TREATING HAIR LOSS WITH SYLFIRM X

So Jin Lee, MD, Director of the Lee So Jin Clinic in South Korea explains how they perform hair loss treatments using the SYLFIRM X

IN AN ERA WHERE grooming and self-care have gained increasing importance, the number of patients visiting a clinic for hair loss treatment is continuously increasing. Additionally, the number of middle-aged and male patients, as well as young and female patients, is increasing.

I run a clinic specialising in hair loss treatment in South Korea, and I am using SYLFIRM X, a RF microneedling device mainly used for skin rejuvenation, skin tightening, and lifting, scarring, melasma and rosacea, as a method of hair loss treatment. Both myself as a physician and my patients are very satisfied with the SYLFIRM X hair loss treatment, and I would therefore like to share my knowledge and clinical experience with treatment methods for hair loss.

Hair loss

Before talking about treatment for hair loss, I would like to give a brief explanation of hair. Hair has a growth cycle consisting of the following three phases: anagen, catagen, and telogen. During the anagen phase, the dermal papilla is supplied with nutrients from the blood vessels and the hair grows for 3–6 years. In the catagen phase, the dermal papilla contracts and separates from the blood vessels for 2–3 weeks, and in the telogen phase, dermal papilla activity stops, and hair is separated from the hair follicles in a process lasting 3–4 months. As this cycle repeats, hair grows and falls out. In general, hair loss occurs when there is an abnormality in the growth phase, resulting in a gradual shortening of the growth cycle, which in turn causes the hair to become thinner and fall out.

Through consultation, the causes and influential factors of hair loss are identified. Hair loss can be caused by a variety of reasons, including heredity, ageing, drugs, nutritional status, physical hair damage, stress, and seborrheic skin. Accordingly, there are various types of alopecia (hair loss); among them, androgenetic alopecia, which is caused by genetic factors and hormones, is the most common. Though this condition is commonly termed male pattern hair loss, it occurs in both men and women.

In addition, by examining the condition of the scalp, the number of hairs, and the thickness of the hair, the symptoms and degree of hair loss can be verified. The type of alopecia can be classified according to the symptoms or the number and range of areas where hair loss occurs, or according to the shape of the hair falling out, of which the M, O, and U types are the most common.

Treatments

Based on the findings above, one or several treatment methods are selected and implemented. Moreover, when considering treatment methods, pathophysiological factors affecting hair growth can also be considered. Many studies have shown that cytokines such as fibroblast growth factor (FGF), insulin-like growth factor (IGF), keratinocyte growth factor (KGF), vascular endothelial growth factor (VEGF), plateletderived growth factor (PDFG), and stem cell factor (SCF) are present in the hair follicle regions and promote hair growth.

Treatment options range from scalp care, use of hair loss products and medications, to energy-based device (EBD) treatment and hair transplant surgery.

For scalp care, scalp scaling and the use of hair loss products are often applied to prevent hair loss. In the case of medications, oral or topical agents are usually used, but the products used differ slightly depending on gender. For men, a topical agent, such as minoxidil, and oral medications, such as Finasteride and Dutasteride, are largely used, while for women, topical applications, such as minoxidil and 17α-Estradiol, are used most commonly.

Several types of EBDs have been used to treat hair loss. For example, low-level light therapy is used to increase the photobiomodulation of hair regrowth, while mesotherapy, which involves the direct, automatic injection of drugs into the scalp, has been used for efficient drug delivery.

Sylfirm X

Among these options, my clinic regularly uses SYLFIRM X. SYLFIRM X is the world’s first and only dual-wave RF microneedling device with CE and FDA approval, and is primarily used to treat a variety of face and body indications, including wrinkles, skin laxity, and scars, melasma, and rosacea. This can also be applied to hair loss.

RF microneedling delivers the thermal effect of RF to the desired skin layer by inserting needles into the skin in a controlled manner. Considering the thermal effect of RF, which causes tissue denaturation or coagulation, and the physical damage of the needles, there may be concerns about hair follicle damage in terms of the safety of hair loss treatment.

However, one pre-clinical study conducted by Dr. Jongju Na, et al. in 2015 in a porcine model confirmed that RF microneedling did not damage hair follicles1, while another pre-clinical murine study conducted by Hyunjo Kim in 2018 confirmed the same2

By using the appropriate pulse duration and power, RF microneedling can stimulate the hair follicles and improve hair loss by increasing blood circulation and cytokine production in the surrounding area. Moreover, when the drug is applied immediately after SYLFIRM X, the open channels created by microneedling increase drug penetration, and the skin subjected to RF heat action is more receptive to the drug action.

To verify the effectiveness of SYLFIRM X hair loss treatment, patients were treated with only the device without applying any drugs or hair loss products. As a result, it was confirmed that hair count and hair thickness were improved even with SYLFIRM X treatment alone. Nevertheless, hair loss is not a simple problem of hair, but a result of complex causes and factors, and for the satisfaction of patients who expect a faster and better effect, combination therapy using SYLFIRM X and hair loss products is predominantly performed in my clinic.

The parameters I primarily use, are CW1, 0.7–0.8 mm, power 4–5, and 1–2 passes. A needle depth up to 1.0 mm is used in consideration of skin thickness and drug penetration, however, many patients in my clinic are sensitive to pain, therefore, 0.7–0.8 mm is preferably used to reduce the procedural discomfort. For seborrheic, inflammatory, or sensitive scalp, the PW2 mode is used instead, and the therapeutic effect is very satisfactory. Therefore, it is recommended to change the mode according to the condition of the scalp.

My clinical tip for the SYLFIRM X procedure is to part the hair during the application; this makes the procedure easier and improves RF transmission within the skin.

SYLFIRM X is very convenient as an operator because the parameter setting and operation are very intuitive, simple, and easy. In addition, compared to other EBD treatment methods such as mesotherapy, there are fewer issues such as pain and bleeding, making it preferable for patients.

Immediately after SYLFIRM X treatment, 2–3 ml of hair products, usually serum, is applied to the treated skin. The serums I use are high-priced products containing growth factors or products that include ginkgo leaf extract, multivitamins, high-concentration amino acids, or/and multi-minerals. To take full advantage of each product’s ingredients, different products are used at every visit.

Furthermore, I prepare my own serum in-house by mixing multivitamins to promote energy metabolism of scalp cells, stem cell growth factors to stimulate hair follicle cells, amino acids to help cell activation, and vasodilators to improve blood circulation and deliver effective nutrients to hair roots, and minerals to improve scalp cell metabolism.

A minimum of 8 SYLFIRM X treatments are generally recommended at intervals of 1–2 weeks, and patients usually start providing feedback after 3 treatment sessions. Patients provide feedback that their hair falls out less at first, later they say that overall hair volume and thickness increase, and the increase in hair volume starts at the back of the head and progresses forward.

In conclusion, SYLFIRM X is safe and effective for hair loss treatment as well as treatment for various skin concerns and problems, providing high satisfaction to both physicians and patients.

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