This article should be read keeping in view that there are number of causes of hair loss. However, this article discusses the most common cause of hair loss known as Androgenetic Alopecia or common baldness and in this article I will be using terms hair loss and hair fall for common baldness unless specified.
Almost 30-40 percent people complain of hair loss by the age of 30 years. This percentage rises with age, like 80 percent men have lost their hair by the age of 70 years. However, young patients are more bothered, more concerned and very often depressed.
Hair fall and hair loss are different terms.
Hair fall means the hair which actually comes out during rubbing/combing of scalp or of its own. This is normal, ranging from 50- 100 hairs per day including both the noticeable and unnoticeable hair fall.
Sometimes this fall can be abnormal too if it doesn't regrow or is shed more than 100 per day. We as dermatologists examine and differentiate the abnormal from normal hair fall. Hair loss on the other hand means the thinning of hair, balding of scalp or receding of hairline. This is always abnormal.
The irony of hair disorders is that hair fall bothers one more than the hair loss. Hair fall makes one scary & he or she takes the medical opinion immediately. But hair loss occurs very slowly and most patients don't notice it for long until they develop the thinned hair, visible scalp or complete baldness. The baldness is completely preventable if the patient presents in very early stage.
Unfortunately, most people have a notion that there is no treatment of hair loss. Some people take treatment into their own hands, by optimising their nutrition, which can affect hair loss (rarely) and leave patients feeling healthier overall.
While some individuals also seek miracle cure for hair loss, but these are rarely effective and often lead to disappointment.
Medical science has advanced leaps and bounds. Nowadays it is considered as completely curable disease. The treatment depends on the stage of hair loss.
Some patients are candidates of medical hair restoration, some need minimal invasive therapy like Microneedling and Platelet rich plasma therapy. And finally some are candidates for surgical hair restoration commonly known as Hair transplant.
Medical treatment involves applying/taking medication. As of now only two drugs have been approved by FDA for hair loss, Minoxidil and Finasteride. These drugs have to be taken/applied regularly and needs high degrees of commitment from the patient.
Most patients need proper counselling for starting this medical therapy and all pros and cons of this therapy have to be discussed with the patient.
Recently, FDA has also approved few devices using low level laser therapy for hair loss. Some therapies like Microneedling and Platelet Rich plasma have also shown good results in some studies.
Hair transplant remains the final treatment option for the hair loss. It can be done in both males and females. This surgery has progressed many folds in recent years. Earlier, we used to do this type of surgery to patients who had moderate degree of baldness. Those having extreme/ severe baldness were not supposed to be good candidates for surgery. Nowadays, almost all degrees of baldness are treatable.
Hair transplant involves the process of extracting the follicles from back side of scalp and placing them in the bald areas. The different types of hair transplant differ from one another only in the manner in which follicles have been extracted. Commonly two methods are employed: Follicular Unit Extraction (FUE) and Follicular Unit Transplant (FUT).
Both the above mentioned methods have their own advantages and disadvantages. FUE has revolutionised the hair transplant.
Traditionally, in FUT, a strip of skin along the posterior scalp is excised and follicles are separated and then placed on the bald areas. We had a limitation in extreme or advanced degree of baldness as there was not enough donor hair on the scalp. This limitation is overcome by FUE, as with FUE follicles can be extracted not only from scalp but also from beard, chest and back known as body hair transplant.
When I started my hair transplant practice in Kashmir, I found that most patients were in the stage who needed transplant and were in advanced grades. I had most patients who needed body as well as scalp hair transplant.
Results of surgery depend on many factors. Skill of the surgeon is very important for the good outcome. Patient factors also influence the outcome. Thickness of the hair shaft, density of the hair and color contrast between hair and scalp are important factors to ascertain before taking a patient for surgery. This gives a good idea how the results would be after the surgery.
The hair transplant surgery is generally considered as a safe surgery. However, patients having other medical/ surgical problems need proper evaluation beforehand.
After transplant hair follicles undergoes a series of events which translates into visible changes on scalp. The hair grows for two weeks and falls off at this stage only to grow back after three months and achieving best results after nine months to one year or even more. So patients should plan the surgery accordingly.
People usually ask for any risks associated with this surgery. As already mentioned this is a safe surgery, however, proper pre op evaluation and intra op monitoring is a must. Some people have concerns about long term effects of surgery. This is just a myth and there are no long term side effects of this surgery.
Author is a Dermatologist, Cosmetic & Hair Transplant Surgeon
Source: Hair loss is a curable disease
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