Do hair transplant patients eventually go bald?

I'm not considering a hair transplant, instead I wanted to know if donor hair from the back of the head eventually goes the same way as the hairs that were lost.

The internet seems to be a mixed bag of results regarding this issue, as I read that donor hair remains for life, yet other cases I read about said that donor hair eventually begins to thin in the same way (normally around 7 years later).

It would be useful to find out more about this, as it could determine whether the galea region is creating balding conditions in follicles, or if the follicles which are native to the galea, are programmed to stop producing hair prematurely.

I know there's been mention on here about a peer reviewed study, which mentioned that follicles from the galea were transplanted on to the forearm, and the ones closest to the balding area of the head, began to thin in sync with head hair follicles, whereas follicles from non-balding areas continued to grow. As a result, people started speculating that a 'balding clock' was present, and this determined the lifespan of follicles.

I still think that the galea contributes to the premature demise of follicles, in being that, the tightness of the region (as well as continuous inflammation) likely causes destruction of progenitor cells. Once these cells are gone, then follicles will no longer produce terminal hair.

So, it may be, that donor hair contains much more progenitor cells and this is why each follicle is more impervious to the effects of inflammation, as the extra numbers of these cells assist in wound healing and follicular regeneration.

But do the conditions within the galea, eventually cause these 'stronger' follicles in hair transplant patients to become redundant?

Caustic Symmetry posted that he knows several transplant patients and they do miniaturize over time just like the native hairs.

Someone posted that the dorearm is the second most DHT rich area of the body behing the beard area, and may have been too much DHT for the weakened hairs to handle.
Tell me this. why was there never an experiment where blood flow was increased to the scalp and the results analyzed? What are they afraid of. Oh wait, there was such an experiment, where the Crown Institute botoxed the scalp muscles allowing blood to flow more freely to the scalp. And yes, it did reverse the miniaturization process as they reported an 18% increase in hair (density I'm guessing).

It is hard to believe that these DHT sensitive hairs just so happen to be located in the only region of tight skin in the body. It's a BS line in my opinion and it makes me sick to see shit lies like this being spread, crushing anyones hope in anything but a drug or surgery.

SlowMoe wrote:Caustic Symmetry posted that he knows several transplant patients and they do miniaturize over time just like the native hairs.

Someone posted that the dorearm is the second most DHT rich area of the body behing the beard area, and may have been too much DHT for the weakened hairs to handle.
Tell me this. why was there never an experiment where blood flow was increased to the scalp and the results analyzed? What are they afraid of. Oh wait, there was such an experiment, where the Crown Institute botoxed the scalp muscles allowing blood to flow more freely to the scalp. And yes, it did reverse the miniaturization process as they reported an 18% increase in hair (density I'm guessing).

It is hard to believe that these DHT sensitive hairs just so happen to be located in the only region of tight skin in the body. It's a BS line in my opinion and it makes me sick to see shit lies like this being spread, crushing anyones hope in anything but a drug or surgery.

Thanks for feedback, Slomoe.

I was the one who suggested the forearm / beard area being very high for androgen delivery. I think I was debating with abc123 over this.

The issue is puzzling regarding the DHT dilemma because a pubmed study states that DHT binds to receptors which exist within the dermal papilla and somehow causes the follicles to shrink.

My own thoughts are, a tight scalp leads to reduced circulation and therefore cellular ATP. When this happens, the cytoplasm becomes engulfed with too much DHT (possibly due to excess masturbating over many years), and it cannot metabolize the hormone.

I think that unmetabolized DHT might a) cause a build up of bacterium to feed upon it, thus creating a toxic environment, and therefore increased immune activity (inflammation) b) a build up of DHT inside the cytoplasm may prevent oxygen molecules from being processed within the mitochondria.

However... even if DHT causes these problems within the papilla, it doesn't matter... that much because these cells surrounding the papilla are continually renewed by the progenitor cells within the hair bulge. So what I'm saying is, if these cells died off because of the issues posed by DHT, then new ones would be produced due to the presence of progenitor cells.

An experiment was carried out in vivo, and it involved the removal of the dermal papilla and matrix, yet, due to the presence of the hair bulge and it's store of progenitor cells, both the papilla and matrix regrew and produced terminal hair. When these PC's diminish from the bulge, then matrix cells no longer continue to grow.

If there was a way of restoring these progenitor cells to the hair bulge, then, I suspect, that hairloss would be cured. Perhaps increased bloodflow to the scalp causes greater migration of PC's to the hair bulge, hence what you said about the Crown institute experiments in relaxing the scalp muscles and achieving some hair growth?

I'll have to dedicate more study into this issue.

The progenitor cells required for hair growth are identified as CD200 and CD34:

Bald scalp in men with androgenetic alopecia retains hair follicle stem cells but lacks CD200-rich and CD34-positive hair follicle progenitor cells.

Androgenetic alopecia (AGA), also known as common baldness, is characterized by a marked decrease in hair follicle size, which could be related to the loss of hair follicle stem or progenitor cells. To test this hypothesis, we analyzed bald and non-bald scalp from AGA individuals for the presence of hair follicle stem and progenitor cells. Cells expressing cytokeratin15 (KRT15), CD200, CD34, and integrin, α6 (ITGA6) were quantitated via flow cytometry. High levels of KRT15 expression correlated with stem cell properties of small cell size and quiescence. These KRT15(hi) stem cells were maintained in bald scalp samples. However, CD200(hi)ITGA6(hi) and CD34(hi) cell populations--which both possessed a progenitor phenotype, in that they localized closely to the stem cell-rich bulge area but were larger and more proliferative than the KRT15(hi) stem cells--were markedly diminished. In functional assays, analogous CD200(hi)Itga6(hi) cells from murine hair follicles were multipotent and generated new hair follicles in skin reconstitution assays. These findings support the notion that a defect in conversion of hair follicle stem cells to progenitor cells plays a role in the pathogenesis of AGA.

http://www.ncbi.nlm.nih.gov/pubmed/21206086

SlowMoe wrote:Caustic Symmetry posted that he knows several transplant patients and they do miniaturize over time just like the native hairs.

Someone posted that the dorearm is the second most DHT rich area of the body behing the beard area, and may have been too much DHT for the weakened hairs to handle.
Tell me this. why was there never an experiment where blood flow was increased to the scalp and the results analyzed? What are they afraid of. Oh wait, there was such an experiment, where the Crown Institute botoxed the scalp muscles allowing blood to flow more freely to the scalp. And yes, it did reverse the miniaturization process as they reported an 18% increase in hair (density I'm guessing).

It is hard to believe that these DHT sensitive hairs just so happen to be located in the only region of tight skin in the body. It's a BS line in my opinion and it makes me sick to see shit lies like this being spread, crushing anyones hope in anything but a drug or surgery.

No they do not

They may suffer shock loss, or loss due to poor follow up care, or because the transplant was done by an unskilled surgeon but they do not progressively miniaturize due to DHT!

Most of the hairs from a transplant are good for life.

The issue is that the hairs are placed into a region that is still balding. The hairs that are lost from this region following the transplant will be the hair that were there in the first place already miniaturizing. This is why transplant patients often use finasteride to prevent the areas they get the HT in from looking bad as they lose more native hair from that region. The people who need transplant after transplant are the ones who never managed to get their balding under control with an adequate regimen. Their transplants arent going bad. The hair that was native to the area is just continuing to miniaturize.

I'm not considering a hair transplant, instead I wanted to know if donor hair from the back of the head eventually goes the same way as the hairs that were lost.

Donor area thinning is simply because the hairs that are taken out in a transplant do not generally regrow. The donor areas does not thin do to miniaturization, at least not in common MPB patients. If the person has something like alopecia totalis, or diffuse unpattered alopecia, then I suppose they can lose hair there as well. But assuming the usual HT patient just as common Androgenetic baldness, then it's a safe assumption that their donor area hair won't miniaturize. Of course every hair taken from the region and transplanted is one less hair in the region (unless they use one of the techniques I posted about in the extracellular acellular matrix thread)https://immortalhair.forumotion.com/t8646-use-of-urinary-bladder-matrix-a-bioactive-acellular-scaffold-in-transplant-donor-scars-and-androgenetic-alopecia-initial-clinical-experience

Well, it seems that a hairloss cure is as likely as discovering the lost continent of Atlantis. In other words, it aint ever happening.

Fact is, it seems that MPB is a condition purposely designed by nature... or maybe we could call it a curse. Fuck knows what the reason for it is, as it is a truly unsightly feature and i wouldn't wish it on anyone. But it has always been there and it aint going away.

But then, maybe we hetero guys find it repulsive because we find long flowing hair attractive on a woman, but women might find bald attractive on a man. Infact, when I shaved my head to the scalp, I got more female attention than I ever got, than when I was a pretty boy pinup.

Maybe we should just accept it and shave the fucking lot off, go get laid and be happy

LawOfThelema wrote:

SlowMoe wrote:Caustic Symmetry posted that he knows several transplant patients and they do miniaturize over time just like the native hairs.

Someone posted that the dorearm is the second most DHT rich area of the body behing the beard area, and may have been too much DHT for the weakened hairs to handle.
Tell me this. why was there never an experiment where blood flow was increased to the scalp and the results analyzed? What are they afraid of. Oh wait, there was such an experiment, where the Crown Institute botoxed the scalp muscles allowing blood to flow more freely to the scalp. And yes, it did reverse the miniaturization process as they reported an 18% increase in hair (density I'm guessing).

It is hard to believe that these DHT sensitive hairs just so happen to be located in the only region of tight skin in the body. It's a BS line in my opinion and it makes me sick to see shit lies like this being spread, crushing anyones hope in anything but a drug or surgery.

No they do not

They may suffer shock loss, or loss due to poor follow up care, or because the transplant was done by an unskilled surgeon but they do not progressively miniaturize due to DHT!

Most of the hairs from a transplant are good for life.

The issue is that the hairs are placed into a region that is still balding. The hairs that are lost from this region following the transplant will be the hair that were there in the first place already miniaturizing. This is why transplant patients often use finasteride to prevent the areas they get the HT in from looking bad as they lose more native hair from that region. The people who need transplant after transplant are the ones who never managed to get their balding under control with an adequate regimen. Their transplants arent going bad. The hair that was native to the area is just continuing to miniaturize.

I'm not considering a hair transplant, instead I wanted to know if donor hair from the back of the head eventually goes the same way as the hairs that were lost.

Donor area thinning is simply because the hairs that are taken out in a transplant do not generally regrow. The donor areas does not thin do to miniaturization, at least not in common MPB patients. If the person has something like alopecia totalis, or diffuse unpattered alopecia, then I suppose they can lose hair there as well. But assuming the usual HT patient just as common Androgenetic baldness, then it's a safe assumption that their donor area hair won't miniaturize. Of course every hair taken from the region and transplanted is one less hair in the region (unless they use one of the techniques I posted about in the extracellular acellular matrix thread)https://immortalhair.forumotion.com/t8646-use-of-urinary-bladder-matrix-a-bioactive-acellular-scaffold-in-transplant-donor-scars-and-androgenetic-alopecia-initial-clinical-experience

How do you know they don't miniaturize? PLENTY of celebs' transplants have miniaturized. Look at Joe Rogan. Ask CS. The truth of the matter is, there isn't enough oxygen in balding scalps for hair to flourish, whether it was always there, or if it was transplanted there.

It is true that hair roots from the so called safe donor area still can be lost, most older men are showing some degree of donor thinning. Having that said, hairs growing in the safe donor area without thinning issues, will typically grow just as much anywhere on the scalp if been correctly transplanted.

Xenon wrote:.

Maybe we should just accept it and shave the fucking lot off, go get laid and be happy

One of the best things I've ever seen written here, haha. The funny thing is, removing the stress of thinning hair from your life probably would benefit your hair situation overall. Funny how that all works. There's no doubt your overall health would do good to just get rid of the stress.

Misirlou wrote:It is true that hair roots from the so called safe donor area still can be lost, most older men are showing some degree of donor thinning. Having that said, hairs growing in the safe donor area without thinning issues, will typically grow just as much anywhere on the scalp if been correctly transplanted.

Yeah, but for how long?

SlowMoe wrote:

Misirlou wrote:It is true that hair roots from the so called safe donor area still can be lost, most older men are showing some degree of donor thinning. Having that said, hairs growing in the safe donor area without thinning issues, will typically grow just as much anywhere on the scalp if been correctly transplanted.

Yeah, but for how long?

Forever. Unless it is taken from an area where the hair could potentially miniaturize (outside of the norwood 7 "horseshoe".

The truth of the matter is, there isn't enough oxygen in balding scalps for hair to flourish, whether it was always there, or if it was transplanted there.

I would definitely agree with this. And the fucker about increasing blood pressure to a 'constricted' capillary network, is rupturing. I guess you could compare it to a reservoir being forced through tiny pipes. The pressure would cause the pipes to break.

Let's also take into account, the fact that we have the temple / crown areas pressed against a pillow for 8 hours every damn night, and have been repeating the same process since we were born.

I don't care what anyone says, the sleep compression issue is definitely a factor in creating a constricted capillary network.

Think about it... we have our temples or crowns pressed against the pillow, and is it merely coincidence that it's usually here where thinning usually begins? And yet the vertex region -- the area we don't sleep on -- usually remains as the temples are receding.

In the temple areas, there are no muscle groups and little BAT, so when the temples are pressed down on the pillow, capillaries are literally pressing against the bone of the skull. So there's little surprise (in my mind at least) that capillaries would constrict under the heavy pressure of the head.

Why don't the back and sides of the head go bald even though they are also pressed down against the pillow? Because there are muscles and BAT stores here, which act as protective cushions to the capillaries. For those of you not in the know about these muscles, google temporalis and occipitalis muscles and you'll find that hair always exists where they are.

Xenon, I habitually either do not use a pillow or use quite a thin one. It hasn't helped the hair. And I have the classic mpb recession. And your proposal does not explain vertex balding.

I'm not dismissing your idea here, sleeping on pillows might have a role, but I can't see it being more than a minor one.

rugrats, apologies. It appears I've been misunderstood. When I said pressing the temples against the pillows, I merely meant the pressure caused to the capillary network caused by the weight of our heads pressing against a surface during the time we are asleep.

If you're sleeping with your temples pressed against a harder surface, this would likely cause even worse compression.

And I can't speak for everyone, but maybe areas of the vertex are also pressed down on during sleep.

Remember, I'm only citing this as a contributory factor, and not the overall cause. IMO there are several factors which cause MPB.

Here is a diagram of the muscles I'm talking about. Some diagrams differ and show the frontalis and temporalis muscles joining, whereas this one shows a gap between both muscles.



So you see a gap between muscles near the temples, showing only area of skull. This may suggest that the capillaries of this gapped region are pressing against bone mass during sleep.

Another possibility: guys who have smaller skulls may not have this gap, and the muscles might almost conjoin. If true, then both muscles would form a protective cushion for capillaries during sleep.

Here is a diagram showing the muscles very close to eachother:



Which is accurate? I don't know, but what I do know is, these muscles don't encompass the galea region -- the very place where mpb occurs.

Looking at this photo it is easy to see how any tight scalp condition may force blood away from the areas which lose hair, which are located at the extrematies of the salp vasculare

Slowmoe, and as i understand it, the capillary network gets smaller throughout the galea region (you could compare it to a tree and it's smaller sub branches). This is probably why the galea region bleeds very little during a surgical procedure.

Xenon wrote:Slowmoe, and as i understand it, the capillary network gets smaller throughout the galea region (you could compare it to a tree and it's smaller sub branches). This is probably why the galea region bleeds very little during a surgical procedure.

Yeah. Just look at the diagrams in my previous post and you can see that. If you look at the thread I made about scalp hypoxia you will read that the oxygen levels in NON-balding men are 13% lower in typical balding regions than in typical non balding regions. What this tells me is that the vascular network in the regions that bald first is relatively weak to begin with.

In those with MPB the oxygen levels were 37% lower in balding regions than in non balding regions.

It has been stated by medical professionals that when scalp tissue falls below 40mmhg, that hair loss has been found to occur, even on areas of the body other than the scalp. The levels found in typical non hair bearing areas NON hair bearing and hair bearing individuals are roughly 32 and 51 respectively. So my conclusion is that an oxygen level of 32mmhg is INSUFFICIENT to maintain hair growth, NO MATTER WHERE THE HAIR ORIGINATES.

Yeh, and continuous exposure to extremely cold air may also cause oxygen deficiency. i mean, hair generally causes the scalp to stay warm, but the cells of the hairline area are exposed. When very cold air comes into contact with these exposed cells, it might well assist in causing them to contract, thus lowering oxygen levels even more.

I used a water pump spray bottle on my temples last year, sometime, as an experiment. I did this several times per day for about 4 days. I stopped because I got a bad cold, BUT several days later i was stunned to see that there was diffuse thinning throughout my hairline.

It may not be a huge issue, but just thought I'd throw that one in as another possible factor to be aware of.

Xenon wrote:Yeh, and continuous exposure to extremely cold air may also cause oxygen deficiency. i mean, hair generally causes the scalp to stay warm, but the cells of the hairline area are exposed. When very cold air comes into contact with these exposed cells, it might well assist in causing them to contract, thus lowering oxygen levels even more.

I used a water pump spray bottle on my temples last year, sometime, as an experiment. I did this several times per day for about 4 days. I stopped because I got a bad cold, BUT several days later i was stunned to see that there was diffuse thinning throughout my hairline.

It may not be a huge issue, but just thought I'd throw that one in as another possible factor to be aware of.

Sounds plausible.

Xenon, Slomoe, vascularity plays a role, sure. There may be many other factors too like calcification, ccsvi, degeneration of the skin layer harboring follicles.

Meantime, how do you suggest one sleep? With pillow, without pillow, you are suggesting both would put pressure. So, inclined bed, or soft mattress?

Great diagrams, we've seen them before, wish there were some research studies on these. I'm going to throw in some additional diagrams and ideas in the next post. Since you guys are brainstorming, see if something occurs to you. I've looked into the skull diagrams so often, I've almost given up

rugrats, I sleep on the muscle groups of the scalp (I rest these areas on a soft pillow), and let the temples hang over the pillow edge. If I sleep on my back, I rest the occipitalis muscles on a pillow, so the crown doesn't touch it (i let the crown hang over the pillow edge too).

In regards to calcification, this is possibly what is happening to blood vessels continually pressing against the bone of the skull during sleep, not to mention them suffering from compression.

Skull expansion and Galea have been discussed in this forum before. Then, muscles of the skull have been discussed and there are even exercises for those muscles. Then there are veins supplying blood in the frontal and top part of the skull.

So, when we are talking of how to ensure rich blood and oxygen supply to mpb areas, we should be focusing not just on general health of vessels but also on whether there could be cranial structures that might be closing/shrinking/ossifying and thus causing perfectly good vessels to go belly up. One can massage and brush a pinched blood vessel all year long but if the supply is choked at some point, I don't see how it can help in a significant way.

Okay, so what do you guys think about these structures in the skull? Could there be ossification, calcification, infection somewhere that could be hurting the blood and oxygen supply?

So ladies and gentlement, presenting Exhibit 1 (dramatic music plays), the Anterior Fontanelle!






From http://en.wikipedia.org/wiki/Anterior_fontanelle , While the posterior and lateral fontanelles are obliterated by about six months after birth, the anterior is not completely closed until about the middle of the second year. Full ossification starts in the late twenties and finishes before the age of 50. Could its ossification have a role in blood supply to the frontal (anterior) part of the skull and scalp?

And now, time for Exhibit 2, are you ready for it... Foramina of the skull!
The human skull has numerous holes (foramina) through which cranial nerves, arteries, veins and other structures pass.

Base of the skull, Upper surface-

Base of the skull. Inferior surface, attachment of muscles marked in red-

Anterior cranial fossa-


I'm linking an older version of wikipedia page for the formina below, as I find the current version to be quite poorly formatted. It lists the various formaina, associated bone and fossa, vessels and nerves; if one has any remaining appetite for further learning or research-
http://en.wikipedia.org/w/index.php?title=Foramina_of_the_skull&oldid=539341033

So, in context of male pattern baldness, i.e., AGA, we are interested in the frontal/ anterior, or even the middle region between the anterior and posterior. Could any of the fossa in these parts be closing or becoming narrow? Could there be any kind of infection, or a presence of microorganisms in any of these sites?

In my mind, if there were a blockage caused by something of that nature, the hair al over the sclap would suffer...But most people with MPB still have robust hair outside the galea region...

Xenon, thanks for the suggestion. It's an idea worth trying. It's been a while since I used soft pillows, I'll put it in my to-do list.

SlowMoe wrote:In my mind, if there were a blockage caused by something of that nature, the hair al over the sclap would suffer...But most people with MPB still have robust hair outside the galea region...

Why do you think that SlowMoe? If a blood vessel is carrying blood to the frontal parts of the brain and skull, and it's functioning is compromised due to problem somewhere in one foramen (singular of foramina), why should that affect the blood vessels and supply elsewhere in the skull/brain/scalp? The whole point of the various diagrams are that there is a network of holes in the skull that provide transit points to blood vessels and nerves. Problem in one hole will only affect its corresponding vessel and its branches, no other.

Edit- What I'm suggesting essentially is, could there be narrowing/ossification in formaina- first in the frontal part of the skull and then the middle/ crown region, and finally the posterior region (the last corresponding to the vertex of the scalp)? After all, this is the classic recession of the Norwood-Hamilton scale.

And did you notice the bolded part in my previous post about the anterior fontanelle- Full ossification starts in the late twenties and finishes before the age of 50. The anterior fontanelle seems to be right at the frontal and temple areas- a NW 3 recession area I think. Could there be a link? Could this gradual ossification of the anterior fontanelle somehow affect vasculature? Could the 'full ossification' be completed earlier in those suffering from mpb?

Well it looks like, with the exception of the frontal hairline, that the vessels that feed the scalp emerge from the skull far upstream of any hairloss..