WEDNESDAY, Feb. 22 (HealthDay News) — Patients admitted to the top hospitals for emergency medicine in the United States have a nearly 42 percent lower death rate than those admitted to other hospitals in the nation, according to a new report.

If all hospitals performed at the same level as the top-ranked hospitals, nearly 171,000 more people in the United States might have survived their emergency hospitalization between 2008 and 2010, according to HealthGrades, an independent provider of consumer information about doctors and hospitals.

Researchers analyzed more than 7 million Medicare patient records from 2008 to 2010. The patients were admitted to the hospital through the emergency department for the following diagnoses: bowel obstruction, chronic obstructive pulmonary disease, diabetic acidosis and coma, gastrointestinal bleed, heart attack, heart failure, pancreatitis, pneumonia, pulmonary embolism, respiratory failure, sepsis or stroke.

The report also found that emergency-room admissions for heart attack decreased 1.7 percent between 2008 and 2010, while admissions for stroke increased 2.2 percent. It also found that more than 61 percent of hospital admissions among seniors begin in the emergency department, the highest of all age groups.

The 10 cities with the lowest risk-adjusted death rates for patients admitted through the emergency department were: Milwaukee; Phoenix-Prescott, Ariz.; Cincinnati; West Palm Beach, Fla.; Baltimore; Traverse City, Mich.; Dayton, Ohio; Cleveland; Fargo, N.D.; and Detroit.

“It is imperative that anyone experiencing a medical emergency go directly to the closest hospital, especially in the event of a heart attack or stroke,” report author Dr. Arshad Rahim, director of accelerated clinical excellence at HealthGrades, said in a company news release.

“That said, our study findings show the care you receive once admitted to the hospital can also make the difference between life and death,” Dr. Rahim added. “We encourage all patients to educate themselves about the quality of emergency medical providers in their area and to choose a top-performing hospital whenever there is a choice.”

More information

The U.S. Agency for Healthcare Research and Quality advises you to do your homework before choosing a hospital.

SOURCE: HealthGrades, news release, Feb. 20, 2012

WEDNESDAY, Feb. 22 (HealthDay News) — A U.S. Food and Drug Administration advisory panel gave its endorsement Wednesday to a highly anticipated weight-loss pill that had been rejected by the health advisers once before.

The committee of outside physicians voted 20-2 to back the drug Qnexa, although the group urged that patients be monitored closely for potential heart problems, the Associated Press reported.

A decision by the full FDA is expected in April. The agency typically follows the recommendations of its advisory panels.

While effective at reducing weight, the drug, manufactured by Vivus Inc., was denied approval in 2010 because of its potential side effects. Before making its decision Wednesday, the advisory panel reviewed two years of data on the drug; when advisers last voted on Qnexa, only one year’s worth of follow-up data was available.

The drug combines the appetite suppressant phentermine and the anti-seizure/migraine drug topiramate. Phentermine was once widely prescribed as the “phen” part of the fen-phen weight loss drug. This combo was withdrawn from the market after its use was linked to high blood pressure in the lungs and heart valve disease. The problems were related to the “fen” or fenfluramine part of the combination, not the phentermine.

No new weight-loss drug has been approved in the United States in the past 13 years, according to published reports. As it stands, Xenical is the only FDA-approved drug specifically for long-term use — up to a year — for weight loss. Xenical is sold over-the-counter as Alli. However, other drugs may be used off label to promote weight loss.

Last April, a study funded by Vivus found that obese patients taking Qnexa lost an average 22 pounds over a year, while also lowering their blood pressure and cholesterol levels.

Dr. Louis Aronne, founder and director of the Comprehensive Weight Control Program at New York-Presbyterian Hospital/Weill Cornell Medical Center in New York City, was cautiously optimistic that Vivus did a good job responding to FDA safety concerns, and that the FDA will give the drug its nod of approval, with some caveats. Aronne was not involved in the trials but has been an adviser to Vivus and other companies developing weight loss medications.

“I am not as pessimistic as most people,” he said.

Vivus has reported that Qnexa may increase the risk of cleft lip in babies of women who use the drug while pregnant. Aronne said the birth defect concern could be addressed through education on who should and should not use the new drug.

“We have learned our lessons with weight loss drugs,” he said. “They need to be used in the right people under the right circumstances.” The heart risks need to be weighed against reductions in heart disease risk factors that come with weight loss, he said.

Qnexa is not any riskier than bariatric surgery, according to Aronne. “The problem is that it can be distributed more widely,” he said. He hopes for a compromise that allows the new compound to be prescribed, but not misused. “Once new medications are approved, local medical boards will need to enforce rules and make sure these medications are prescribed appropriately to the right candidates,” he said. “We don’t want to open up pill mills.”

One thing is clear, he said: More options to treat obesity are needed. “For hypertension, there are 120 medications in nine categories,” Aronne said. “We need new options and we need to get physicians thinking about obesity and obesity treatments.”

Dr. Scott Kahan, an obesity expert at Johns Hopkins University in Baltimore and director of the National Center for Weight and Wellness in Washington, D.C., agreed. He is optimistic about the FDA’s upcoming decision on Qnexa. “The weight loss effects are striking and approaching the amount of weight loss over two years that we get with bariatric surgery,” he said. “This is really impressive.”

More information

Learn more about weight loss medications at the U.S. National Institutes of Health.

SOURCES: Louis Aronne, M.D., founder and director, Comprehensive Weight Control Program at New York-Presbyterian Hospital/Weill Cornell Medical Center, New York City; Scott Kahn, M.D., associate director, Johns Hopkins Weight Management Center, Baltimore, and director, National Center for Weight and Wellness, Washington, D.C.

WEDNESDAY, Feb. 22 (HealthDay News) — Melanoma that has spread to other areas of the body is almost always fatal, but a new drug appears to double survival for those with a certain type of this skin cancer, researchers report.

A mutation in the BRAF protein occurs in about half the people who develop melanoma. Researchers say Zelboraf (vemurafenib), a drug approved by the U.S. Food and Drug Administration in 2011, blocks that mutation, thereby killing the cancer cells.

“We demonstrated in a large group of patients overall survival approached 16 months, which is far beyond what we have seen in other trials,” said lead researcher Dr. Jeffrey Sosman, a professor of medicine at the Vanderbilt-Ingram Cancer Center in Nashville, Tenn.

Survival for people with advanced melanoma is usually six to 10 months. Some new drugs have extended that to maybe 11 months, “but this is the first time we have shown such a long extension in survival,” he said.

All of the patients had late-stage (stage 4) melanoma. Sosman said it’s hoped that Zelboraf will work even better when given sooner.

“If we use it in an earlier stage, then we are hoping to cure patients who would not be cured otherwise,” he said.

Results of this phase 2 trial — undertaken to assess the effectiveness and safety of the drug — are published in the Feb. 23 issue of the New England Journal of Medicine.

For more than a year, Sosman’s team followed 132 patients with previously treated metastatic melanoma, meaning the cancer had spread and was considered inoperable.

Zelboraf is a pill that patients take twice a day, and more than half who took the drug responded to it, the researchers said.

A response meant more than a 30 percent reduction in the size of tumors. Only 14 percent of patients failed to show any response to Zelboraf whatsoever, meaning their disease continued to progress.

Previously, no more than 10 percent of patients responded to any of the other available treatments, the researchers said.

The main limitation with Zelboraf is that tumors eventually become resistant.

Side effects include joint and muscle aches, which are fairly easy to manage in most patients, Sosman said.

Some patients also experienced skin changes, including sun sensitivity and rashes. “Patients develop incredible photosensitivity so patients have to be very careful about direct sunlight and use sunscreen as well as just staying out of the bright sun,” Sosman said.

Also, the drug indirectly causes squamous cell cancers of the skin in some patients. “These generally never spread and are easy to remove, and patients who have gotten them can remain on treatment,” Sosman said.

The drug costs around $10,000 a month, Sosman noted. “It’s comparable to other cancer drugs that have shown improvement in survival, but like a lot of cancer drugs, it’s expensive,” he said. “You probably need to take the drug for an indefinite period of time.”

Drug maker Hoffmann-La Roche funded the study.

About 70,000 Americans are diagnosed with melanoma each year. Of these, about 8,000 will die from the disease.

Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City, said the study is a leap forward. “This finding is significant in that there is nothing right now for this kind of cancer. It’s basically a death sentence,” she said.

That the researchers showed improved survival is clinically significant, she said, even though “the survival wasn’t that much longer.”

If the drug were given for early-stage melanoma, it’s possible it would improve survival even more, Green said. Eventually, she said the research will lead to a cure for melanoma.

“There’s new hope every single day for melanoma,” she said. “I think in our lifetime we are going to see cures for this cancer.”

More information

For more information on melanoma, visit the U.S. National Library of Medicine.

SOURCES: Jeffrey Sosman, M.D., professor of medicine, Vanderbilt-Ingram Cancer Center, Nashville, Tenn.; Michele Green, M.D, dermatologist, Lenox Hill Hospital, New York City; Feb. 23, 2012, New England Journal of Medicine

WEDNESDAY, Feb. 22 (HealthDay News) — It’s been found that removing precancerous polyps during colonoscopies can prevent deadly malignancies from developing. Now, new long-term research supports the idea that the screening test not only prevents colorectal cancers, but dramatically cuts deaths from the disease.

Analyzing the results of the National Polyp Study — which followed about 2,600 patients whose precancerous polyps were taken out during colonoscopies for up to 23 years — researchers from Memorial Sloan-Kettering Cancer Center in New York City and colleagues found that this course of action netted a 53 percent drop in colon and rectal cancer mortality compared to deaths expected among similar patients in the general population.

“This is very strong evidence that provides assurance that there is a long-term benefit to removing these polyps,” said lead author Ann Zauber, a biostatistician at Sloan-Kettering. “Over more than 20 years, we’re getting this very consistent decrease in colon cancer deaths, so that’s very exciting.”

The study is published Feb. 23 in the New England Journal of Medicine.

In a related study published in the same issue, researchers from Spain found that fecal immunochemical testing (FIT) — which uses stool samples to detect the presence of colorectal cancer — yielded similar detection rates as colonoscopy in finding cancerous lesions. However, colonoscopy detected more advanced polyps than FIT, though more people opted to participate in fecal testing.

Colorectal cancer, the third most common type of malignancy worldwide, is one of the few cancers that can be prevented when screening tests are done properly, experts said. But the invasive and involved nature of colonoscopy — during which the bowel is viewed with a camera after a day-long bowel cleanse — seems to deter about half of Americans who should be screened from undergoing the test. The U.S. Preventive Services Task Force recommends colorectal screening for those between 50 and 75.

“Research like this is still needed because despite all of what we know and recommend, the American people are still not good at getting screening. So we really have a ways to go,” said Dr. David Bernstein, chief of the division of gastroenterology at North Shore University Hospital in Manhasset, N.Y. “To me, it’s honestly a no-brainer.”

The National Polyp Study, which involved seven clinical centers, also found that patients who had precancerous colon polyps removed had the same low death rate from colon cancer for up to 10 years after the procedure when compared to another group of patients in whom no such polyps were found. Researchers used the U.S. National Cancer Institute’s Surveillance, Epidemiology and End Results population-based registry program to compare observed death rates in those with precancerous polyps to a similar group in the general population.

Meanwhile, the Spanish study, a trial involving more than 50,000 people that is still under way, will compare colorectal cancer deaths after either one-time colonoscopy screening or FIT screening every two years for a period of 10 years.

Dr. Anthony Starpoli, a gastroenterologist at Lenox Hill Hospital in New York City, said the Spanish study drives home the point that colonoscopy is superior to other types of screenings, but compliance with all types is low.

“It’s easier to do FIT, but it’s not a substitute for colonoscopy,” he said. “It’s a good screening test to do before colonoscopy, or in the interim between colonoscopies . . . but you would be surprised at how many people don’t get FIT. It just does not get done.”

Starpoli suggested that doctors spend more time explaining colonoscopy screening to patients instead of “simply mandating they have a test.”

“I think this is the fault of the physicians,” he said. “I think it’s an education issue, and [these studies] help in the education. It’s pretty clear-cut.”

More information

The U.S. Centers for Disease Control and Prevention has more on colorectal cancer screening.

SOURCES: Ann G. Zauber, Ph.D., biostatistician, Memorial Sloan-Kettering Cancer Center, New York City; David Bernstein, M.D., chief, division of gastroenterology, North Shore University Hospital, Manhasset, N.Y.; Anthony Starpoli, M.D., gastroenterologist, Lenox Hill Hospital, New York City; Feb. 23, 2012, New England Journal of Medicine

WEDNESDAY, Feb. 22 (HealthDay News) — If you’re afraid of going to the dentist, optimism and humor might help ease your worries, new research suggests.

About 50 percent of adults suffer some degree of dental fear and about 5 percent have severe dental fear. Even so, most people with dental fear go to the dentist regularly.

Swedish researchers have found that important factors in managing stress during a dental visit include optimism on the part of the patient and an atmosphere of humor in a patient’s interaction with the dental staff.

In one study, the University of Gothenburg team asked people with dental fear to complete a questionnaire and identified five main methods used by the patients to fight dental fear:

• Using internal resources. For example, telling yourself you’re strong enough to endure it, despite your fear.
• Self-distraction. For example, counting or singing to yourself or playing mental games with yourself to keep your mind off the dental treatment.
• Distancing. For example, telling yourself that the pain sensation feels like something else, such as numbness.
• Prayer.
• Optimism. For example, thinking ahead to when the treatment is over.

“The study has shown that patients who adopt an optimistic mindset cope with dental treatment significantly better and they visit the dentist more regularly than patients who spend their time in prayer, despair or catastrophizing,” researcher Jenny Bernson said in a university news release.

In a second study, interviews with patients with dental fear revealed that humor was an important factor in dealing with dental visits.

“Psychological barriers can be broken down by humor, both as a result of the patient and the dentist coming together more as equals, and as a result of humor reducing stress, increasing well-being and creating a pleasant atmosphere,” Bernson said.

More information

The Columbia University College of Dental Medicine has more about dental anxiety and phobia.

SOURCE: University of Gothenburg, news release, Feb. 14, 2012

WEDNESDAY, Feb. 22 (HealthDay News) — New guidelines outlining the causes and prevention of sudden death among athletes were released this week by the National Athletic Trainer’s Association (NATA) in the United States.

“These guidelines were developed for any level of sports participation, and to truly help save a life,” NATA President Marjorie Albohm said in an association news release. “It is also critical that a school, team or league’s medical professionals have an emergency action plan in place. In the event that an injury occurs, every minute counts when it comes to appropriate care and transport of the athlete.”

“While collegiate and professional teams have athletic trainers on staff to prevent and treat injuries, only 42 percent of high schools have access to our members,” Albohm noted. “Legislation is improving, though, with 35 states and Washington, D.C., having passed youth sports safety laws. And the NFL just mandated new guidelines requiring athletic trainers in booths during games to watch for hard hits and concussions.”

The new position statement includes many recommendations for preventing sudden death among athletes. Here are some of the highlights:

• An athlete’s chances of survival are much greater if there is an established, site-specific emergency plan.
• Recognition of the type of problem is key to treatment. Sudden cardiac arrest should be suspected in any athlete who has collapsed and is unresponsive.
• Public access to early defibrillation is critical. The time between when an athlete collapses and receives the first shock from an automated external defibrillator should be less than three to five minutes.
• If a serious brain injury is suspected in an unresponsive athlete, medical staff must be prepared to transport the athlete to a health-care facility, while ensuring adequate ventilation and elevating the head to help decrease intracranial pressure.
• In cases of suspected heatstroke, the athlete’s core temperature must be determined soon after collapse to ensure accurate and immediate assessment.
• Ensure athletes with asthma are properly educated about their condition and how to recognize good or bad breathing days. A structured warm-up program may decrease their risk of an asthma attack or their reliance on asthma medications.

The position statement appears in the February issue of the Journal of Athletic Training.

More information

Washington University has more on preventing sudden death in young athletes.

SOURCE: National Athletic Trainer’s Association, news release, Feb. 20, 2012

WEDNESDAY, Feb. 22 (HealthDay News) — As if the debilitating headaches weren’t bad enough, women who get migraines or have had them in the past are at increased risk for depression, a new study suggests.

Migraines are intense, throbbing headaches often accompanied by nausea and sensitivity to light or sound. They are three times more common in women than in men.

The study, by researchers at Brigham and Women’s Hospital in Boston, suggests that women with any history of migraines were about 40 percent more likely to develop depression than women without a similar history.

“We believe the most important aspect of our study is that migraine patients and their physicians should keep this potential link in mind,” said senior study author Dr. Tobias Kurth, a neuroepidemiologist at Brigham and Women’s Hospital.

Kurth noted that doctors who treat patients who have migraines might consider asking some specific questions about depression.

The researchers analyzed data from more than 36,000 participants in the U.S. Women’s Health Study who did not have depression and had answered questions about their migraine history. The women, aged 45 or older, were categorized either as having active migraine with aura (visual disturbances such as flashing lights or temporary loss of vision); active migraine without aura; prior history of migraine; or no history of migraine. The women also provided information about any depression diagnoses during the study’s follow-up period.

Kurth and his colleagues found that more than 6,400 of the women had current or past migraines, and that during an average 14 years of follow-up, nearly 4,000 developed depression.

Women with any history of migraines were 36 percent more likely to develop depression than women with no history of the headaches, and there was no difference between migraines with aura and migraines without aura. The researchers also found that women with only a past history of migraine had 1.41 times the risk of developing depression.

Although the results suggest a link between migraines and depression, they do not show cause and effect.

Kurth said further research is necessary to determine why migraines might increase the risk of depression. “There is not really an easy answer,” he said, adding that future studies might look at whether there is a specific common biological mechanism linking both diseases.

Dr. Richard Lipton, vice chair of neurology at Albert Einstein College of Medicine and director of the Montefiore Headache Center in New York City, applauded the research.

“This is a very strong study because of the cohort design, the large sample and the long-term follow-up,” he said.

Lipton noted several study limitations, however. The results don’t apply to men or to younger women, he said, and it is possible the number of women with depression was even greater, since the diagnosis was based on self-reporting.

The study is scheduled for presentation at the American Academy of Neurology annual meeting in New Orleans in April. Funding was provided by the U.S. National Heart, Lung and Blood Institute and the National Cancer Institute.

Research presented at medical meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

To learn more about migraines, visit the National Headache Foundation.

SOURCES: Tobias Kurth, M.D., adjunct associate professor of epidemiology, Harvard School of Public Health, and associate epidemiologist, Brigham and Women’s Hospital, Boston; Richard B. Lipton, M.D., professor and vice chair, neurology, and director, Montefiore Headache Center, Albert Einstein College of Medicine, New York City; study abstract, Feb. 22, 2012, scheduled for presentation, American Academy of Neurology annual meeting, April 21 to 28, New Orleans

WEDNESDAY, Feb. 22 (HealthDay News) — Toddlers are more likely to become easily upset and act out if their parents anger quickly and overreact to their children’s behavior, according to a new study.

Researchers looked at the behavior of adopted children aged 9 months, 18 months and 27 months and their adoptive parents in 361 families in 10 states. Researchers also analyzed genetic data from the children and their birth parents.

The study found that adoptive parents who had a tendency to overreact were quick to anger when toddlers made mistakes or tested age-appropriate limits. The children of these parents acted out or had more temper tantrums than normal for their age.

Children who had the greatest increases in these types of negative emotions as they grew from infants to toddlers (from 9 months to 27 months of age) also had the highest levels of problem behaviors at 24 months. This suggests that negative emotions may have their own development process that impacts children’s later behaviors, according to lead author Shannon Lipscomb, an assistant professor of human development and family sciences at Oregon State University, and her colleagues.

They also found that genetics plays a role, particularly in children who inherited a genetic risk of negative emotionality from their birth mothers but were raised in a low-stress or less reactive family environment.

The findings, published in the latest issue of the journal Development and Psychopathology, help improve understanding of the complex link between genetics and home environment, according to the researchers.

“Parents’ ability to regulate themselves and to remain firm, confident and not overreact is a key way they can help their children to modify their behavior,” Lipscomb said in a university news release. “You set the example as a parent in your own emotions and reactions.”

More information

The Nemours Foundation has more about toddler growth and development.

SOURCE: Oregon State University, news release, Feb. 20, 2012

WEDNESDAY, Feb. 22 (HealthDay News) — U.S. health experts recommended Wednesday that all adults get vaccinated against whooping cough, an infectious bacterial disease that triggers uncontrollable coughing and is especially dangerous to infants.

The U.S. Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted to expand the vaccination recommendation to include all adults, including those aged 65 and older. Specifically, the panel recommended that adults aged 19 and older who have not been vaccinated should do so.

Children have been vaccinated against whooping cough since the middle of the last century.

Last September, the CDC and the American Academy of Pediatrics issued revised recommendations for the so-called Tdap vaccine, which protects against whooping cough (pertussis) in older children and adults. The vaccine also protects against diphtheria and tetanus. All three illnesses are caused by bacteria, and are potentially deadly diseases.

The latest recommendation takes the September guidelines a step further.

Infectious disease expert Dr. Marc Siegel, an associate professor of medicine at New York University in New York City, said he agrees with the new recommendation.

“The original shot only lasts 10 years,” he said. In addition, there’s a growing pertussis outbreak in the United States, he noted.

“Adults are often carriers or spreaders with low-grade or full-blown infections, which can be passed on to infants,” Siegel said. “The pertussis vaccine can be given as part of the Tdap series every 10 years.”

In 2010, more than 21,000 people in the United States got whooping cough, the highest number since 2005 and one of the highest numbers in more than 50 years, federal health officials said.

A whooping cough outbreak in 2010 in California sickened more than 9,100 people and killed 10 infants. That rate of illness was the highest recorded in the state since 1947, according to the CDC.

Whooping cough — which gets its name from the “whooping” sound children make when they cough — is easily transmitted and causes severe, uncontrollable coughing. It mainly affects older children and adults, but can be a particularly serious threat to infants who are too young to be immunized. Although children aged 2 months and older receive a similar vaccine known as DTaP, which protects against the same three diseases, pertussis is often transmitted by older, unvaccinated family members, friends and relatives.

According to the CDC, whooping cough is most dangerous for babies — more than half of infants younger than 1 year old who get the disease have to be hospitalized. About one in five infants develops pneumonia, and in rare cases (one in 100) the disease can be deadly, especially in infants.

“Changes in recommendations for pertussis vaccination have come about as a consequence of the re-emergence of whooping cough,” Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, told HealthDay. “Vaccination is critical in the pediatric age group because of the higher rate of lung damages, morbidity and mortality of this preventable disease.”

More information

The Nemours Foundation has more about whooping cough.

SOURCES: U.S. Centers for Disease Control and Prevention; Marc Siegel, M.D., associate professor, medicine, New York University, New York City; Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City

WEDNESDAY, Feb. 22 (HealthDay News) — Doctors may have a leg up on baldness: Transplanting hair from a patient’s legs to his head for what may be a more natural look.

In the February issue of the Archives of Dermatology, Dr. Sanusi Umar explained that the finer, softer hair found on the leg is an ideal candidate for hair grafts that aim to recreate the hairline.

“The whole idea is to take hair transplantation to the next level,” said Umar, a private practitioner in Redondo Beach, Calif., and clinical instructor in dermatology at the University of California, Los Angeles.

There are “several problems” with traditional methods for hairline transplant, he believes.

“First, the traditional transplant takes hair from the middle of the back of the head, and that hair happens to be the thickest hair on the head,” he said. That means that, “if you take it from there and put it in the hairline, despite your best efforts, it will end up slightly harsh[-looking] and unnatural in the hairline. It’s problematic to say the least,” Umar explained.

“The other issue is that people bald or thin to varying degrees,” he noted. “You can have mild baldness or it can be very severe.” This means that the standard method of hair transplant is of little use to a man who has lost most of his head hair and therefore has no source for the transplant.

“You’re fighting a losing battle because there’s just not enough to work with. Most ethical practices will therefore tell a very bald person that they cannot do it because it will not look natural,” Umar said.

“In addition to that, over the years there are a lot of patients that have had hair transplantation that is antiquated,” he added. “They have a ‘pluggy’ look. They have scars. And they no longer have any donor supply left on the back of the head to deal with that issue, because it’s already been used up.”

Looking for a solution, about seven years ago Umar began exploring “advanced body hair transplantation” or the “U-graft method.”

Essentially, the technique involves scouting for hair from all over the body, keeping in mind that not all patients are equally hirsute.

“With this approach I can combine beard hair, chest hair and leg hair, depending on the person’s hair distribution,” Umar noted. “Mixing that with some thicker head hair as well, I can come up with about 20,000 to 30,000 hairs, which means I’m then able to tackle some very severely bald individuals.”

However, recreating a natural hairline at the forehead requires especially fine hair. Umar believes that leg hair “works the best in terms of simulating nature [in this spot]. Sometimes we can also take hair from the nape of the neck, which is also very fine. And then for behind the hairlines we can use some of the thicker head hair.”

In his case report, Umar published the results of two such transplant efforts. One involved the exclusive use of leg hair follicles to recreate the front of the patient’s original hairline/temple area, while the other involved mixing transplanted leg and head hair to soften and bring forward a custom-designed “widow’s peak” hairline for a patient.

In both cases, the transplant procedure gave rise to what Umar described as a “fully grown and soft-looking hairline” within nine months. Between 75 to 80 percent of the fine transplanted leg hair flourished in its new home on the head, and three to four years later both patients had experienced minimal hair loss in the transplant area.

However, Umar noted that men seeking such procedures should be both patient and prepared for a hefty bill. The procedures are typically spaced over two sessions (each involving three to five days) that are spread over the course of a year. And at $7 to $10 per hair follicle graft (with each follicle containing anywhere from one to four strands of hair), the bill will ultimately total in the thousands, Umar said, with so-called “slick bald” patients facing the highest expense.

Opinions from other experts in hair transplantation were mixed.

Dr. Malcolm Roth is president of the American Society of Plastic Surgeons and chief of the division of plastic surgery at Albany Medical Center in Albany, N.Y. He hailed the innovation as “yet another example of how new techniques continue to refine and improve outcomes in cosmetic procedures to give patients more natural results.”

However, Dr. Barry DiBernardo, who has a private practice in Montclair, N.J., said the procedure does raise a few questions and concerns.

“Finding hair from other parts of the body is not new at all,” he noted. “We’ve long considered that option, because clearly when you’re designing a hairline . . . the more we can make it look like what was there in the first place, the better,” DiBernardo explained.

“But when you use body hair it can be a different thickness,” DiBernardo said. “It can have more curl to it than the original hair. So these reports sound fine. But the approach does raise the issue of a hair mismatch, which of course will depend on the person. Everybody varies,” he said.

“The other thing is the question of the potential for scarring, or leaving pinpoint scars, following harvesting of hair,” DiBernardo pointed out. “Because while you’re not going to see the back of the head and it’s a very good area for healing to begin with, you will see the leg. And the leg certainly doesn’t heal as well as the scalp.”

More information

Find out more about hair transplants at the U.S. National Library of Medicine.

SOURCES: Sanusi Umar, M.D., clinical instructor, dermatology, University of California, Los Angeles, and private practice Fine Touch Dermatology, Redondo Beach, Calif.; Barry DiBernardo, M.D., director, private practice, New Jersey Plastic Surgery, Montclair, N.J.; Malcolm Z. Roth, M.D., president, American Society of Plastic Surgeons, and chief, division of plastic surgery, Albany Medical Center, Albany, N.Y.; February 2012, Archives of Dermatology