Where is our Location?

Our address: Dr. Bishan Mahadevia Dr. Mahadevia's Hair Transplant Clinic 3/A New Bhramakshatriya Society Nr. Pritamnagar Akhada Pritamnagar, Paldi Ahmedabad- 380006 Gujarat, India We are 14 Km or 45 to 60 minutes drive from Ahmedabad International Airport ( Known Sardar Vallabhbhai Airport) We are 12 Km or 25 to 30 minutes drive from Ahmedabad Kalupur Railway station

How to reach us:        If you are coming to India for the first time you need to take the visa from Indian Embassy in your country. Ahmedabad has some direct international connections from, Dubai, Sharjah, Singapore, New York, London. You can otherwise get the connection from Bombay (Mumbai) or Delhi.

For International flights: http://www.expedia.com/, http://www.globester.com/ ,  http://www.ezeego1.co.in/

www.cheapinternationalflights.net/airfares2_fs.html, http://www.airvalues.com/ ,

http://www.zoomtra.com/,

For domestic Flights: www.makemytrip.com, www.yatra.com, www.cleartrip.com, www.travelchacha.com, http://www.ixigo.com/, http://www.expedia.co.in/

Trains: www.makemytrip.com, www.yatra.com, www.cleartrip.com

Tourist Information:

Teperature43 - 23º C in summer and 36 - 15 ºC in winter

Average Rainfall 93.2 cm

Official Language Gujarati

Languages spoken Gujarati, Hindi, English

Ahmedabad:      http://www.ahmedabad.org.uk/tourist-attractions.html

Gujarat: http://www.gujarattourism.com  , http://www.tourismofgujarat.com/

India:    http://www.indiatouristspots.com/,  http://www.touristplacesinindia.com/ , http://www.toptouristplaces.com/

Visa:     check at              http://www.visatoindia.com/

Where to stay:                      

Hotels at walking distance: (N.B. Pick up and drop, on prior request can be arranged)

1. Hotel Chicago: Nr. V S Hospital, Ellis bridge Ashram Road, Ph: 079- 26578126, 26577225
Fax : 079- 26577226 http://www.hotelchicago.in (Rooms around 1500 -2500 per day)
email: chicago@icenet.net ( Sp. Note: This is closest to our clinic, reasonably priced, clean, comfortable, give good services, accepts credit cards, provide airport pick up and drop services.)

2. Hotel Maruti : Next to Hotel Chicago mentioned above (Rooms around 700- 1500 per day)
Ph: 079-26589871 Website: www.hotelmaruti.com

3. Hotel Apex: Phone: 079 26578101, 26579660 . (Room around 500 - 1000 per day). Sahjanand Trade Centre, Opp. Kothwala Flats, Ashram Road, Paldi.

4. Inder Residency: Opp. Gujarat College Ellisebridge, Tel: 079- 26560407
email: inder-residency@egujarat.net or inderad1@sancharnet.in web: www.inder-residency.com ( Higher price and facilities,)
5. Hotel Royal Plaza:
Hare Krishna Complex, Opp. Kothawala Flat, Pritamnagar, Ellisebridge, Ahmedababd-380006 Ph: 26576708, 26578235. Room rates from Rs. 600 to 1500
6. Hotel Dev Residensy:
7. Fortune Land Mark:  (about 4 Km from the clinic and rates and luxury facilities) http://www.fortunelandmark.com/  Address: Usmanpura Cross Roads,
Ashram Road, Ahmedabad - 380 013, INDIA. Phone+91 (79) 3988 4444 Fax +91 (79) 3001 4445 Email info@fortunelandmark.com
8. Taj Residency Ummed ( 5 star hotel near Air port ) http://www.tajhotels.com/Business/Taj%20Residency%20Ummed,AHMEDABAD/default.htm. Address Taj Residency Ummed
International Airport Circle, Hansol, Ahmedabad - 382 475,
Gujarat, India.
Phone:(91-79) 6666 1234 / 2286 9999
Fax:(91-79) 6666 4444
Email: residency.ahmedabad@tajhotels.com

 

Galeatomy what is it?

SCALP has 5 layers (S: Skin C: Cutaneous Tissue A: Apponurosis (Galea) L: Loose Areolar Tissue P: Pericranium) According to one theory it was believed that 3rd Layer Galea or Apponurosis which is a a tough sheet like layer under the skin tightens over the blood vessels passing through it to the skin and does not allow enough blood to pass through it to the skin. This leads to hair loss. Well this theory is never been proven. Galeatomy as a procedure is there for many years now and not new; is deviced with the hope that by cutting this constricting layer blood vessels will carry more blood to the skin and will therefore control the hair loss. This theory was never been proven and those who have performed this surgery in the past have never substantiated this belief. This procedure which I have no personal experience of has never been supported by even international association like ISHRS where hair loss specialists from around the world are active. It is also important to note that most of the scalp blood supply come from front and back of the head and not from the underneath the Galea and those vessels above the Galea and they do not have to cross the Galea. There are few surgeons in Belgium who rpomote this but have perhaps never presented their results in ISHRS.

Does FUE have less hair in the same number of grafts than that by strip method?

well there is view like that because in FUE some of the grafts (about 8-10%) can have partial extraction of the grafts due to the nature of the procedure this may extract less number of hairs. As against the in FUE we have a freedom of choosing follicles with 3-4 hairs unlike the strip method therefore total number of hairs extrcted at time may be same or even more than the same number of grafts by strip method as in strip we do not have any choice but to harvest whatever is available in the strip area.

Flakiness due to Minoxidil liquid- Is Foam better?

Propylene Glycol is often the cause for this dryness, irritation, itchiness and flakiness. Daily thorough shampoo wash and application of say Johnson’s baby oil at nighttime on alternate days on the scalp is usually beneficial. Conditioner for the dry scalp or hair can be used. Foam based preparation has no PG (Propylene Glycol) For more details check: here

Hair Transplant in Young age

The hair loss started in young age is usually due to strong genes and at times is very rapid and if you go for early hair transplant you may lose more of non transplanted hair in near future and that can make you unhappy very soon. We cannot predict your future hair loss and its extent and time. If you begin surgery when you are young, you may find your hair loss exceeds your donor capacity. Since the hair loss is recent the desire to look as it was just a few months ago is intense and it is prcticlly not possible with transplant because can not achieve the normal density.

Most medical treatments such as Minoxidil, Propecia, Avodart, etc. do not grow a significant amount of hair in most individuals. What they do often though, is slow or even stop hair loss. This is very important to you. You are buying time until we have a better solution and perhaps limiting the amount of hair restoration you will require over the course of you lifetime. This may ultimately save you money and preserve you coverage for a longer period of time. You may also slow your hair loss until such time that you become more comfortable with your degree of hair loss.

Well having said that it is equally true that having hair loss at young age also creates great mental stress because that is the age when everyone wants the best of the looks.

On the other hand if you have a good donor area and also the awareness about possible hair loss and reasonable expectation out of HT and can control the hair loss medically transplant can give you happiness although you do have possibility of hair loss and further transplant in near future. If you do consider surgery at a young age, I recommend FUE. This is the only true stand alone procedure. In other words, you can elect to shave your head down and still appear natural because you will not have a linear strip scar in your donor region. Hair Line placed in a conservative fashion in a younger male.

Minoxidill Liquid application

As for the Minoxidil with Retin-A 1ml is the dose.The best time is in the morning after bath on dry scalp. so that the effect lasts for 24 hours till the next hair wash. Do not apply on hair from the top but use it on the skin. Look skywards and allow drops to fall on the hair line area in the front the liquid will roll over to the back on the skin till the crown rather than hair. That way your hairs may not remain sticky. One of my patients taught me this.

Medications used for Hair Loss

There are host of medications used for hair loss only Finasteride and Minoxidil are FDA approved for Hair Loss prevention: some of them are Minoxidil Group (eg Avacor, Procede, Folliguard, Hair Advantage, T-Flavanone, Scalp Med; The Herbal/Biologics group (eg Saw Palmetto, Hair Genesis, Soy, Nuhair, FNS, Procerin, Folligro, Emu Oil; The Vitamin/Mineral group (eg Folligen, Hair Vitamins, L-Lysine, Hair Zx, Triaxin, copper peptides; Home Made Group (eg Oz-Brew); Miscellaneous (eg dutasteride, Nioxin, Kevis, Revivogen, Spironolactone, Procyanide, Nizoral, Fluridil) many aurvedic, Chinese and other traditional medcations area alos promoted but it may not be safe to use the ones that are not well studied.

Hair Loss and Laser Therapy/ cold Laser/ LLLT

Laser Therapy

Low-Level Laser Therapy (LLLT) or Cold Laser in hair restoration utilizes cool lasers to stimulate hair growth and reduce shedding of hair. LLLT is based on the scientific principle of photo-biotherapy. Photo-biotherapy occurs when laser light is absorbed by cells and stimulates cell metabolism and protein synthesis. Although the exact mechanism by which laser light promotes hair growth is still unknown, it appears to stimulate the follicles on the scalp by increasing energy production and by reversing miniaturization (the process leading to thicker hair shafts and a fuller look).

Laser light is in the visible red light spectrum and is generated in a laser diode. The energy level is far below that of laser beams that cut or burn tissue. The low-level red laser light has a very low absorption rate in human tissue making it safe for use in the treatment of hair loss. The Revage laser emits 670nm of visible red light.

Low energy lasers have been used for over thirty years to accelerate healing after wounds or burns and to reduce pain. In 1992, Pontinen published the first paper discussing its possible use in promoting hair growth. Since then there has been much progress is defining the exact parameters necessary to accomplish this, In 2007, the FDA cleared for marketing the use of low-level lasers for the treatment of androgenetic hair loss in men. This clearance was based on the device’s safety, and not on its effectiveness in treating hair loss.

The HairMax LaserComb, cleared by the FDA as a Class II medical device in January 2007, is a compact version of the larger laser therapy units used by hair clinics in other countries to stimulate hair to increase in thickness and make the hair appear fuller. This home product has teeth that part the hair to potentially enable the laser light to reach the scalp in areas of existing hair.

The Revage Laser System, from Apira Science, utilizes Rotational PhotoTherapy (RPT). The Revage 670 is a Class IIIA diode laser approved by the FDA for cosmetic use. It is a low-level laser system that contains 30 laser diodes that rotate 180 degrees around the scalp. This dynamic process increases the contact of the laser energy with the hair follicles and is potentially more effective than a static system in delivering the laser energy to the scalp. It also eliminates human error and variability in self administration. A potential limitation is the fact that existing hair may interfere with the laser beam effectively reaching the scalp.

The unit may prove to be useful for hair loss in women where the thinning tends to be diffuse or those experiencing telogen effluvium. LLLT can be used safely in conjunction with other medications including Propecia and Rogaine and there are no contraindications which would interfere with hair transplant surgery.

While these cool laser treatments have been approved for use, their long-term effectiveness has yet to be determined. A 12 month program can require treatments from 3x per week tapering to one treatment per month and the results and satisfaction from patients thus far have been sporadic.

How Effective is Hair Loss Treatment with Laser Comb?

It is difficult to tell since there are no long-term studies using the LaserComb.From the data we have available, it seems to be about as effective as Rogaine (Minoxidil). As most who have used Minoxidil know, it only works in areas where there is a fair amount of miniaturized hair and over time loses its effectiveness. The HairMax LaserComb is not as effective as Finasteride and, of course, is not a substitute for surgical hair restoration.

Which Laser Comb Works Best ?

I have been trying to find some evaluation of which laser combs work best for “hair restoration”. I have seen some dermatologists speak about the Hair Max laser comb and its effectiveness (considering patient compliance, the amount of time the patient has been losing hair, the amount of total hair loss at time of treatment, etc.). I have also seen reference to the Sunetic laser comb which claims to have a superior technology to the Hair Max and offers a changeable head to allow treatment of the skin for healing, wrinkles, etc. A company in Michigan also offers a laser comb called the Hair Rejuvenator which it claims is superior to either of the other combs but I have not heard of any dermatologist who recommends this comb. A firm in Australia also offers a laser comb (Aculas) which it claims is the most effective; however, the makers of the Hair Rejuvenator comb say it is too powerful and dangerous and could cause blindness. Amidst all these claims, the consumer (patient) is left wondering which best option is and which is merely hype or fraud.

There are no comparative studies thus far. For a hand-held device, I would stick with the Laser comb for now since it is the only one that has cleared the FDA.Some others may work as well (and are less expensive) but we just don’t know at this time – and how useful any of them are long-term is also still not known.

How is Rogaine for Women vs Rogaine for Men

How is Rogaine for Women Different from Rogaine for Men?

Rogaine for men is 5% minoxidil and Rogaine for women is 2%. Another difference is that the 5% solution has propylene glycol in it whereas the 2% is alcohol based. The propylene glycol helps the minoxidil penetrate the skin better and makes the medication more effective. Although both the alcohol and propylene glycol based preparations can irritate the scalp, propylene glycol can cause actual allergic reactions in those who are sensitive.

Propylene glycol is greasier to have on the scalp than the alcohol based formulation. For patients who complain of the greasiness, we advise Minoxidil 5% at bedtime and 2% in the AM.

A side effect of minoxidil specific to women is increased facial hair and this is seen predominately with the 5% propylene based formulation. Women are also more likely to experience lightheadedness or dizziness from the medication.

Minoxidil with Retin-A or Minoxidil Without Retin-A?

Which Hair Loss Treatment is Better: Minoxidil with Retin-A or Minoxidil Without Retin-A?

Minoxidil has been prescribed (off-label) in combination with other medications, such as topical retinoic acid (Retin-A), to enhance its penetration into the skin and thus increase its effectiveness. This combination of medications, however, can significantly increase the absorption of minoxidil into the bloodstream and may increase the risk of potential side effects, including changes in blood pressure and severe scalp irritation that has, on occasion, led to scarring.

If person wants to add Retin-A to the minoxidil regime, the Retin-A should be applied only once a day, since the Retin-A will bind to the skin and will last for at least 24 hours.

Applying Retin-A more frequently will not increase its effectiveness (in facilitating the absorption of minoxidil); it will only increase the incidence of side effects. Retin-A can be applied to the scalp at the same time as Minoxidil, or by itself.

Retin-A should not be compounded with minoxidil (mixed together by your pharmacist or your doctor) for the following reasons:

1. Minoxidil works best when used twice a day. Retin-A is best used once a day.
2. Using Retin-A twice a day wastes money and increases the incidence of side effects
3. If you develop side effects from the Retin-A, it is best to stop only the Retin-A. If they are compounded, you would need to stop both and will lose the benefit of minoxidil.

Hair Loss Medications: Bimatoprost

Bimatoprost

Latisse

Latisse is the first FDA approved (Dec. 2008) topical medication for eyelash growth. It is used to make eyelashes longer, thicker and darker. Applied once a day, it works in over 75% of those using it. Latisse takes about 16 weeks to work. The drug is available only through a doctor’s prescription.
Latisse is applied once a day to the base of the upper eyelashes. The bottom lashes receive the drug from the top lashes through blinking. A 30-day supply costs approximately $120 (About 6000 INR) . Once results are seen, it is possible to decrease the application to every other day, decreasing the cost and the inconvenience of applying the medication.But it has to continued for maintenance.
Background Latisse was first marketed under the name Lumigan to treat eye conditions associated with glaucoma. While being studied for the medical condition glaucoma, researchers noticed the drug had the side effect of stimulating eyelash growth and darkening of the eyelashes. It re-applied for FDA approval for the cosmetic purpose of eyelash growth under the new name. The active ingredient in both Lumigan and Latisse is Bimatoprost. Both products are made by the company, Allergan.
How it Works? Bimatoprost is a compound derived from fatty acids designed to bind to prostaglandin (PG) receptors. PG receptors are present in hair, particularly in the dermal papilla and outer root sheath of the hair follicle. Although the precise way that Bimatoprost works is unclear, it is believed to affect the growth of hair follicles by increasing the percent of hairs in the anagen (growth) phase of the hair cycle and increasing the duration of this phase. The long-term safety of Bimatoprost is based on clinical trials over 13 years.
Side Effects Side effects occur in about 4% of patients using Latisse and include itchy eyes, redness and skin pigmentation. The rare side effect of iris pigmentation that can occur when Bimatoprost has been used in much higher doses for glaucoma has not been reported when it is used to treat eyelashes, but this is still a potential risk. Any individual on antibiotics or other drugs, with heart medication, as well as those with neurological and certain other diseases, and those with severe allergies should discuss these conditions prior to beginning the treatment program. In addition, pregnant women as well as those with skin infections or other conditions on the upper eyelids are not good candidates.Latisse also has the potential to stimulate the growth of scalp hair although there may be some risk when applying it repeatedly to a large surface area.
Off-Label Use Although Latisse has been approved for use on eyelashes, its potential benefit in making eyebrows more full is currently being explored. This is, of course, an easy added advantage of using the medication, since there is usually enough medication left on the applicator stick to use on the eyebrows as well – for those who desire thicker brows.
At present, the cost alone would make this form of treatment prohibitive.

Hair Loss Medications: Spironolactone and Oral Contraceptives

Spironolactone:

Aldectone

Aldactone (spironolactone 25mg, 50mg, 100mg) is a medication that is primarily used to treat high blood pressure (hypertension). Therapy is usually started at a dose of 25mg twice a day. It works as a diuretic causing increased amounts of sodium and water to be excreted from the body, while potassium is retained.

Because of its ability to retain potassium, the medication can elevate the blood levels of potassium to dangerous levels (hyperkalemia). It should, therefore, only be used under a doctor’s supervision.

Spironolactone has anti-androgenic affects and has been used in the treatment of hair loss in women. It is a weak competitive inhibitor of the binding of androgens to their cellular receptors and decreases the synthesis of testosterone

Studies suggest that spironolactone requires at least 200mg/day for stopping loss and that it has little effect on regrowth of hair. Unfortunately, this dose is high enough to elevate potassium levels and place the patient at risk of hyperkalemia and other side effects, including cramps and diarrhea.

Since spironolactone is an anti-androgen (inhibits testosterone), it causes sexual dysfunction and breast enlargement in men. Because of these side effects, it is not used as a treatment for male pattern hair loss.

Oral Contraceptives:

How birth control pills work At the beginning of each menstrual cycle, estrogen levels begin to rise, and the lining of the uterus thickens in preparation of a fertilized egg (this period is called ovulation). After ovulation, progesterone, another reproductive hormone, rises preparing for a fertilized egg. Conception occurs when a fertilized egg implants in the uterine wall. If conception does not occur, both estrogen and progesterone levels drop, signaling the thickened uterine lining to shed and ushering in menstruation.

Oral contraceptives, also known as “birth control pills” (BCP) are a synthetic mixture of the hormones progesterone and estrogen. They prevent ovulation by maintaining constant levels of these hormones. As a result, the ovary does not release an egg and the estrogen level does not rise.

What are the risks involved with taking oral contraceptives? Oral contraceptives (OCA) can be associated with increased risks of several serious side effects. Women taking them are advised not to smoke due to an increased risk of blood clots, stroke and heart attack. Importantly, they do not protect against HIV infection or other sexually transmitted diseases.

Birth control pills causing hair loss BCP’s can cause hair loss through two different mechanisms, through drug induced shedding and by facilitating female pattern genetic hair loss. These are two very distinct processes.

Almost any drug can potentially cause hair loss but oral contraceptives are particularly implicated in a process called telogen effluvium, or hair shedding. Essentially what happens is that the drug causes hair in the growing phase (anagen) to be shifted to the resting phase (telogen). After the telogen phase (normally lasting about 2-3 months), hairs are spontaneously shed before they enter a new growth cycle (of 3 – 7 years). Normally only about 10-15% of hairs are in telogen at any one time, but this can increase to as much as 50% in telogen effluvium. As a result, large amounts of hair can be shed as they pass through this short telogen cycle. Interestingly, telogen effluvium can occur with starting birth control pills, switching birth control pills, or even discontinuing the BCP’s that a patient has been on for a long period of time. Fortunately, this process can be reversible once the implicating agent is stopped or the scalp has time to adjust to the new medication.

If a woman has a genetic predisposition for hair loss, then oral contraceptive medications containing progesterone can potentially increase that loss by adding a source of exogenous (outside) androgens. The birth control pills that are higher in progesterone compared to estrogen will more likely contribute to this process. In contrast to hair shedding, the thinning seen in genetic hair loss is characterized by a progressive decrease in hair shaft diameter rather than frank hair loss.

Birth control pills as a treatment for female pattern hair loss Just as progesterone dominant BCPs can facilitate female pattern hair loss, oral contraceptives higher in estrogen can stimulate hair growth by prolonging the anagen phase of the growth cycle. A problem is that estrogen dominant birth control pills have a greater incidence of certain side effects. Your gynecologist should advise you on which BPCs should be used in your particular situation.

The newer oral contraceptives such as Yasmin, Yaz, Desogen, Mircette, OrthoCyclen Ortho-TriCyclen and Ortho-TriCyclen Lo have lower androgenetic effects and are useful in patients concerned about hair loss. In particular, Yaz and Yasmin contain the progestin drospirenone, which has anti-androgen properties, and can therefore be particularly helpful in women experiencing female pattern hair loss.

Hair Loss Medications: Dutasteride

Dutaseride:

Avodart /Dutas

In 2002, the FDA approved Avodart (dutasteride 0.5mg) for the treatment of prostate enlargement in men (the medical term is symptomatic benign prostatic hyperplasia or BPH). Dutasteride is not approved for the treatment of male pattern hair loss.

Like finasteride, dutasteride is an inhibitor of the enzyme 5 alpha-reductase responsible for the conversion of testosterone to DHT (dihydrotestosterone). However, unlike finasteride, which only inhibits the Type II form of the enzyme, dutasteride inhibits both the Type I and Typ

e II forms of the 5 alpha-reductase enzyme. This dual effect makes the drug more potent but also increases the incidence of adverse reactions.

The Type II form of the enzyme is found predominantly in the hair follicle. The Type I form of the enzyme has been found in the scalp and sebaceous glands, but its exact role in hair growth has not been determined. Type I is responsible for 1/3^rd circulating DHT and type II for 2//3^rd circulating DHT.

Effects on Hair Growth Dutasteride 0.5mg/day decreases serum DHT 91% and scalp DHT 54%. Finasteride 5mg/day decreases serum DHT 71% and scalp DHT 38%. Based on these results, dutasteride should be significantly more effective in the treatment of androgenetic alopecia than finasteride. However, since the Type I form of the 5 alpha-reductase that dutasteride blocks is not present in significant quantities in the hair follicle, these effects may not be as significant as one might expect. The increased efficacy of Dutasteride is felt to be due, in part, to its effects on lowering serum DHT.

Side Effects Dutasteride was investigated in controlled multi-center studies involving 4,325 men aged 50 and above with prostate enlargement. Drug-related side effects during the first six months were as follows: impotence (4.7 percent vs. 1.7 percent for placebo), decreased libido (3 percent vs. 1.4 percent), breast tenderness and breast enlargement (gynecomastia; 0.5 percent vs. 0.2 percent) and ejaculation disorders (1.4 percent vs. 0.5 percent).

The incidence of most drug-related sexual adverse events decreased with duration of treatment. The incidence of drug-related breast tenderness and breast enlargement remained constant over the treatment period. Ejaculate volume may be decreased in some patients with continued treatment. This decrease did not appear to interfere with normal sexual function.

Effects on PSA Dutasteride will reduce the amount of PSA measured in the blood and this must be taken into account when PSA is used in the detection of prostate cancer.

Precautions The precautions when using dutasteride for prostate enlargement are more significant than for finasteride and include:

• Women who are pregnant or may become pregnant should not handle dutasteride because of possibility of absorption of dutasteride and subsequent potential risk to a male fetus.
• Men treated with dutasteride should not donate blood until at least six months after their final dose to prevent giving dutasteride to a pregnant woman through a blood transfusion.
• Men with an allergic reaction to dutasteride or its ingredients should not take it.
• Men with liver disease should talk to their doctor before taking dutasteride.
• Because of the potential for drug-drug interactions, care should be taken when administering dutasteride to patients taking potent, chronic CYP3A4 enzyme inhibitors (e.g., ritonavir).

Additional Points

Unlike finasteride, were families that had a deficiency of the Type II 5-alpha reductase enzyme were followed for years without any adverse effects, there is no natural biologic model for dutasteride.

• The half life of dutasteride is 5 weeks compared to 6-8 hours for finasteride and serum concentrations of dutasteride are detectable up to 4-6 months after discontinuation of treatment.