Hats Off: Hair Loss

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When I was little, thanks to my mom and dad, I thought all women had babies and all men lost their hair.

As I got older, I realized that pregnancy was optional, but hair loss was your genetic destiny. Subsequently, I deemed it much easier to be a woman. But since the ’80s more has changed than just bangs and shoulder pads. There are now effective treatments for hair loss—and I’m not talking about toupees recently.

Dr. Tim Minton of Savannah Facial Plastic Surgery added hair-loss treatments to his repertoire not only because he was trained in the field, but also because studies show that treatments actually work. That’s good news for male-pattern baldness as well as the large number of women who experience hair loss.

Plug it in 
To treat hair loss, a surgeon would traditionally take a batch of hair follicles from a “healthy growth” area (usually at the back of the head) and transplant them to a thinning area, usually at the
frontal scalp or crown. To harvest the hair, the surgeon would take a strip of skin from which to harvest the follicles. This created a large linear scar that could be visible with very short hair.
Additionally, hair plugs resulted in an unnatural look because it’s difficult to mimic the natural angle the hair would grow or sit. 

The solution presented itself in the process of taking individual follicular units as opposed to a big strip of skin. The second-generation NeoGraft device Minton uses has a punch mechanism that harvests tens of thousands of random individual follicle units. Those units are then transplanted to the new area with care and concern for the most natural angle and heal without a visible scar.

Miracle grow
Before surgical treatments, Minton always begins with the nonsurgical hair restoration treatments, which have made huge advances in the past 10 years. Patients with hair loss often have wispy hairs that can be encouraged into mature, long hairs through nonsurgical methods such as platelet rich plasma treatments (PRP). By drawing a patient’s blood and isolating the platelet rich plasma, these growth factors can be used as a regenerative medicine. In orthopedics, PRP is used for tissue and joint regeneration, facials, and it’s even injected to improve libido. “The concern is that we’re using PRP in regenerative medicine without a lot of evidence-based data as to protocol and its effi cacy,” say Minton, “except when it comes to hair.” Large-scale studies show that PRP is
eff ective for hair, and protocols—how many treatments to do, and when to do them—are also prescribed. 

The treatment involves microneedling the scalp and then infusing PRP to activate the follicles. It usually requires three treatments every four weeks and maintenance treatments every 6-12 months. “PRP is also helpful when doing a hair transplant in order to stimulate the new follicles to grow and to help the scalp accept those follicles,” notes Minton. 

Often, the best approach to hair re-growth is to combine several nonsurgical approaches like PRP to get the desired results. Another nonsurgical, cutting-edge treatment for hair loss involves low-level laser light therapy which photo-stimulates hair follicles. When this procedure first came out, a patient would visit the doctor’s office a couple of times a week and sit under the laser light for
about 30 minutes. “Today, they make a cap that you wear at home that looks like a beanie and is hooked up to a battery,” says Minton. “It’s studied and proven to stimulate hair growth.”

According to Minton, the oral medication Propecia is also very effective in treating hair loss but may cause sexual side effects in men. “Now compounding pharmacies have come out with a topical Propecia that may provide the same level of growth without the side effects,” says Minton. A smorgasbord approach to hair loss seems to produce the best results—not only for treatment, but also for long-term maintenance. 

And as for my childhood test of whether or not it’s easier to be a man or a woman, it’s looking like more of a draw. Thanks, technology.