement and relief, asking how the surgery went. John explained that everything went well, although the surgical team had to remove slightly more tissue than originally expected to fully address the affected area.

When Acne Keloidalis Nuchae Appears with Another Condition

During the episode, Dr. Umar explains that John’s case was unusual because he had two inflammatory scalp disorders occurring together.

In addition to acne keloidalis nuchae, John also had dissecting cellulitis, a deeper inflammatory condition that can cause painful lumps or cyst-like nodules under the scalp.

Cases like John’s show why careful evaluation is important. Sometimes patients diagnosed with AKN may also have related conditions such as folliculitis decalvans, which is another type of inflammatory scalp disorder.

Recognizing these overlapping conditions helped the Bumpinator, Dr. Umar, determine the most appropriate treatment approach.

Why Proper Diagnosis Matters

Dr. Umar explains that bumps on the back of the head are often mistaken for simple razor bumps or ingrown hairs. However, conditions like acne keloidalis nuchae and dissecting cellulitis involve chronic inflammation around hair follicles, which can gradually damage the scalp if left untreated.

By identifying the exact pattern of disease and removing the affected follicles during surgery, doctors can stop the cycle of inflammation and prevent further scarring.

For patients like John, proper diagnosis and treatment can make a dramatic difference in both scalp health and confidence.

For medical details of this case, visit dru.com.

Watch John’s Story

Watch the thirteenth chapter of John’s transformation here:

• Instagram
• TikTok

Take the Next Step

If you or someone you love is facing Folliculitis Decalvans (FD), don’t lose heart.
Early, expert attention can change the trajectory of your journey. Watch Anwar’s story, learn more at dru.com, and explore your own next steps toward healing.

At The Bumpinator and The BaldCast, every patient is a hero.

The post Acne Keloidalis Nuchae and Dissecting Cellulitis: A Complex Scalp Case Explained appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

The primary goal of Dr. U’s team was to remove the diseased tissue from the hard bumps on the back of the head, while creating a natural looking contour at the back of the scalp.

Removing the Source of Inflammation

One of the primary goals of the surgery was to completely remove all of the lesions from the area of the chronic folliculitis of the nape. By removing this tissue, it is possible to eliminate some of the inflammatory signals (also known as cytokines), which are responsible for the progression of pus filled bumps on the head. 

Dr. Umar stated that by removing the inflammatory source, along with John’s continuing weight loss, he expects to see a slowing down, cessation, or improvement of the activity of both DC and cutis verticis gyrata CVG in the future.

Ongoing Post-Operative Management Plan

Dr. Umar also discussed how other non-surgical treatments will be utilized to help manage the dissecting cellulitis post-operatively. He emphasized that this will be an additional part of a multi-step process in managing John’s chronic scalp condition, which is well understood to be a long term problem. 

While the surgery addressed the structural and advanced disease of the scalp, the medical treatment will continue to address the chronic nature of the disease to ensure optimal healing, maintenance of scalp health, and durability of the results achieved through the surgery.

For medical details of this case, visit dru.com.

Watch John’s Story

Watch the twelfth chapter of John’s transformation here:

• Instagram
• TikTok

Take the Next Step

If you or someone you love is facing Folliculitis Decalvans (FD), don’t lose heart.
Early, expert attention can change the trajectory of your journey. Watch Anwar’s story, learn more at dru.com, and explore your own next steps toward healing.

At The Bumpinator and The BaldCast, every patient is a hero.

Disclaimer:
This story reflects one patient’s personal experience and treatment by Dr. Sanusi Umar. Individual results vary. Always consult a qualified physician for personalized advice.

The post Quieting The Fire Due To Pus Bumps On The Scalp appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

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.

“At The Bumpinator, we show what happens when insight meets the right tools. Hope is not a plan. We show the plan,” said Dr. Umar.

Unlike spectacle-driven medical shows, The Bumpinator focuses on thoughtful diagnosis, precise technique, and results that last. Viewers see Dr. Umar use his patented UGraft Zeus hair-extraction system, Athena tension suture guards, and advanced phytoactive formulations to address keloids, acne keloidalis nuchae, folliculitis decalvans, dissecting cellulitis, botched hair surgeries, and extreme hair loss.

Dr. Umar’s peer-reviewed research has been published in leading journals, including JAMA Dermatology, Dermatologic Surgery, JAAD, Dermatologic Therapy, and Clinical, Cosmetic and Investigational Dermatology, with select works available on the Research & Publications page of this site.

“People arrive after years of setbacks,” said Dr. Umar. “We show what happens when careful thought and innovation come together.”

Many of the conditions featured in The Bumpinator occur across all populations but are more frequent in some groups, including African American and Hispanic patients. By featuring people from many backgrounds, the series highlights how advanced and inclusive care can bridge long-standing gaps and deliver outcomes that restore both health and confidence.

“These are human stories first,” Dr. Umar said. “Our patients reflect the world’s diversity, and our goal is always the same—to restore confidence through knowledge and innovation.”

About The Bumpinator

The Bumpinator is a digital docuseries created by Dr. Sanusi Umar that documents complex skin, scalp, and hair cases resolved through innovative procedures and original medical devices. Filmed primarily at Dr. U Hair and Skin Clinic in Manhattan Beach, California, the series blends clinical rigor with authentic patient stories.

About Dr. Sanusi Umar

Dr. Sanusi Umar, MD, FAAD, is a board-certified dermatologist, hair-restoration surgeon, inventor, and educator. He leads Dr. U Hair and Skin Clinic, serves on faculty at Harbor-UCLA Medical Center and the David Geffen School of Medicine at UCLA, founded the Hair Peace Foundation, and organizes the Los Angeles Hair Restoration Courses (LAHRC). His expertise has been featured on Dr. Pimple Popper, Good Morning America, The New York Times, and MSNBC.

Watch the trailer: https://youtu.be/_JlmfLjv5FU
Full premiere: October 23, 2025 on YouTube

English: The Bumpinator shares authentic patient journeys from diverse communities, presenting medical innovation that serves everyone.
Español: The Bumpinator comparte historias reales de pacientes de comunidades diversas, mostrando innovación médica que beneficia a todos.

The post Dr. Sanusi Umar Launches The Bumpinator, a Digital Docuseries Tackling Complex Skin and Hair Conditions Others Could Not appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

Introduction to FD and Treatment Dilemma

FD is characterized by the development of purulent plaques or masses, leading to scarring alopecia. This condition primarily affects middle-aged men and presents a complex challenge due to the limited efficacy of current treatments. The result is often result in recurrence upon cessation. Our case series, organized in a paper titled “Refractory Folliculitis Decalvans Treatment Success with a Novel Surgical Excision Approach Using Guarded High-Tension Sutures,” and published in the Clinical, Cosmetic, and Investigational Dermatology Journal, delves into a novel surgical technique that provides a beacon of hope for those afflicted with this refractory condition.

The Breakthrough Surgical Approach

“In this case series, we treated five patients with histologically confirmed FD using a surgical excision approach. The distinctive feature of this technique is its emphasis on second-intention healing with the assistance of carefully applied high-tension sutures. Although unconventional, this method demonstrated notable effectiveness in wound contraction and eventual healing.”

Results and Significance

The results of this case series are striking. All patients experienced successful wound healing, with wound contraction ranging from 47% to 83% of the original wound diameters. Moreover, this approach achieved complete remission in all cases. There were no instances of disease recurrence observed over a follow-up period of 10 to 24 months.

Unprecedented Long-Term Remission

What sets this surgical technique apart is its ability to achieve lasting remission in FD patients, even in cases where conventional treatments have failed. This represents a significant advancement.  Many FD patients have experienced a series of treatments that provide only temporary relief at best. Our approach provides a potential solution to disrupt this recurring cycle, offering individuals an opportunity for sustained relief and an enhanced quality of life.

Implications for Future Research and Clinical Practice

While this case series marks a noteworthy step forward, it’s important to recognize that it’s in its early phases. To establish the complete extent of the technique’s effectiveness and safety, more extensive controlled studies are required. Nevertheless, these initial positive outcomes encourage researchers and clinicians as they explore enhanced treatment options for FD.

Conclusion

Our case series on refractory FD treatment using a novel surgical excision approach with guarded high-tension sutures is a milestone in dermatology. The technique’s ability to achieve long-term remission holds the promise of transforming the lives of those affected by this challenging condition. As we await further research and validation, this breakthrough brings renewed optimism and progress to the realm of FD treatment.

The post Refractory Folliculitis Decalvans Treatment Success with Novel Surgical Excision Approach: A Breakthrough Case Series appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

What Exactly Is Low-Level Light Therapy

Low-Level Light Therapy, also known as LLLT or photobiomodulation therapy, involves using specific wavelengths of light energy to stimulate cellular activity and promote hair growth. These therapeutic light sources emit low levels of laser or LED light, targeting the scalp and stimulating the hair follicles.

Mechanisms of Action

Enhanced blood circulation

LLLT increases blood flow in the scalp and stimulates microcirculation around the hair follicles. This improved circulation provides essential nutrients and oxygen necessary for hair growth.

Anti-inflammatory effects 

LLLT has been found to reduce inflammation in the scalp, which can contribute to hair loss. When specific wavelengths of light are applied to the skin, it activates cellular processes that promote healing, reduce inflammation, and alleviate pain. LLLT stimulates the mitochondria within cells, improving their energy production and releasing chemical signals that regulate inflammation. By modulating the immune response and reducing pro-inflammatory cytokines, LLLT helps to calm and soothe the body’s inflammatory pathways and, thus, creates an environment conducive to hair growth.

Cell metabolism and protein synthesis

Light energy absorbed by the hair follicles stimulates cellular processes, promoting DNA synthesis, cell proliferation, and protein synthesis. The mitochondria absorb the photons emitted by the low-level light sources, the powerhouse of the cell, which then leads to the production of adenosine triphosphate (ATP). ATP provides energy to the cells, promoting their growth and function. Additionally, LLLT is believed to decrease the activity of dihydrotestosterone (DHT), a hormone that contributes to hair loss in individuals with a genetic predisposition. These factors contribute to the growth and maintenance of healthy hair.

Benefits of LLLT as Hair Loss Treatment 

Non-invasive

Unlike surgical hair restoration methods, LLLT is a non-invasive treatment without incisions, making it safe and painless.

Convenient and Easy to Use

LLLT can be performed at home using handheld devices or through in-office sessions. The treatments are usually short, requiring only a few minutes daily or weekly, depending on the device used.

Effectiveness and Clinical Studies

Numerous studies have been conducted to evaluate the effectiveness of LLLT in treating hair loss. Research findings indicate that LLLT can be a valuable addition to the arsenal of hair loss treatments. A randomized controlled trial published in the American Journal of Clinical Dermatology in 2014 demonstrated that LLLT increased hair density in men and women suffering from androgenetic alopecia, a common form of hair loss. Another study published in Lasers in Surgery and Medicine in 2019 found that LLLT resulted in significant hair regrowth in individuals with alopecia areata, an autoimmune condition causing patchy hair loss.

Side Effects of LLLT

Low-level light therapy is generally considered safe and well-tolerated. However, like any medical treatment, there can be potential side effects, which are typically minimal and temporary. Below are some possible side effects of using LLLT for hair loss treatment.

Mild Scalp Irritation

Some individuals may experience mild scalp irritation, itching, or redness during or after LLLT sessions. However, these effects are usually temporary and subside quickly.

Dryness or Flakiness

In some cases, LLLT may cause temporary dryness or flakiness of the scalp. Patients can manage this by ensuring proper scalp hydration and using moisturizing products, if necessary.

Headaches

Rarely individuals may experience a mild headache following LLLT treatment sessions. If this occurs, it is advisable to consult with a healthcare professional.

What’s the Verdict?

Low-level light therapy offers a promising solution for individuals struggling with hair loss. Its non-invasive nature, safety profile, and demonstrated effectiveness make it an attractive option for those seeking to restore their hair and regain confidence. While LLLT may not be a universal cure for all types and severities of hair loss, it has shown remarkable potential as an adjunctive treatment in combination with other therapeutic approaches. As the field of hair restoration continues to evolve, LLLT holds a bright future in the fight against hair loss. As always, if you’re considering trying out LLLT or any other hair loss treatment, it is essential to consult with a qualified dermatologist before pursuing the specific treatment type.

Frequently Asked Questions

Can I use LLLT to treat my hair loss if I’m Norwood 6?

LLLT is better suited for the initial stages of hair loss. If your hair loss has progressed to NW 6 already, you should consult a dermatologist to find the best treatment option for you.

After how many uses will I notice an improvement if I use a home device?

You would need to use a home LLLT device at least 8-10 times, for 10-15 minutes each time. Allow about two weeks between treatment sessions. 

References

(No date) Efficacy and safety of a low-level laser device in the treatment of … Available at: https://dash.harvard.edu/bitstream/handle/1/12152951/3986893.pdf?sequence=1 (Accessed: 12 July 2023).

Farivar, S., Malekshahabi, T. and Shiari, R. (2014) Biological effects of low-level laser therapy, Journal of lasers in medical sciences. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291815/ (Accessed: 12 July 2023).

Henderson, R. by E. (2021) Low-level laser treatment can stimulate hair follicles and hair growth, expert finds, News. Available at: https://www.news-medical.net/news/20210920/Low-level-laser-treatment-can-stimulate-hair-follicles-and-hair-growth-expert-finds.aspx#:~:text=%22This%20low%2Dlevel%20laser%20therapy,10%20times%2C%20every%20two%20weeks (Accessed: 12 July 2023).

NE;, A.M. (no date) The use of low-level light for hair growth: Part I, Journal of cosmetic and laser therapy : official publication of the European Society for Laser Dermatology. Available at: https://pubmed.ncbi.nlm.nih.gov/19466643/ (Accessed: 12 July 2023).

N;, P.R.T. (no date) Quantitative proteomic analysis of dermal papilla from male androgenetic alopecia comparing before and after treatment with low-level laser therapy, Lasers in surgery and medicine. Available at: https://pubmed.ncbi.nlm.nih.gov/30843235/ (Accessed: 14 July 2023). 

Pillai, J.K. and Mysore, V. (2021) Role of low-level light therapy (LLLT) in androgenetic alopecia, Journal of cutaneous and aesthetic surgery. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8906269/#:~:text=Studies%20have%20shown%20that%20LLLT,in%20both%20males%20and%20females (Accessed: 12 July 2023). 

The post Illuminating Hope: Low-Level Light Therapy for Hair Loss Treatment appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

Neurotoxins

Neurotoxins are chemical signals that can alter the strength and excitability of neural connections. They bind to specific receptors or the neuron and thus block or weaken incoming signals. 

Botox vs. Daxxify

Botox and Daxxify are neurotoxin treatments that aim to reduce wrinkles and fine lines; they both work at the neuromuscular junction by inhibiting the release of the neuromodulator called acetylcholine. Normally, the nerves transmit an activation message to the muscle by releasing acetylcholine into the space between the nerve and the muscle. Blocking the release of this chemical neuromodulator results in failed muscle activation, causing paralysis or weakness.

Similarities and Differences

As neurotoxins, both of these injectables are skeletal muscle relaxants. As such, the two are similar in many ways. 

Both injectables are prescription only and have a similar profile regarding drug interactions – both are reported to have 24 major drug interactions and 90 moderate drug interactions. Similarly, neither Botox nor Daxxify has alcohol or food interactions. The two injectables can cause complications in individuals with dysphagia, respiratory and neuromuscular disorders, and infections. 

Despite the broadly similar drug profiles, Botox and Daxxify have some crucial differences, too. These distinctive traits determine the correct neurotoxin for your purposes and how long the results will last. 

Daxxify has abobotulinumtoxinA (ABO) as a base, while Botox uses onabotulinumtoxinA (ONA). The two injectables also use different stabilizers for botulin. Botox uses albumin, while Daxxify uses a peptide instead. 

Daxxify is also not recommended for patients with cardiovascular diseases, while Botox is advised against if the patient has UTI. 

Side Effects and Complications 

Both drugs’ side effects can range from mild to critical. The more severe side effects generally involve the toxin botulinum spreading beyond the intended area. Depending on the migration area, extent, and the patient’s medical history, the spread can cause critical and fatal issues.

Natural Looking Treatment Results For Crows Feet & Forehead Wrinkles

The early signs of crows feet and forehead wrinkles started to reveal themselves on this patient. Dr. U performed a Botox treatment to create the subtle improvements that she wanted.

Which one is right for you

Although both neurotoxins are relatively fast-acting, Daxxify provides more immediate results based on clinical trials. 

When considering which injectable to use, it’s also essential to consider the treatment area. Currently, Daxxify is only approved for treating frown (glabellar) lines, so if that’s your specific target area, Daxxify may be the better choice, assuming the claim of its effects lasting longer holds.

Botox has a much more comprehensive array of uses, including its off-label uses. Some of these uses include the treatment of jowls, frown lines, crows’ feet, smoker’s lines, gummy smiles, horizontal forehead lines,  horizontal neck lines, and more. 

Ultimately, choosing between these treatments depends on individual preferences and desired outcomes. Daxxify and Botox each have their advantages, so which one is better for you depends on your specific goals. 

Frequently Asked Questions

Which injectable lasts longer?

The results’ length mainly depends on the patient’s metabolic rate and the stabilizer used in the injectable. Daxxify uses a peptide as a stabilizer instead of the human blood serum albumin used in Botox. The peptide makes botulin more stable, so the results typically last longer.

Are Daxxify side effects worse than Botox side effects?

Daxxify and Botox side effects are similar – potential bruising, headaches, and migration risk. 

References

1. Daxxify: Uses, dosage, side effects & warnings. Drugs.com. Accessed June 28, 2023. https://www.drugs.com/daxxify.html.

2. Onabotulinumtoxina Injection: Uses, side effects, interactions, pictures, warnings & dosing. WebMD. Accessed June 28, 2023. https://www.webmd.com/drugs/2/drug-153463/onabotulinumtoxina-injection/details.

3. Rapaport L, Migala J, Petrarca M, Groth L, Lawler M, Haupt A. Daxxify: 8 things to know about the new Botox Alternative. EverydayHealth.com. Accessed June 28, 2023. https://www.everydayhealth.com/healthy-skin/fda-approves-daxxify-things-to-know-about-botox-alternative/.

The post Is Daxxify Better Than Botox? appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

• hairline
• crown. 

Choose a Doctor Carefully

Each FUE hair transplant case has its unique challenges, and for this specific patient, the following were important factors to consider: 

1. Significant baldness. He falls into the level 5 baldness category.
2. Thin hair. This means he will require a lot more grafts to achieve density
3. Duration of baldness. This results in a slick area of baldness. Typically, in such areas, the follicular apparatuses have been replaced by fibrous (scar) tissue, with a loss of the fat usually found around the follicles and believed to encourage hair regrowth.

Expanding the Donor Pool

Since the patient is interested in FUE hair transplant for global coverage (putting hair in all the bald areas), he sought a doctor who could increase his donor potential by safely harvesting hairs from the scalp, beard, and body areas. 

Addressing the problem of thin hair by using thicker-haired donor areas 

Beard hair grafts are thicker than head hair grafts. In a patient with thin-shafted donor hairs, the large caliber of beard hairs can be an advantage in imparting density. 

Creating a soft natural hairline by using thin hair-shafted donor grafts

A necessary process to creating a natural-looking restoration is in the crafting of soft natural looking hairlines. In all hairlines, there is a transition from a slick area of no hair to an area of thick hairiness. This transition must be subtle. Harsh pluggy hairlines are unnatural and give away the procedure to even a casual observer. The practitioner must use finer donor hairs, typically from the nape, periauricular areas, or the body, to overcome this. Nape and periauricular hair are usable in patients that have passed the FUE shave test developed by Dr. U. Body hair should also be used in patients that meet defined criteria such as density of hair in the body hair donor location the hair caliber. These criteria for body hair qualification were published in the aesthetic surgery journal.

After much research, he consulted Dr. Umar (also called Dr.U) in Manhattan Beach, California.

A Customized Approach to His Make Pattern Baldness

At his consultation with Dr. Umar’s hair restoration clinic, the patient and the practitioner decided on using the patient’s beard, scalp, and nape as donor areas. 

During the procedure, Dr. Umar drew the patient’s hairline to graft the area with hair follicles taken from his donor areas. For his FUE hair surgery, 4287 hair grafts were derived from the patient’s head, 1820 from his beard, and 373 from his nape. After preparing the hairline, the frontal scalp, and the crown, which were the target areas, Dr. Umar started implanting the grafts along the drawn hairline. After grafting the area, he proceeded further down the back of the head to fill the scalp and crown area in a pattern and density that assured the most optimal results. 1026 hair grafts were used to fix the patient’s hairline, 1442 filled the frontal scalp, and 4012 grafts were implanted to improve the coverage in his crown area. 

Drastic Improvement in the Patient’s Hair Coverage

The patient was satisfied with his hair surgery results and said it turned out how he wanted. He was also happy with the smooth process and how he’d expected it to take much longer. Although with conventional FUE, there can be difficulties and complications when extracting grafts from a non-head area, the UGraft Zeus is fully equipped to harvest grafts from anywhere on the body. Dr. Sanusi Umar designed the device to overcome the usual challenges of conventional FUE. This means BHT FUE is no longer an issue. Neither are curly or coily hair, long unshaven hair, or thick skin hair transplant surgeries. For these reasons, the UGraft Zeus serves as an all-purpose FUE device. Its adjustability makes the FUE procedure much quicker and less challenging and provides optimal results. It’s easily a win for both the patient and the doctor.

Below you can see a much fuller coverage 1 year and 8 months after surgery.

His receding hairline was one of the patient’s chief complaints. The patient could address that issue by undergoing an FUE operation at Dr. Umar’s clinic (Figure 6). 

Figure 6 shows a drastic improvement in the man’s crown and the posterior area of the head. The hair transplants have a natural look that still gives the patient great coverage.

The video below shows that the patient’s male pattern baldness is masterfully reversed with the FUE hair transplant. 

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References

1. Hair Follicle: Function, Anatomy, and Conditions. Healthline. https://www.healthline.com/health/hair-follicle. Published 2022. Accessed August 5, 2022.
2. Male Pattern Baldness: Causes, Identification, and Prevention. Healthline. https://www.healthline.com/health/male-pattern-baldness. Published 2022. Accessed August 5, 2022.
3. Umar S, Shitabata P, Rose P, et al. A New Universal Follicular Unit Excision Classification System for Hair Transplantation Difficulty and Patient Outcome.

Frequently Asked Questions

As some doctors say, is FUE too challenging to perform on Afro hair?

Dr. Umar has specifically developed Ugraft Zeus to accommodate patients of all ethnic and racial backgrounds. He has made sure to tackle the challenges of conventional FUE and, for FUE, has solved the problems of curly-coily hair, skin thickness, and firmness. Unless extreme factors prevent you from getting an FUE hair transplant, you will not be turned away by us simply on the merit of having an Afro-type of hair.

Can you use Dr.UGraft Zeus for a transplant on women with long hair?

Its improved design allows the Ugraft Zeus to perform FUE surgeries on long hair without shaving the donor area. You could come in for a procedure with long hair and still have a successful FUE hair transplant, whether you’re looking for treatment for female or male pattern baldness or other types of hair loss. 

Further Reading 

https://dru.com/rethinking-the-impossible-for-severe-baldness-worse-than-norwood-7/

https://dru.com/the-social-pitfalls-of-the-male-hairpiece/ 

The post Patient Gets Hair Grafts from His Scalp and Beard to Address His Severe Hair Loss appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

Introducing the Male Contraceptive Pill

According to the study, 75% of men in the trial who took the pill said they would be comfortable using it. This is a significant improvement from the feedback to previous versions of the male contraceptive pill, where most participants would feel like the side effects are too adverse for them to use it regularly. 

In another study, the pills were also shown to be 99% effective in preventing pregnancy in mice. This is solid evidence that they work well in lowering testosterone levels. It’s important to mention that the pill may not behave the same in human clinical trials because, as Hodge et al. demonstrated in a recent study, the same genes in humans and mice behave differently. This means more research is needed, but whatever results we have now seem promising.

More Than Birth Control: Potential Antidote to Hair Loss

Although the primary purpose of the pill is to prevent pregnancy, given that it works by bringing down testosterone levels, it could potentially be used to venture into other uses, such as Male Pattern Baldness (MPB) prevention. Suppose the studies that led to the development of the male contraceptive pill were to be used as a pilot study for androgenic alopecia treatment research. In that case, it could prove promising, given the mechanisms of MPB.

From Testosterone to DHT

DHT is an androgen hormone responsible for developing male sex characteristics such as facial hair and deepening of the voice. It is also implicated in some forms of male pattern baldness, as DHT receptors are also found in the scalp. 

DHT (dihydrotestosterone) is converted from testosterone when the enzyme 5-alpha reductase (5AR) converts free testosterone into dihydrotestosterone (DHT). The process of producing the hormone is known as 5 alpha reduction. 

Why The Pill Could Work

Given that DHT plays a crucial role in male pattern baldness, one way to prevent hair loss is to target how much DHT is created in the body. Lowering testosterone levels decreases the amount of DHT circulating in the body, reducing its effect and the risk of MPB. 

As already discussed, the male contraceptive pill does bring down testosterone levels in the body, as shown by the effective pregnancy risk reduction. Since DHT is converted from testosterone, less testosterone in the bloodstream means less DHT floating around near the receptors in the scalp. 

Things to Consider

Although the results of this trial portray a very optimistic picture, it’s worth noting that at  96 participants, the trial size was too small to make any solid conclusions. Some of the 96 were in the control group and were given the placebo. This further reduces the number of participants who took the birth control pill. Naturally, a clinical trial with a bigger sample size would be needed for the results to be more conclusive.  

Another consideration is that one of the tests conducted was done in mice. This is the one that yielded the impressive results of 99% effective prevention of pregnancy. As we briefly touched on this above, although many genes are the same in humans and mice, those genes behave differently in the two species. It’s easy to get blinded by the 99% effectiveness statistics, but it’s crucial to understand where and how those statistics come from. Based on the study by Hodge et al., the high gene expression divergence score confirms that it’s better to study new drugs affecting species-specific mechanisms directly in humans. 

Something that can’t be overlooked is the importance of healthy testosterone levels in men. Low testosterone levels can lead to various negative consequences, including decreased sex drive, erectile dysfunction, low muscle mass, increased body fat, decreased bone density, and decreased energy levels. It can also cause depression, irritability, and difficulty concentrating. Additionally, low testosterone levels put men at an increased risk of heart disease, diabetes, and other health issues. Addressing low testosterone levels is vital to maintaining physical and mental health.

In the Meantime…

While the studies on the male control pill show promising effectiveness in reducing testosterone levels, it will be a while until the pill is on the market. Even further research and trials will be required to extend the scope of the pill usage to hair loss. So what are some other alternatives in the meantime?

FDA-Approved Drugs

Finasteride, an FDA-approved drug targets MPB by blocking the enzyme 5AR, thus, inhibiting the conversion of testosterone to dihydrotestosterone (DHT). However, the drug has severe side effects in men, such as erectile dysfunction, depression, loss of libido, anxiety, brain fog, and more. For women, it’s not even approved and is forbidden to be prescribed to pregnant women. 

Another FDA-approved drug for hair loss is Minoxidil. This drug works by inhibiting the effects of androgen hormones on the hair follicles to stop hair loss and by stimulating the follicles to prompt new hair growth. But Minoxdidl doesn’t come free of adverse effects either. Some unwanted effects of the drug include skin irritation, pruritus, and telogen effluvium (TE). 

Botanical Alternatives

Another way to improve scalp and hair health is using well-researched botanical products. Botanical hair and scalp treatments can be very beneficial for several reasons. They often contain natural ingredients packed with nutrients, vitamins, and minerals that can help nourish and revitalize the hair and scalp. Botanical treatments can help promote hair growth, reduce hair loss, and improve the overall health and condition of the hair. In addition, many botanical ingredients have anti-inflammatory and anti-bacterial properties that can help calm and soothe an irritated scalp, which can help reduce dandruff and other scalp-related issues. Botanical hair and scalp treatments can help you achieve healthier, more vibrant hair and improve overall health.

Some commercial products, such as Aveda and Gashee, use those botanical ingredients to maximize hair health without the side effect profile that comes with drugs. Gashee products, for instance, comprise plant-based ingredients such as green tea, aloe vera, horsetail, and rosemary oil. These ingredients have been known to improve hair strength, reduce breakage, and promote healthy hair growth. Green tea, for instance, contains catechin, antioxidants that reduce inflammation in the scalp – one of the main reasons for hair loss. The best part is, by using a product like Gashee, you get all the benefits of the natural ingredients without any adverse side effects of drugs such as Finasteride or Minoxidil. 

Frequently Asked Questions

Will the use of the male birth control pill cause erectile issues?

The pill is not on the market yet, so it’s hard to tell. The trial participants did say they did not experience any adverse side effects that would make them uncomfortable using the pill regularly. It’s good to keep in mind that low testosterone levels are unlikely to come without consequences. 

Can I improve my hair health and reduce hair loss without lowering my testosterone levels?

Ensuring your scalp is healthy, your hair follicles are nourished and protected, and your hair strands are strong and moisturized are all good places to start improving hair health. You can use well-researched and tested botanicals to achieve those goals. 

References

1. Endocrine Society. Dimethandrolone undecanoate shows promise as a male birth control pill. Endocrine Society. https://www.endocrine.org/news-and-advocacy/news-room/2018/dimethandrolone-undecanoate-shows-promise-as-a-male-birth-control-pill. Published November 15, 2019. Accessed March 18, 2023.
2. Endocrine Society. Male contraceptive pills show promise in new study. Endocrine Society. https://www.endocrine.org/news-and-advocacy/news-room/2022/male-contraceptive-pills-show-promise-in-new-study. Published June 22, 2022. Accessed March 18, 2023.
3. Hodge RD, Bakken TE, Miller JA, et al. Conserved cell types with divergent features in human versus Mouse Cortex. Nature. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6919571/. Published September 2019. Accessed March 18, 2023.
4. Puckering E. New study shows huge breakthrough in male contraceptive pill. LADbible. https://www.ladbible.com/news/new-study-male-contraceptive-pill-20220903. Published September 3, 2022. Accessed March 18, 2023. 

Further Reading

https://dru.com/9-reddit-users-on-what-happens-when-youre-balding-at-20/

The post New Male Contraceptive Pills: Good for Hair Loss? appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.

• Hairline, 
• Crown,
• Mid-scalp,
• Frontal scalp.

The patient wanted a hair transplant surgery to restore hairline and mid-scalp hair. He also knew he didn’t want to compromise the quality of the transplant for any reason, including distance. 

This is why to get a hair transplant; the patient traveled from London to the Dr. U Hair and Skin Clinic in beautiful Manhattan Beach, CA.

Baldness? We Don’t Know Her. 

The patient saw Dr. Umar for a consultation and was categorized as NW3. After drawing his hairline and discussing his transplant goals, the patient and Dr. Umar decided on 7400 grafts to address the patient’s problem areas.

The grafts were derived from the patient’s head, nape, and beard using the UGraft Zeus – the first all-purpose FUE device invented by Dr. Sanusi Umar.

By getting hair transplants at the Dr. U Skin and Hair clinic, the patient received a hairline, crown, and mid-scalp hair restoration that changed his look in the best way possible. The new youthful look made him feel more confident and comfortable in his skin. As you can see below, his transplants turned out so natural they were indistinguishable from the rest of his hair. 

Check out his amazing hair surgery results below! 

https://youtube.com/shorts/Yn_ACN3XpD0?feature=share 

References

1. Hair loss – Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926. Published 2022. Accessed September 28, 2022.
2. Umar S, Lohlun B, Ogozuglu T, Carter MJ. A Novel Follicular Unit Excision Device for All-Purpose Hair Graft Harvesting. Clin Cosmet Investig Dermatol. 2021;14:1657-1674. Published 2021 Nov 16. doi:10.2147/CCID.S333353

Frequently Asked Questions

Do hair transplants last forever, or will they fall out?

Generally, if your surgeon takes the grafts from areas with permanent hair, the transplanted hair should not fall out. However, there have been instances when transplanted hair has been known to thin out. Common reasons for this will include the following:

1. Possible grafting of non-permanent hair,
2. Scarring alopecia or some other autoimmune disease that attacks or weakens the hair follicles,
3. Rarely, there may be no apparent cause. 

Will people be able to tell I got a hair transplant when they stand close by?

Hair transplants aim to have a permanent and unnoticeable solution to hair loss, unlike wigs, hairpieces, etc. If you go to a skilled hair transplant surgeon, they should be able to make sure your transplants blend in with the rest of your hair seamlessly. That being said, it’s not impossible for someone with a trained eye to notice transplants if they’re standing close to you. 

Further Reading 

https://dru.com/dr-ugraft-bht-to-repair-a-botched-hair-transplant-in-a-santa-monica-los-angeles-patient/

https://dru.com/botched-and-donor-depleted-severely-bald-patient-repaired/ 

The post Baldness? We Don’t Know Her.  appeared first on Dr. U Hair & Skin Clinic | FUE Hair Restoration, Dermatology and Laser Surgery | Los Angeles, Manhattan Beach | Dr Sanusi Umar MD.