A growing number of researchers in the scientific community are now starting to find more evidence that supports the potential of plant extracts to improve hair loss conditions. You can find impressive medical and academic studies by just performing your own Google search. 

A medical journal called Case Studies in Dermatological Medicine published the work of Sanusi Umar MD in a report entitled, A Multimodal Hair Loss Treatment Strategy Using A New Phytoactive Topical Formulation.

A Multimodal Hair Loss Treatment Strategy Using A New Topical Phytoactive, published in Case Studies in Dermatological Medicine

5 patients suffering from different hair loss conditions (i.e androgenic alopecia, CCCA, traction alopecia, and post-menopausal hair loss) were given the opportunity to use an all-natural topical treatment called Gashee, developed by Dr.U himself. 

All five individuals experienced amazing improvements in their hair loss.  

So how was this made possible? According to Dr.Umar, there are many factors that contribute to alopecia, not just one or two. Inside of working with just one or two pathways, we have to consider an entire picture consisting of multiple, interacting components, including inflammation, oxidative stress, and the effects of protein signaling on the different phases of our hair cycle. 

Synthetic drug chemicals rely on very specific molecules and can only target a single pathway. On the other hand, plants naturally contain a variety of compound variations that can seamlessly address the multiple targets associated with real-life hair loss scenarios.

Previously, skin thickness type was completely overlooked in the practice of FUE hairline restoration, as well as in the hair transplant industry as a whole. It has been assumed that hair curvature presents a challenge when attempting to use a straight cylindrical punch to follow the hair shaft down to the follicle. In theory, this may seem to be a logical basis for transected grafts. But direct observations on actual patients do support the concept of skin thickness (either extreme thickness or extreme softness) as a much more significant factor to consider.

Skin Type and Hair Type – Which matters more in FUE hair transplant?

While hair type can also contribute to hair transplant graft transection across patient cases, it plays a much smaller role towards the overall final percentage. Here is the rationale.

Current and older generations of FUE technology fail to serve patients of color. It was simply assumed that the underlying problem was the unpredictable angulation that Afro-textured hair grows in. This makes it difficult for a straight punch to follow the curvature in order to excise around the follicle without transecting it.

Through careful observation in his own clinic in Redondo Beach, Los Angeles, Dr. U noticed comparatively higher transection rates patterns in other ethnic groups, such as those of Asian and Arabic descent, specifically. Although their hair was far from curly and kinky, their skin thickness apparently was the contributor to their graft damage.

Skin Thickness – How does my skin thickness type affect the outcome of my FUE hairline restoration?

All human skin can be categorized within the same spectrum. Those with exceptionally hard and thick skin will find themselves at one extreme end, while those with soft and thin skin will be at the other. However; there are many shades of variance in between, accounting for the wide variety of human phenotypes we see around us in.

Skin thickness will determine a few very important things in FUE hairline restoration. It is the source of tissue resistance the FUE punch will need to cut through in order to retrieve the follicle graft from its origins in the skin. With unusually thick skin, it is more difficult to cleanly and completely excise the follicular unit graft using FUE instrumentation of generic strength and design. Patients with thick skin will need much more powerful tools to see success in their hairline restoration.

Conversely, thin skin can sometimes be too delicate for even the most gentle FUE technology. Using tools that are too fast, rough, or powerful runs the risk of the hair transplant specialist tearing through the skin surrounding the follicle instead of excising it. This leaves the hair graft naked, with no tissue sheath protecting it in the recipient area which will adversely affect their ability to survive in their new location.

Dr.UGraft ™ is engineered to accommodate any type of skin. This all-in-one technology is the first of its kind. Capable not only of FUE hairline restoration in patients of every skin type and thickness, it is also able to extract grafts from the body (where the surrounding tissue is always going to be much softer than the scalp). This unique technology is able to make BHT body hair transplant an option for just about any patient.

Frequently-Asked Questions About Skin Thickness and Hair Restoration for Men

Why has the importance of skin type never been emphasized before in hairline restoration?

As discussed above, most doctors rationalized that the curliness of the hair was the primary cause of transected grafts. Since basic FUE tools, have a cylindrical shape, the practitioner can only rely on the visible hair shaft above the skin as a cue for aligning their punch correctly in order to accurately surround the hair follicle. Trying to trace the curvature of the hair with this configuration would be a futile attempt.

Will skin thickness disqualify me from FUE hairline restoration?

If your hair transplant specialist uses the Dr.UGraft ™ FUE system in his or her practice, the thickness of your skin will be accounted for due to the intuitive and customizable features of this technology.

This technology is built to alert the operator when faced with extreme skin resistance (due to very thick skin) or resistance which is very weak. He or she can then adjust the speed and torque settings, allowing the punch to safely extract your grafts without harming the outer tissue sheath.

Further Reading

An especially comprehensive study on BHT body hair transplant in a large sample of Dr. U’s own patients

Dr. U on hair loss in the New York Times

Hair loss can certainly result from Acne Keloidalis Nuchae (AKN), a condition which manifests as varying sizes of bumps on the back of the head. To understand how this form of alopecia occurs, it is important to realize that with this condition, an amplified skin healing response (which is related to a genetic predisposition) is triggered by the presence of the individual’s own hair. 

The hair follicles are no longer able to produce new hair shafts as they once did. Due to the extensive damage inflicted, the skin produces large amounts of thick collagen with the intent of repairing itself. These processes are the basic causes of AKN related hair loss, following the formation of bumps on the back of the head.

It is very important to have this awareness, especially with the widespread misconception that Acne Keloidalis Nuchae is the result of unclean barber clippers and can therefore be treated with DIY (e.g. rubbing alcohol and apple cider vinegar) approaches aimed at addressing bacteria

Is It Possible to Restore Hair In Acne Keloidalis Nuchae Sufferers ?

Understandably, the hair loss which occurs due to AKN can be disheartening for most patients. While it is actually not possible to regrow hair in the areas that have been affected, surgical or laser treatments can be employed to produce more discrete or natural looking outcomes. The exact approach used would determine the type of result which can then be achieved.

An Improved Appearance Through A Raised Posterior Hairline or Sparser Hair Density Following Laser Treatment

New improvements in laser treatment for Acne Keloidalis Nuchae result in better cosmetic outcomes for patients. Depending on the severity of the presentation, they may result in a raised posterior hairline or sparser hair density, coupled with a more natural-looking form of hair coverage. 

To see how these improvements are attained and why they make a positive difference for patients, a good starting point is to first understand the rationale beyond the procedure.

In essence, the aim of a laser treatment would be to epilate (i.e. remove) hair so that it no longer perpetuates and sustains the progression of Acne Keloidalis Nuchae.

Dr.U has outlined specific treatment zones for epilation, based on the spread of the AKN lesions. As one example, if small lesion bumps are concentrated in the lower part of the nape area, the treatment zone would require that all hair is removed within this region, rather than just addressing the individual bumps on the back of the head which would leave a patchy appearance. This would cleanly raise the posterior hairline above an area where hair  has been entirely removed. The end result is far more natural looking in appearance. And many patients would prefer this to having empty regions surrounded by hair.

If the bumps on the back of the head have spread much further up the scalp, Dr.U recommends giving individuals the option to retain some hair, versus completely epilating the entire back of the head. Patients would then be able to retain more styling choices (e.g. short buzz cut).

AKN laser treatment shown before and after procedure with a rather unnoticeable raised posterior hairline and a cohesive region of hair left in tact.

Posterior Hairline In Alignment with Linear Scar

For large-sized lesions, Dr.U has developed a specialized surgical removal technique where the lesion is excised according to a bat-shaped contour. When the wound-edges close together, this results in a linear scar which is then discretely aligned with the posterior hairline and inconspicuous to onlookers.

Large AKN lesion excised with resulting linear scar discretely aligned with posterior hairline

Thin Linear Scar Covered By Hair 

Trichophytic closure results in a thin linear scar through which the patient’s own hair grows through

A small sized lesion in the upper part of the nuchal area can be excised. Dr. U has developed The appearance of the wound closure outcome can be improved upon using a method known as Trichophytic closure, an approach used in strip surgery. This is where the upper and lower wound edges are cut at specific angles to produce a more seamless looking end-result when they are closed-together. The lower wound margin would also contain decapitated hair follicles. 

The purpose of this  would be to grow hair through the upper wound margin and resulting linear scar, providing an additional form of camouflage. 

With these surgical methodologies, Acne Keloidalis Nuchae patients are now have new alternatives which are capable of closely approximating the appearance of restored hair. This includes less noticeable scarring and an improved cosmetic appearance through a more normal looking posterior hairline.

Further Reading

Read more about punch size and its relation to pain experienced by the patient 

Did David Beckham have a hair transplant? Find out more here