Answers to frequent questions about hair loss and replacement

By E. Ronald Finger CONTRIBUTOR

We frequently get questions about solutions for hair loss in men and women. Here are some answers.

1. What causes hair loss? The most common cause is genetic. Other causes are hormonal, such as thyroid imbalances, stress or excess testosterone causing an increase in DHT (dihydrotestosterone). Many men taking steroids have increases in DHT, causing permanent hair loss. In men, genetic hair loss is called male pattern baldness (MPB) and in women, female pattern baldness (FPB). Common causes in women are braids or tight hair pulled back, causing traction alopecia.

Non-surgical treatments are minoxidil 5% (Rogaine) foam or solution, and in men Finasteride, a prescription medication that prevents conversion of testosterone to DHT. Often both are used together to reduce hair loss. Another excellent product is Spectral-DNC spray, which reduces DHT topically.

PRP (platelet-rich plasma) scalp injections can also be successful. Blood is drawn from the patient and processed to isolate the platelets, which contain multiple growth factors, and then injected into the scalp. Injections are at one and three months, and then annually.

Often PRP injections are used with hair transplants to prevent further hair loss in the balding areas. Lately we have been injecting Exosomes, which requires no blood drawn and contains many more growth factors.

For women, hormones should be checked. If normal, they can try minoxidil and/or Spectral sprays. For men and women, hair transplants are often the best choice.

2. What do you mean by hair transplants? Hair grafts are removed from the back of the scalp, where they are not destined to fall out, and micro-grafted to the balding areas. In their new location, they will usually grow permanently.

3. What are some current hair transplant techniques? FUE (follicular unit extraction) involves removing – with a “punch” – a 1-millimeter micro-grafts containing from one to four hair follicles (thus, hairs). FUE grafts require no sutures and leave no visible scars in the back of the scalp.

FUT (follicular unit transplant) removes the grafts by removing a hair-bearing strip of scalp, closing the defect with sutures, and dissecting the strip into the same 1mm grafts as with the FUE.

FUT is faster and only a strip of scalp needs to be shaved, but it does leave a minimal scar hidden by hair.

4. What is NeoGraft? An automated FUE technique allowing a greater number of grafts to be taken than manual FUE.

5. What are the most important factors to consider? The skill and experience of those performing the grafts. The hairline must be designed naturally, the grafts must be placed in the proper direction, and the grafts must be single hair follicle grafts for a totally natural hairline.

Behind the hairline, grafts with 2 to 4 follicles are used for more density.

6. What results can I expect from a graft? Grafted hair starts growing at three months. Full density can be achieved at about one year to 18 months. Generally, it is permanent.

E. Ronald Finger, MD, FACS is a board certified plastic surgeon with offices in Savannah and Bluffton. fingerandassociates. com or hairrestorationsavannah.com