Dr. Robert Bernstein discusses the benefits of the ARTAS Robotic Hair Transplant system in The Aesthetic Guide, a leading periodical in the field of aesthetic surgery. The article examines how robotic Follicular Unit Extraction (FUE) procedures are an improvement over FUE using handheld devices.
Q: Both Propecia and Minoxidil definitely can work in the front of the scalp as long as there is some hair in the area. Although their mechanisms of action are different, both Propecia (finasteride) and Rogaine (minoxidil) act to thicken miniaturized hair regardless of where it is on the scalp. In fact, there are published data (Leyden et. al., JAAD, 1999) demonstrating this improvement in a controlled clinical trial of men with frontal hair loss. — J.S., Great Falls, Virginia
A: Both Propecia and Minoxidil definitely can work in the front of the scalp as long as there is some hair in the area. Although their mechanisms of action are different, both Propecia (finasteride) and Rogaine (minoxidil) act to thicken miniaturized hair regardless of where it is on the scalp. In fact, there are published data (Leyden et. al., JAAD, 1999) demonstrating this improvement with finasteride in a controlled clinical trial of men with frontal hair loss.
The source of the confusion on this topic is the fact that the FDA limited the application of the drugs to the crown on the package inserts for both Propecia and Rogaine. The FDA did this because Upjohn (the company that introduced Rogaine) and Merck (Propecia) only tested the medications on the crown in the clinical trials. Logically, the fact that DHT causes frontal hair loss and Propecia works by blocking DHT gives a reasonable explanation for the efficacy of the drug on the front of the scalp. Also, a side effect of the use of minoxidil is facial hair, so how could it not also work on the front of the scalp? It is regrettable that some doctors and many patients think that these medications won’t work on the front of the scalp. Unfortunately, many hair restoration surgeons have done little to educate the public and dispel this myth.
To reiterate, yes, both of these medications can work on the front of the scalp to prevent hair loss and thicken a thinning hairline. However, it is important to note that neither of these medications can grow hair on a totally bald scalp or lower an existing hairline. Hair follicles must exist for the medications to work. It is also important to stress that the best results come from using both finasteride and minoxidil together.
Could a recently FDA-approved drug for rheumatoid arthritis also be a cure for a common type of hair loss called alopecia areata? The drug is called Xeljanz, and that’s what Dr. Brett King, assistant professor of dermatology at Yale, is hoping.
Dr. Bernstein was interviewed by Spencer Kobren on The Bald Truth, the critically acclaimed broadcast on hair loss and hair restoration. They discussed the latest in robotic hair transplant surgery, the ARTAS Robotic System, FUE and FUT hair transplant procedures, and the future of hair restoration.
Dr. Bernstein was interviewed by Spencer Kobren on The Bald Truth, the critically acclaimed broadcast on hair loss and hair restoration. They discussed the latest in robotic hair transplant surgery, the ARTAS Robotic System, FUE and FUT hair transplant procedures, and the future of hair restoration.
The follicular unit extraction (FUE) procedure consists of four steps: the separation of follicular units from the surrounding tissue, the removal of follicular units from the scalp, the creation of recipient sites, and the placement of follicular units into these sites. The first step is performed by the ARTAS robotic hair transplant system – the part of the FUE procedure requiring the greatest precision and that is most subject to human error.
Robert M. Bernstein, MD, MBA, FAAD, a Clinical Professor of Dermatology at Columbia University in New York and a pioneer of modern hair transplant procedures, is honored to be included in New York Magazine’s annual ‘Best Doctors’ issue for the fifteenth consecutive year.
Dr. Bernstein’s two decades of innovation in surgical hair restoration and dedication to his patients at Bernstein Medical – Center for Hair Restoration have earned him placement in the 2014 edition of the peer-nominated ‘Best Doctors’ issue. The respect his colleagues have for his work stems from his leadership and dedication to advancing and improving surgical hair restoration procedures.
While grafts can fall out within the first few days after a hair transplant, this is extremely rare. More often, patients will mistake the hair that normally falls out after a transplant for the graft itself. This is because the hair has a little bulb at the bottom of it, but that’s not the follicle; it’s just the root sheath, so it is nothing to be concerned about.
At Bernstein Medical, generally, we don’t perform surgical hair restoration on patients younger than 25. This is because it is difficult to determine if the donor area contains enough stable hair to perform a hair transplant. We advise patients in their late teens and early twenties to first use medication and to postpone surgery until they are at least 25 years old.
Recent news reports, coupled with warnings from Merck and the FDA, about Propecia’s possible persistent sexual side effects have caused growing concern about this popular hair loss treatment. An increasing number of men now fear that Propecia (finasteride 1mg) will cause permanent sexual dysfunction.
A 2014 meta-analysis, however, found that the number of self-reported cases of persistent sexual dysfunction by patients given finasteride was statistically no different from the number reported by patients given a placebo.
This latest research supports the conclusion of existing literature that there is no correlation between finasteride use and persistent or permanent sexual dysfunction. That said, this is an important issue that still needs to be studied.
