Hair transplant surgery patient before and after photos with Trichostasis Spinulosa

Procedure detail

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.

4335 Grafts
Singles...1078
Doubles...2922
3/4...335

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.

Bald class

Bald class 6

Norwood stage 6

The balding areas at the temples join with the balding area at the vertex. The band of hair across the top of the head is gone or sparse.