Latest / Scalpel and Skin / Are Hair Loss Treatments Worth It? Minoxidil, PRP, Exosomes & Hair Transplants | EP 06

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Are Hair Loss Treatments Worth It? Minoxidil, PRP, Exosomes & Hair Transplants | EP 06 · Scalpel and Skin

• 0:00
  SPEAKER_00: Today we're talking about hair loss therapies, and you are wearing a bald cap, a wig.
• 0:06
  SPEAKER_00: What are you talking about?
• 0:07
  SPEAKER_03: This is just me.
• 0:09
  SPEAKER_03: And we're back.
• 0:11
  SPEAKER_03: I'm feeling a little off the wall right now.
• 0:16
  SPEAKER_00: Is this like George Costanza?
• 0:18
  SPEAKER_03: Doesn't everybody have like nine wigs in their office?
• 0:22
  SPEAKER_03: Supplements, in-office procedures, PRP, PRF, PGDF, Minoxidil, Finasteride, Red Light caps, worth it or not worth it?
• 0:44
  unknown: Okay.
• 0:49
  SPEAKER_00: I mean, I'm not surprised at all.
• 0:53
  SPEAKER_03: All right.
• 0:54
  SPEAKER_03: So here we are.
• 0:56
  SPEAKER_03: Welcome to episode six of Scalpel and Skin.
• 0:59
  SPEAKER_03: I'm Dr.
• 0:59
  SPEAKER_03: Eldric Lebraska, bald, board-certified plastic surgeon north of Pittsburgh and New York City, here with my baby sister, Mystical Ebraska, a cosmetic dermatology physician assistant for 16 years.
• 1:11
  SPEAKER_03: What are we going to talk about today?
• 1:12
  SPEAKER_00: Today we're talking about hair loss therapies, and you are wearing a a what what do we call this?
• 1:20
  SPEAKER_00: A bald cap?
• 1:21
  SPEAKER_00: What are we talking about?
• 1:22
  SPEAKER_00: A wig cap.
• 1:22
  SPEAKER_03: This is just this is just, you know, I this is just me.
• 1:25
  SPEAKER_00: I encourage everyone who's listening to just really quick go on YouTube and see what this looks like.
• 1:36
  SPEAKER_00: Cause it's you look like a swimmer.
• 1:40
  SPEAKER_00: It's giving Michael Phelps.
• 1:42
  SPEAKER_00: But thank you.
• 1:43
  SPEAKER_03: Michael Phelps is a world-class athlete, much like our father.
• 1:49
  SPEAKER_00: Yes, he is.
• 1:50
  SPEAKER_00: Yes.
• 1:51
  SPEAKER_00: Yes.
• 1:52
  SPEAKER_00: Much like our father.
• 1:55
  SPEAKER_03: Um, all right.
• 1:56
  SPEAKER_03: For those of you that don't know, our father was a football player for West Virginia University in the 1970s, and uh most of y'all are women, and so this you're not gonna get this, but he had a tryout with the Miami Dolphins.
• 2:09
  SPEAKER_03: Uh, and had he made the team, he would have uh been on the 1972 Miami Dolphins football team.
• 2:15
  SPEAKER_00: He tried out for the Miami Dolphins.
• 2:17
  SPEAKER_03: He had a tryout.
• 2:18
  SPEAKER_03: I don't know the I don't remember the details.
• 2:22
  SPEAKER_00: This is um news to me.
• 2:24
  SPEAKER_00: This is blowing my mind.
• 2:25
  SPEAKER_00: Yeah.
• 2:26
  SPEAKER_03: Well, you hate sports, and they were the only team that ever went undefeated, or I guess the last team that went undefeated, 1972.
• 2:35
  SPEAKER_00: The only thing I have to say is I look amazing.
• 2:39
  SPEAKER_00: Finkel is Ironhorn and Ironhorn is Finkel.
• 2:42
  SPEAKER_03: Ace Ventura.
• 2:43
  SPEAKER_03: That's an Ace Ventura pet detective reference.
• 2:45
  SPEAKER_00: Yes.
• 2:46
  SPEAKER_03: Incredible.
• 2:48
  SPEAKER_00: I think I'm hilarious.
• 2:49
  SPEAKER_03: You are hilarious.
• 2:50
  SPEAKER_03: Your last name is Labrasco.
• 2:52
  SPEAKER_03: We're all pretty funny.
• 2:53
  SPEAKER_03: We're we're all pretty funny.
• 2:55
  SPEAKER_00: Who got that reference?
• 2:56
  SPEAKER_00: You are my people.
• 2:57
  SPEAKER_03: I just doing the peace sign here.
• 2:59
  SPEAKER_00: You got it.
• 3:00
  SPEAKER_00: So you're my people.
• 3:01
  SPEAKER_03: Yeah.
• 3:02
  SPEAKER_03: Darn right I am.
• 3:03
  SPEAKER_03: So when it comes to hair replacement or hair therapy, there's a few different types of what do we want people to get from this today?
• 3:13
  SPEAKER_03: We want to get people to understand there's supplements, there's at-home treatments, there's in-office treatments that someone like you or or I could do, and then there's surgical treatments, right?
• 3:25
  SPEAKER_03: Did I did I miss any?
• 3:26
  SPEAKER_00: No, medication, at supplements, at-home treatments, top topical treatments that'd be considered at home, in-office non-invasive treatments, and then surgical.
• 3:36
  SPEAKER_00: Yep.
• 3:37
  SPEAKER_03: Okay.
• 3:37
  SPEAKER_03: Got it.
• 3:38
  SPEAKER_03: So let's let's talk about, let's get the supplement one out of the way here quickly.
• 3:43
  SPEAKER_03: So why didn't you tell me to brush my hair?
• 3:50
  SPEAKER_03: Okay.
• 3:51
  SPEAKER_03: So let's talk about supplement therapy.
• 3:55
  SPEAKER_03: So this is this is stuff that you can you can get in a pharmacy or grocery store or whatever and buy over the counter.
• 4:02
  SPEAKER_03: Buy over the counter, yeah.
• 4:04
  SPEAKER_00: So probably the most popular one that most people know by name is Neutrophil.
• 4:09
  SPEAKER_00: It's probably it's probably the most well-studied supplement for hair loss.
• 4:16
  SPEAKER_00: It's still a supplement, though.
• 4:17
  SPEAKER_00: You know, it's it's do I think that it's okay?
• 4:22
  SPEAKER_00: Yes, I think it's okay.
• 4:24
  SPEAKER_00: I think that it it needs to be used in combination with other things to to really work.
• 4:31
  SPEAKER_00: Does it hurt?
• 4:32
  SPEAKER_00: No, I no, I mean I it certainly can hurt.
• 4:35
  SPEAKER_00: So it's got sal palmetto in it, which is uh uh herbal supplement that uh blocks some of the hormones that can cause hair loss, it has ashwagonda in it, which can help maybe with stress-related hair loss.
• 4:51
  SPEAKER_03: Can you spell that?
• 4:52
  SPEAKER_00: Cannot spell that.
• 4:55
  SPEAKER_00: It has some anti-inflammatory type uh herbs in it.
• 5:01
  SPEAKER_00: It's a it's a propriet, it's a proprietary blend.
• 5:04
  SPEAKER_00: So it's something that the company created.
• 5:05
  SPEAKER_00: So we don't really know what's in it.
• 5:06
  SPEAKER_00: Yeah, it's something that the company created, and and I think it's okay, but it's not cheap, and it's not, it's probably not going to fix all of your problems if if you're having significant hair loss.
• 5:20
  SPEAKER_00: It's just not.
• 5:21
  SPEAKER_03: That's fair.
• 5:21
  SPEAKER_03: So I think I I I I think I noticed there's a bottle of it in my in my uh uh bathroom closet.
• 5:29
  SPEAKER_03: I don't know, like maybe a rep gave it to me at some point in time.
• 5:31
  SPEAKER_03: Would that have happened?
• 5:31
  SPEAKER_03: They've they I don't think it's opened and and I'm bald, so I probably should take it, huh?
• 5:37
  SPEAKER_03: Okay.
• 5:38
  SPEAKER_03: I I don't have anything else to talk about as far as supplements go.
• 5:41
  SPEAKER_03: I I I think they can't hurt.
• 5:43
  SPEAKER_03: They're not particularly expensive, but they're not inexpensive sometimes.
• 5:47
  SPEAKER_03: And maybe you get a little benefit from it.
• 5:49
  SPEAKER_03: Oh, go ahead.
• 5:50
  SPEAKER_00: There's what there's one more that that we should mention.
• 5:53
  SPEAKER_00: It's called biotin.
• 5:55
  SPEAKER_00: It's a supplement that a lot of people know of and associate it with hair growth.
• 5:59
  SPEAKER_00: So biotin is is is marketed very well as a hair loss supplement, but there actually aren't really any great clinical studies on it.
• 6:09
  SPEAKER_00: Unless you're truly biotin deficient, I wouldn't tell you to take biotin.
• 6:14
  SPEAKER_00: And it's actually very rare to be deficient in biotin.
• 6:17
  SPEAKER_00: So that's another one I would just save your money.
• 6:20
  SPEAKER_00: It can affect certain lab values and things like that.
• 6:23
  SPEAKER_03: Okay.
• 6:24
  SPEAKER_03: Um dramatic class.
• 6:30
  SPEAKER_00: And we're back.
• 6:32
  SPEAKER_00: Uh again, this is an episode that needs to be watched on YouTube because the the wig, this is Richard Simmons.
• 6:41
  SPEAKER_03: This is uh this is actually my Bob uh Bob Vila.
• 6:45
  SPEAKER_03: No, not Bob Vila.
• 6:46
  SPEAKER_03: Bob uh is that him?
• 6:48
  SPEAKER_00: Yeah, Bob Vila.
• 6:50
  SPEAKER_03: The artist.
• 6:50
  SPEAKER_03: Yeah, the artist.
• 6:51
  SPEAKER_00: No, Bob Vila.
• 6:53
  SPEAKER_00: Bob Ross, Bob Ross.
• 6:54
  SPEAKER_00: Bob Ross, Bob Vila is the construction guy.
• 6:57
  SPEAKER_03: Yeah, this is my Bob Ross wig.
• 6:59
  SPEAKER_00: I I was gonna do a curly brown wig.
• 7:02
  SPEAKER_03: Yeah, about five years ago, I was doing gonna do a Bob Ross uh character and like paint, do before and afters and do paint like on iPad or whatever, but the technology wasn't really there.
• 7:14
  SPEAKER_03: I wasn't good enough with video editing at the time, and I couldn't figure out how to do it.
• 7:18
  SPEAKER_03: I have an easel here somewhere, but the character never took off because I couldn't uh my video editing skills weren't good enough.
• 7:24
  SPEAKER_03: You should I could do it now because you should totally do it now.
• 7:28
  SPEAKER_03: Easy now.
• 7:29
  SPEAKER_03: The uh social media editing has come a long way in the last five years.
• 7:32
  SPEAKER_03: So I'm gonna wait for it.
• 7:35
  SPEAKER_03: Instant cure of hair loss.
• 7:38
  SPEAKER_03: I was bald just a minute ago, and now I have this beautiful, flowing, beautiful haircut.
• 7:43
  SPEAKER_03: All right, so now we're, you know, we're to the next ones.
• 7:46
  SPEAKER_03: At-home treatments.
• 7:47
  SPEAKER_03: What can you do at home beyond supplements?
• 7:50
  SPEAKER_00: Okay, so there are two FDA-approved medications prescription for hair loss.
• 7:57
  SPEAKER_00: One is minoxidil, topical minoxidil.
• 8:00
  SPEAKER_00: Okay, brand name Rogain.
• 8:02
  SPEAKER_00: Okay.
• 8:03
  SPEAKER_00: You can actually get it for by prescription, or you can now go buy it over the counter.
• 8:07
  SPEAKER_00: It's been well, it's been available over the counter a long time.
• 8:09
  SPEAKER_00: But your but your doctor can write you a script for it too, if your insurance will cover it.
• 8:13
  SPEAKER_03: Insurance covers hair loss?
• 8:14
  SPEAKER_00: Every once in a while.
• 8:16
  SPEAKER_00: Every once in a while, insurance will cover it.
• 8:18
  SPEAKER_00: So, so rogain.
• 8:19
  SPEAKER_03: Okay, so rogain.
• 8:21
  SPEAKER_00: Yeah, rogain is a great treatment for hair loss.
• 8:23
  SPEAKER_00: So, um, or minoxidil, we'll call it minoxidil.
• 8:26
  SPEAKER_00: So it prolongs the the growth phase of hair.
• 8:29
  SPEAKER_00: It also helps with blood flow to the hair follicle.
• 8:32
  SPEAKER_00: And you can do it topically, and as of a few years ago, you can actually, there's an oral version of minoxidil that's very effective, but honestly, probably comparable to the topical version in terms of efficacy.
• 8:45
  SPEAKER_00: And the oral can have some heart side effects.
• 8:49
  SPEAKER_00: Heart side effects, okay.
• 8:51
  SPEAKER_00: Yeah.
• 8:51
  SPEAKER_03: So um typically one of the other side effects, or is that the other one that has male side effects?
• 8:57
  SPEAKER_00: That's the other one.
• 8:57
  SPEAKER_00: So you're you're thinking of phenasteride.
• 8:59
  SPEAKER_00: So phenasteride is the other FDA-approved medication for hair loss in men.
• 9:06
  SPEAKER_00: It's actually just FD approved in men, but women can take phenasteride too.
• 9:10
  SPEAKER_00: And phenasteride's a prescription and it works by blocking some of the hormonal receptors in the hair follicle.
• 9:17
  SPEAKER_00: It's called 5 DHT.
• 9:19
  SPEAKER_00: And they're both pretty good, right?
• 9:20
  SPEAKER_00: They're both called Okay.
• 9:22
  SPEAKER_03: Five DHT, yeah.
• 9:24
  SPEAKER_03: Yeah.
• 9:24
  SPEAKER_03: Yeah, you're right.
• 9:25
  SPEAKER_00: Five alpha reductase.
• 9:26
  SPEAKER_03: Those are both pretty good treatments, right?
• 9:28
  SPEAKER_00: Oh, yeah.
• 9:28
  SPEAKER_00: Oh, yeah, absolutely.
• 9:29
  SPEAKER_00: They work.
• 9:30
  SPEAKER_00: They both work.
• 9:30
  SPEAKER_00: I think that I think all men who are experiencing hair loss should be on topical rogain and phenasteride.
• 9:38
  SPEAKER_00: Phenasteride will help save what you have, and rogain can help with growth.
• 9:43
  SPEAKER_00: The earlier the better.
• 9:44
  SPEAKER_03: Right.
• 9:45
  SPEAKER_03: I think it's, I think absolutely.
• 9:47
  SPEAKER_03: Thank God I have incredible hair like Bob Ross.
• 9:52
  SPEAKER_03: I'm very thankful for that.
• 9:55
  SPEAKER_03: So uh all men should should be on something for that if you're experiencing any uh loss.
• 10:00
  SPEAKER_03: And so how do you know, like, let's say I'm 35, and how do I know if I need to, if I'm gonna need something like that?
• 10:10
  SPEAKER_03: Is there is you know, can I look at my my parents or my grandparents or whatever and and you know, take a look?
• 10:17
  SPEAKER_00: Yes, genetics play definitely play a big role, but the vast majority of men are going to experience some degree of hair loss.
• 10:25
  SPEAKER_00: And the reason that it happens is because of testosterone.
• 10:30
  SPEAKER_00: So men lose their hair because of testosterone.
• 10:34
  SPEAKER_00: Women can also lose their hair because of testosterone.
• 10:39
  unknown: Okay.
• 10:39
  SPEAKER_00: We just don't have as much of it.
• 10:40
  SPEAKER_00: So that's why we don't lose as much hair.
• 10:43
  SPEAKER_00: But hair loss in general is what we call multifactorial.
• 10:47
  SPEAKER_00: So there are a lot of different reasons, and a lot of times they compound to cause hair loss.
• 10:52
  SPEAKER_00: So it's not just the hormones, there can also be stress and certain medications and lifestyle and diet.
• 10:59
  SPEAKER_00: And in women, low iron can play a role because you women have menstrual periods, so can get low iron.
• 11:08
  SPEAKER_00: So there are a lot of a lot of different factors that contribute.
• 11:11
  SPEAKER_00: It's not just the hormones.
• 11:13
  SPEAKER_00: So my approach to hair loss is kind of like throw the kitchen sink at it.
• 11:17
  SPEAKER_00: Like just do everything that you can.
• 11:21
  SPEAKER_00: I had a actually a very, very nice, um, very polite and respectful 19-year-old male patient recently who came in.
• 11:34
  SPEAKER_00: He his mom wanted him to come in because his older brother had started lose started losing his hair in his 20s, and their dad started losing his hair in his 20s, and and this night, very nice young man uh was starting to thin.
• 11:50
  SPEAKER_00: And he's very young, and he didn't want to do anything.
• 11:53
  SPEAKER_00: It's tough.
• 11:53
  SPEAKER_00: He but he didn't want to do anything.
• 11:55
  SPEAKER_00: He, you know, he's in college, just hoping he was gonna keep his hair.
• 11:58
  SPEAKER_00: Yeah, he just didn't want to deal with it.
• 12:01
  SPEAKER_00: So his mom, who's been my patient for a very long time, she said, Will you just see him?
• 12:07
  SPEAKER_00: Will you talk to him?
• 12:08
  SPEAKER_00: I think you have the type of personality that maybe you could get the message across to him.
• 12:15
  SPEAKER_00: And I just said to him, Look, you're gonna be 20 years old, 40-year-old you is gonna really wish that you did these things now.
• 12:23
  SPEAKER_00: Because if you do them now, sure, you can potentially preserve some of what you had.
• 12:29
  SPEAKER_00: You're really gonna slow things down.
• 12:31
  SPEAKER_00: And I think a light bulb went off in his head, and he was like, Yeah, you know what?
• 12:35
  SPEAKER_00: I better start doing some stuff.
• 12:37
  SPEAKER_00: So I at least got him to start doing some topical monoxidil, and he's he's kind of thinking about the finasteride too, and we'll we'll see how he does.
• 12:48
  SPEAKER_00: But he'll he'll be really glad that he did it 2018.
• 12:51
  SPEAKER_03: For sure.
• 12:52
  SPEAKER_03: So I I think that's a really good thing.
• 12:54
  SPEAKER_03: And so dramatic pause again.
• 12:57
  SPEAKER_03: Oh my god.
• 12:58
  SPEAKER_03: Oh my god, this is great.
• 13:06
  SPEAKER_00: What the hell is that?
• 13:08
  SPEAKER_00: Wait, wait.
• 13:10
  SPEAKER_00: That is is this like George Costanza?
• 13:14
  SPEAKER_00: George Costanza.
• 13:16
  SPEAKER_00: It is George Costanza.
• 13:21
  SPEAKER_03: It was still in the container.
• 13:23
  SPEAKER_03: I've never used it before.
• 13:25
  SPEAKER_03: Oh my god, this is this is something.
• 13:29
  SPEAKER_00: It's amazing.
• 13:30
  SPEAKER_03: Are the foreheadlines here?
• 13:31
  SPEAKER_03: Is that what is that what that is?
• 13:32
  SPEAKER_00: I want to make sure that so it's a maybe that's how it goes.
• 13:36
  SPEAKER_00: It's bald on the top, and then there's a lot of hair down the sides.
• 13:41
  SPEAKER_03: So I just switched wigs again, everybody, and the this wig I just pulled out.
• 13:46
  SPEAKER_03: I doesn't everybody have like nine wigs as a as a grown man in their office.
• 13:54
  SPEAKER_03: Because I sure do.
• 13:55
  SPEAKER_00: The thing is, I just know that they were just sitting in your office.
• 13:59
  SPEAKER_00: Like you didn't need to plan this, they were already there.
• 14:02
  SPEAKER_03: No, I thought about it this morning.
• 14:04
  SPEAKER_03: I said, uh, how am I gonna make this episode interesting?
• 14:08
  SPEAKER_03: And I said, I I because it's it's it's not the most sexy topic, okay?
• 14:14
  SPEAKER_03: And so I said, Well, I'm just gonna have to take it upon myself to wear a bunch of wigs.
• 14:18
  SPEAKER_00: So that's I love hair loss.
• 14:22
  SPEAKER_00: Talk about hair loss as much as I'll talk about lasers.
• 14:24
  SPEAKER_03: Yeah, and that's why you're boring.
• 14:26
  SPEAKER_03: So, anyway, let's talk about procedures that you, Mystica, can do in the office, or that I can do, or that Heather can do at Labrasco Plastic Surgery, so to help people more men than women, but both with hair loss.
• 14:40
  SPEAKER_00: We can do what's called platelet-rich plasma or platelet-rich fibrin, PRP or PRF for short.
• 14:49
  SPEAKER_02: Okay.
• 14:49
  SPEAKER_00: So that is when we we actually draw your blood.
• 14:53
  SPEAKER_00: So it's a simple blood draw.
• 14:55
  SPEAKER_00: And then we have a machine in the office that will spin the blood and it separates the layers of blood.
• 15:03
  SPEAKER_00: So it'll separate the red blood cells from what's called the platelet-rich plasma.
• 15:08
  SPEAKER_00: And the platelet-rich plasma is very rich in growth factors.
• 15:13
  SPEAKER_00: And those growth factors, when you inject them and put them back into the hair follicle, can help with regeneration.
• 15:21
  SPEAKER_00: And it's it's actually, I've seen really, really nice results from these treatments.
• 15:27
  SPEAKER_00: And I do men and women probably equally.
• 15:29
  SPEAKER_03: So I had uh, so one of my best friends, uh his name is Sam, and he lives in New York City, and he had uh PRP uh multiple times.
• 15:39
  SPEAKER_03: And uh he I I he's got more hair now than he had uh 20 years ago.
• 15:45
  SPEAKER_03: He got a beautiful result from it, and uh and I love it.
• 15:48
  SPEAKER_03: I think it's great.
• 15:49
  SPEAKER_03: You did a few treatments on me, and unfortunately, I again I'm just not super good at at doing series of things, mostly because you then make me do stuff to you, um, and and I don't get the chance to do it again.
• 16:04
  SPEAKER_00: You have to you have to maintain it.
• 16:06
  SPEAKER_00: So a lot of people will do it differently, but it's always typically going to be a series of three or four sessions.
• 16:12
  SPEAKER_00: So I do three sessions about four to six weeks apart each session, and then to maintain, I think the minimum is about once every six months.
• 16:23
  SPEAKER_00: If you want to do it a little more frequently than that, that's that's also fine.
• 16:27
  SPEAKER_00: But minimum once every six months to maintain the growth.
• 16:31
  SPEAKER_00: And people do really well, and it's it's easy, it's non-invasive, it's a little pinchy, it's a little draw the blood.
• 16:38
  SPEAKER_03: What like what do you mean?
• 16:40
  SPEAKER_03: Like so you have to get pull blood out?
• 16:42
  SPEAKER_00: Yeah, yeah.
• 16:43
  SPEAKER_00: So just like when I do it, yeah.
• 16:45
  SPEAKER_00: So just like when you go to a lab to get routine blood work done, we just stick you with a with a needle in your arm and draw the blood, and then can I bruise?
• 16:56
  SPEAKER_00: You could get a little bruise from it, big deal, right?
• 16:59
  SPEAKER_03: Right.
• 16:59
  SPEAKER_03: You're tough.
• 17:00
  SPEAKER_03: That's man up or woman up, girl up.
• 17:03
  SPEAKER_03: Okay, so what else?
• 17:05
  SPEAKER_03: There's another product that's kind of maybe there that uh that you like.
• 17:10
  SPEAKER_00: Yes.
• 17:10
  SPEAKER_00: So there's also something called PDGF, which is newer to the market.
• 17:16
  SPEAKER_00: That stands for platelet derived growth factor.
• 17:20
  SPEAKER_00: And PDGF is it's recombinant, so it's it's made in a lab, but PDGF is one of the growth factors that when we inject you with PRP and PRF, that we are trying to stimulate in the hair follicle.
• 17:34
  SPEAKER_00: So this just skips the step of the blood draw and it's it's comes from a lab.
• 17:41
  SPEAKER_00: So it it eliminates some of the variability because PRP and PRF is only as going, it's only going to be as good and healthy as the patient.
• 17:50
  SPEAKER_00: So if they're older or they're on certain medications, their PRP is not going to be as good as, say, a 20-year-old's.
• 17:57
  SPEAKER_00: So the PDGF just eliminates that variability because it's made in a lab.
• 18:02
  SPEAKER_03: Um Can you react to it negatively?
• 18:06
  SPEAKER_03: Can you get a can you react to the if if you're pulling something up, like uh, you know, can I get like a a uh like a transfusion reaction?
• 18:14
  SPEAKER_00: No, I I mean not that I'm aware of, but it's it is a it's very new.
• 18:19
  SPEAKER_00: So it's it's not something that right now we're injecting, but what we can do with it is we can get it into the hair follicle by other delivery methods, for instance, microneedling.
• 18:34
  SPEAKER_00: So microneedling is when you take um a microneedling device and it has little microneedles and you create uh what's called a controlled skin injury.
• 18:43
  SPEAKER_00: So you create little tiny holes up in the hair follicle, and then you can put the PDGF right on top of that so it's delivered into the follicle.
• 18:52
  SPEAKER_00: And I'm not doing that right now.
• 18:54
  SPEAKER_00: I do, I do.
• 18:55
  SPEAKER_00: But you want to well, I I would, but I think that PRF is so effective.
• 19:00
  SPEAKER_00: So I tend to just lean towards that.
• 19:03
  SPEAKER_00: But I have some colleagues who do microneedling with PDGF and they've seen great results.
• 19:08
  SPEAKER_00: And and and you know, they do it because maybe they don't have the ability to do PRP.
• 19:12
  SPEAKER_00: You know, we we yeah.
• 19:15
  SPEAKER_00: So it's that's another really good, potentially good treatment option.
• 19:19
  SPEAKER_03: What about exosomes?
• 19:21
  SPEAKER_00: Uh so exosomes are signaling molecules, and this is newer technology.
• 19:27
  SPEAKER_00: It sounds fancy.
• 19:28
  SPEAKER_00: It sounds fancy.
• 19:29
  SPEAKER_00: It is fancy.
• 19:29
  SPEAKER_03: Yeah, I wrote futuristic on here.
• 19:32
  unknown: I did.
• 19:32
  SPEAKER_03: I wrote futuristic on.
• 19:33
  SPEAKER_00: I was I I am very skeptical.
• 19:36
  SPEAKER_00: I'm I'm very skeptical of new things that come on the market, but I saw some of the clinical studies for topical exosome therapy for for hair loss.
• 19:47
  SPEAKER_00: The the company is called Plated.
• 19:50
  SPEAKER_00: And I was like, you know what?
• 19:51
  SPEAKER_00: These these look really promising.
• 19:53
  SPEAKER_00: So I I ordered six vials of plated.
• 19:58
  SPEAKER_00: Um, I gave some to kept some for myself.
• 20:00
  SPEAKER_00: I just I wanted to try it and see how it worked.
• 20:03
  SPEAKER_00: So for me personally, I took before photos of myself and I used just plated for four months.
• 20:11
  SPEAKER_00: I didn't use anything else.
• 20:12
  SPEAKER_00: I stopped my monoxidil, all of it.
• 20:14
  SPEAKER_00: And just a few weeks ago, I took my after photos, and you've seen them.
• 20:19
  SPEAKER_03: And it's incredible.
• 20:21
  SPEAKER_00: It's pretty freaking incredible.
• 20:24
  SPEAKER_03: Incredible.
• 20:25
  SPEAKER_03: Your results were like, I was shocked.
• 20:26
  SPEAKER_03: I was like, same.
• 20:28
  SPEAKER_03: Yeah, I mean, you're growing hair.
• 20:30
  SPEAKER_00: I mean, there is there is no denying those results.
• 20:33
  SPEAKER_00: No denying.
• 20:34
  SPEAKER_00: I and and this is this is from me.
• 20:37
  SPEAKER_00: So I am definitely a believer.
• 20:39
  SPEAKER_00: This doesn't mean that all patients are going to get the results that I got.
• 20:42
  SPEAKER_00: You your individual health and reasons for your hair loss, that's all going to play a role.
• 20:48
  SPEAKER_00: But I am definitely pro plated exosomes.
• 20:54
  SPEAKER_00: And and you can buy this on your own, or you can come to Skin Lab and buy it.
• 20:58
  SPEAKER_00: The really the only downside is the retail price.
• 21:02
  SPEAKER_03: How much is it?
• 21:03
  SPEAKER_00: It's not cheap.
• 21:04
  SPEAKER_00: It is$375 for a three-month supply.
• 21:07
  SPEAKER_03: Okay.
• 21:08
  SPEAKER_00: But you use it for three months every day, and then you can do it maybe three days a week for maintenance.
• 21:13
  SPEAKER_00: And and kind of like the way I look at it as women, especially, we pay three, four hundred dollars to get our hair done every couple months.
• 21:21
  SPEAKER_03: So that's true.
• 21:23
  SPEAKER_03: That is absolutely true.
• 21:25
  SPEAKER_03: What about our are you know, the the thing that everybody talks about these days is peptides?
• 21:30
  SPEAKER_03: Are there any peptides that that do anything for the hair?
• 21:34
  SPEAKER_03: I I'm frankly not familiar.
• 21:35
  SPEAKER_03: I I don't know.
• 21:36
  SPEAKER_03: I'm sure there are.
• 21:38
  SPEAKER_03: I'm sure, you know, they're probably not approved yet.
• 21:41
  SPEAKER_00: Nothing's not.
• 21:42
  SPEAKER_00: Maybe they will be, maybe they won't be.
• 21:45
  SPEAKER_03: Yeah.
• 21:45
  SPEAKER_03: Very good.
• 21:46
  SPEAKER_00: So there's also red light caps.
• 21:48
  SPEAKER_00: Red light, red light caps.
• 21:50
  SPEAKER_00: That's okay.
• 21:50
  SPEAKER_00: You know, so that's you can get these over the counter, or you can buy them.
• 21:53
  SPEAKER_00: You can buy them online.
• 21:55
  SPEAKER_00: They're um red light caps that you can put on your head and and
• 22:00
  SPEAKER_03: um deliver red light to the to the hair follicle he's he's wearing another wig and it's a black curly it's a black curly wig I actually think you look really good with hair like that that's that's a good look for you thank you I think this is very Michael Jackson 70s it is it is so this is probably from from one of your Michael Jackson costumes I'm feeling a little off the wall right now that's a Michael Jackson album from the 70s for those of you that weren't born in the 70s.
• 22:33
  SPEAKER_00: Um so yeah so that's red light caps red light caps they can um just kind of keep the hair in the growth phase longer again this is not something that I would do just by itself you'll be extremely underwhelmed by the results but if you do it in combination with some of these other things may be helpful.
• 22:50
  SPEAKER_03: So I operate um at and and uh work out of Dr.
• 22:54
  SPEAKER_03: Steve Perlman's office in New York City on 60th and Park Avenue uh and he has one of those uh red light caps it seems it's very cool looking and uh looks I think it's pretty new to him um but I think they're getting very nice results so far.
• 23:12
  SPEAKER_00: So um my guess though is that they're doing that in combination with other things.
• 23:16
  SPEAKER_00: Oh they absolutely are I bet they're doing PRP and then putting the cap on or or transplant and putting the cap on something like that.
• 23:24
  SPEAKER_03: All of it.
• 23:24
  SPEAKER_00: Yeah.
• 23:25
  SPEAKER_03: All of it.
• 23:25
  SPEAKER_03: Yep yep.
• 23:26
  SPEAKER_03: Uh so you know let's talk then a little bit about transplant.
• 23:30
  SPEAKER_03: Um let's talk about maybe the little bit of the history of hair transplant and you know what it has evolved into now and why I can't sell it because I had I bought a device about five years ago and it failed that that dam device is still collecting dust isn't it?
• 23:49
  SPEAKER_03: No no I uh we we we sold it um it's it's it's somewhere else I I hope doing very well okay so hair transplant by history in the beginning what they would do is they would take little chunks of hair like multiple hairs and and and place them often in the front and so what it looked like it would be like dull plugs of multiple hairs in the front it was very obvious and it didn't look very good.
• 24:17
  SPEAKER_03: You know the thing about donor hair is it's fine out there's only so many you can do multiple treatments but you only have so many hairs that you can move you know over time, right?
• 24:26
  SPEAKER_03: And so that was how it was done at first.
• 24:30
  SPEAKER_03: And then and then there was the strip method where what they would do is they'd go and then take a strip of tissue from essentially from behind your ears from ear to ear and remove that and then like a big hole in your head and and then they would suture that clothes and then they would take the that strip of skin and hair over to under a microscope and they would take each individual hair out and then they would place it where you needed hair in the front over the crown etc and and that was very nice that that works very well but a big giant scar.
• 25:04
  SPEAKER_03: Once if your hair thins or you keep your hair short or whatever in the back you can see that scar.
• 25:09
  SPEAKER_03: So better not quite there yet but recently and I say in the last 10 years or so the new thing is FUE follicular unit extraction.
• 25:19
  SPEAKER_03: So one individual like little tiny removal of one hair at a time without a big scar.
• 25:26
  SPEAKER_03: And so what you do is you come in and you shave your hair you know a couple like it should be a day or two old I guess.
• 25:33
  SPEAKER_03: And so there should they should just be able to see the hair poking through and they take you know 1500 2500 graphs or whatever they remove it and then they put it in the areas that needs hair and it it works.
• 25:45
  SPEAKER_00: One little one little one little hair follicle at a time right one hair follicle at a time.
• 25:50
  SPEAKER_03: So how long does that take it takes all day it can be you know 12 hours or more but it's effective it works it's it it's really really good and if I was you know if I didn't have this luscious hair that I have here right now I would consider getting it.
• 26:07
  SPEAKER_00: So I have a couple of patients who have done it recently male patients and they look amazing.
• 26:13
  SPEAKER_00: Right.
• 26:14
  SPEAKER_00: They look they look great.
• 26:15
  SPEAKER_03: It's really really good I mean how much does it cost?
• 26:19
  SPEAKER_03: So you can fly to Turkey um yeah there's a big there's a big tick TikTok movement.
• 26:24
  SPEAKER_03: Yeah there's TikTok movement to fly to Turkey to get it done.
• 26:27
  SPEAKER_03: It's probably I it's got to be 15 grand like to to fly all the way to Turkey have it done stay in Turkey for a few days or a week or whatever and then fly back that you can have it I mean but yeah but you can have it done here for 15 grand right you can have it done in in you know places in here in the United States there's people there's play people places in Pittsburgh it's probably more expensive in New York City in in in LA in San Francisco in Chicago in the Carolinas Atlanta Miami you can get it done here in the United States without a freaking trip to Turkey I I mean if you're gonna go to Turkey you know I don't I don't know Pittsburgh I think it's around 2000 in Pittsburgh is it?
• 27:09
  SPEAKER_03: Okay I you know I think that's about right okay yeah I I had the this is the device that I had you know things were going really well on social media I was I was feeling really confident I bought one I thought I could sell procedures to men but the the fact of the matter is my audience is is skews way too far female and I just nobody saw it and you know lesson learned uh it is what it is it if I was a great device though if I was a guy and my hair was thinning or I had a receding hairline I would definitely do it.
• 27:40
  SPEAKER_03: So let's go and do the reveal for what my hair actually looks like.
• 27:44
  SPEAKER_03: There we go.
• 27:45
  SPEAKER_03: You know it's had a bunch of wigs on for you know for the last half hour or whatever.
• 27:50
  SPEAKER_03: But you know we're we're gray a little bit but the the hairline's the same as it was in my 20 in my teens.
• 27:56
  SPEAKER_03: So uh thankfully good yeah thanks to my my my dad and my grandpa get some plated get some plated yeah maybe I'll get some plated could be a little fuller you never know it it was fuller before I put the wigs on a little bit ago let's talk about for these different products worth it or not worth it so the the the theme behind scalpel and skin is worth it or not worth it supplements worth it or not worth it not worth it why no harm not not by itself not by itself fair absolutely home treatments by itself monoxidyl finasteride red light caps worth it worth it okay in office procedures PRP PRF PGDF worth it need DGF worth it hair transplant absolutely worth it worth it absolutely worth it yep so you know it maybe it seems that we are skewing to the more invasive treatments is worth it and the less invasive treatments not worth it but the the bottom line is you want results you you want to see improvement and sometimes you just have to do more aggressive treatments to see improvement.
• 29:05
  SPEAKER_00: So yeah but you can also get minoxidil at target yeah you're right I mean you're right you can get monoxidel at target yeah that's the easiest thing you could do if your hair's thinning go grab a$30 bottle of minoxidil 5% not 2%$30 oh my god totally worth it right oh yeah the target brand the target brand absolutely is that all how long does that last a month three months three three months oh my god that's nothing yeah it's nothing ten dollars a month right I mean it's it's that might not be the exact price but it's it's not crazy a Chipotle bowl is fifteen dollars now so exactly exactly more hair more hair or a burrito or a or a bowl yeah so I mean that's that's the easiest thing you could do totally worth it I absolutely agree so let's wrap it up Mystica do you have anything else to say about hair therapies no I just think I I think our hair in a lot of ways is our identity so I think anything that you can do to preserve your hair will in the long run sort of help with with with confidence it absolutely will.
• 30:17
  SPEAKER_00: So which was your favorite wig I was I definitely the Bob Ross I mean that I that goes without saying I want one yeah I'll let you borrow mine.
• 30:29
  SPEAKER_03: Thank you guys very much this makes six episodes of scalpel and skin we we did it where you know we're to a half dozen now do we have five listeners yet TBD I don't know yeah we probably have five family members and and and staff that probably look I'll bet I'll bet by now we have like 17.
• 30:48
  SPEAKER_00: All right we'll see what happens we're we'll we're gonna keep track so again I'm Dr.
• 30:52
  SPEAKER_03: Elgin Labraska board certified plastic surgeon North Pittsburgh Pennsylvania and New York City I'm here with my beautiful baby sister Mystical Lebraska 16 years board certified physician assistant cosmetic dermatology she is the master of everything skin.
• 31:08
  SPEAKER_03: I am the master of the scalpel together we are scalpel and skin let's go that's it for today's episode of Scalpel and Skin.
• 31:15
  SPEAKER_03: Follow the show wherever you listen and come find us on social media.
• 31:18
  SPEAKER_03: Send us the treatments, trends or questions you want us to break down next this is scalpel and skin.
• 31:24
  SPEAKER_03: Let's go