What are the appropriate diagnostic methodologies for evaluating causes of Hair Loss?
A scientific approach for diagnosis involves clinical examination, scalp biopsy along with an extensive blood workup. Hair loss is seen not just as an aesthetic concern as it appears prima facie but is indicative of deep rooted medical concerns which must be addressed simultaneously in order to ensure long term effective results. Infact, clinical examination by a dermatologist combined with a scalp biopsy reading is considered the gold standard in diagnosing the cause of hair loss.
What is the most scientific approach to managing hair loss?
Multidisciplinary approach, subject to case examination is the best way to address hair loss concerns as their outcome is more permanent and effective.
Why is it important to do a host of blood work in diagnosing cause and treatment of hair loss?
As earlier mentioned more and more research goes to prove that hair loss may appear as an aesthetic presentation but is a translation of underlying medical conditions be it metabolic disorders, hormonal imbalance, stress, auto immune diseases, digestion and absorption disorders, blood disorders etc. Hence on diagnosis, treatment in a multidisciplinary way meaning dermatology along with gastroenterology or endocrinology or hematology or psychiatry as the case may deem fit addresses the concern more holistically and hence treatment effectiveness is assured in such cases. At Hairline International Hair & Skin Clinic, this approach is core to the philosophy of medical practice.
Isn’t it very expensive if one must undergo many blood tests and meet doctors from various disciplines in order to resolve these hair loss concerns?
Any route chosen otherwise will resolve the problem temporarily on the surface but may not get rid of the trigger or the root cause as you may call it. In fact you may lead to spending less in the long run considering that you have averted illnesses from becoming chronic with appropriate medical guidance from specialists (multidisciplinary) and adapting to life style and diet modification or as may deem fit for that patient. Some of the research findings at Hairline International Hair & Skin Clinic suggest that a lot of men under 30 years of age have male pattern baldness and on close observational mapping this group of patients is actually seen to have a lipids concern combined with other anomalies.
If I just address the blood parameters would it then address my hair loss concerns; would I need clinical management then in that case?
Well, all that is subject tothe patient expectation whether the concern is dandruff, or hair loss arrest or hair re-growth, or managing any other hair loss disease. Both options exist depending on the expectation of results;
Clinical treatments are generally more aggressive whereas home management takes longer and compliance is seen as an issue in the case of home management. Besides, being a multidisciplinary approach it can be applied on a very aggressive footing to resolve this issue from the core if the clinical approach is adopted.
We also see that patients expect miracles in the first few sessions of therapy which is difficult to live up to, however, as we understand it takes a couple of months, maybe earlier if complete medical guidelines are followed coupled with clinical management services.
Clinical management is generally recommended in the case of hair fall control whereas hair transplantation is generally considered a gold standard procedure for assuring hair re-growth. Sometimes one does deal with the challenge of limited donor hair in a candidate opting for hair transplantation. In that case non-surgical options or, else the newer techniques are incorporated to achieve those results.
Limited donor hair kind of challenges are now being met with promising techniques like hair multiplication, hair cloning, stem cells, gene therapy to make a difference in this arena.
Are there any specific blood tests for hair loss?
Yes, there are and we at Hairline International Hair & Skin Clinic
discuss that with the patient during a formal consultation.
Is there anything topical that I can use instead of consuming medications?
Yes, topical applications are available for hair loss treatments, like topical minoxidil in varied percentages used once or twice a day, for both men and women, with topical finasteride combination for men to reduce the risk of oral finasteride side effects and with progesterone combination for women with hormonal disturbances, peri-menopausal and post-menopausal women.
Other formulations like saw palmetto extract-herbal DHT blocker can be used topically in the form of serum in both men and women.
To support the above topical therapy, Triamino copper nutritional complex (TRICOMIN SPRAY) with an exceptional leave in conditioner formulation can be used. This enriches hair and scalp with a unique blend of essential amino acids, minerals and hair building ingredients when applied to dry or damp hair every day. It is designed for both men and women with thinning hair.
What do you think of Minoxidil and Finasteride for regrowth and hair loss control?
The management of baldness is a multidisciplinary effort. Minoxidil and Finasteride (US FDA approved) are usually recommended as first line therapy for male pattern baldness. They may also be used simultaneously when hair loss is progressive or further re-growth is desired after 12 months. Combination of Minoxidil and Finasteride is more effective than individual use, suggesting synergistic effects of the medications. Both systemic and topical applications are effective in androgenic hair loss.
To what extent do they work?
Minoxidil, a vasodilator, available as topical application for hair re-growth is effective both in crown and frontal alopecia, more so in crown. Minoxidil causes hair in the later phases of the cell cycle to shed early, and often followed by growth of new thicker hair. This effect is temporary and does not appear to change follicular structure, leading to indefinite use of minoxidil application to maintain the obtained growth, while irregular usage or abrupt stoppage may lead to excessive shedding.
Finasteride, like minoxidil is effective at the crown and frontal Hairline International Hair & Skin Clinic area, but more so at the former. Increased hair growth is noted in people aged between 18-40 years with mild to moderate hair loss (male pattern baldness). Available as both topical and oral formulations, it reverses the androgenic effects on hair follicles to some extent. Finasteride reduces the formation of DHT. This also leads to increased levels of testosterone and estradiol. Gynecomastia, erectile dysfunction, and depression are some possible side-effects. Hence, it reduces the possibility of long term usage.
FAQ's on General Hair loss concerns
Can hair loss occur in young adults?
Male pattern hair loss can occur as early as 15, although it begins anywhere from the 20’s and the early 30s. Familial history may help determine the same. Alopecia Areata and Telogen effluvium can occur in younger children as well.
Can Hair Loss occur due to Improper hair care?
Yes, hair loss can occur due to improper care such as use of faulty hair care products like shampoos, conditioners, gels, hair dyes and also due to improper hair styles such as repeated tugging of hair in to ponytails repeated combing etc.
What temperature water should I use for shampooing my hair?
For the average person, who simply wants to shampoo his or her moderately-soiled hair, lukewarm water is the way to go. Warm water allows the shampoo to most effectively remove the dirt and oils in the hair.
Does changing a shampoo increase hair fall?
No, it alters only the texture of hair.
Can chronic itchy scalp result in hair loss?
Yes, itchy scalp due to sweat build up or other unhygienic hair care practices or ring worm infections results in breakage of hair. Psoriasis related hair fall is a result of too much scratching and also due to forcefully removing the flakes besides stress. Dandruff associated with itching is a precursor to baldness.
What Infections of the Scalp contribute to hair fall?
A number of infectious and infection related conditions can contribute to hair fall. The commonest one seen in Indian Populations are ring worm and Piedra-Fungal infections, folliculitis- bacterial infection, Demodex Folliculorum infection, Seborrheic Dermatitis etc. These infections affect the hair fibre resulting in brittle hair, breakage and bald patches of skin in the affected area. In severe cases they permanently damage the hair follicle.
What is the cause of my recurring dandruff?
Commonest triggers include increased oil production, oily skin, oily scalp, excessive sweating, poor hygiene, Weather (hot and humid or cold and dry), infrequent washing or shampooing, Concurrent yeast or fungal skin infections, poor immune system, chronic illness, emotional or mental stress.
How does one prevent dullness of hair?
Apply light oil half an hour before washing scalp. Use a mild shampoo for daily use and not strong detergents to cleanse scalp daily of dirt. Avoid blow drying frequently. Use only cold mode on hair dryer and keep it at a distance from the scalp. UV protection shampoos are also as good option for summers.
How to prevent hair shaft breakage?
Don’t comb hair when it is wet as the roots will be loose. Detangle the knots using fingers. Use wide toothed combs and avoid roller brushes.
How often should I trim my hair?
Once every 6-8 weeks. This helps prevent split ends.
How can I make my hair look dense instantly?
There are special fibers which can be sprinkled on your hair for a fuller look and hence conceal thinning of hair. These hair fibers are electro-statically charged and sticks to your hair when sprinkled.
How do I make my thin hair look healthier?
Consume a diet rich in minerals and vitamins like fruits, green leafy vegetables, dry fruits. Avoid hair colours containing ammonia. Dietary supplements can help. Tricomin, which works on the copper peptide technology is also known to thicken the hair.
I have recently shifted to Bangalore post that I notice an increase in hair fall.
Yes, change of place increases stress and alters the dietary pattern resulting in increased hair fall.
I have been working out at gym since a year and on whey proteins, I have noticed increase in hair fall post that. Is that possible!
Yes, along with whey proteins a drastic change in body weight along with deficiency of micro-nutrients can result in hair fall.
What medicines cause hair loss?
Amphetamines, lithium, anti-coagulants, birth control pills, beta blockers, gout treatment, anti-depressants are some of the medicines which can cause hair loss. Hair Therapy and changing or discontinuation of the drug does help in arresting hair fall.
Can smoking and alcohol cause Hair loss?
Smoking does affect in an indirect way. It increases the blood pressure and decreases the oxygen in the human body. Decreased blood circulation leads to rapid hair shedding and dryness. Excessive alcohol intake on the other hand depletes zinc from the system needed for hair growth so should be taken in moderation.
Can usage of cell phones cause hair loss and what preventive action should be taken to reduce the problem?
Yes, studies show that hairfall is one of the side effects. Certain preventive measures can be taken like buying a low level radiation device, use a headset or a speaker while talking, don’t communicate when the signal is poor or put on charge, avoid radiation shields if possible.
I have diffused hair loss and my scalp looks very noticeable. Solution!!
Camouflages like Toppik would be an ideal solution for diffused hair loss cases. This product instantly fills out the balding or thinned out areas or post-transplant temporary camouflage.
How do I conceal small bald patches diagnosed as Alopecia Areata?
Couvre, an alopecia masking lotion promoted by the National Alopecia Areata Foundation is totally undetectable making a thinned out scalp unnoticeable
I fear getting a hair transplant done but I want hair. Suggest!
Non-surgical hair restoration is then a good way to go. At Hairline International Hair & Skin Clinic, we have one which is a readily available hair unit which is normally an international product and factory made or we customize the unit on the basis of the grade of hair loss. This service is very unique to Hairline International Hair & Skin Clinic wherein a unit is designed on the basis of the grade of hair loss keeping in mind the areas where the hair is present and also keeping in mind which parts of the hair need more ventilation and less density and also looking at specifically increasing density in areas where the same is not available besides appropriate incorporation of colour assessment. Infact whether it is use of grays in a certain percentage with black or a curl construction all of the same can be captured in the final product. The bases used for construction are non allergenic and the methods used to fix them are also medicated in nature.
I want highlights in my hair without the use of hair dyes.
Highlight extensions are available in various colours and lengths that can be clipped on without worrying about hair loss.
I am a woman who has lost hair around my parting. Options!!
The latest revolutionary product available for multi styling purpose is called a fringe. The benefit is that it not only covers the parting but gives you the flexibility of making multiple styles.
How do you treat Hair Thinning in women?
Post the investigations, the doctor concludes the underlying cause triggering the hair fall be it thyroid dysfunction or PCOD or diabetes or any other kind of internal trigger. Based on that a specialist, be it an endocrinologist, physician or gynecologist comes in to treat the underlying cause simultaneously working with parallel treatments with prescribed medication to address the issue of hair fall and promote hair growth.
Can oral contraceptives cause hair fall?
Yes, oral contraceptives are a common trigger of hair loss for many women.
Why does my hair fall out after pregnancy?
When pregnant high levels of estrogen make your scalp hold on to your hair that would have normally fallen out. A few months post birth your hormone levels return to normal and the hair falls out. Losing hair after giving birth is considered normal. Nutritional supplements along with appropriate treatment and diet normally take care of the problem.
Is my PCOD problem and hairfall correlated?
Polycystic ovarian disorder is a condition with underlying Insulin resistance which causes hormonal imbalance resulting in male pattern baldness and excessive facial hair. With medical management results seem to be very effective both for hair loss control and reduction of excessive facial hair.
Is there a connection between my thyroid level and excessive hair loss?
Overactive or an Underactive Thyroid is a condition in women manifesting hairfall, accelerating the process of androgenetic alopecia, loss of hair on the outer edge of the eyebrows or general loss of body hair.
Does Iron Deficiency lead to increased hair loss?
Anemia causes a low blood count and a less effective circulatory system as a result of which the hair follicles do not receive the necessary quantity of oxygen supply and nourishment which causes the hair to thin and fallout over time.
I’m a woman in my menopausal years what is causing so much hair loss in my case?
Hair loss in menopausal women is primarily caused by hormonal changes during which there is a fall in estrogen levels and a spike in androgen levels which in turn accelerates the thinning process.
How do you treat hair loss during menopause?
Proper investigations, Medication, Lifestyle change, consuming natural forms of phyto-estrogens and in the extreme stage undergo Hair transplant.
Do diabetes, hypertension, dyslipidemia and thyroid dysfunction aggravate hair loss?
Definitely they all cause hair loss.
Does stress lead to hair fall?
Both emotional and physical stress (such as a serious illness or recovery from surgery) is associated with hair loss. Stress aggravates conditions such as alopecia areata, trichotillomania and telogen effluvium.
FAQs on Hair Transplant
What is Hair Transplant ?
Hair Transplant is a surgical technique that involves moving donor hair follicles which are genetically resistant to balding to the recipient balding areas of the scalp. The transferred tissue is not rejected as it is not foreign tissue. It retains its own characteristics, color, texture, growth rate and curl after transplantation and re-growth. It is primarily used to treat male pattern baldness.
Hair transplant can also be done to restore hair in eyelashes, eyebrows, moustache, beard, pubic area and scars caused due to burns, trauma etc.
Does any hair loss treatment work in the frontal area or are they effective only in the crown?
Hair transplant is the ideal treatment for treating frontal hair loss in men with Androgenetic Alopecia.
What can I do to slow down/stop a receding Hairline International Hair & Skin Clinic?
Early use of medication can help slow down the receding Hairline International Hair & Skin Clinic and prevent baldness. Autologous PRP and hair transplantation are suggestive alternatives.
Will transplanted hair ever fall out?
No, transplanted hair is harvested from the permanent donor zone. This hair is resistant to the effects of DHT. No matter where the hair is moved to it will maintain its resistance to DHT and survive indefinitely.
Will my hair transplant results look completely natural?
Hair transplantation, when done right, can be so natural that even your hair stylist will not know that you’ve had it done.
How long does a hair transplant procedure take?
At Hairline International Hair & Skin Clinic, an FUT procedure roughly 3000 grafts takes about 6 hours and a mega session comprising of 4500-5000 grafts takes about 8-10 hours. Whereas in an FUE procedure comprising of 6000 follicles it takes about 6 hours roughly to complete the procedure. Surgeons performing the surgery are members of the ISHRS and adopt best practices to ensure effective and long term results.
Does the hair transplant procedure hurt?
Patients are given local anesthesia in the donor and recipient areas. Most patients find that once the anesthesia is given that they feel no pain or discomfort during the surgery. Following surgery, patients will typically feel some amount of soreness and numbness, with some mild discomfort. Most patients are pleasantly surprised by how minimal the discomfort from the surgical procedure is.
What is the recovery/healing time?
With today’s very refined micro hair transplantation procedure the incisions are very small and less invasive than past procedures. This results in more rapid healing. Most patients feel fine within a day or two following surgery, although some numbness and mild soreness can be expected for several days following surgery.
Will people know I had a hair transplant?
Immediately following surgery a patient’s recipient area is typically pink with scabs forming around the micro incisions. These hundreds of tiny incisions will heal rapidly within a week to ten days.
During the first few days after the surgery a person’s hair transplants will be noticeable if there is no previous hair to mask these temporary scabs. However, most patients feel comfortable being in public without wearing a hat within 5 to 7 days following surgery.
Once the transplanted hair grows out the results should look entirely natural, even under close examination.
When will my newly transplanted hair start to grow?
Normally it takes between three to five months following surgery before the transplanted hair follicles begin to grow new hair. The transplanted hair grows very thin initially and gradually grows thicker and fuller over time. After one year a patient’s transplanted hair will be fully mature and will continue to grow for a life time.
What is the role of a platelet rich plasma procedure when done along with a Hair Transplantation procedure?
The role of platelet rich plasma is to preserve and enhance hair follicle viability, promote and enhance tissue repair and healing, and to reinvigorate dormant hair follicles and stimulate new hair growth.
What are the other scalp conditions in which a Hair transplant can be done?
Androgenetic alopecia(male/female pattern baldness)is the commonest condition. Other conditions in which a transplant can be done are scarring alopecia due to auto immune conditions, trauma, scalp psoriasis, burnt scalp tissue, hypertrophic scar tissue etc. Hair transplant can also be done in physically challenged patients like Polio, HIV and HBsAG positive cases, patients with underlying medical conditions such as Diabetes, Hypertension, Thyroid disorders, Heart Diseases etc.
What are the different techniques of a Hair transplant followed at Hairline International Hair & Skin Clinic?
Strip Harvesting (Follicular unit technique), Follicular unit extraction, long hair transplant, body hair transplant.
Will transplanted hair ever fall out?
No, transplanted hair is harvested from the permanent donor zone. This hair is resistant to the effects of DHT. No matter where the hair is moved to it will maintain its resistance to DHT and survive indefinitely.
Can gray hair be transplanted?
Yes, gray hair can be transplanted as safely and successfully as hair of any hair color. Transplantation of gray hair is successful because gray hair is as healthy as other hair except that it lacks melanin pigment.
Can women undergo Hair Transplants?
Yes, it is a treatment for women too. Modern techniques of hair transplantation are successful in treating typically diffuse female-pattern hair loss if it is not progressive. In case, one does not choose surgical intervention then hair fringes are very useful non-surgical procedure for restoring hair quickly.
What other procedures can be combined with hair transplant to maximize the results?
Platelet rich plasma when done in combination with a hair transplant procedure enhances the hair follicle viability rate, promotes and enhances tissue repair and healing, reinvigorates dormant hair follicles and promotes new hair growth in the non transplanted areas as well.
Are Platelet Rich Plasma sessions required pre or post Hair Transplant procedure?
Depending on the case, 4-6 PRP sessions post hair transplant procedure will help in the re-growth of transplanted as well existing hair. In case of poor donor area, 4-6 sessions of PRP can be given before a hair transplant procedure to improve the donor area as it is very rich in growth factors.
FAQ's on PRP
What are the new approaches and treatments available for arresting hair loss and promoting re-growth?
Platelet rich plasma is a very promising treatment and in certain cases has seen reversal of miniaturized hair in the vertex area of the scalp. It is extremely safe since it is drawn from the patient’s own blood centrifuged and then the concentrated platelets are injected into the affected region of the scalp. This treatment done once a month has seen promising results from hair fall control and re-growth perspective.
Does Platelet Rich Plasma reduce hair loss?
Yes, Platelet rich plasma enhances the hair follicle viability by the growth factor molecules (PDGF, VEGF which promote blood vessel formation, cell replication, skin formation) present in the platelets thus reducing hair loss to some extent.
Does Platelet Rich Plasma re-grow hair?
Platelet Rich plasma promotes hair growth from follicles by the action of platelet derived growth factors on the hair follicle stem cells. The platelet growth factors induce follicle stem cells to shift from a dormant state to an active state that starts the process of hair growth, enhancing the hair growth and hair thickness from the dormant follicles.
What is your current feedback on this PRP treatment? Does it really work?
Even-though PRP is an advanced treatment, growth factor results in the form of hair -loss control and hair re-growth is certainly dependent on multiple factors like grade of alopecia, underlying medical conditions, nutritional health etc. and hence a multimodality approach is preferred to get a better outcome. Earlier grades of alopecia with thinning hair respond well to PRP given monthly when combined with supplements and topical medications. Best results of this treatment have been seen as re-growth in the vertex area of the scalp.
FAQ's for PRFM
1. What is PRFM?
A. Platelet rich fibrin matrix is the latest breakthrough where one’s own platelet which consists of stem cells and growth factors embedded in fibrin are injected in the scalp for regrowth of hair.
2. How does PRFM help to regenerate the hair?
A. PRFM one’s own blood containing platelet rich stem cells, growth factors and tissue regenerating factors embedded in a fibrin matrix are injected in the scalp to regenerate hair.
3. What are the potential benefits of PRFM?
A. PRFM helps to regenerate lost hair, arrests hair fall and increases the hair thickness twice the original volume.
4. Is PRFM right for me?
A. PRFM is seen to be effective in all types of male and female pattern baldness but a thorough blood investigation is required before starting the treatment.
5. Who is not a candidate for PRFM therapy?
A. Scarring hair loss patients are not a candidate for PRFM therapy.
6. How soon can I go back to regular activities?
A. Regular activities can be resumed back soon after the procedure is complete.
7. Will my insurance cover PRFM therapy
A. No, there is insurance coverage for PRFM therapy.
8. Previous doctor has advised me for hair transplant can I avoid surgery with PRFM
A. Yes, hair regrowth with PRFM is possible without transplantation.
9. how long has PRFM been in existence?
A. PRFM is practised worldwide for conditions like tissue ulcer healing and regeneration. Hair regrowth is the latest breakthrough of this technology.
10. Are there any exclusion criteria that interest from someone from getting PRFM?
A. Blood pressure, sugar levels and anaemia needs to be treated before the procedure.
11. How long does it take for PRFM to work?
A. Visible hair growth is noticed after 4 sessions.
12. Is PRP a curative treatment for baldness?
A. Yes, PRP is a very effective treatment for baldness.
13. How many PRFM injections are ideally advised?
A. 4-6 sessions of PRFM is ideally advised.
FAQ's on Vertical Harvesting
1. What is Vertical Harvesting?
A. Vertical Harvesting is the method of extracting hair follicles from the donor area. This is inbetween FUE & FUT method of extraction. In FUT method of extraction in some patients can form a scar. In FUE method quality & quantity of the graft is always inferior & problematic. To overcome these 2 drawbacks have introduced Vertical Harvesting to eliminate the scar formation. Excellent quality & quantity of the graft along with extraction of strong DFU follicles.
2. Is it used in FUE / FUT method of Hair Transplant?
A. FUT Horizontal is superior to FUE horizontal.
3. In this type of harvesting will there be excess of blood loss?
4. What are the benefits of Vertical Harvesting?
A. Chances of getting DFU follicles high.
5. Is it expensive type when compared to others?
A. Less expensive than FUE.
6. Does it increase in yield?
A. Yes increases yield superior to FUE same as that of FUT.
FAQ's on Biologic's for scalp psoriasis
What is psoriasis?
Psoriasis is a chronic, chronic skin disease characterized by skin with white scales, redness, swelling, and itching or pain. It appears without a trigger or warning in the teens to 30’s (for most people) and waxes and wanes in severity for life.
What causes psoriasis?
The exact cause of psoriasis is still unknown. Two processes-rapid skin growth and inflammation combine to cause the skin changes that lead to psoriasis.
Is psoriasis contagious?
One of the most common misconceptions about psoriasis is that it is a contagious disease. Much of the uncertainity and fear people experience when seeing psoriasis. For the first time comes from a fear "catching". Psoriasis is not contagious and begins treating the patient immediately
Are there different types of psoriasis?
There are different types of psoriasis; however, the most common type is plaque psoriasis vulgaris. Scalp psoriasis is one variant were we see well defined red scaly patches on scalp. Most of them misunderstand them to be having dandruff. The majority of psoriasis studies focus on patients with plaque psoriasis, but most therapies will work for all types of psoriasis to some extent. Some may have overlapping forms or a type that may evolve from to another over time.
Is psoriasis genetic? Will i give it to my children, or will get it if a relative has the disease?
Psoriasis is thought to be caused by a combination of genetic and environment. Although several genes had been associated with an increased risk of psoriasis the significant of any one gene in the development of psoriasis not known.
Does psoriasis tend to be stable or does it fluctuate over time?
Psoriasis does not have a predictable course, so it is impossible to predict whether a particular person will improve or worsen over time. For people with known triggers that exacerabate their disease, exposure to these factors such as stress may predict worsening while reduction of these Triggers could predict stabilization or improvement.
What are the treatment available?
Various treatments right from topical steroids to oral methotrexate, cyclosporins are available.
What are the newer drugs for psoriasis?
Biologicals are a breakthrough in the treatment of psoriasis. Alzumab is an immunoglobulin g1, anti cd6 biologic. It is indicated for the treatment of patients with active moderate to severe chronic plaque psoriasis, scalp and nail psoriasis who are candidates for systemic therapy.
Any contraindications of alzumab?
Alzumab should not be administered to patients having history of severe allergy or known hypersensitivity reaction to any component of alzumab or any murine proteins. Also in any active serious infection.
How can i decide which treatment is best for me?
Work with your doctor and start with the treatment that the doctor recommends for your specific condition, depending on the severity of your disease and your overall health status. Do the treatment follow-ups with your doctor and ensure to continue the treatment as guided.