Removal of Acne Keloidalis Nuchae (AKN) Transforms Quality of Life

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“It means everything to me. I finally got my life back,” this patient commented. He underwent treatment at DermHair Clinic for the surgical removal of acne keloidalis nuchae, and the results have changed his life. For years he had struggled with the condition, a chronic formation of large, keloid-like pustules on the back of the scalp. They started out as if to be mere razor bumps on the back of his head, but then grew to unsightly proportions and would not go away.

He tried everything to get rid of his AKN, which was frequently itchy and leaked puss. First he pursued medical treatments such as antibiotics and steroid injections. Then it was three attempts at surgery, all of which were unsuccessful. The acne keloidalis nuchae remained, and deteriorated his confidence and self-esteem both socially and professionally.

At last, he came to Dr. Umar to try a fourth surgery. Dr. Umar successfully excised the entire AKN mass, and only three months after treatment, the area is healing nicely. His scalp shows no signs of remaining infection, and the recovery process has far surpassed that of his prior procedures. He has no more itching and no pain. “Dr. Umar, a miracle is going on behind the head thanks to you,” the patient said. “[Acne keloidalis nuchae] affected me academically and professionally. But I’m happy that it’s better now and I can move on.”


Acne Keloidalis Nuchae (AKN) Surgically Corrected

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This patient suffered a condition called acne keloidalis nuchae, which was causing him to have bumps on the back of his head. Acne keloidalis nuchae, or AKN, is a condition that ravages the hair follicle, usually on the back of the head near the nape of the neck. It results in scarring, hair loss, and what appears to be razor bumps on the back of the head; however in many cases these bumps grow to become large puss-filled masses. This patient had been wearing his hair long to cover the bumps, but wanted to pursue treatment before they grew bigger.

His options were to have ongoing corticosteroid injections to the area every month, or to have permanent treatment—surgical excision. He opted for surgery. Dr. Umar successfully removed the area of the scalp that was affected by acne keloidalis nuchae.

Several months after the surgery, his AKN is gone and the area shows great improvement. The patient is now able to cut his hair short, without the embarrassment he faced before. In addition, his newfound confidence is influencing many areas of his life. “I get out more, I’m starting to exercise,” the patient says. “I feel great. I’m glad I did it.”


Dr. Umar Featured on KCAL 9 News To Talk About Hair Loss

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The Norwood Scale

The Norwood Scale

Hair loss is an endemic source of cosmetic discontent—oftentimes it can even lead to depression, mood swings, lowered self-esteem, and social phobia. The millions of people that suffer genetic baldness, or hair loss due to an illness or other trauma, are constantly searching for a viable means of hair restoration, or at least concealment. For men and women alike, the search seems daunting and endless. Unfortunately, there is no “cure.” However, there are things that can be done to mitigate hair loss. And depending on the degree of hair loss, they range from simple home remedies to surgical solutions.

KCAL 9 News welcomed renowned hair transplant specialist Dr. Sanusi Umar onto the show to discuss the simple things that can be done to catalyze hair restoration on your own.

Home Remedies to Abate Hair Loss

“There are a number of causes of hair loss,” Dr. Umar affirmed to show hosts Dave Gonzalez and Sandra Mitchell, “but there are a number of things you can do to minimize the extent.” Some of these hair restoration remedies include:

  • Eating a healthy diet, full of the right proteins, vitamins, and nutrients.
  • Taking vitamins if your dietary choices are restrictive
  • Protecting your hair against the sun—UV rays damage hair and cause breakage.
  • Condition your hair and prevent drying it out with harsh chemicals

Dr. Umar named several foods that are helpful in preventing hair loss, which incorporated spinach, broccoli, chicken, beans, and salmon. The goal is to consume foods that are rich with iron, biotin, protein, and essential oils. Vitamins like B-12 make for a helpful hair restoration supplement if you don’t eat the right foods. As for UV protection, simply putting on a hat in prolonged sun exposure helps, or using hair products that contain an HPF (like SPF for skin). To further prevent drying and breakage, be sure to condition your hair regularly and avoid chemicals like alcohol, bleach, and chlorine.

When Hair Loss Is Beyond the Aid of Natural Remedies

Dr. Umar moved down the line of foods and products placed on the KCAL 9 News display counter, to end with the more aggressive hair restoration treatments. For more serious or advanced hair loss, like pattern baldness, FDA-approved Rogaine (minoxidil) is a topical treatment available to both men and women. The doctor also mentioned propecia (finasteride), which is an FDA-approved, prescription only pill for hair loss prevention.

Dr. Umar acknowledged that Rogaine only really helps about 30% of users, so for patients who are beyond the help of medications, surgical hair restoration remains an option.

Deciding Between FUE and FUT For Hair Transplant

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Making the leap into hair transplant can be incredibly overwhelming. There is so much research to be done, so many choices to be made, so many goals to be fulfilled. The process involves an exhausting list of variables to be considered, which includes:

  • Your age
  • How bald you are/how many hair grafts you’ll need
  • What surgeon/hair clinic you choose
  • How much you’re willing to pay
  • The technique you choose

All of the above take part in the final results—and each one has the potential to make or break your hair transplant. Last, but certainly not least on the list, technique is like the vehicle you choose on the road to restoration. One will get you to your final destination while another may not be able to make it all the way.

FUE for Hair Transplant

FUE stands for follicular unit extraction. This method of surgical hair restoration got its big boost in the 1990’s, when development took off in full force. Hair surgeons wanted to improve on the existing techniques (one of them being FUT) in order to create the best outcomes possible.

FUE is a tedious, labor-intensive surgery that removes the hair grafts one at a time from the donor area for implantation into the recipient area. The donor area is usually comprised of the back of the head, but now with body hair transplant, FUE incorporates donor hair from almost anywhere on the body. FUE results in minimized scarring, quick healing, and optimal results—especially for hairline design.

FUT for Hair Transplant

FUT stands for follicular unit transplant. This method came before FUE, and thus it is a more antiquated method of hair transplant. Its development came about in the 1980’s but it still continues to be a popular method today. FUT removes the hair grafts by excising a linear strip of flesh from the back of the patient’s scalp. This creates the infamous strip scar, and also limits the number of hair grafts that can be transplanted as well as the caliber of hair that can be used. Ultimately, it is a quicker surgery, though more invasive, and hairline design suffers.

How to Choose

Each procedure has its pros and cons. While FUE creates superior results, FUT is more affordable for most people—and both require a skilled and experienced surgeon for the best possible results.

FUE or strip surgery

Information for hair transplant patients to know when evaluating FUT versus FUE

Dr. Umar Talks Eyebrow Transplant with The New York Times

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It seems not long ago that the exceptionally thin eyebrows of celebrities like Gwen Stefani and Pamela Anderson were the guiding force for widespread cosmetic over-plucking. In hindsight, enduring that physical torture was not the only consequence; women are now finding their arches to be permanently emaciated. Their brows won’t grow back. As the full, sculpted brows of Kim Kardashian take the lime light, women are searching for ways to adhere to this new aesthetic standard. The New York Times takes a look at the options, which include eyebrow pencil, eyebrow tattooing, and eyebrow transplant.

What is Eyebrow Transplant?

Kim Kardashian eyebrows are a popular choice for clients of Dr. Sanusi Umar, a dermatologist in Beverly Hills, Calif

Kim Kardashian eyebrows are a popular choice for clients of Dr. Sanusi Umar, a dermatologist in Beverly Hills, Calif

This minimally invasive microsurgical procedure (when follicular unit extraction is used) is the only viable means of getting real, permanent hair to grow again along the brow bone. Dr. Umar uses FUE (follicular unit extraction) to remove hairs one by one from the nape of the neck or the legs for implantation to the eyebrow area. The procedure takes 4 to 5 hours, the New York Times reports. And when it’s over, the patient never again has to deal with the daily application of eyebrow pencil, or the unnatural appearance of eyebrow tattoos. No smudges, no off-colored ink. Instead, she (or he) has real, natural-looking eyebrow hair restored.

As a dermatologist and world-leading hair transplant surgeon, Dr. Umar normally treats a large population of balding men. But his populace of female patients has grown recently, and they present to him seeking eyebrow transplant while clutching images of Kim Kardashian and Brooke Shields. “Right now, Kim Kardashian is hot—that is, eyebrow-wise,” Dr. Umar tells the New York Times with a laugh.

The Eyebrow Transplant Experience

One of Dr. Umar’s recent eyebrow transplant patients, Sarah Tirosh, was featured in a KNBC Health News special for undergoing the procedure. As an aging woman who over-plucked her brows for years, she couldn’t get them to grow in. Pencil was a tiring option and she found eyebrow tattooing inconvenient and expensive, reporting that it required touch-ups every few months because the ink fades so quickly.  She went to Dr. Umar for the best permanent solution available: eyebrow transplant using FUE. Within ten months of the procedure she found the results extremely pleasing and well worthwhile.

This groundbreaking procedure is also noteworthy for it’s repairing capabilities in the case of an accident or other misfortune. Those who’ve endured chemotherapy, alopecia areata, thyroid dysfunction, burns, etc now have some cosmetic respite.

Why Treatments for Hair Loss Are So Important

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Image courtesy

Image courtesy

We have doctors to treat us for all kinds of ailments. Some of them specialize in the ears, nose, and throat while others specialize in treating kidney problems and yet others target just the heart, brain, eyes, or feet. Problems with hair fall under the care of dermatologists, who are generally considered specialists of the hair, skin, and nails. While thinning hair is mostly disconcerting for cosmetic reasons, it’s time we start thinking of treatments for hair loss as an important part of our overall health.

What Your Hair (Loss) Can Tell You

Thin, brittle hair is considered unattractive, and thus we want to know how to tackle hair restoration head-on. But before you go straight for the Rogaine, or other hair restoration solutions, consider this: there’s a lot that hair loss can tell you about your health. If you notice you have thinning hair, make an appointment with your dermatologist to find out why. Pursuing the right treatments for hair loss starts with knowing the underlying cause. While hair loss can be a symptom of the typical androgenic alopecia diagnosis, pattern baldness isn’t the only threat to your tresses. Hair loss can be a sign of serious underlying illnesses. To name a few:

  • Anemia
  • Diabetes
  • Thyroid dysfunction
  • Malnourishment/vitamin deficiency
  • Lupus
  • Alopecia areata
  • Scalp infection
  • Emotional shock/stress/depression

Many of these are not permanent causes of hair loss, and hair restoration will naturally occur with the treatment of the illness itself. However, only your dermatologist can start to determine what’s causing your hair to fall out.

The Beauty of Hair Loss

Although it tends to be cosmetically displeasing, the beauty of hair loss is that we can notice it fairly quickly and do something about it. If you’re losing more than 50 to 100 strands per day, this is your body’s way of telling you that it’s giving in to genetics and aging (pattern baldness), or that something is wrong. Don’t ignore these signs. Pursue your treatments for hair loss under the care of a doctor, just as you would for any other ailment. The more quickly you go to the dermatologist, the more quickly you will know what’s happening and be on a safe and healthy road to hair restoration.

Once the cause is determined, clinically proven treatments for hair loss may include Rogaine (minoxidil), Propecia (finasteride), or hair transplant.

Surgical Hair Restoration for Permanent Hair Loss Causes

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Male or female pattern baldness is number one among hair loss causes. By the age of 50, 85% of men will struggle with this unfavorable cosmetic fate, while 50% of women will endure it to some degree by the age of forty. However, pattern baldness, also known as androgenic alopecia, is not the only permanent cause of hair loss. There are various other disorders and situations that lead to permanently thinning hair. And one of today’s best treatments for such cases is surgical hair restoration.

Pattern Baldness and Other Hair Loss Causes

Traction alopecia. Image courtesy of

Traction alopecia. Image courtesy of

Pattern baldness develops as a weakness within the genetically inherited androgen receptors, which eventually leads to DHT sensitivity amid hairs on the scalp. DHT (dihydrotestosteron), the hormone metabolite of testosterone and the enzyme 5-alph-reductase, is the main culprit for the cause of this condition. However, new variables are now in question, such as the involvement of certain prostaglandins.

Other hair loss causes that may lead to permanent baldness, and thus require surgical hair restoration, include:

  • Lupus
  • Chemotherapy (hair grows back in most cases, but occasionally does not)
  • Traction alopecia
  • Trichotillomania (a psychological disorder resulting in obsessive plucking of hair)
  • An accident or burn

Why Surgical Hair Restoration Is The Solution

In cases of permanent damage, the loss of hair is irreversible. At the early onset of pattern baldness, the condition might be mitigated by the application of Rogaine or a Propecia prescription, but in its advanced stages the hair that is lost is gone forever. Likewise, in the event of Lupus-related hair loss, traction alopecia, trichotillomania, or an accident/burn, there is either a chemical barrier or the barrier of scar tissue preventing the hair from ever growing back naturally.

The idea behind surgical hair restoration is to take viable, DHT-immune hairs from a donor zone on the patient’s scalp (non-head donor sources are now an option) and implant them into the balding recipient areas. Here, the harvested donor hairs will take root and grow anew.

Surgical hair restoration can safely correct all listed hair loss causes, with minimal invasiveness and with natural-looking results. Follicular unit extraction is the leading method of hair transplant due to its ability to treat severe cases, its freedom to design the hairline more effectively, and its minimized resultant scarring.

FUE Hair Transplant Costs More Than Rogaine or Propecia, Right?

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The cost of FUE hair transplant, or any surgical hair restoration procedure, is sometimes a deterrent for hair loss sufferers. And the balder you are, the more expensive the surgery, since more grafts are needed. Most clinics charge a per-graft amount, ranging from five dollars per graft to twelve. For someone who requires the median 4,000 grafts, an FUE hair transplant could run anywhere from 20,000 to 40,000 dollars. That’s a car! A down payment on a house! Or it could easily be a 20 to 30-year supply of Propecia…

A Lifetime of Propecia and Rogaine

Propecia (finasteride) is a prescription only drug. Depending on your insurance and the pharmacy you go to, the drug can cost anywhere from $60 to $100 for a 30-day supply. Over the course of 30 years, this would add up to $36,000, on the high end. To make matters worse, there is no cheap generic version available, which means the balding are forced to pay this outrageous monthly cost. To lower this cost, some have resorted to getting a generic Proscar prescription (given for benign prostatic hyperplasia) and literally cutting the pill into four pieces, since it’s a 5mg pill instead of one. However, many doctors will not agree to this.

Rogaine (minoxidil) is an over-the-counter fix and is not quite as expensive, but it’s also not as effective for treating hair loss as Propecia. A month’s supply of Rogaine runs $20 to $30. On the high end, that’s $10,800 over 30 years.

Many people find Propecia and Rogaine eventually stop working after ten or so years. Thus, many wouldn’t need a lifetime supply of the stuff. But what do they do then? Additionally, even during those initial ten years of use both Rogaine and Propecia are proven ineffective at reducing hairline recession and both only stop hair loss, they do not re-grow lost hair. A ten-year bill would be about $3,600 for Rogaine and  $12,000 for Propecia, with inconsistent coverage, potential health risks, and non-permanent results.

FUE Hair Transplant – Worth Every Penny

In the hands of the right surgeon, an FUE hair transplant will be worth the money you spend. Surgical hair restoration is able to fill the areas you want filled—hairline, crown, or otherwise—add global density, and restore your hair for a lifetime. The transplanted hairs are DHT immune and therefore permanent. In addition, FUE hair transplant is able to restore the severely bald through body hair transplant; an impossible feat with medication.

So, while some people turn from surgical hair restoration due to cost, those who think long-term will reconsider. A $20,000 investment is always better when you have something to show for it at the end.

FUE Hair Transplant – The Ultimate Hair Loss Cure?

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For any man or woman, the odds of enduring thinning hair are high. Eighty-five percent of men will suffer male pattern baldness by the age of 50, while 50% of women will suffer female pattern baldness by the age of forty. And with hair carrying such social and cultural weight with regard to beauty, sexuality, and success, this means that most people are searching for a hair loss cure.

In the ongoing search for this Holy Grail of cosmetic refuge, the balding will most assuredly come across various treatment options. From Rogaine to FUE hair transplant, to stem cell hair cloning, it may be difficult to decipher what really is the ultimate solution to pattern baldness.

Finding the Hair Loss Cure: Options

The ultimate option lies in what the sufferer wants to gain, aside from the obvious head of hair. Is this head of hair temporary? Permanent? Surgical? Non-surgical? The truth is, there really is no “ultimate” option—only the best option for the individual. FUE hair transplant is the best surgical option available, while Rogaine is the best over-the-counter treatment, Propecia the best prescription available. And there are also some natural remedies that may help to slightly reduce hair loss over the years, like vitamins and adequate sleep.

What Makes FUE Hair Transplant the Ultimate Surgical Hair Loss Cure

FUE hair transplant largely blossomed in the 1990’s. FUE stands for follicular unit extraction and requires individual graft excision from the donor zone; contrary to its long-time competitor FUT (follicular unit transplant) which harvests the donor hair by excising a strip of flesh from the donor zone.

With FUE and FUT being today’s leading methods of surgical hair restoration, a comparison between the two shows quite evidently why the former is a superior option. (Of course, either technique is only as good as the surgeon performing it.) FUE hair transplant leaves behind no linear scar, provides more room for hairline design due to the freedom to extract specific donor hairs, and has less downtime after surgery. It has also paved the way for the groundbreaking technique, body hair transplant, wherein donor hair can be extracted from several areas on the body rather than confined to the rear scalp.

hair loss surgery options

hair transplant surgery can be done using the strip surgery method or Follicular Unit Extraction

When all is said and done, the ultimate hair loss cure depends on what the patient wants and needs. No one can determine your best treatment option but you.

Large Volume FUE Body Hair Transplant Procedures With The Help of uGraft

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Real Self ( a popular site for patients to ask questions that are answered by real doctors) recently asked Dr. Umar about the phenomenal results his patients experience as a result of body hair transplant.

According to the site, most hair transplant patients who participate on Real Self say they received between 2,500-5000 grafts. But many of the individuals treated by Dr. Umar receive 10,000-20,000 grafts using hair from different areas of the body.

Body hair transplant gave excellent results in this patient

Body hair transplant gave excellent results in this patient


before and after images of body hair transplant procedure performed by Dr. Umar

before and after images of body hair transplant procedure performed by Dr. Umar


The key to being able to accomplish this lies in using the uGraft technology. This was developed by Dr. Umar himself.

The large volume results that body hair transplant  achieves using uGraft is amazing. And it offers much promise to patients with severe forms of baldness. But what is also interesting is that these procedures make excellent use of hair that is normally considered to be undesirable.  According to Dr. Umar,We seek to use a perceived disadvantage of body hair (namely thin caliber) to our advantage … to feather out what was hitherto considered a good hair transplant derived hairline … in order to give the hairline the subtlety that is expected in natural form.”

This patient video which was featured on Real Self shows the results of a patient body hair transplant procedure that used 20,000 grafts. Initially, 15,000 grafts were reinserted. And a year later, Dr. Umar touched up areas of low hair density using 5,000 grafts. The donor pool of these two procedures consisted of 5500 grafts from the head donor area and 14,500 grafts from other areas of the body: nape, beard, chest, abdomen, legs and arms.


The use of body hair for transplant procedures can offer wonderful results.  However there are a few considerations to be aware of. The follicles taken from other regions of the body will grow hair that has the same qualities as before:

  1. Difference in color between head and body hair.  In some patients, head hair is a different color from body hair. Once body hair follicles are reinserted into the scalp, they will continue to have the same color
  2. If non-beard hair extracted from other regions of the body are used, they will continue to grow at the same length. For example chest and leg hair will continue to be short once used on the head
  3. The texture of body hair will not change once they are transplanted into the scalp.

Body hair transplant is essentially an advanced form of Follicular Unit Extraction.  Although FUE technology like Neograft and Artas is available to help facilitate different aspects of the procedure, they are not ideal for harvesting follicles from body regions.