Anatomy of hair growth-anagen/catagen:

There are 3 phases of hair growth in the scalp. Anagen means growth phase, catagen means degradation phase, and telogen means resting phase. There are normally one to one and a half lakh hair follicles on our heads. Out of this, 85% of the hair follicles are in the hair growth phase. The hairs which are seen on our head are of the anagen phase. This cycle is of 2 to 6 years.

Why do males & females lose hair?

If there is hair loss in males or females, then male or female pattern baldness which is called androgenic alopecia, alopecia areata, cicatricial alopecia, anagen, or telogen effluvium can be the reason. Most women have a stress-induced hair loss called telogen effluvium that is easily treatable. Androgenic alopecia is often the cause of hair loss in males. Apart from this, hair loss also occurs due to vitamin deficiency, thyroid diseases, side effects of medicines, and some diseases. I have given information about this in detail in our first blog on hair transplant. You must read that blog.

Now let us learn a little about genetic baldness. In patients who have genetically coded baldness, the anagen phase is shortened due to androgen i.e. Dihydrotestosterone. The hair on the head is short and thin instead of being long and thick. Genetic baldness is not an overnight process. It is slow, progressive, and unpredictable.

Indications for treatment:

When should we consult a dermatologist or plastic surgeon for hair loss?

Many patients who are generally health-conscious get worried if hair loss occurs. On average 60-100 hairs are lost daily. It is normal. Why do we call it normal? Like I told you in the anatomy section, there are three phases of hair growth. There is hair shaft shedding in the catagen and telogen phase and these hairs are part of that process. This cycle goes on continuously. You can call it physiological hair loss.

So when should you show up for treatment? First, if there has been a lot of hair thinning in a very short time, if you comb and a big bunch of hair comes on the comb, after getting up from sleeping if there is a lot of hair on the pillow then this is pathological hair loss. You should consult a hair loss doctor or hair transplant surgeon if you feel that your hair quality is gradually thinning, hair growth has decreased, and if baldness has started appearing on your scalp.

Who are the doctors for hair loss?

In today's advertising era, if you search on Google search or Practo or JustDial or other platforms for hair loss doctors or hair transplant surgeons, you will find many people. So it is important for you to know from which doctor you should consult. In general, you should consult only a dermatologist or a plastic surgeon. MBBS, MS, M.Ch, or DNB in ​​Plastic and Reconstructive Surgery are the degrees of plastic surgeons. Dermatologists’ degrees are MBBS, MD or DVD, or DDV Skin. You must know the doctor's degree before consulting the hair loss doctor.

What tests are needed for hair loss assessment?

It is necessary to recognize nutritional deficiency or hormonal disorder in hair loss assessment because if we do not treat the basic cause of hair loss, then even if we do advanced treatment of hair loss, the results will not be good. Usually, I test for CBC, ESR, Sr. Ferritin levels, Vit D3 levels, and Vit B12 levels. If needed, I get zinc and male and female hormone levels (testosterone, DHEA) tested in females. In some selected patients who I suspect have an inflammatory disorder, a scalp skin biopsy should be done so that we can get the definitive diagnosis. So let's move on to the different methods of hair growth.

What are different hair growth methods?

If you are a male patient and you have only a little hair thinning, then grow your hair by 10 cm to cover the bald scalp, change the hairstyle and change the parting line from where the hairs are twisted to the right and left. You can benefit from this to a great extent.

• Lifestyle modification: Stress is a well-known risk factor for hair loss. To reduce stress, you can do meditation, yoga. Eat healthy food which have multivitamins and antioxidant-rich food including fruits and green leafy vegetables. Every day you must do at least light exercise.‍
• Medical line of treatment: These are mainly used to reduce further hair loss. Sometimes it also causes hair regrowth. In medical treatment, mainly minoxidil and finasteride are FDA-approved treatments. Minoxidil is used in 2% or 5% strength. After applying on the scalp, it increases the blood supply and prevents additional hair loss. Finasteride is an antiandrogen drug that inhibits the conversion of testosterone to dihydrotestosterone. It has a lot of effect after taking a 1 mg daily dose. Dutasteride is also used in off-label use. A hair-specific multivitamin is an essential treatment.
• PRP-Platelet rich plasma therapy: After drawing 10ml of blood, it is spun in a centrifuge machine. After that, the platelet-rich plasma is separated. PRP is injected into the scalp with a very small needle. Injections are given either with an insulin syringe or with a microneedling machine. The growth factors in PRP support hair follicle growth. I usually combine this with hair mesotherapy or Recosma laser. Optimum treatment sessions should be 4 to 6 sessions..
• Hair Mesotherapy: In hair mesotherapy, ready-made growth factors are injected into the hair.
• Low level Light therapy: It is used as a supportive treatment. Lasers in low wavelengths stimulate hair growth by increasing blood supply, growth factor release, and stimulation of follicles to re-enter or spend more time in the catagen phase.
• Hair Transplant: People who have established baldness have no option but hair transplant at present. For details of FUE and FUT hair transplants, read our hair transplant blog.
• Camouflage: Scalp micropigmentation, hair wigs, hair replacement systems that employ artificial hair are suggested to patients who lack donor areas, have cardiovascular risk factors, those who are not prepared for hair transplant and in whom hair loss is progressive. In scalp micropigmentation, using medical-grade tattoo ink, tattooing is done and an illusion is created so that the head looks like there is hair on it. The most popular artificial hair fibers are Toppik & Dermmatch.

How is the treatment selected at Arra Aesthetics?

I take the history of hair loss in all the hair loss patients who consult me, such as how long the hair loss is happening, whether the hair loss is continuous or intermittent, how many hairs fall every day, whether they have taken treatment for hair loss, who has the problem of baldness in the family and whether there is any disease or not. After this, I do an examination of their scalp, so that I can find out if they have pre-existing problems like dandruff or scarring alopecia. After my assessment with the patient, I will discuss the possible reasons for their hair loss. After this, I will inform them about the investigations to be taken by them. If their hair loss is physiological then I reassure them. They do not need to do any investigation or treatment, I stress this matter. I discuss the options of hair transplant with people who have more than 40% hair loss or who are already bald. For patients who have thinning hair and minimal baldness that do not qualify for a hair transplant, I start medical treatment with Minoxidil, Finasteride, and a hair-specific multivitamin. I suggest PRP treatment, hair meso, and low-level laser treatment to those whose hair loss is a bit advanced. I recommend a hair-related diet, and lifestyle modifications to almost every patient.

Future of hair regrowth:

Follicular hair regeneration:

This famous technology called Regenera Activa. In this, a biopsy is taken from the back of the head and it is processed with a special Regeneacon device. After the procedure, an injectable micrograft containing the patient's own cells, extracelluar matrix, and growth factors is injected into the skin. It takes 3 to 4 months to get the result and these results last for about 2 years. Keep in mind this does not work for very severe hair loss.

• Recosma laser: It is a special laser, based on 2940 nm wavelength. The role of the Recosma laser has just been established in wound healing. After the superb results of laser wound healing, we have started using it for hair loss treatment in which it helps in hair growth through the regenerative method.‍
• Radiofrequency for Hair Growth: In many scientific publications, fractional radio frequency has been used for hair growth and encouraging results have been found.
• Sulfonyl transferase booster Tattoo: In patients who have low minoxidil response, this topical treatment increases the activity of sulfonyl transferase and increases the minoxidil response.

Choose your hair loss doctors carefully if you want to maintain good hair.

Book an appointment with Arra Aesthetics today to know which hair loss treatment is best for you!