PEER-REVIEW | HAIR LOSS |
numbing of the scalp and abnormal scarring of the graft34. For a few weeks
after the procedure, temporary telogen effluvium can occasionally occur in densely packed grafts, but could be minimized or prevented with the application of minoxidil solution applied twice daily to
both the
recipient and donor areas for 1 week before and 5 weeks after the operation35–36
.
Low level light therapy Hypertrichosis has been recognized to occur as a side-effect with low fluences and all laser types. It could be due to sub-optimal fluences that are too low to induce thermolysis, but high enough to stimulate hair growth37
Botulinum Toxin A 60 week study included 50 males between 19 and 57 years of age with Norwood/Hamilton ratings II to IV were injected with 150 units of botulinum toxin type-A (BTX-A) into the muscles surrounding the scalp in equally divided doses.
This study
concluded that there was a statistically significant increase of hair count (18%) between baseline and week 48. Hair loss was also reduced by 39%. The conversion of testosterone to DHT is favoured in a low oxygen environment whilst in high oxygen environment DHT is converted to estradiol. By injecting BTX in the peripheral musculature
. The level of
evidence in using phototherapy in AGA remains poor and there are also some safety concerns. Moreover, the optimum wavelength, coherence and dosimetric parameters remain to be determined38
. In a 26 week the scalp43
one achieves decompression of the perforating blood vessels through relaxation of the musculature involved and simultaneous increase in oxygen delivery to frontal and coronal areas of .
Hair transplantation is the most
randomized, double-blind, sham device-controlled, multicentre trial, 110 males with Norwood- Hamilton classes IIa-V AGA used HairMax® LaserComb (Lexington Int., LLC, FL) or a sham device. Participants in the HairMax® LaserComb device exhibited a significantly greater increase in mean terminal hair density than participants in the sham device39
. Another
double-blind study using a home device with 630, 650, and 660 nm wavelengths for 18 minutes daily showed significantly greater hair density and mean hair diameter than a sham device40
.
Treatments with limited evidence for efficacy For those men who opt for a watch-and-wait policy, tinted cosmetics, hair lightening, and adequate hair styling may help to camouflage the defect. Hair extensions or hair pieces may also cover the scalp. Prosthetic implantation of synthetic is not recommended anymore as this is associated with a high number of side-effects41–42
22 . January/February 2016 |
prime-journal.com
common hair restoration surgery used for AGA. The safe donor area is a horizontal
area in the occipital region. There must be at least 40 FUs/sq cm in the donor area. Hair is harvested by using either the follicular unit extraction or the strip
method or a combination of the two. promoting factors44–45
Cell mediated treatment and platelet- rich plasma Research in this area is still in phase I or II clinical trials. Cultured cells or the use of cell secreted factors can be injected directly into the hair follicle and promote hair growth. Cells from the hair follicle mesenchymal tissue can be cultured and then used to promote new hair follicle formation from epithelial tissue. Another approach is that cells are cultured and the supernatant is processed to produce compounds such as Wnt proteins that are rich in hair growth .
Platelet-rich plasma (PRP) isolated from whole blood is
gaining popularity in the cosmetic field and it is one of the latest methods of treatment for various types of alopecia46
. In a recent study conducted on 11 patients not
responsive to 6 months of treatment with minoxidil and finasteride, PRP demonstrated a significant reduction in hair loss between the 1st and 4th injection given with a negative pull test in 9 patients47
. PRP injection could be a
simple, cost effective and feasible treatment option for androgenic alopecia.
Other treatments Products containing different blends of vitamins, mineral components and herbs are often marketed to consumers
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