"Hair Loss - Prevent It & Restore Your Image Starting Today"

Hair loss in men or women can contribute to the appearance of looking older than chronologic age.

One of the hair restoration procedures may be used alone, or in combination with a procedure for facial skin rejuvenation to take years off of a patient's apparent age.

The word "alopecia" is the medical term for hair loss. Alopecia does not refer to one specific hair loss disease -- any form of hair loss is alopecia.

Any person who feels that hair loss is a problem should consult a dermatologist.

The first step in treating hair loss is diagnosing its cause.

Based on medical evaluation, a dermatologist will recommend the procedure that is right for the individual patient.

Some advertised clinics might recommend a costly hair analysis or a scalp biopsy to properly diagnose your hair loss. The only reason to have a hair analysis is to assess the possibility of poison-induced hair loss. A hair analysis may reveal substances such as arsenic or lead; however, hair loss caused by poisoning does not present itself in a typical male pattern.

You should avoid these clinics and seek the advice of a certified dermatologist who can properly examine you and help you treat your hair loss.

Treatment options include:

- Male pattern baldness may be medically treated with topical minoxidil or oral finasteride, drugs that can restart hair growth in some patients.

- Hair restoration surgical procedures include hair transplant, scalp reduction, scalp extenders, and scalp lifts.

Hair Loss and Hair Restoration

Hair restoration procedures and treatments can reverse the appearance of aging associated with hair loss and restore a more youthful look—for women, men and people of all racial and ethnic backgrounds. Dermatologists and dermatologic surgeons can help each patient with hair loss select an appropriate hair restoration treatment.


Causes of Hair Loss

MALE and FEMALE PATTERNS OF HAIR LOSS

Medical treatment for Male pattern baldness

SURGICAL HAIR RESTORATION


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"Causes of Hair Loss"

By far the most common reason for loss of scalp hair is androgenetic alopecia.

About 50 million men in the U.S. have scalp hair loss due to male-pattern androgenetic alopecia (male-pattern baldness).

More than 30 million women in the U.S. have scalp hair loss due to female-pattern baldness.

Androgenetic alopecia is an inherited condition—that is, it "runs in the family."

Causes can include heredity, various acute and chronic diseases, nutritional deficiency, medications, radiation, and improper cosmetic hair treatments


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"Male and Female Patterns of Hair Loss"

The typical hair-loss patterns of male-pattern and female-pattern androgenetic alopecia are somewhat different. In men the initial hair loss—perhaps as early as age 20 to 30—may be in the frontal and temple areas of the scalp. When hair loss begins early it tends to continue and become more severe—the "cue ball" pattern shown in this photo:

Female Pattern Baldness :

Female-pattern androgenetic alopecia often appears a bit later in life than male-pattern androgenetic alopecia—age 25 to 45.

Mistakenly thought to be a strictly male disease, women make up a significant percentage of American hair loss sufferers. Forty percent of women have visible hair loss by the time they are age 40, according to the American Academy of Dermatology.

Hair loss in women can be absolutely devastating for self image and emotional well-being

About one in four women experience female-pattern androgenetic alopecia.

A woman may notice increased hair loss in association with events that influence hormonal patterns: use of birth control pills, menstruation, pregnancy, and menopause.

In women the most common conditions are androgenetic alopecia baldness, and telogen effluvium which causes thinning of scalp hair but not bald patches.

The hair-loss pattern of female-pattern androgenetic alopecia tends to be thinning of hair rather than complete loss of hair. Female hair loss is likely to begin in the center of the scalp rather than at the front and temples as seen in men.

A typical pattern of hair loss in female-pattern androgenetic alopecia is shown in this photo:

Female-pattern androgenetic alopecia; thinning hair in the central part of the scalp.

The "cue ball" complete loss of hair that occurs in many men rarely occurs in women.

Male-pattern and female-pattern androgenetic alopecia are not only very common, they are very treatable.

Both surgical and medical treatments have high rates of success. The medical treatments are more effective in treating crown hair loss than frontal hair loss.

Other Reasons for Hair Loss
Other causes of hair loss are not necessarily associated with aging but are rather due to disease and scalp injury. While they are much less common than androgenetic alopecia it may be important to know about them if your hair loss may be due to a cause other than androgenetic alopecia.

Causes include various acute and chronic diseases, nutritional deficiency, medications, radiation, and improper hair treatments.

A condition of unknown cause called alopecia areata occurs in both men and women, causing hair loss in small circular patches

The common and most of the less common causes of hair loss can be treated successfully by a variety of hair restoration procedures.


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"Medical Treatment for Male Pattern Baldness"

Remember that successful treatment of hair loss is greatly dependent on early intervention. It is critical to begin treatment with an effective product as soon as you notice the onset of hair loss.

The following two treatments have been clinically proven to successfully treat hair loss in men to varying degrees.

Finasteride (Proscar, Propecia)

Finasteride is the generic name for the brand name drugs Finpecia and Propecia.

In December 1997, the FDA approved a 1mg dose of finasteride for the treatment of androgenetic alopecia (male pattern baldness) in men. Propecia is the first drug in history to effectively treat male pattern baldness in the majority of men who use it.

How Finasteride Works

Finasteride's hair-raising success is due to its ability to specifically inhibit 5-alpha-reductase, the enzyme that converts testosterone into a more potent androgen dihydrotestosterone (DHT).

This reduction in DHT has proven to stop the progression of hair loss in 86% of men taking the drug during clinical trials. 65% of trial participants had what was considered a substantial increase of hair growth.

At this point, the only truly effective medically proven way to arrest the hair loss process is to lower DHT levels. The American Hair Loss Association recommends finasteride as the first line of attack for all men interested in treating their male pattern baldness.

Minoxidil

Minoxidil was the first drug approved by the FDA for the treatment of male pattern baldness.

Minoxidil has been clinically proven to slow the progression of hair loss and regrow lost hair.

The American Hair Loss Association still recommends the drug for those who have not responded favorably to finasteride treatment or for those who would like to add another product to their regimen. The AHLA does not recommend minoxidil as the first line of attack for men suffering with male pattern baldness, but does recognize it as an effective treatment for a small percentage of its users.

MEDICAL TREATMENT FOR FEMALE PATTERN BALDNESS:

Beginning treatment as soon as possible after the hair loss begins gives the best results, because prolonged androgenetic alopecia may destroy many of the hair follicles.

The use of anti-androgens after prolonged hair loss will help prevent further damage and encourage some hair regrowth from follicles that have been dormant but are still viable.

Stopping treatment will result in the hair loss resuming if the androgens aren't kept in check in some other way. Maintaining your vitamin and mineral levels helps while you're on anti-androgen medications.

Minoxidil

Applying a solution of minoxidil directly to the scalp can stimulate hair growth.

When applied topically, the amount of minoxidil absorbed through the skin into the bloodstream is usually too small to cause internal side effects

Oral Drugs:

Some oral medications are also helpful. Your doctor will evalulateyour condition and accordingly prescribe the required drugs.

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"Surgical Hair Restoration"

If you and your doctor have determined that hair transplants are the best option for you, you can feel comfortable knowing that board-certified plastic surgeons have been successfully performing this type of procedure for more than thirty years.

The Best Candidates for Hair Replacement

Hair replacement surgery can enhance your appearance and your self-confidence, but the results won't necessarily match your ideal. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.

It's important to understand that all hair replacement techniques use your existing hair. The goal of surgery is to find the most efficient uses for existing hair.

Hair replacement candidates must have healthy hair growth at the back and sides of the head to serve as donor areas. Donor areas are the places on the head from which grafts and flaps are taken. Other factors, such as hair color, texture and waviness or curliness may also affect the cosmetic result. There are a number of techniques used in hair replacement surgery. Sometimes, two or more techniques are used to achieve the best results.

Transplant techniques, such as punch grafts, mini-grafts, micro-grafts, slit grafts, and strip grafts are generally performed on patients who desire a more modest change in hair fullness. Flaps, tissue-expansion and scalp-reduction are procedures that are usually more appropriate for patients who desire a more dramatic change.

Remember, there are limits to what can be accomplished. An individual with very little hair might not be advised to undergo hair replacement surgery

Planning Your Surgery

Hair replacement surgery is an individualized treatment.

In your initial consultation, your surgeon will evaluate your hair growth and loss, review your family history of hair loss, and find out if you've had any previous hair replacement surgery. Your surgeon will also ask you about your lifestyle and discuss your expectations and goals for surgery.

If you decide to have hair replacement surgery, your surgeon will explain anesthesia, the type of facility where the surgery will be performed, and the risks and cost involved. Don't hesitate to ask your doctor any questions.

Make sure you understand your surgeon's plan-which procedures will be used and how long each will take. Ask your doctor to give you an idea of what you will look like after the procedure or, in the case of grafts, after each stage of treatment.

Preparing For Your Surgery

Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking and avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly. If you smoke, it's especially important to stop at least a week or two before surgery; smoking inhibits blood flow to the skin, and can interfere with healing.

You should arrange for someone to drive you home after your surgery. Plan to take it easy for a day or two after the procedure and arrange for assistance if you think you'll need it.

The Surgery

Hair transplantation involves removing small pieces of hair-bearing scalp grafts from a donor site and relocating them to a bald or thinning area. Grafts differ by size and shape.

Round-shaped punch grafts usually contain about 10-15 hairs. The much smaller mini-graft contains about two to four hairs; and the micro-graft, one to two hairs. Slit grafts, which are inserted into slits created in the scalp, contain about four to10 hairs each; strip grafts are long and thin and contain 30-40 hairs.

Generally, several surgical sessions may be needed to achieve satisfactory fullness-and a healing interval of several months is usually recommended between each session. It may take up to two years before you see the final result with a full transplant series.

The amount of coverage you'll need is partly dependent upon the color and texture of your hair. Coarse, gray or light-colored hair affords better coverage than fine, dark-colored hair. The number of large plugs transplanted in the first session varies with each individual, but the average is about 50. For mini-grafts or micro-grafts, the number can be up to 700 per session.

Just before surgery, the "donor area" will be trimmed short so that the grafts can be easily accessed and removed. For punch grafts, your doctor may use a special tube-like instrument made of sharp carbon steel that punches the round graft out of the donor site so it can be replaced in the area to be covered-generally the frontal hairline.

For other types of grafts, your doctor will use a scalpel to remove small sections of hair-bearing scalp, which will be divided into tiny sections and transplanted into tiny holes or slits within the scalp.

When grafts are taken, your doctor may periodically inject small amounts of saline solution into the scalp to maintain proper skin strength. The donor site holes may be closed with stitches-for punch grafts, a single stitch may close each punch site; for other types of grafts, a small, straight-line scar will result. The stitches are usually concealed with the surrounding hair.

To maintain healthy circulation in the scalp, the grafts are placed about one-eighth of an inch apart. In later sessions, the spaces between the plugs will be filled in with additional grafts. Your doctor will take great care in removing and placement of grafts to ensure that the transplanted hair will grow in a natural direction and that hair growth at the donor site is not adversely affected.

After the grafting session is complete, the scalp will be cleansed and covered with gauze. You may have to wear a pressure bandage for a day or two. Some doctors allow their patients to recover bandage-free.

A tube-like instrument punches round gafts from the donor site to be placed in the area where hair replacement is desired.

Flap surgery:

Flap surgery on the scalp has been performed successfully for more than 20 years. This procedure is capable of quickly covering large areas of baldness and is customized for each individual patient. The size of the flap and its placement are largely dependent upon the patient's goals and needs. One flap can do the work of 350 or more punch grafts.

A section of bald scalp is cut out and a flap of hair-bearing skin is lifted off the surface while still attached at one end. The hair-bearing flap is brought into its new position and sewn into place, while remaining "tethered" to its original blood supply.

As you heal, you'll notice that the scar is camouflaged-or at least obscured-by relocated hair, which grows to the very edge of the incision.

In recent years, plastic surgeons have made significant advances in flap techniques, combining flap surgery and scalp reduction for better coverage of the crown; or with tissue expansion, to provide better frontal coverage and a more natural hairline.

Scalp reduction :

This technique is sometimes referred to as advancement flap surgery because sections of hair-bearing scalp are pulled forward or "advanced" to fill in a bald crown.

Scalp reduction is for coverage of bald areas at the top and back of the head. It's not beneficial for coverage of the frontal hairline. After the scalp is injected with a local anesthetic, a segment of bald scalp is removed. The pattern of the section of removed scalp varies widely, depending on the patient's goals. If a large amount of coverage is needed, doctors commonly remove a segment of scalp in an inverted Y-shape. Excisions may also be shaped like a U, a pointed oval, or some other figure.

The skin surrounding the cut-out area is loosened and pulled, so that the sections of hair-bearing scalp can be brought together and closed with stitches. It's likely that you'll feel a strong tugging at this point, and occasional pain.

Getting Back to Normal :

How soon you resume your normal routine depends on the length, complexity and type of surgery you've had. You may feel well enough to go back to work and resume normal, light activity after several days.

Many patients who have had transplants (plugs or other grafts) are dismayed to find that their "new" hair falls out within six weeks after surgery. Remember, this condition is normal and almost always temporary. After hair falls out, it will take another five to six weeks before hair growth resumes. You can expect about a half-inch of growth per month.

Follow-Up Procedures

You may need a surgical "touch-up" procedure to create more natural-looking results after your incisions have healed. Sometimes, this involves blending, a filling-in of the hairline using a combination of mini-grafts, micro-grafts, or slit grafts. Or, if you've had a flap procedure, a small bump called a "dog ear" may remain visible on the scalp. Your doctor can surgically remove this after complete healing has occurred.

In general, it's best to anticipate that you will need a touch-up procedure. Your surgeon can usually predict how extensive your follow-up surgery is likely to be.

Is it appropriate for a woman to have a hair restoration procedure? Isn't this something usually done for men?

Hair loss is a problem affecting about 35 million men in the United States —and about 22 million women.

Although hair transplantation and other hair restoration procedures were at first used primarily for men to correct male pattern baldness, women have increasingly turned to dermatologists for help in restoring a "full head of hair" look. Inherited tendency is a major cause of hair loss in women just as in men.

Hormonal changes of pregnancy can lead to hair loss. Other causes include stress and nutritional deficiencies. Before a hair restoration program is undertaken by a woman, a dermatologist must evaluate the cause(s) of hair loss and recommend the hair restoration procedure that will be most effective.

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