Many Players, Politicians or Film stars have found their losing hair as a
big challenge to their personality or even their carrier. Some have
chosen to go for the artificial solutions like hair piece and some have
chosen to go shaven head and some have preferred to go for a permanent
solution of Hair Transplantation. Some of the examples are given here
who are believed to have undergone hair Transplant surgery to give a
more youthful Hair line. The information is not first hand but mostly
through internet search. Abhijit an Indian Playback singer, Elton Johns, Brndan Fraser, Sunil Gavaskar, George Cloony, Harsha Bhogle, Italian Prime Minister Silvio Burlusconi, Jude law, James Nesbitt , Joel McHale, John Cleese, Kevin Kosner, Matthew Mcconaughtey, Mel Gibson, narendra Modi Gujarat,s CM, Nicolas cage, Rana Naveed Ul hassan ( Pakistani Cricketer), Ravi Shashtri ( Indian Cricketer), Salman Khan ( Indian Film Star) Virendra Sehwag ( Indian Cricketer), Nawaz Shareef ( Pakistan ex PM) and brother , Tom Arnold, Tom Hanks, Will young are to name a few.
Good Bye Hair Loss - Blog by Dr. Bishan Mahadevia - Tips for Hair Loss, Hair Transplant, Hair Treatment, Baldness, Hair Cloning and Hair Cosmetics
Sunday, May 9, 2010
Saturday, May 8, 2010
Saturday, April 24, 2010
BHT ( Body Hair Transplant)
Body hair transplant (BHT):
For common baldness usually the hair roots from the back of the head is preferred but in some situations hairs roots from other part of the body are used which is called BHT
Body hair transplant (BHT): Procedure: Essentially it is FUE (Follicular Unit Extraction) but often bulky soft tissue underneath without strong bony support makes it difficult than that from the scalp. Usual sites are Beard, Pubic, Chest and Back.
Advantages:
- Esp. valuable when scalp donor is exhausted or limited Minimal evidence of scaring due to FUE technique used
- Large Donor area
- May be a better choice for eyebrow reconstruction where one can have better matching hairs then the fast growing thick scalp hair
- Some believe unlike scalp hair which is weakened by the male hormone DHT, body hair thrives and grows thicker and longer as time goes on
- BHT can be used to feather out the hair line by cherry picked fine BHT in patients with coarse donor hairs in the occipital area.
Disadvantages:
- Slow procedure and very taxing for surgeon not only due to awkward positioning but also this is due to acute angulations of more superficially placed follicles. The follicles are often in the more bulky soft tissue with less bony support. Some of the Body Hairs are not strong shafted to facilitate easy extraction.
- Not all Body Hairs are of good quality some may take long time to grow, and may not even grow long & thick enough (We believe Beard, armpit and Pubic hairs are of better quality hair for head hair replacement) This May leave pigmented or Hypo pigmented marks in donor site esp. in dark skin
- Most FU have one and very few have 2 hairs. 3 and 4 hair FU in BHT are practically non existent. So we are transferring less number of hairs and therefore turns out more expensive to patients.
- There is cyclical variation in the amount of coverage that the body hairs provided (due to natural body hair growth/resting cycles). Body hairs did grow longer than in their original location, but not as long as scalp donor hair.
- Persons with Fitzpatrick type 3-6 skins are prone to healing with initial hyperpigmentation (much like the dark marks that you get temporarily subsequent to an acne attack) Sometimes, instead of dark pigments, you could get lighter pigmentation (hypopigmentation) in the initial phase as well. The improvement of hyperpigmentation (dark spots) can be hastened by the use of fading creams. Wounds that heal initially by hyperpigmentation can end up finally with a much shrunken spot that is either normal in color relative to the surrounding skin or may assume a relatively faintly hyper or hypo pigmented hue.
Precaution:
For avoiding the telogen hair from extracting you need to shave the area about 4-5 days in advance of the procedure because the telogen hair are likely to be damaged during extraction due to the nature of their structure.
Body hair varies in calibre, texture and color. It is recommended to mix body hairs with scalp hair to achieve a uniform look and feel.
Body Hair Transplant (BHT)
There are about one hundred thousand hairs on the normal human head and about 1 million hairs of the body. Person having major loss of class 7 (almost 75000 hair out of 100000 are lost) may not have enough donor hairs at the back and side of the head (only 12500 out of remaining 25000 may be transplanted). Often donor hair may be even less. This situation made some surgeons to look for other Body hairs. Dr. Woods , Dr. Cole, Dr. Poswal and Dr Umar may be the torchbearers. Body Hair Transplant (BHT) as a major plus point may become donor hair because they are not genetically DHT susceptible hairs as some of the scalp hairs in MPB. But there are many issues with the effective use of BHT as routine. The conventionally used donor hairs from the back and sides of the scalp are very much similar to the hairs to be replaced in MPB but the characters of the BH has many variations such as thickness, length, colour, texture, the growth period etc. As a result for many years BHT was given the back seat. But some studies have shown that BHT hairs may change some of the character if not fully but partially when transplanted to the scalp (recipient "co-dominance" - or partial donor dominance) and this generated more interest and BHT is now being seen more seriously. . BHT is not widely practiced because, it requires special instruments, is very time consuming and the results can be somewhat unpredictable. Results are typically not at par with scalp hair yields Many patients consider body hair unnecessary and try to remove it. A body hair transplant serves a dual purpose by moving unwanted body hairs to the scalp, where they are more productive.
Body hairs from various areas have
been used:
Wet zone or Apocrine zone
: armpits and pubic hairs (so called because of Apocrine nature of sweat
glands- In the case of sweat produced by
the apocrine glands, which are located near hair follicles on
the scalp, underarms, and groin area, the sweat contains fatty compounds. Bacteria
feed on this sweat when it is secreted to the skin´s surface, and the resulting
waste products, fatty acids, ammonia, and chemical reactions
form a palpable odor which is unique for every individual.
Possible Uses of
BHT:
1.
Obviously the most common use of BHT is as a viable
option for those whose traditional donor hair supply is depleted.
2.
To feather
out hair line by cherry picked thin and soft body hairs esp. in the people with
strong and coarse scalp hairs where taking the thin hairs from the nape of the
neck or per auricular area may not be a good option because they do not belong
to what is conventionally called safe donor zone of scalp.
3.
To camouflage the widened strip scars of already
depleted donor area where taking further the hairs from the scalp either by
strip or FUE is not a sensible option. Coarse Beard hairs and other BHT from
Apocrine area which grow thick and long is a good option.
4. Body
hair is an excellent filler to increase the density for use in between
naturally thinning hair
5. Transplanted
scalp hair for the eyebrow restoration may not be the best match and grow very
fast and need to be trimmed often. Some body hair with better match ( lighter
colour, thinner diameter and slow growth than that of scalp hairs).
6. Body
hairs may be used for restoration of the hairless scar etc which become more
obvious in the exposed part of the body.
7. Donor
recharging or Donor sealing of the scalp donor area by BHT esp. when the scalp
donor area is very thin.
Problems:
·
Tiny Hyper or hypopigmented marks
may be visible in some
·
Follicluitis esp. in case of buried
or transected follicles with ingrown hairs may sometimes need antibiotics or
steroid to resolve.
·
Keloid esp. is possible in the chest
and shoulder area- one may doe a small test grafting
·
Redness for few weeks may be
possible avoid sun exposure and use steroid application
·
Unpredictable growth at times
·
Long time to grow at times after
transplant
·
Synchronous cycles
·
Due to difficulty in extraction
compared to scalp hair may be more expensive and time consuming ( slow
extraction and less yield per day) due to difficult positioning of doctor and patient.
It is a general perception that the short hair style gives the less ugly
feeling of baldness than when the side and back hairs are kept long. Also,
keeping the hair shorter might cut down on the number of grafts needed to
diminish the bald look. BH usually do not grow very long (1 to 2 inches or less
because their hair cycle is short) since it will not grow as long as scalp
hair, a shorter hair style should ultimately be preferred.Technical issues for BHT:
1.
The acuity of direction makes it demanding to use the
instruments with more precision
2.
Most BH do not
have as close a Bony support to the skin as that to the scalp hair (except in
case of sternum and shin of tibia etc.). Some firm background support makes it
easier to extract the grafts and in case of pubic and abdominal area due to
minimal firm support at the back ground may make extraction more challenging.
3.
Many body hairs are not robust and without the good
bony background it may nor be easy to harvest such hairs in some areas esp.
when they are acutely placed and every other hair grows in different direction.
This makes the extraction process very slow.
4. At
a given time 80 to 90% of scalp hair are
in anagen ( growing phase) and only about 40
to 60% of Body hair are in anagen
phase Some studies show that body
hair has a very short anagen phase and a very long telogen phase.
Their duration of anagen is much shorter (12 to 16 weeks) as compared to the scalp donor hair (2 to 5 years).This means that body hair grows in a period of about six months to about 2 inch long, and they then rest on this length for some years. In Body Hair Transplantation when hair is transferred from the body to the scalp, it may have considerable delay in growth due to their long telogen phase. That does not mean that 10% to 20% of head hair and 40 to 60% of body hair died. It means that those percentages should always be resting or in telogen. As one hair cycles out, another cycles in and begins to grow. since body hair growth cycles are faster and more hairs are resting at any given time, it takes more body hair ( and even more BH follicular unit grafts- because most grafts have only one hair unlike the scalp grafts which may have up to 4 hairs) than scalp hair to create the same illusion of density. In Body Hair Transplantation when hair is transferred from the body to the scalp, it may have considerable delay in growth due to their long telogen phase.
Their duration of anagen is much shorter (12 to 16 weeks) as compared to the scalp donor hair (2 to 5 years).This means that body hair grows in a period of about six months to about 2 inch long, and they then rest on this length for some years. In Body Hair Transplantation when hair is transferred from the body to the scalp, it may have considerable delay in growth due to their long telogen phase. That does not mean that 10% to 20% of head hair and 40 to 60% of body hair died. It means that those percentages should always be resting or in telogen. As one hair cycles out, another cycles in and begins to grow. since body hair growth cycles are faster and more hairs are resting at any given time, it takes more body hair ( and even more BH follicular unit grafts- because most grafts have only one hair unlike the scalp grafts which may have up to 4 hairs) than scalp hair to create the same illusion of density. In Body Hair Transplantation when hair is transferred from the body to the scalp, it may have considerable delay in growth due to their long telogen phase.
5.
The dermal components of the hair, secondary germ cell and
the dermal papilla are attenuated in telogen
hairs, and more prone to damage during individual follicular extraction. Transactions by shearing forces will
be higher with a higher chance of leaving behind vital cells that are essential
for the healthy regeneration of the hair follicle.
Therefore, only body donor hair follicles in the active anagen phase (which are strong even at the dermis level) are preferred for transplant. The hairs are shaved flush with the skin, 4-5 days prior to extraction. At the end of three to four days, the actively growing hair is easy to identify due to their increased length. If telogen hair is successfully extracted it will be bulbless hair and if transplanted will grow villous or thin hair if at all it ever grows.
Therefore, only body donor hair follicles in the active anagen phase (which are strong even at the dermis level) are preferred for transplant. The hairs are shaved flush with the skin, 4-5 days prior to extraction. At the end of three to four days, the actively growing hair is easy to identify due to their increased length. If telogen hair is successfully extracted it will be bulbless hair and if transplanted will grow villous or thin hair if at all it ever grows.
6. Pre shaving pinpoints body donor hair whose growth cycles are more closely synchronized. Transplanting these hair
results in a closer synchronization of the growth and synchronized shedding
phase of these hairs at least, in the
initial growth cycles. However, over couple of years, as the hair go
through repeated growth cycles, the growth phase of these transplanted body
hair lose their synchronicity. Without preshaving and selection of only non
growing hair, a certain proportion (perhaps 10-30%) of the early anagen
hairs could be mistaken for telogen hair because of factors like clear
bulbs that are yet to get pigmented.
7.
Positioning of
surgeon and also that of patient varies greatly from one area of body to that of other and even in
the same area due to variable direction of hairs the angling and direction of
instrument keeps changing unlike in case of scalp hair extraction.
8.
It has been said that the rate of growth: Body hair grows about 0.2 mm per day while scalp
hair grows about .44 mm per day. The same body hair transferred to the scalp
grows about .34 mm per day.
9.
predictability
of growth- somewhat less than the
scalp hairs
10.
Mix the
various body as well as scalp donor hair in any particular area of scalp to achieve a uniform look and feel
Friday, April 16, 2010
Masturbation does it cause Hair loss or baldness?
well research has shown that it is not masturbation or sex that increases the testosterone level but it is the abstinence ( staying away from sex) that may raise the level of testosterone ( check this link: http://www.ncbi.nlm.nih.gov/pubmed/11760788?ordinalpos=16&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
On the contrary it is the raises Testosterone level that may induce Masturbation or sexual urge.
On the link that you have sent if you read in the website on this page ( http://www.herballoveshop.com/product.asp?PID=1007) you find this:
-->On the contrary it is the raises Testosterone level that may induce Masturbation or sexual urge.
On the link that you have sent if you read in the website on this page ( http://www.herballoveshop.com/product.asp?PID=1007) you find this:
"The
essential ingredients in MoodMax help the liver excrete the excessive hormones
which are very harmful to cells. Binding of excessive testosterone, DHT or
estrogen to hair roots or hormone receptor cells causes hair loss or alternates
genes for the malicious development"
-->Thursday, April 8, 2010
Mesotherapy for Hair Loss and Baldness
Mesotherapy (from Greek mesos, "middle", and therapy from Greek therapeia, "to treat medically") is a non-surgical cosmetic medicine treatment. Mesotherapy employs multiple injections of pharmaceutical and homeopathic medications, plant extracts, vitamins, and other ingredients into the subcutaneous fat. Dr. Michel Pistor (1924-2003) performed clinical research and founded the field of mesotherapy. There is no conclusive research proof that these chemical compounds work to target adipose (fat cells) specifically. Some physicians[have expressed concern over the efficacy of mesotherapy, arguing that the treatment hasn't been studied enough to make a determination. It is expressed by Rod Rohrich, M.D., Chairman, Dept. of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas: "There is simply no data, no science and no information, to my knowledge, that mesotherapy works,"
For experiences of Mesotherapy one can refer to this link as well: http://www.realself.com/Mesotherapy/reviews
Besides ineffectiveness the possible allergy and long term side effects of the drugs are never studied well. More over it is advised to be taken and continued at few weeks interval for maintenance
Usually by a thin needle of 30 number gauge either manually or by a mesotherapy computerized mesogun aided injection (or as some people use dermaroller which makes tiny tunnel to channel the drug in the skin) of liquid containing vitamins, minerals and hormones or in case of hair loss treatment Finasteride or Minoxidil area injected in subdermal layer in a very small quantity at say every 1 cm distance of the bald area of scalp Skin. It is said that Vit. B 6 or pyridoxine, Azailic acid and Zinc are found to be 5 alfa reductase enzyme inhibitors (and in turn DHT inhibitors) in some research and some people inject these molecules as well. There is although always a concern of Hypotension ( drop in blood pressure) if Minoxidil is directly injected as it is the Hypotensive medication when given systematically. Finsteride has not been found to be effective locally any ways. These appear to be just claims rather than good science in this treatment, so one should be cautioned about this. In case od Dermaroller the needles penetrate the stratum corneum, the hard outer surface of the epidermal layer of the scalp.It is claimed that hundreds of tiny channels are created through the stratum corneum, which facilitate the passage and absorption of Minoxidil into the dermis to maximize it’s absorption by the hair follicles. The Derma Roller also stimulates blood flow to the hair follicles via direct scalp massage. The dermal damage induces the release of growth factors that stimulate the production of new collagen and elastin and stimulates the miniaturized hairs to grow stronger.
Besides ineffectiveness the possible allergy and long term side effects of the drugs are never studied well. More over it is advised to be taken and continued at few weeks interval for maintenance
Usually by a thin needle of 30 number gauge either manually or by a mesotherapy computerized mesogun aided injection (or as some people use dermaroller which makes tiny tunnel to channel the drug in the skin) of liquid containing vitamins, minerals and hormones or in case of hair loss treatment Finasteride or Minoxidil area injected in subdermal layer in a very small quantity at say every 1 cm distance of the bald area of scalp Skin. It is said that Vit. B 6 or pyridoxine, Azailic acid and Zinc are found to be 5 alfa reductase enzyme inhibitors (and in turn DHT inhibitors) in some research and some people inject these molecules as well. There is although always a concern of Hypotension ( drop in blood pressure) if Minoxidil is directly injected as it is the Hypotensive medication when given systematically. Finsteride has not been found to be effective locally any ways. These appear to be just claims rather than good science in this treatment, so one should be cautioned about this. In case od Dermaroller the needles penetrate the stratum corneum, the hard outer surface of the epidermal layer of the scalp.It is claimed that hundreds of tiny channels are created through the stratum corneum, which facilitate the passage and absorption of Minoxidil into the dermis to maximize it’s absorption by the hair follicles. The Derma Roller also stimulates blood flow to the hair follicles via direct scalp massage. The dermal damage induces the release of growth factors that stimulate the production of new collagen and elastin and stimulates the miniaturized hairs to grow stronger.
Saturday, April 3, 2010
Why male pattern hair loss occurs on the top horse shoe area of scalp?
The Pattern loss is genetic hair loss where the hairs at the top central and horse shoe shaped are is where the hairs gradually miniaturize and die because these hairs are Genetically Hormone (5DHT) sensitive. This is the reason this hair loss is also called Andro Gentic Alopecia (AGA).
When the head is developed from embryo the frontal and parietal bone area of the head has migrated Neural crest tissue but the occipital and temporal bone area ( back and side of the head ) does not have this tissue of origin. It is believed that certain genes responsible for AGA affect only these hairs which are having Neural crest origin and the area at the back and sides escape the effect of these genes.
Friday, April 2, 2010
Turban Alopecia in Sikhs
slow process but it can be irreversible.
Sikhs
males have religious reasons not to cut their hairs throughout the life. The
long hairs are kept hidden under their turban after winding them in a ‘Rishi knot’. It is an irony that this
long hairs due to constant traction on the root due to this knot result in
premature hair loss over the years. This especially happens in the frontal and
temple area where the traction stress is maximum. This is common to all those
Sikhs round the world may be in millions. It's a subject rarely discussed
because it's relatively easily hidden, but hair loss is a big problem among
Sikh men and covering it up doesn't take away the associated distress.
Traction
alopecia can be exacerbated by the ritual combing of the hair. This can be
alleviated by straightening out the hair and working through tangles with the
fingers before combing, thereby reducing the pull of the comb. It's important
to keep the hair soft and in good condition even if you're not worried about
other people seeing it.
To prevent this problem, I
would advise avoiding unnecessary stress on the hair by winding the
‘Rishi’ knot less tightly. The
problem is not with wearing the turban, but with improper hair care. Hair
must be combed down at night and then joora
retied in the morning. Keeping joora tied all the time does not allow hairs to
relax properly.
Use a
light fabric and only use as much fabric as is absolutely necessary to contain
the hair. The weight of extra fabric will put added strain on your hair. Be
careful not to bind the turban too tightly - it's better to secure it with
grips further back on the scalp if necessary, as hair is most vulnerable toward
the front of the head. With Be careful to position your hair directly on top of
your head before you bind it. This will enable your head to support most of the
weight of your hair directly when you are upright. If you tend to lean
backwards when sitting, be careful to keep your head upright.
Some
Sikhs who suffer from traction alopecia choose to give up on wearing turbans
altogether and to keep their hair in pony tails instead. If you do this, make
sure that you don't draw it back too tightly from your head and that you secure
it loosely.
It is
interesting to note that traction alopecia often occurs as a result of various
headwear and hair styles, including hair extensions, wearing tight ponytails
and wearing tight fitting-hats.
But if
you take care to look after your hair and bind it appropriately, you are likely
to be able to keep much of the length of it at the back for most of your life.
As a permanent solution to restore hair, hair Transplant is recommended as it is not possible to medically
restore lost hair as shown in one of my patients.Turban Alopecia in Sikhs
Although
Sikh men are as susceptible to other forms of hair loss as anyone else, they
commonly suffer from what is known as traction alopecia. This occurs when the knotting
of long hair pulls on the hair over time so that its roots are damaged. It is
different from pulling hair out accidentally when taking the turban on or off.
It is a slow process but it can be irreversible.
Sikhs
males have religious reasons not to cut their hairs throughout the life. The
long hairs are kept hidden under their turban after winding them in a ‘Rishi knot’. It is an irony that this
long hairs due to constant traction on the root due to this knot result in
premature hair loss over the years. This especially happens in the frontal and
temple area where the traction stress is maximum. This is common to all those
Sikhs round the world may be in millions. It's a subject rarely discussed
because it's relatively easily hidden, but hair loss is a big problem among
Sikh men and covering it up doesn't take away the associated distress.
Traction
alopecia can be exacerbated by the ritual combing of the hair. This can be
alleviated by straightening out the hair and working through tangles with the
fingers before combing, thereby reducing the pull of the comb. It's important
to keep the hair soft and in good condition even if you're not worried about
other people seeing it.
To prevent this problem, I
would advise avoiding unnecessary stress on the hair by winding the
‘Rishi’ knot less tightly. The
problem is not with wearing the turban, but with improper hair care. Hair
must be combed down at night and then joora
retied in the morning. Keeping joora tied all the time does not allow hairs to
relax properly.
Use a
light fabric and only use as much fabric as is absolutely necessary to contain
the hair. The weight of extra fabric will put added strain on your hair. Be
careful not to bind the turban too tightly - it's better to secure it with
grips further back on the scalp if necessary, as hair is most vulnerable toward
the front of the head. With Be careful to position your hair directly on top of
your head before you bind it. This will enable your head to support most of the
weight of your hair directly when you are upright. If you tend to lean
backwards when sitting, be careful to keep your head upright.
Some
Sikhs who suffer from traction alopecia choose to give up on wearing turbans
altogether and to keep their hair in pony tails instead. If you do this, make
sure that you don't draw it back too tightly from your head and that you secure
it loosely.
It is
interesting to note that traction alopecia often occurs as a result of various
headwear and hair styles, including hair extensions, wearing tight ponytails
and wearing tight fitting-hats.
But if
you take care to look after your hair and bind it appropriately, you are likely
to be able to keep much of the length of it at the back for most of your life.
As a permanent solution to restore hair, hair Transplant is recommended as it is not possible to medically
restore lost hair as shown in one of my patients.Saturday, March 27, 2010
FUE and lateral damage
FUE Technique is sufficiently advanced now so that to avoid less trauma to not only the follicular unit to be extracted but also to the follicles around that. The strip method in fact while cutting out the strip and then while making the slivers and then cutting the individual grafts from the slivers can damage more number of grafts than done by individual follicular extraction.
1. When follicular units are extracted the cut is only made till the level of sebaceous glands and the part of the follicle below that level which is harboring stem cells and is important for the growth is not touched with knife by the techniques that we use so not only the follicle to be extracted but follicles around that are not damaged.
2.The lower part of the follicle is any way loosely attached to the surrounding and easily come out without cutting.
3. More over we use tumescence ( inflate tissue with saline) this separates the follicular units from one another so that while extracting one the other does not come in the way.
4. We use smaller punches with 0.75 to 1mm diameter which which avoids the lateral trauma to the surrounding follicles check the attachment.