Dear Dr. Donovan, your video is great as always! I would be happy if you allowed me to adapt it for a Russian speaking audience (and I e-mailed about it to you)!
amazing thanks fpr the video doctor . i got an unusyal question but knowing pentoxyfilline is an antifibrotic and antiinfkammatory could it be usefull in ffa or lpp? thanks
Hi Dr. Donovan, thanks so much for this great Q&A. I have another question about microneedling: I asked my dermatologist about microneedling for male AGA, but his concern was cumulative fibrosis and suggested I should trial no more than once every three months. However, I have heard several other dermatologists (including yourself) who don't seem to have so much of a problem with microneedling every week or every two weeks. I therefore surmise that the potential for problematic fibrosis cannot be so clear cut. What are your thoughts on this? Could such infrequent microneedling also be efficacious?
Great question! Microneedling is not a first line treatment. Rather it is a third line treatment (see webinar) for one reason - studies are poor and we don't have all the answers. If studies were amazing and we had all the answers this treatment would be propelled from a third line position into a first line spot. It's not. So lots of answered questions in microneedling - and another 100 more than this one that you ask ! There is no evidence whatsoever of "cumulative fibrosis"although it is a very good thought and something that needs to be studied. This is more theoretical than anything. Many of the new treatment approaches to AGA and building on the concept that hair growth activating pathways may be 'woken up' with injury to the scalp. Thanks for the question and stay tuned as we learn more!
Thanks so much for the reply. What I was hoping was that wounding in general was understood well enough to reliably predict the consequences of microneedling, even in the absence of specific microneedling studies. But I guess microneedling produces a very unusual type of wound!
@@nathan87 yes, and also there are 205,000 microneedling protocols. You can buy lots of different sizes microneedles 0.25 mm, 0.35 mm, 0.4, 0.5 mm, 0.6 mm 0.7 mm, 0.8 mm etc etc all the way up to 2 mm. you can buy rollers and stamps and pens. You can do one pass two passes three passes of the needle. If using a stamp or roller, you can press hard or gingerly light. There are thousands upon thousands upon thousands upon thousands of protocols. The way a person might do microneedling is usually going to be different than the way his or her friend of neighbour does it. Even the way a person does microneedling this week is going to be different from the way they do it next week.
One of your questions was about indents occurring after steroid injections. I have noticed several dents in my scalp in the last few months and have NOT had any injections. I've had no scalp injuries either. What could have caused it and what is this a sign of? I've been having alot of diffuse loss since they appeared. Thanks!
Thank you for sharing. You may want to review this with a dermatologist and consider a 4 mm punch biopsy. These issues can arise from many potential causes. Often a biopsy is helpful - but first and foremost a good history and examination is needed.
@donovanmedical9780 Thank you so much for responding. I just saw a dermatologist at Johns Hopkins last week and she wasn't concerned saying everyone has scalp irregularities but this is not normal for me. She said I had AGA and seb derm but my concern was an emerging FFA. I also have some eyelash and eyebrow loss. She would not do a biopsy saying it would only cause additional inflammation. Is it possible to send you the images from that visit? I know you can't make a diagnosis but if you were concerned I would seek a second opinion near me. Thanks again!
@@pamedwards6522 thanks. You might want to check out our volunteer program at the Donovan Hair Academy. We answer tough questions every week and use the questions to train the next generation of top hair specialists in the world. www.donovanhairacademy.com/qow
@donovanmedical9780 I will definitely do that. I have had alopecia areata in the past and was concerned about diffuse areata at first but then started to lose my frontal hairline. lThank you so much!
Dear doctor Donovan, you are amazing! I am so happy to have the opportunity to learn from you ♥
Thank you so much. We're so glad you to have you with us!
Wow nice find of a Channel, greetings from Germany
Thanks and welcome! See you again sometime.
You are number one doctor ❤
Thank you for your kind words!
Thanks a lot!!!
Thank you for the great content!
People in the hairlose community loves your work!
thank you so kindly.
You are a king! Ive learned so much
I am so glad. Thank you!
The amount of knowledge I've gained from your videos , can't put them in words ❤ thansk a lot doc
Thank you. i am so glad
Dear Dr. Donovan, your video is great as always!
I would be happy if you allowed me to adapt it for a Russian speaking audience (and I e-mailed about it to you)!
Thank you
amazing thanks fpr the video doctor . i got an unusyal question but knowing pentoxyfilline is an antifibrotic and antiinfkammatory could it be usefull in ffa or lpp? thanks
Thank you so much for this valuable knowledge! 🙏
Where might we be able to submit questions?
thank you! We've have another session in the future.
Hi Dr. Donovan, thanks so much for this great Q&A. I have another question about microneedling: I asked my dermatologist about microneedling for male AGA, but his concern was cumulative fibrosis and suggested I should trial no more than once every three months. However, I have heard several other dermatologists (including yourself) who don't seem to have so much of a problem with microneedling every week or every two weeks. I therefore surmise that the potential for problematic fibrosis cannot be so clear cut. What are your thoughts on this? Could such infrequent microneedling also be efficacious?
Great question! Microneedling is not a first line treatment. Rather it is a third line treatment (see webinar) for one reason - studies are poor and we don't have all the answers. If studies were amazing and we had all the answers this treatment would be propelled from a third line position into a first line spot. It's not. So lots of answered questions in microneedling - and another 100 more than this one that you ask ! There is no evidence whatsoever of "cumulative fibrosis"although it is a very good thought and something that needs to be studied. This is more theoretical than anything. Many of the new treatment approaches to AGA and building on the concept that hair growth activating pathways may be 'woken up' with injury to the scalp. Thanks for the question and stay tuned as we learn more!
Thanks so much for the reply. What I was hoping was that wounding in general was understood well enough to reliably predict the consequences of microneedling, even in the absence of specific microneedling studies. But I guess microneedling produces a very unusual type of wound!
@@nathan87 yes, and also there are 205,000 microneedling protocols. You can buy lots of different sizes microneedles 0.25 mm, 0.35 mm, 0.4, 0.5 mm, 0.6 mm 0.7 mm, 0.8 mm etc etc all the way up to 2 mm. you can buy rollers and stamps and pens. You can do one pass two passes three passes of the needle. If using a stamp or roller, you can press hard or gingerly light. There are thousands upon thousands upon thousands upon thousands of protocols. The way a person might do microneedling is usually going to be different than the way his or her friend of neighbour does it. Even the way a person does microneedling this week is going to be different from the way they do it next week.
One of your questions was about indents occurring after steroid injections. I have noticed several dents in my scalp in the last few months and have NOT had any injections. I've had no scalp injuries either. What could have caused it and what is this a sign of? I've been having alot of diffuse loss since they appeared. Thanks!
Thank you for sharing. You may want to review this with a dermatologist and consider a 4 mm punch biopsy. These issues can arise from many potential causes. Often a biopsy is helpful - but first and foremost a good history and examination is needed.
@donovanmedical9780 Thank you so much for responding. I just saw a dermatologist at Johns Hopkins last week and she wasn't concerned saying everyone has scalp irregularities but this is not normal for me. She said I had AGA and seb derm but my concern was an emerging FFA. I also have some eyelash and eyebrow loss. She would not do a biopsy saying it would only cause additional inflammation. Is it possible to send you the images from that visit? I know you can't make a diagnosis but if you were concerned I would seek a second opinion near me. Thanks again!
@@pamedwards6522 thanks. You might want to check out our volunteer program at the Donovan Hair Academy. We answer tough questions every week and use the questions to train the next generation of top hair specialists in the world. www.donovanhairacademy.com/qow
@donovanmedical9780 I will definitely do that. I have had alopecia areata in the past and was concerned about diffuse areata at first but then started to lose my frontal hairline. lThank you so much!