Dr. Abbasi Hair Clinic Surgical Treatments 1. Scalp flaps: Transferring a hair bearing part of scalps to the bald area. 2. Reducing the extension of the bald area by surgical methods. 3. Planting artificial hair in the skin of the bald area. 4. Transplanting hair follicles and restoring a natural look in the bald or thin area. The 1st three methods are only used in special cases because of the unpleasant look they bring, allergies of the artificial material and graft rejection. The 4th method which is the one mostly used throughout the world is done in different methods: A. Punch method B. Micro and mini graft and it is latest version follicular unit graft In the punch method bunches of extracted hair follicles are transplanted in the recipient are. Because of it is doll like, brush like appearance, patients are not pleased with the result and in fact it brings extra stress and anxiety. But the micro- mini grafts give a normal appearance to the bald area. First, a hair bearing part of the skin is incised and taken from the back or side of the head (the area which lacks androgenic hormone receptor). Then it is divided into follicular unit graft with sharp instruments. The grafts are then transplanted in the bald area or between the existing hair follicles in the thin area. The growth of these follicles gives a normal and natural look which pleases the patients. Unlike the punch method where holes are made in the recipient area, only sharp thin openings are made. Who Is Candidate for Hair Transplantation? 1. Men with androgenetic alopecia or thin hair.
2. Women with thin hair. 3. Patients who have become bald following diseases, burns or surgery of scalp. 4. Patients who have thin or no eyebrows, eyelashes congenitally. 5. Patients whose beard or moustache has local or linear alopecia following trauma or surgeries. (cleft lip) 6. People who have thin eyebrows following tattooing. 7. Patients who have undergone flap surgery or punch before and are not pleased with the result. Non Surgical Treatments There are now more topical and oral medications than ever. Determining the right medication or combination of medicines for you depends on your age,sex and cause of hairloss degree of hair loss and budget. Only two hair restoration medications have been approved by FDA: Topical medication Minoxidil and orally administered Finasteride. Neither guarantees to stop hair loss or the regrowth of new hair, for hair loss can be due to many causes that may or may not be treatable by these two. Finastride is only available by prescription from a physician.minoxidil is available as an over-the counter topical medication.both of these drugs are most effective when recommended and prescribed by a hair specialist physician who has made the diagnosis. Finasteride: It selectively inhibits the activity of 5-alpha reductase type 2, an enzyme essential to the activity of certain androgenic hormones. Testosterone is the most potent of the androgenic hormones. Whithin the cells sensitive to testosterone ( prostate,skin and hair follicles ),it is converted to dihydrotestosterone (DHT) by 5 alpha reductase.it has been investigated that men with normal or high levels of 5-alpha reductase are more likely to develop male pattern hair loss (MPHL) and benign enlargement of the prostate gland. Finasteride,which inhibits the activity of this enzyme was first developed to treat benign prostatic enlargement. Then it was studied in treating MPHL and was proved to be effective.
Finasteride: in women Many women experience a form of androgenetic alopecia known as female-pattern hair loss The only medical therapy available for women is topical minoxidil (Rogaine ). Finasteride can have under-masculinizing effects on a male fetus; therefore, finasteride should not be taken by a woman who is pregnant or who may become pregnant during the course of treatment. A woman who is experiencing hair loss should consult a physician hair restoration specialist for examination, diagnosis and recommendation for treatment based on diagnosis. What About Minoxidil (Rogaine )? Minoxidil (Rogaine ), a treatment applied topically to the scalp in 2% or 5% solution. Minoxidil is available over-the-counter but is best used under the supervision of a Dermatologyist. Minoxidil (Rogaine ) tends to be more effective in women than in men. The reason for this is not well understood. Only the 2% solution of Rogaine is approved by the FDA for marketing to women, but there is substantial evidence from hair counts and photographic before-and-after evaluation that the 5% solution has additional benefit for women just as it has for men Minoxidil is a drug that was developed for one medical use (to lower blood pressure), but turned out to have another unexpected but valuable application (to stimulate growth of hair in people with MPHL). The effect of minoxidil on hair growth was not predictable on the basis of its vasodilating action (relaxing blood vessels to lower blood pressure). Neither is minoxidil known to have any effects on androgens, the male hormones associated with androgenetic alopecia. The topical solution has been shown over a period of 15 years of clinical trials and patient care to be a safe and effective treatment for hair loss due to MPHL. It is effective in about 30% of persons who receive the treatment. For reasons not yet understood, women have a higher response rate than men to topical minoxidil. Topical minoxidil is generally more effective in improving hair growth in central areas of the scalp than in frontal areas. Minoxidil has been shown to be effective in increasing the amount of time that hairs stay in the anagen (growth) phase versus telogen (resting) phase. It has been shown effective in initiating growth of vellus (soft, fine) as well as terminal (long, coarser) hairs. When topical minoxidil is first applied, shedding of telogen-phase hairs may be increased for a short time. This loss of telogen-phase hairs is temporary, and the lost telogen hairs will be replaced by new hair over the next weeks and months of minoxidil therapy. Once started, topical minoxidil treatment for androgenetic alopecia is a lifetime commitment if the treatment proves effective. If regular application of topical minoxidil
is halted, all hair grown in response to the therapy will be rapidly lost over the next 3 to 6 months. Minoxidil can complement and supplement other hair restoration treatments. For example, in a planned approach to hair restoration agreed to by a patient and physician hair restoration specialist, minoxidil may be used to complement hair transplantation or other surgical methods such as scalp reduction [Roenigk HH, Jr. Scalp reduction. In: Roenigk & Roenigk s Dermatologic Surgery, 2nd ed. New York: Marcel Dekker, Inc., 1996:1213-1226]. Minoxidil may be applied to stimulate hair growth inside and/or outside areas of surgical hair restoration, contributing to improved "fullness" of scalp hair. Side effects of topical minoxidil are few and generally minor (transient skin irritation or itching). The vasodilating (blood-pressure lowering) effect of oral minoxidil does not occur with the topical formulation. There is a small risk for facial hair growth associated with use of minoxidil a finding that may be a side effect of the drug or may be due to accidental application of the topical solution to the face. Nonsurgical Hair Additions and Replacements Some people want "a little extra" to enhance medical or surgical hair restoration. Other people are temporarily or permanently unable to grow hair and are therefore not candidates for transplantation. And some may want to avoid any type of surgical procedure or may be attracted to the promise of unlimited density and fullness. Images