| hair research | ARTICLE Follicular unit micrografting procedures allow for a
definitive aesthetic and natural-looking hair restoration for most male and female baldness (Figure 1). The amount and thickness of scalp hair varies tremendously between different ages, sexes and ethnic origins. The hereditary incidence is notable in both men and women who have a strong family history of baldness. The male and female hair loss can begin as early as
the age of 18 years. it usually evolves in spurts. in normal hair loss, less than 100 hairs fall each day and are replaced by new thick hair. in the evolution of male and female pattern baldness, the new hair is fine and thin (intermediate hair or miniaturised hair). Male and female baldness usually progresses in a definitive pattern. Dihydrotestosterone (DhT) is the specific hormone
responsible for male and female pattern baldness. The number of testosterone receptors of the follicular cells and the activity of the 5-alpha-reductase enzyme in different areas of the scalp are increased.
Objective measurement of alopecia using a digital camera a digitalised phototrichogram (2) or videotrichogram (3) (Figure 2) enables an objective measurement of hair growth parameters, such as density calibre, number of miniaturised, terminal hairs, and the hair growth rate. it is possible to determine the precise hair quantity available for the transplantation session (e.g. a strip 30 cm long and 1 cm wide, with a density of 150 cm2 approximately 4500 hairs).
will provide
The Bouhanna multifactorial classification a range of hair and scalp parameters are evaluated and computerised: ■ Bald and hairy areas ■ scalp thickness and laxity ■ hair emergence obliquity ■ hair density ■ hair length ■ hair colour ■ hair growth rate. The Bouhanna multifactorial classification (Figure 3)
(4) provides a better assessment of each male and female baldness for an easiest and precise medical and surgical indications.
Medical treatments for male and female baldness Minoxidil By far the most publicised medical treatment available for male pattern baldness is 5% minoxidil lotion and 2% minoxidil for female baldness (Figure 4 —overleaf) (5, 6). The exact mechanism of action is still debated, but it is able to increase the duration of the anagen growth phase, leading to the production of progressively thicker and longer hair. it is important to point out that the bioavailability of
sulfotransferase differs among individuals, and this could explain the different response to treatment. The first signs of improvement generally appear after 4–6 months of therapy.
Total hair count Hair < 40 m Hair > 40 m
0.64cm2 60 12
48
1cm2 94 19
% 20 75 80
Total hair count Hair < 40 m Hair > 40 m
Figure 2 Videotrichogram evaluation of donor and recipient area
0.64cm2 109 28 81
1cm2 171 44
127 %
25 75
Figure 1 Frontal androgenetic alopecia after one micrograft session Frontal area Occipital area
Figure 3 Bouhanna multifactorial classification: evaluation of the four axis and hair transplant distribution The male and female hair loss can begin as early as the
age of 18 years. It usually evolves in spurts. Male and female baldness usually progresses in a definitive pattern.
prime-journal.com | May 2011 ❚ 47
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