Hair loss is a common and distressing problem affecting men and women of all ages.

Causes

The causes of hair loss include:

• Androgenetic alopecia.
• Nutritional deficiency e.g protein, zinc, biotin etc.
• Infections e.g tenia capitis, folliculitis.
• Drugs e.g anti-coagulants, anti-depressants, contraceptive pills etc.
• Pregnancy
• Trauma
• Pollution
• Psychological stress.
• Auto immune diseases like alopecia areata.
• Telogen effluvium
• Modern day hair styling products.

At Hair Life, we provide solutions for hair loss due to any condition or disease.

Androgenetic Alopecia

It is the most common type of hair loss in each sex. It involves:-

1. Male pattern baldness
2. Female pattern baldness

It is characterized by the gradual conversion of hair from terminal to vellus state, apparently caused by progressive shortening of the anagen phase of the hair cycle. It is also called androchronogenetic alopecia since the process is time dependent.

AGA is controlled by a single, dominant, autosomal gene. The expression of this gene is dependent on the level of circulating free androgens. MPHL is an inherited condition passed through specific genes from one or both parents. The hair follicles most typically subjected to AGA are in the frontal and crown regions of the scalp.

In women, AGA tends to be less severe, later in onset, slower to develop and more diffuse, although no less patterned. It is probably due to lower levels of androgens in women.

Mechanism of hair loss     

The mechanism of hair loss in MPHL has been well characterized. It is now known that DHT is the main culprit in this disorder. Testosterone is converted to DHT by 5 alpha reductase enzyme. DHT is then bound by receptors found on the cell membranes of hair follicles. In genetically susceptible individuals DHT binds with the receptors, enters the cell, interacting with its nucleus, altering protein production and eventually causing the affected hair follicles to miniaturize thereby altering growth cycle timing. Over time these follicles grow shorter, thinner, less pigmented hair and may eventually cease hair fiber production completely. These hair also spend more time in telogen phase then do the unaffected follicles.

Females experience a somewhat different hair loss process than their male counterparts. Recent evidence has shown FPHL to be a different inherited disease from MPHL. Women may have ovarian or adrenal hyperandrogenism causing AGA. In most cases women‘s hair loss does not result in baldness.

Evaluation of hair loss:

The actual evaluation of MPHL is done by use of grading scale developed by Hamilton and modified by Norwood.

Norwood Scale

GRADE 1 Normal head of hair with no visible hair loss.

GRADE 2 The hair is receding in wedge shaped pattern.

GRADE 3 Same receding pattern as norwood 2, except the hairline has receded deeper into the frontal area and the temporal area.

GRADE 4 Hairline has receded more dramatically in the frontal region and temporal area than norwood 3 and there is the beginning of a bald spot at the back of the head.

GRADE 5 Same pattern as norwood 4 but much reduced hair density.

GRADE 6 The strip of hair connecting the two sides of the head that existed in norwood 4 and 5 no longer exists in norwood 6.

GRADE 7 Norwood shows hair receding all the way back to the base of the head and the sides just above the ears.

Grade 1 and 2 represent normal pre and post pubertal individuals whereas grade 3 to 7 represent degrees of male pattern baldness.

The Ludwig Scale

The Ludwig scale uses 3 different types to diagnose the severity of female pattern hair loss. These types are:

Type I

In this stage, the hair loss is mild and may occur on the top and front of the scalp and it is noticeable on parting down the center of the scalp as more scalp becomes visible over time.

Type II

In this stage, the hair loss is considered to be moderate. There is thinning, shedding and general decrease in volume and the central part widens with time.

Type III

In this type, the hair loss is extreme and hair is so thin and scalp is so much visible that naked eye can see it. There is hair miniaturization, progressive thinning and extensive loss.

Treatment

It involves

• Medical treatment
• PRP
• Surgical treatment
• Medical Treatment

We also provide medical treatment for hair loss which includes:

1.Finesteride

For men the standard of care today is the use of finesteride 1 mg. It works by blocking 5 alpha-reductase that results in decreased DHT production in the male. Hair loss stops in 3 to 6 months and regrowth usually occurs in the following 6 to 18 months.

2.Minoxidil

Like finasteride, topical minoxidil must be used consistently to sustain results. When discontinued, hair counts return to baseline within several months.

These two drugs are the only FDA approved drugs for treatment of hair loss.

2. PRP Treatment

PRP stands for platelet rich plasma.It is a blood plasma that has been enriched with platelets.

At Hair life, we have been performing PRP therapy as a therapeutic option for male and female patients experiencing hair loss. PRP is an exciting non-surgical therapeutic option for patients who require stimulation of hair growth for hair loss conditions. PRP is a medical procedure for scalp, skin and hair stimulation. PRP contains special cells called platelets that can cause growth of hair follicles by activation of certain growth factors and by stimulating the stem cells and other cells in the microenvironment of the hair follicle. The primary purpose of using PRP in hair restoration is to stimulate inactive or newly implanted hair follicles into an active growth phase.

The growth factors present in platelet rich plasma include:

• platelet-derived growth factor
• transforming growth factor beta
• fibroblast growth factor
• insulin-like growth factor 1
• insulin-like growth factor 2
• vascular endothelial growth factor
• epidermal growth factor
• Interleukin 8
• keratinocyte growth factor
• connective tissue growth factor

Procedure

In this procedure about 40 ml blood of the patient is taken. It is then centrifuged to seperate blood cells and the plasma. The plasma contains platelets which are broken down by adding calcium gluconate. This causes the release of growth factors from the platelets. This enriched plasma is then injected into the scalp. The procedure is carried out under local anaesthesia. So it is a painless, extremely safe and comfortable procedure with no side effects.

Results

Results can be seen within 1 to 2 months. Patient can have as many sessions as he want at monthly intervals.

 3.HAIR TRANSPLANT SURGERY

The third and last option available is hair transplant surgery which is the ultimate solution for hair restoration.  Hair transplant surgery involves the transfer of hair from a donor area (hair rich zone that is genetically resistant to balding) to a recipient area (bald area).

It involves 3 steps.

1.Consultation and examination

At an initial consultation, the surgeon analyzes the patient’s scalp, discusses their preferences and expectations, and advises them on the best approach and what results might reasonably be expected.

Pre-operative tests

Some tests are advised by the doctor to know the blood count, hepatitis B and C and HIV status of the patient.

Pre-operative instructions

Before the day of surgery patient is advised the following:

• Avoid smoking.
• Avoid alcohol.
• Refrain from taking tea and coffee.
• Take your medicine as prescribed by the doctor.
• Wear an open button shirt.
• If the patient has some medical ailment like high blood pressure, diabetes e.t.c and he is on medication then he is advised to bring his medication along with him.

2.SURGERY

Types of Hair Transplant Surgery

There are basically two types of hair transplant surgery available in Pakistan. These include:

1.Follicular unit strip surgery( FUSS) :

It is also called follicular unit technique FUT. This is an old technique. In this, the patient is given a mild sedative and then local anaesthesia is applied to the head.  A scalpel is used to remove strip of hair bearing tissue from the donor site. The strip is taken according to one’s head size and flexibility of skin. The wound is then closed with sutures by a special technique called Trichophytic closure which results in a fine pencil line thin scar. While closing the wound , the technicians begin to dissect the strip into follicular unit grafts which are units containing 1 to 4 hair, and remove excess fatty tissue using binocular stereo microscopes while trying to avoid damage to the follicles.

The surgeon creates micro holes or slits in the bald area or the recipient area where the grafts are implanted very carefully.

The whole procedure takes about 6 to 8 hours. The stitches of the donor area are removed after a week and the resulting thin scar is covered by the patient ‘s hair. The implanted hair will fall after 3 to 4 weeks and new hair start growing within 2 to 3 months and results will be achieved within 8 to 12 months.

Advantages

This method has the advantage of more number of grafts and the graft survival rate is higher as compared to the other technique thereby creating a dense look.

Disadvantages

1. The scar generated in the donor area will become visible whenever the patient will have a head shave.
2. Moreover there will be no growth of hair over the scar.
3. Skin flexibility is reduced in this procedure.

2.Follicular unit extraction (FUE)

This technique is the latest one available in Pakistan. In this, whole head of the patient is shaved. Then surgeon designs the hair line of the patient according to set rules. After that the patient is given a mild sedative and then local anesthesia is applied to the head. Then individual follicular units containing 1 to 4 terminal hair and 1 to 2 vellus hair are removed from the donor area using 0.8 or 1 mm punch.

The surgeon creates micro holes or slits in the bald area or the recipient area where the grafts are implanted very carefully.

The whole procedure takes about 6 to 8 hours. The implanted hair will fall after 3 to 4 weeks and new hair start growing within 2 to 3 months and results will be achieved within 8 to 12 months.

Advantages

This technique has the advantage of

• No cut
• No stitches
• Minimal scar
• Minimal bleeding
• Skin flexibility is not reduced
• Early recovery
• Patient can wear very short hair
• Minimal pain

Disadvantages

Lesser number of grafts are obtained in this type of procedure so density is less as compared to FUT.

3.Post-operative care

After the procedure is done the patient is properly guided about the care of newly implanted hair and a prescription is given by the doctor which includes pain killers and antibiotics etc.

Patient has to come for a head wash the next day which is optional as if the patient can’t come then he is guided to wash his head.

These implanted hair grow naturally like rest of the patient’s hair and these hair are for lifetime. They don’t fall out. Patient can easily dye, perm and cut his hair with no worries.

OUR SPECIALTIES INCLUDE

• Restoring natural hair for men and women.
• Corrective surgeries for improper transplants performed elsewhere.
• Corrective surgeries for restoring frontal hairline, side burns and eye brows.
• Corrective surgery for trauma and burn patients.
• Single hair feathering technique for thinning hair.
• Surgery for eyelashes.

Treatment of other hair diseases

HAIR LIFE provides a wide range of treatments to males and females for all sorts of hair diseases like dandruff, bacterial infections, patchy hair loss, split ends, lichen planus etc. Dr. Waris Anwar has a wide expertise in the diagnosis of various hair disorders and providing very effective solutions for that.