Honestly, why arent the armpits and butt one of the first choices for donor sites? The scarring will be least visible here and it seems like "free hair". Who cares where it comes from, its just a hair folicle. And certainly you would think doctors would not care too much...I mean it is medicine. Medicine is not always and rarely is pretty. Maybe it is because I am a scientist and logically its just another hair follicle. Who cares where it comes from? I personally would rather have tiny scars under my pits than on my legs.

The reason I'm pretty sure you shouldn't use underarm hair is because of the sweat glands in the armpit area (one's underarm stink would sort of travel with the follicles). I know that's a bad layman's explanation of a more complicated scientific point, but that's the basic reason I've heard.

I agree with Charlie Chaplin. In FUE the sebaceous gland of each follicle must be preserved for proper graft growth. If you transplant the underarm hairs to the scalp, the extra oily and smelly sebaceous glands go with them. I know of no doctor that is willing to transplant underarm hair to your scalp for this reason.

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Edited: 06/25/2003 at 11:43 AM by Hair Loss Help Moderator

unfortunately this is contraindicated for those that had the cross-species Kangaroo hair transplant--sorry about that

The sweat glands do not belong to the Follicular Unit, it is an independent structure that has is own duct connecting to the skin surface. Sweat produced by the sweat glands has no smell, it’s mostly water, the offensive odour only appears when bacteria’s proliferate in that moist location, and sheltered locations such as armpits and groin accumulate moist easily and over an extended period of time. I also never heard that the sebaceous glands from the FU’s of the armpits were extra oily and smelly, where does this come from? It’s not possible to “transplant odours”.
In light of recent discoveries it looks that follicles from every location of the body survive and adapt when moved to another place of the same body. The only reasons I can think of that prevent the usage of any type of hair are being difficult to extract the hair from that location and/or the characteristics of that hair not being able to blend in well with the existing hair at the recipient area (even after some adaptation of the hair). Other than these cases every follicle is a follicle.

The sweat glands do not belong to the Follicular Unit, it is an independent structure that has is own duct connecting to the skin surface.

Interesting perspective, but I do not agree. And I'm not sure if all of the HT doctors would agree with you on this. At the NY seminar Dr. Woods showed us follicular units up close and emphasized the importance of ensuring that the sebaceous glands were properly extracted with each follicular unit punch.

I also never heard that the sebaceous glands from the FU’s of the armpits were extra oily and smelly, where does this come from? It’s not possible to “transplant odours”.

http://www.eucerin.co.uk/skin/skincell_5.html

"The glands of the skin (glandulae cutis) include the sweat, scent, sebaceous and milk glands. The sebaceous glands are nearly always connected to hair follicles which deliver the lipid-containing secretion to the surface through their funnel shaped openings. The size of the sebaceous gland and therefore the amount of sebum itself differ according to body region. The glands found on the face, for example, are bigger than those found on the arms or legs. An important influencing factor in sebaceous gland activity is the androgens.

In light of recent discoveries it looks that follicles from every location of the body survive and adapt when moved to another place of the same body.

Sure they can survive. I wouldn't want armpit hair on my head though.

The only reasons I can think of that prevent the usage of any type of hair are being difficult to extract the hair from that location and/or the characteristics of that hair not being able to blend in well with the existing hair at the recipient area (even after some adaptation of the hair).

I agree those are valid reasons, but not the only reasons.

Other than these cases every follicle is a follicle.
Based on the information in the link I posted and discussions I've had with HT doctors I do not agree.

It might be helpful for a HT doc to join the thread to give us some more insight.

This was my thinking as well. I thought the smell was due to fact the skin folds over itself and collects moisture, etc leading to the smell. I do not know for sure though...but the question still remains. Would these areas be better or altenative candidates for body donor hair?

Edited: 03/09/2003 at 10:16 AM by Hair Loss Help Moderator

I agree the smell is due to moisture. However, I also believe these follicles are physiologically different than those found on the head, chest, back, etc. Once on the head the armpit follicles would be much more clean due to less moisture and bacteria buildup. However, I think the follicles are also very difficult and painful to extract from the armpit and are therefore not a good donor source.

Peter, but dont you think it up to the patient to make that choice? I would rather go through the pain and have the scarring more hidden. I guess the point I am making is, is it a viable option for those concerned about scarring on the body? I do not know how difficult it would be to extract or other problems, but I am not convinced that it is not an option yet. Darn...too bad we dont have cloning yet.

I don't know any HT doc that will allow you to make the choice.

What follows is an absurd comparison, but please bear with me.
I read a legal case about a guy that had a limb cut off in an accident. He refused to allow the doctors to reattach his limb. He insisted he didn't want it. Later he sued the hospital claiming the doctors should have restrained him and reattached the limb. His claim was that he was obviously not intelligent enought to make decisions about his medical care and the doctors had an ethical responsibility to force him to undergo limb reattachment surgery.

It asks an interesting ethical question. Is a doctor obligated to do what he feels is medically appropriate or should he allow his patient to make that decision?

I'd also like to address your scarring question. If you are concerned about scarring I don't feel you should be. I saw many Woods patients up close in NY. I couldn't tell where the FUE punches had been made on their bodies or heads. They healed so well it was nearly impossible to tell anything was done. Also, you can use Mederma and other products to help minimize scarring. Dr. Cole also suggested using a running suture to help the wounds heal by primary intention (wounds touching) vs. secondary intention (wounds open). The running suture could help your FUE holes heal faster with less scarring.

I recommend you meet with few HT doctors to see if any of them will transplant underarm hair for you.
If a doctor has a different opinion than me I'd love to read it. I like to hear opposing viewpoint because it helps further everyone's understanding.

"However, I think the follicles are also very difficult and painful to extract from the armpit and are therefore not a good donor source."

This was the comment I was responding to. If the doctor can do it (the difficulty seems to be kind of unknown) and you are willing to accept the pain, then why would you not be allowed to make this decision? Obviously if one cannot extract them then there is no point. Anyway, enough about that.

Secondly, I have no GOOD knowledge about the scarring on the body. I have seen poet's pics and there are obvious regions of redness so I would not know what to expect. I have heard it leaves pitting, but do not know how real that is. Your first hand knowledge is as good as any so its good news to hear you say the scarring is minimal.

P.S. I am very far away from a transplant so I will not be talking with doctors. With my hair short, noone knows I am balding exept for me. I am just thinking about the future and learning about options.

'

Edited: 06/25/2003 at 11:42 AM by Hair Loss Help Moderator

Secondly, I have no GOOD knowledge about the scarring on the body. I have seen poet's pics and there are obvious regions of redness so I would not know what to expect. I have heard it leaves pitting, but do not know how real that is. Your first hand knowledge is as good as any so its good news to hear you say the scarring is minimal.

Some people don't heal well. Poet may heal slowly. Who said it leaves pitting? I've never seen pitting. If you are concerned about scarring or pitting you should talk to your doctor about using Mederma post transplant and/or a running suture to help the FUE holes heal better.

Also, Poet said he hasn't used Mederma to help the healing. Obviously the scarring is not that big of a deal to him since he doesn't apply any topicals to help the region heal faster.

Peter Mac, it seems that you think that sweat glands and sebaceous glands are the same thing. They are not. Sweat glands are one thing and Sebaceous glands are another. Sweat glands are independent structures and Sebaceous glands belong to the FU.
You still didn’t tell me why you think that the Sebaceous glands of the FU’s at the armpit produce more sebum or a sebum that is smelly, that is not true, in my case I have oily scalp hair and I can tell you that the armpits hair is less oily than the scalp hair. The sebum is not smelly and the sweat is not smelly. A follicle is a follicle, if you can extract it you can use it.

I like European Guy. He asks some tough questions and makes us research all of our answers.
First of all, I'm not a doctor...so I really can't answer any of your questions with certainty.

Anything I say is pure speculation based on what I've read.
Anyway, let's start with a skin cross section picture:



You are correct. When you were discussing sweat glands I translated that to sebaceous glands as I was reading it.

When the doctor extracts the hair follicle with an FUE punch this pic shows the sweat gland is really close to the hair follicle. Of course, other pics I've seen show it being further away.

I don't know if the armpit area has a denser concentration of sweat glands that could be damaged by extraction or different sebaceous glands with different sebum production levels that would not be suitable for the scalp.

These are just theories I'm throwing out. I think it would be good for a doctor to join the discussion as I suggested before. I can continue posting possible theories, but that doesn't help anyone that wants conclusive answers.

Edited: 03/09/2003 at 09:57 PM by Hair Loss Help Moderator

I think the main reason I brought this up was to question if these are viable sources, not to state they are. I still think it is a good question and as of yet I have not seen anything conclusive to indicate that it is not a possible choice. Basically, it may just be another option and options are always nice. I THOUGHT, and may be completely wrong, but body hair was initially considered a last resort. To me, if you have little/no scars I would think body hair can be a good first option after there has been proven success. This could just just be an extension of that. Anyway...just thinking about the options we have right now, I am not claiming this will or will not work or is a good or poor choice because I dont know.

Edited: 03/10/2003 at 09:27 AM by Hair Loss Help Moderator

some people strongly feel that body hair should only be used as a supplement to head hair or only used if head donor hair is depleted. The theory is that because the texture, hair physiology, sebaceous oil production, etc. is different enough on body hair that it should only be used as a last resort.

My opinion has always been not enough research has been done yet. Body hair has been shown to take on many head hair characteristics once moved to the scalp. I think a double blind, placebo controlled study is in order to determine if anyone can really tell the difference between body hair and head hair after it's transplanted.

there are two types of glands in the skin. one is a sweat gland and the other is a sebaceous gland. some sweat glands such as those in the arm pits, anal, pubic, margin of the eyes, and ear regions are larger an produce slightly different secretions depending on the area. is it the skin bacteria that create the odor in these areas or is it possible that some bacteria are found in the sweat glands too. the sebaceous glands secrete into the follicular canal. sweat glands are not associated with hair and secret on the surface of the skin. it is possible that in extracting a follicular group with FIT that a sweat gland could be extracted and transplanted also.

the question of odor is a very good one. Peter mac points out excellent thoughts here that perhaps body hair is not best suited for many regions of the scalp. if you listen to some individuals though, you will find that body hair has done them a world of good in both their donor scars and when transplanted to the crown area. yes, they may have a different texture. dr. woods has found them invaluable in his treatment of extensive degrees of hair loss, as well as, donor area scars. he has extensive experience with this subject so i think his comments here would be invaluable.

these are all excellent thoughts. the truth is we don't have all the answers. all i can say for sure is i am glad to have an additional source of hair and so are a number of patients.

sebaceous glands typically produce an oily substance. they rest higher in the dermis next to the hair shaft and sweat glands rest lower in the dermis separate from the sweat glands.

we know that beard hair develops under the influence of DHT. we also know that if you block dht production beard hair continues. therefore there is little reason to suspect that dht reduction will reduce the growth of body hair transplants, but this too must be looked at.

peter mac is correct. we need to do a great deal more reasearch.

www.forhair.com

Dr. Cole,

You said:

"we also know that if you block dht production beard hair continues"

Are you sure? I have heard numerous patients experiencing a reduction in beard growth when on Propecia... and now when on Dutasteride.

Also, I have seen a lot of men with chest hair who are balding. However, a lot of guys who have significnat beard growth, but no chest hair often have amazing hair. e.g., Brad Pitt. These two guys with the best hair that I see on a daily basis have faster beard growth than me, but they have ZERO chest hair.

Is chest hair more responsive to DHT than beard hair -- since the connection beteen that and hair loss is so strong?

Obviously all of this is speculation basis on my observations only. I feel that balding in Orientals/Native Americans/most black men could be dut to other factors besides DHT since they have no body hair or very limited in case of African Americans.