This not quite NW6 patient came to Dr. Hasson for as much coverage as possible in one session. Dr. Hasson created a mature hairline that while still giving the patient a more youthful appearance was conservative thus allowing for more coverage on the top of the scalp.
What makes this case interesting is not that the patient wore a hair system for many years but what wearing the system did to his scalp. When the patient removed his hair system for his consultation Dr. Hasson noticed black dots in the balding scalp. They looked like large black heads. After careful examination Dr. Hasson squeezed some out thinking that they were black heads. What came out was surprising to all of us. Hair. Not just one or two but several hairs would literally pop out and “blossom” like flowers standing in a vase.
This condition is called “trichostasis spinulosa”. From Emedicine.medscape.com…
“Trichostasis spinulosa results from successive production and retention of vellus telogen club hairs from a single hair matrix in a follicle. Hyperkeratosis plugs the follicle and results in the retention of the vellus hairs in the obstructed follicular infundibulum. The precise cause of this phenomenon remains undetermined.”
This is what Dr. Hasson first saw when the system was removed from the patient’s scalp. As you can see the dots look like large blackheads.
Then we shaved the scalp so we could get a better view of the situation. This zoom image shows that there are many hairs trapped in one “hole”.
Dr. Hasson squeezed these out and we placed one under a microscope. You can see what appears to be at least ten to twelve follicles tightly grouped together.
And they simply fell apart when pressure was applied as if they came from hair cut clippings.
We can only assume that this was caused by wearing the system but ultimately there has not been enough study on this subject to know exactly why this happens.
So, we then did the transplant that I described above.