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Thank you for your question.

You submitted your question without a photo and you're asking, is it possible to kill

a dormant follicle by using a 0.7 millimeter punch when placing a graft. Well, I think

it's fair to conclude that you're considering hair transplant surgery and you are concerned

about the viability of dormant follicles when you have your surgery.

Well, I can certainly help you understand some of the science and the rationale behind

a treatment strategy that I recommend for patients every day in my practice. A little

bit of background, I'm a Board-certified cosmetic surgeon and Fellowship-trained oculofacial

plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island

for over 20 years. I am also the founder of TrichoStem™ Hair Regeneration Centers, a

system that we developed using extracellular matrix and platelet-rich plasma (PRP) to help

hair transplant heal better going back now about 7 or 8 years. And we've developed

a treatment that non-surgically helps people with hair loss for men and women suffering

mostly from genetic pattern hair loss. So certainly, I am no stranger to the challenges

of dealing with the consequences of hair transplant surgery. This as I said was the rationale

behind our Hair Regeneration treatment.

When you place a hair graft, you are dealing with a scalp depending on the advanced nature

of the hair loss with a certain percentage of existing hair that you can see and a certain

percentage of hair that you cannot see. When you think about the science of hair loss that

is androgenetic alopecia, there is a continuous decrease in the growth cycle or the active

growing phase while there is a prolongation of the resting phase known as the telogen

phase. What that means is that a certain significant percentage of hairs are actively not growing

at any given time.

Now what you are certainly aware of clearly by the way you asked your question is that

there is also a certain percentage of collateral damage during a hair transplant depending

on the relevant density of existing hairs. It was always a rationalization by every hair

transplant surgeon that when you are placing grafts that hairs that were thinned were going

to go away anyway.

Well, when we were doing hair transplant and using extracellular matrix and platelet-rich

plasma (PRP), we found that thinning hair actually became thicker. From this, we were

able to develop painstakingly over several years a process we call TrichoStem™ Hair

Regeneration. What I learned over time is a way to reactivate hair that was not growing,

thicken thinning hair and prolong the lifespan of existing hair.

With further time of treating a wide range of patients from young males with aggressive

pattern of hair loss to older males with minimal to moderate progressive hair loss to women

of all ages of the same age range that we developed a classification system and that

classification system factors in gender, age, age of onset of hair loss, rate of progression,

degree of progression and other variables that we have customized so that the dosing

and the strategy is optimized. But when I came down to comparing in certain patients

the question of transplant versus injection, it was clear that a significant percentage

of patients actually had results with our injection exceeded not just one but two hair

transplants. The reason for this was that the reactivation of dormant hairs, hairs that

you are concerned about being potentially traumatized or damaged permanently by a placement

of a stab incision in the scalp or the placement of a hair during a transplant.

So when I look at our results, I look at thickening of the thinning hair then I realize that it

was an optimal strategy even for patients who are still going to get a hair transplant.

So it wasn't necessarily a question of either/or but what I basically explain to my patients

every day is that every hair that is present, thick and is providing scalp coverage is a

hair that doesn't have to be transplanted which means that in my practice, when patients

come to me let's with frontal progressive hair loss and they still want to get a frontal

hairline developed, well part of the strategy is to first do Hair Regeneration treatment

and also in some patients, the addition of a DHT blocker depending on our algorithm in

which some patients or some males of higher DHT sensitivity or would still benefit from

a DHT blocker more than others, then we can see after the course of a year to 18 months

or so how much scalp coverage there is with this strategy. Like I said, every hair that

becomes thick and covers the scalp is a hair that doesn't have to be transplanted. And

it's a reminder that there is a limit of the number of grafts that can be harvested

and placed. So it actually works very well in synergy.

And it's important to understand that hair transplant is one treatment strategy but pharmaceutical

and stem cell or Hair Regeneration technology are all part of an overall treatment strategy.

There is no cure for hair loss but there is a way to optimize coverage maximally for every

individual based on the variables that we look at.

So to answer again the question of whether or not you can get a dormant follicle traumatized

by a punch, the answer is yes. Yes, you have to go straight through the skin and if there

is a hair follicle underneath that and the stab goes through, you are either going to

damage the hair follicle directly or just vascular compromise. The trauma of surgery

and inflammation can also comprise the survivability of the grafts as well as existing hairs.

We've had patients who have come who had mega session surgery where 90% of the grafts

did not survive. So we have people coming from around the world who have had transplants

and have been very challenged in getting the outcome they were hoping for. It doesn't mean

you shouldn't do a transplant but I would suggest just thinking about what is the potential

to maximize coverage before you do the transplant.

So I hope that was helpful, I wish you the best of luck and thank you for your question.

For more infomation >> How Hair Transplants can Damage Existing Hair Follicles, and a Transplant Alternative Treatment - Duration: 9:19.

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Why Minoxidil Doesn't Cause Hair Loss, but Additional Treatment is Needed for Aggressive Hair Loss - Duration: 10:27.

Thank you for your question.

You submitted your question without a photo. And you're describing in your question that

you've been on minoxidil for about 4 weeks and that it has been your observation that

your hair loss is actually getting worse to the point that you are counting over a hundred

hairs per day. And it seems that you're asking whether or not this is caused by the

minoxidil. Well, I can certainly share with you how I discuss the use of minoxidil in

my practice for patients who like yourself are dealing with hair loss.

A little bit of background, I'm a Board-certified cosmetic surgeon and Fellowship-trained oculofacial

plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island

for over 20 years. I am also the founder of TrichoStem™ Hair Regeneration Centers, a

system we developed which was derived from the use of platelet-rich plasma (PRP) and

Acellular matrix during hair transplant as an additional tool in the treatment armamentarium

for men and women with genetic pattern hair loss. And we treat patients from all around

the world and we've been doing this since 2011.

So I spend a lot of time putting the treatment strategies into context for people who are

suffering from male pattern hair loss. And it's important to understand that the use

of minoxidil may have a certain value based on its pharmaceutical effect but its relative

success for patients does vary. And it's also important to recognize that the drug

which was originally a drug for hypertension, for high blood pressure, had this side-effect

of hair growth. However, there is variable expression of male pattern hair loss. So you

can understand that there are people who start losing hair early and they lose hair very

fast. There are people who start losing hair closer to their late 30s and lose hair very

slowly and there is a wide variation in between. So it is common that patients will do something

called a correlation-causation error which means that they will use a drug like minoxidil

and because their hair loss is still progressing, they feel that the drug caused the hair loss.

It's kind of a temporal thing but not necessarily a cause and effect.

It's also important to understand that minoxidil is not the only treatment for hair loss. And

that if you are progressing, you may want to also look at other strategies and this

is the discussion that I'll have with my patients. Essentially, just to go over the

concept of Hair Regeneration, when we were doing hair transplants and we wanted to help

our patients for a better wound healing in the donor area as well as better graft survival,

the material that we used, Acellular matrix and platelet-rich plasma (PRP) appeared to

also stimulate hair growth and so thinning hairs became thicker that were not transplanted.

And from that, we derived a system to help patients maximize hair growth.

And what we do is essentially an injection treatment and then we watch our patients.

And routinely, we'll also do a booster injection around 15-18 months or 15-24 months depending

on a profile that I developed from all these years of experience in treating so many patients

from around the world. And basically the profile that I am referring to is based on the gender,

the age of the patient, the age of onset of hair loss, the rate of progression of hair

loss, the degree of progression as well as other variables which is the use of different

drugs, the certain hormonal issues and other medical conditions.

That being said, it is not unusual for me to hear the story that someone tried minoxidil,

they got frustrated with it and then they abandoned it or they tried minoxidil and they

thought that it made their hair loss worse.

So when I see a patient and they learn about Hair Regeneration and they want to come for

a treatment, I also discuss with them other options that includes transplant, that also

includes for men the use of a DHT blocker like finasteride. It's very important to

understand that regardless of the strategy where no one is curing hair loss, what we

are doing is we're working with your genetics to maximize the longevity and coverage of

your scalp.

So a lot of my patients who are describing a scenario like yours where they're losing

a lot of hair, if it's a male pattern hair loss patient, then I'll say to them well

even with Hair Regeneration where we can really, independent of other drugs, make a big impact,

I have attributed a certain level of DHT sensitivity based on a person's profile. So for a lot

of our patients, I still have a discussion about DHT and I'll put them also on a drug

like finasteride.

Now of course, there's a lot of fear about finasteride and the medical community still

has a general consensus that the drug is effective and is relatively safe enough to continue

prescribing it with consistency. That being said, the key to hair loss is not just DHT.

We've had many patients who were on finasteride and they would still progress but I feel that

the DHT blocker did have a value in sustaining the hair follicle longer than otherwise would

have been without the pharmaceutical intervention. In those patients, I'll do a Hair Regeneration

treatment and their hairs will get thicker. So DHT blocking will prolong the lifespan

of the hair. The stimulation of Hair Regeneration results in better coverage. So ultimately,

there's kind of a synergy opportunity there.

Now if someone has been on minoxidil for an extended period of time then I usually let

them stay on it because that's a strategy to control a variable. However, minoxidil

has a certain pharmaceutical effect that is dependent on the drug being continuously applied

and the relative responsiveness. And I would argue that it is really dependent on relative

DHT sensitivity and the rate of progression. So if someone has, let's say, someone in

their late 30s or really 40s is starting to lose hair to the point that they're noticing

something, that somebody who has a later onset probably has a slower progression, someone

like that generally seems to do well with minoxidil. In contrast, a younger person with

an early onset and rapid rate of progression generally doesn't seem to find value in the

use of minoxidil.

So I would say that it is important for you to explore all the options you have to help

you with your hair loss that includes the drug called finasteride, the technology of

PRP and Acellular matrix which we call in our practice TrichoStem™ Hair Regeneration

as well as of course, what everyone knows about hair transplant and see what strategy

makes the most sense for you. And as far as the minoxidil is concerned, it is again, without

the benefit of more information and detail, I can't say if the minoxidil is not going

to have any value in your long-term treatment strategy but I think you have to look at other

options in order to get the most optimal strategic benefit for your hair loss situation.

So I hope that was helpful, I wish you the best of luck and thank you for your question.

For more infomation >> Why Minoxidil Doesn't Cause Hair Loss, but Additional Treatment is Needed for Aggressive Hair Loss - Duration: 10:27.

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Peripheral Neuropathy : Causes, Diagnosis, Symptoms, Treatment, Prognosis - Duration: 13:16.

hello viewers welcome to my channel and in today's topic is peripheral neuropathy

yeah but before starting this topic I would like to request you to like

subscribe and share these videos to support this channel and if you need

more information about any disease or any medical condition you can visit my

website which is www.DiseasesAndTreatment.com you know and the link for the website is just

below this video in the description area so you can click that link to visit my

website no I thought Apothic what is painful in your back to you

you're the beta for the nervous system connects the nerves from your brain and

a spinal cord or the central nervous system to the rest of your body and this

includes your arms hands feet legs internal organs mount and face unit and

the job of these nerves is to deliver the signals about the physical sensation

back to your brain now the peripheral neuropathy is a

disorder that occurs when these nerves malfunction because they are damaged of

they are destroyed you know and this disruption nerves normal functioning and

that this might send the signals of the pain when there's nothing causing pain

you know or they might not send a pain signal even if something is harming you

you know so this can be due to like injury it may be due to an inherited

disorder or maybe like systemic illness or maybe due to infection you and the

disorder is like uncomfortable but treatments can be very helpful and the

most important thing to determine is whether the peripheral neuropathy is the

result of a serious underlying the next thing is what are the types of

peripheral neuropathy well there are more than 100 different types of the

peripheral neuropathy unit and each type has the unique symptoms and specific

treatment options you know so the peripheral neuropathies are further

classified by the type of a nerve damage in one do you know like mono neuropathy

occurs when only one nerve is damaged you know and they're pulling neural at

ease which means that more which are more common and the multiple nerves are

involved you you know the three types of the peripheral nerves are deaf detect

you know like sensory nerves motor nerves and autonomic nerves you

know yeah the sensing nerves are which

connect to your skin and the motor nerves which connect to your muscles and

the autonomic nerves which connect to your internal organs

okay so sensory motor and autonomic nerves you know so the sensory nerves

will be connected with the skin motor nerves connected to the muscles and the

autonomic nerves which are connected to the internal organs like heart or lungs

spleen and liver etc so the pay for the Apache can affect one nerve grow or

maybe all of three you know and the simple of a peripheral neuropathy may

include like a tingling in the hands or maybe tingling in the feet you know a

feeling like you are reading at white glove or socks you a numbness in the

hands or numbness in the field the buzzing of shocking sensation may be a

week or heavy feeling in the arms or in the legs you know that is - difficulty

especially in case of autonomic nerve damage you are maybe

thinning of the skin now we have the sensing nerves I know of you know

and sexual dysfunction especially in men you know idea excessive sweating so

these are the common signs and symptoms you know and these symptoms can also

indicate or the like conditions and make sure to tell your doctor about all your

symptoms in detail units so it will help your doctor to make the right diagnosis

okay this is what other causes well the people who have the family history of a

peripheral neuropathy they are more likely to develop this observer you know

and the variety of factors and underlying conditions may also cause the

condition like generalized diseases or maybe you know injury or maybe alcohol

and toxins you know infections autoimmune disorders you know when we

are talking about generalize which may be the lot of damage caused by the

diabetes is often the most common forms of neuropathy and this leads to the

numbness pain and loss of sensation in the extremities maybe in the feet when

I'm in the hands human and the risks often everything freezes like if you're

overweight if you have a high blood pressure or a is over 40 you know have

the diabetes you and other correct diseases may cause the new path these

are nerve damage which means you know like kidney disorders hypothyroidism and

diseases that cause the chronic inflammation unit and deficiencies of

vitamin b1 b6 b12 and II you know which are essential for the nor health you

know and function you injuries like accidents alcoholism smoking infections

autoimmune disorders it's a YCA such as herpes simplex or when it's yours or

strawberry which you can pause you know shingles

HIV and AIDS you know and autoimmune diseases like rheumatoid arthritis

Lupe's they can also affect a very formal system you know in many ways you

know and there are certain medications that I can cause a nerve damage and they

may include like anti convulsions you know drugs to fight bacterial infections

some blood pressure medications and my medications used to treat cancer you

know the next thing is how do doctors diagnose well first of all your doctor

will perform the physical examination and he will look at your reflexes you

know responses you know of the nerves and muscle if I you know it must be a

question about the history of the disease you know like which idiots

involved you know for how long you were having any underlying condition except

like any family history and if he suspects then he will otherwise the

further test which meaning you would like blood tests to me you then wait I

mean be six orbit we're worried levels in the blood you know twittered function

tests CT scan or MRI to see if anything pressing on the nerves you know

such as like a heavier base or maybe tumor you know and sometimes you talk to

me advise the nerve biopsy you know this is a minor surgery and that involves

removing small amount of the nerves not this shows you that can be seen under

the microscope to see if there's an inflammation of any of them abnormality

you know and and other this is electromyography you know which is you

can show the problems how your body's enough signals move right to your

muscles you know and enough conduction study is another treatment as well is

there another test you in this test your doctor will place the electrodes onto

your skin and then the person tiny most of electric

so the nerves to see if the nerves are transmitting signals properly you know

and this procedure is slightly uncomfortable while it's happening but

it's I should have hired afterwards you know so it's comparatively it's a safe

procedure otherwise you know and it helps to diagnose the new practice you

know and specifically which normal

involve you know what's diagnosed and what are the treatment options well the

treatment is based on the treating the underlying disorder underlying cost you

know and if the diabetes is the cause making certain that blood glucose is

controlled it's very important you know and if it's due to the vitamin

deficiencies then the vitamin supplements play an important role that

part of treatment you and the many treatments can bring relief and can help

you return to your normal activities you know and sometimes a combination of

treatments work better you know there's some over-the-counter medications like

Paulino well maybe non-steroidal anti-inflammatory drugs you know explain

and Epico formula they can help to control the pain you know and if they

don't work then your doctor may prescribe you those stronger medications

for the pain you know and these material like narcotics sometimes antiepileptic

medications and then some antidepressants you know maybe

combination and the prescription drugs for the sexual dysfunction

men made cool are also helpful and make look like where or or maybe strained

right since I you know you dr. can use several medical treatments to control

the symptoms of these conditions you know and plasmapheresis

is a blood transfusion that removes the potentially irritating antibodies from

your bloodstream and if you get a nerve block you're taught to believe in jet

and anesthetic directly into them now soon and another great option is like

transcutaneous electronic nerve stimulation you know which is known as

te NS and but it does not work for everyone but many people like it because

there's a drop free tribunal and you know during this treatment electrodes

placed on the skin they send signal a small loss of the electrode electricity

into the skin you know and the goal is to disrupt the nerves from transmitting

the pain signals to not bring you and

economic costs and spleens are also helpful if the neuropathy affects your

feet your arms your legs and your hands you and some of the like massage their

medications or yoga and acupuncture and chiropractic you know they're also

helpful to many the same points if the neuropathy is due to any underlying

condition you know you may be able to spot your pear phone

by just simply treating their underlying condition but if this is not the case

you can successfully manage the symptoms of your pay for liberty and to speak

with your doctor or could run on best medical check option for you okay it can

be controlled well or prevented like we avoid alcohol drinking more mission in

moderation is okay in our white smoking healthy lifestyle healthy joy exercise

regularly so this ways you can lower the chance of

having supper a little bit and if your blood pressure blood sugar and they are

well controlled thank you very much for watching this video if you need more

information about any disease any medical condition you can visit my

website which is www.hyken.com and please do not forget to Like

subscribe and share these videos to support this channel thank you