BHT after 1 year video- Presentation Surat GAPSCON 2012 at Surat

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Dr. Mahadevi'a  was invited for presentation of his work on Body Hair Transplant on 19th February 2012:

Follica may be next breakthrough in hair growth treatment?!

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Follica has raised money to begin a human trial of its hair cloning technology. According to the company’s website, the company has obtained “an exclusive, worldwide license from the University of Pennsylvania to develop and commercialise a breakthrough technology that has been demonstrated to stimulate the genesis and development of new follicles.” It is announced it had completed a $5.5 million Series A financing round.

Is this a first successful Human Hair cloning?

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Scientists in Berlin have used human adult stem cells to develop hair follicles using 3 D Biodegradable Scaffold, from which hair then grows naturally. The treatment provides new hope for people suffering from hair loss.Only a few hair follicles would need to be taken from the"patient"and used to generate as much new hair as is needed, which can then be grafted.
check this video:
http://youtu.be/iAS_k1IrJpA

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Restoration Robotics, Inc., MOUNTAIN VIEW, California, a medical device company, has on 14th March 2011 announced that they have received 510K clearance from (FDA) for a ROBOT  for harvesting hair follicles from the scalp in men diagnosed with androgenetic alopecia (male pattern hair loss) with black or brown straight hair.  The name of the Robot for this technology is ARTAS™ System.

ARTAS™ is a physician-controlled, state-of-the-art, interactive, computer-assisted system that enables harvesting of hair follicles during hair restoration procedures. It combines several features including a video image-guided robotic arm, special imaging technologies, small dermal punches, force sensor, robotic arm,and a computer interface. The ARTAS™ System is capable of identifying and harvesting individual follicular units to implement the follicular unit extraction (FUE) technique. The software that runs the instrument helps the surgeon target follicular units for extraction and also uses stereoscopic video images to guide the needle mechanism and robotic arm.

The robotic harvesting technique resembles that of follicular unit extraction ( FUE). The donor area, as in FUE is cropped to short length to enable the stereo camera system to visualize hair follicles. The imaging algorithms are capable of identifying follicular unit, determining their type (1 hair FU, 2 hair FU, 3 hair FU etc.) and calculating the angle, orientation & location of each follicular unit on the scalp surface. Using this position  & location data, the imaging system semi autonomously guides the robotic arm & mechanism to core & extract follicular units one at a time; The punch size is 1mm in ID. The coring of the follicular units is enabled by a proprietary punch designed that aims to minimize transaction rate. The system, using a feature called visual servoing, continuously tracks & adjusts to patient movement so that harvesting of targeted follicular units is precise. Based on inputs by the user, the degree of automation can be adjusted, e.g. the system may be configured to harvest 10-20 grafts sequentially. The harvested follicular unit may then be automatically transported to a vial where it is kept moist and cool. It may be possible to achieve harvest speed of up to 1000 grafts in an hour.

The Benefits
There is growing interest in FUE because of its many patient benefits, such as less discomfort and a quicker return to normal activities. The ARTAS™ System solves many of the technical challenges experienced by physicians currently attempting the FUE procedure which gives physicians and patients new choice. Rapid healing and lack of a linear scar, which makes this procedure different from the strip method.

Limitations:
The Robot is approved for only straight back and brown hairs and for those with curly , gray or blond hair may have to wait for some later date.

On a personal communication it was mentioned that the system may harvest up to 1000 grafts in an hour with Transaction rate under 6%.

For more :    www.restorationrobotics.com.

Effect on Graft survival of Dense packing

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Check this research paper: double click the picture to read it in separate view

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Well we can do up to 60 per sq. cm but we do not recommend it because of significantly reduced survival rate if transplanted over 30 per sq. cm. Check the attached pdf file of the research paper: For example, if grafts are placed at a density of 50 FU/cm2 but only grow at a density of 40 FU/cm2, the results would still look good to the eye because a density of 40 FU/cm2 looks good. However, in reality this represents a loss of 20 percent of the grafts, which is unacceptable in hair transplantation due to the limited donor supply.

Transplanting Crown

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Transplanting in crown with early hair loss has following drawback in your case at this stage and age of hair loss;
1. The miniaturized weak existing hairs in this area may not be able to sustain the surgery and some of them may be lost sometime after this procedure ( shock loss)
2. The Transplant may be possible between the existing hairs so we can only put small number of hairs without damaging the existing hairs
3. If you lose more hair in future around the area of transplant you will have central are of transplanted hair with surrounding halo of no hairs ; this will not look natural.
4. You can certainly improve the area by use of medications then why you need surgery?

 Photo from: http://www.bernsteinmedical.com/hairtransplantblog/can-the-hair-grafts-be-packed-together-densely/

Astressin-B Potential new treatment for hair loss & gray hair

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According to an article published in on line journal Plosone.org Million Mulugeta, D.V.M., Ph.D., co-director of UCLA’s preclinical stress biology research program at the University of California, Los Angeles, claim that they have uncovered a promising hair-loss treatment & may have the potential to affect hair color, including gray hair..

The experiment wasn’t focused on hair loss. Instead, it was designed to study a chemical compound that blocks the effects of stress on the gut.

The research team, during a study of the effect of a compound called Astressin-B while conducting stress-hormone experiments on mice that typically develop head-to-tail baldness as a result of being genetically altered to overproduce a stress hormone (The mice used in the experiments had been genetically altered to overproduce a stress hormone called corticotrophin-releasing factor, or CRF. Corticotropin-releasing factor over-expressing (CRF -OE)-mice that display phenotypes of Cushing's syndrome and chronic stress, including alopecia. CRF-OE mice develop bilateral symmetric hair loss in adulthood). The goal of the experiments was to study the effect of Astressin-B ((5 µg/mouse) injected peripherally once a day for 5 days) to determine whether it would block the effects of stress on the colon but accidental finding was the mice treated with Astressin –B had recovered the full cover of fur on the back in few weeks compared to the placebo ( injected with saline) given mice which did not recover. A sterssin-B induced pigmentation and hair re-growth that was largely retained for over 4 months (a significant period for average 2 years life of mouse) when mice were killed Histological examination indicated that alopecic CRF-OE mice had hair follicle atrophy and that Astressin-B revived the hair follicle from the telogen to anagen phase.

The team repeated the experiment several times and got the same results — bald mice grew new hair in a few weeks. The researchers also injected the compound into young mice before they went bald. Those mice never lost their fur.

The researcher said the compound appears to have affected the mice skin pigment as well as spurred hair growth. This could mean Astressin-B has the potential to affect hair color and gray hairs. Majority of Pigments were regained by about 1 week and the hair was regained by about 2 weeks

Temporary blockade of the CRF receptors could thus be a breakthrough therapy for alopecia particularly for patients in acute (chemotherapy, traumatic stressful events) or chronic stress setting.

Findings of a mouse study may not be applicable to humans, but results may spur more study of the role stress might play in human hair loss. Hair growth cycles are very different in mice and humans, so one could draw only limited conclusions from the research

The research would probably be useful only for hair loss related to stress, likes that caused by one-time events, rather than as a treatment for genetic baldness.

 

REGENERATIVE MEDICINE & STEM CELL THERAPIES- EMERGING FIELD IN HAIR RESTORATION

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Scalp cloning vs. Hair cloning?

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Your thought is ingenious but the scalp transplant would involve very major surgery under general anesthesia with higher risks. More over it will have circumferential scarring, which may not look natural.

 



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Warning for the use of Minoxidil!

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Well The reason they write not to use on shaved head is if you are having sensitivity to minoxidil and if you are exposing your shaves head to sun for long time there may be irritation. Although this is not very common but if you are having sensitive skin and if you have more sun exposure you may not apply Minoxidil with shaved head. Shaved head infact makes the application easy and with direct application on long hairs can make your hair stiff and the crusting on the scalp under the hair may not be easy for you to remove.

Same way hair loss can be due to many reasons some skin conditions with hair loss may have more skin irritation if Minoxidil is applied and therefore  it is best suited for hair loss such as Androgenetic alopecia ( male pattern baldness or common baldness) . Because this common baldness has some link to father or mother side genetically it is written on the information leaflet given with minoxidil that  those with no family history of hair loss may not use it. Since you certainly have a pattern hair loss it is Ok for you to use it without any problem. In fact it is the right indication for minoxidil

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Donor recharging, Donor Sealing or Donor Farming

"Recharging donor" area which is also known as "Donor sealing"  even called "Donor Farming" is not new by concept and some surgeons have even practiced this in past. The typical indication would be
1. When surgeon has by poor & aggressive planning over harvested a particular area of donor scalp and that looks thin compared to other parts of donor area. The best way to recharge is to take anagen BHT. When well performed there is no reason why BHT would not grow.
2. When the shock loss has occurred in donor area where hair does not grow back
3. when patient wants to keep the hair very short and want to avoid visibility of dotted scars. The transplanted BHT will bring back the pigments to the donor area and reduce the visibility
4. It may be useful esp. if someone wants to intentionally over harvest good quality scalp donor hair for better cosmetic result in the front and therefore replace donor with BHT instead of using BHT at the front or top.

More over when donor recharging done in the fresh wound immediately after extraction would cause higher chances of BHT growth rather than recharging done in the previous FUE scar with reduced blood supply.

Concealer or Hair Thickening Cosmetics

Toppik, Dermmatch or Nanogen are the Hair cosmetics or concealer which by static adhesion to the existing thin hair will thicken the hair and also by covering the skin reflect no light there by it can give the better cover and volume to the hair thinning area.



Hair thickening Fibres ( Nanogen, Toppik, Hair Magic), particles (DermMatch) , spray  (ProTHIK, Fullmore, Mane), scalp colour cream (COUVRe) or tattoo (Dermography) is temporary (party) solution.

It may have some value in early thinning and in post hair transplant early growth phase.

They are very inert material and would not harm your skin and hairs even on long term use. You can get more info on www.toppik.com , www.dermmatch.com or www.nanogen.com. They can easily be removed on shampoo wash.

Because these products are directly available on their website located abroad when some people in India may want to buy this in India following is the contact details in India:

1. Toppik powder in India: http://www.nutraskyncare.com/

Midas Chamber 301,
Opp. Laxmi Industrial Estate,
Off New Link Road,
Andheri , Mumbai – 400053.
Tel: 0226740022/32428898E-mail:- sales@nutraskyncare.com

2. Nanogen Powder

Telephone : 0-98241-46737 Email : admin@nanogenindia.com  

3. Hairouse Powder: ( More economical of the 3 )

 Nithyasha Health Care , 14, Rukimini Niwas, Gogtewadi,Senapati Bapat Marg, Mahim 16, Tel 224225096, 224225296, 09224585251

 
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Ferritin and Hair Loss in woman

Low serum ferritin hair loss?

Iron deficiency is defined as having a ferritin level of under 40ng/ml or iron saturation of Ferritin under 20%.

Iron deficiency is the most common cause of Chronic Telogen Effluvium ( CTE) in premenopausal women ('During one period, a woman will lose around 10-15 mg of iron, while throughout a pregnancy around 600-1000mg will be lost) . 72% of women in the premenopausal group were found to have iron deficiency as the cause of Chronic Telogen Effluvium (CTE).

In postmenopausal women; medications are the most common cause of telogen effluvium.

The loss of this ferritin from the follicle cells can affect the ability of the hair to grow. This leads to the development of vellus (non pigmented fine hairs), which can be an early indication of deficiency. The presence of vellus hairs is easily mistaken for miniaturized hair seen in androgenic alopecia. We should note here that Iron deficiency hair loss could therefore mimic the pattern of androgenic alopecia hair loss.

When low ferritin levels and female hair loss coexist, the patient is most likely diagnosed with Chronic Telogen Effluvium, or CTE. This hair loss condition usually occurs in women of childbearing age (18-50 years old), and results in evenly-distributed hair loss. Women with low serum ferritin hair loss usually notice one of two things:

• Increased loss of hair during shampooing or brushing.
• Less density of hair, as in a thinner feeling ponytail, or less hair to clip back.

If iron levels are insufficient to maintain blood health, the body "robs" iron from other cells. Since hair is not as essential to the body as is blood, the body often sacrifices the less important function of hair growth for the essential function of blood maintenance.

It is important to note that hemoglobin is the standard measure for iron in the blood, and while hemoglobin levels can diagnose anemia, they do not always correspond with low serum ferritin hair loss. A woman can have plenty of hemoglobin, yet still suffer from low serum ferritin levels

Rushton suggests that serum ferritin concentrations of 40 ng/mL or greater are required for maintaining good hair while 70ng/ml is required for regrowth

Iron metabolism

 

Total body iron averages approximately 3.8 g in men and 2.3 g in women.

Typically about 65% of the iron is in hemoglobin (in red blood cells) and about 4% in myoglobin (in skeletal muscle). About 30% of the iron in the body is stored (as ferritin or hemosiderin) in liver, bone marrow, and the spleen other tissues cells. A small percentage of the body's iron is in transport between various compartments of the body (in association with transferrin) or is a component of enzymes in cells throughout the body.

 Ferritin is a protein complex that contains about 23% iron. It's formed in the intestine when iron unites with a special protein called apoferritin. It is then stored in the body's tissues, especially the liver, spleen, and bone marrow.

Iron Deficiency and Ferritin:

Iron is stored mainly in the liver, within the iron storage proteins ferritin and hemosiderin. Iron stimulates the liver to make ferritin, and serum ferritin provides a reliable estimate of body iron stores. Ferritin is a protein found inside cells that stores iron so your body can use it later. Some Ferritin is released in the blood when the cell uses the iron. The amount of ferritin in your blood (serum ferritin level) is directly related to the amount of iron stored in your body.

Lower-than-normal levels may be due to:

• Heavy menstrual bleeding
• Intestinal conditions that cause poor absorption of iron
• Iron deficiency anemia

The fall of iron stores normally passes through several stages: lowered iron stores, iron depletion and iron deficiency anemia.

1) Lowered iron stores: This is indicated when the iron stores are reduced but not exhausted. No clinical effects are detected.
2) Iron depletion: Shows up in laboratory tests. Hemoglobin concentration may be well below ‘normal’ for that individual’s reference range. This can be detected by Ferittin Test.
3) Iron deficiency anemia: No iron is left remaining in the bone marrow. Hemoglobin production falls to the point where concentration is well below the reference range.

It is important to note, therefore, that iron deficiency (low iron stores, i.e. low ferritin) can occur even if the patient is not clinically anemic and has normal haemoglobin levels

The deleterious effects of iron deficiency are partly due to impaired delivery of oxygen to the tissues and to a deficiency of iron-containing compounds. Clinical features include restlessness and irritability lower IQ scores in adolescent girls fatigue in nonanaemic women, and abnormalities in response to infection and impaired T-cell proliferation.

It is believed that as people have reduced or do not have red meat intake

There may be a number of reasons why the amount of iron absorbed is not sufficient. Firstly, only about 10% of ingested iron is absorbed into the blood each day, and this is dependent on the type of food in the diet. Certain foods may inhibit the absorption of iron, such as tanins found in tea and coffee, also bran and egg albumin.

One can lose iron by: intestinal bleeding, excessive menstrual bleeding, poor digestion, long-term illness, ulcers, and heavy use of anti-acids. [Irritable bowel syndrome too]

Controlling iron deficiency

You can maximize your iron absorption by eating a combination of iron-rich foods such as red meat, green, leafy vegetables, shellfish, egg yolk, nuts and cereals with food or drinks that are high in vitamin C for example, a glass of freshly squeezed orange juice.  Avoid tea until at least an hour after eating as it contains tannin, which interferes with iron absorption.

One method of controlling iron deficiency in the body is to stimulate the liver to synthesize ferritin, the protein that stores iron in order to maintain the correct balance. Hair follicles are known to contain ferritin, and when the circulating stores of ferritin decline then these stores are called upon to ensure support for more essential cells, such as bone marrow.

Treatment:

1.     Eat a balanced diet that includes plenty of iron. Sources include red meat, spinach, broccoli, prune juice, kidney beans and chickpeas.

2.     Add Vitamin C-rich foods to your diet to help boost absorption of iron: Vitamin C sources are citrus fruits and juices, berries, green peppers, tomatoes, broccoli and spinach.

3.     Iron supplementation. The use of an iron supplement may help low ferritin hair loss by adding more iron to your system. The rationale for iron supplementation is that once the serum level is raised to the necessary threshold point, hair growth will resume. However, one of the biggest drawbacks to this type of treatment is that it takes a long time, because ferritin levels must be increased gradually. Allow 2-3 months for hair to stop shedding, and 6 - 12 months for new hairs to become long enough to make a visible impact. Woman usually needs between 18 and 30 mg daily
Excess iron can accumulate in the body. This increases the risk of heart disease, cancer, and some other conditions that are worse than hair loss.
Many people find that eating red meat is a better option than pills when serum ferritin levels are low. The iron in red meat is absorbed well.

"If you need to take iron supplements, do not take them at the same time as vitamin E, Antacids, tea or coffee. And choose an organic form of iron such as ferrous gluconate or ferrous fulmerate. Inorganic forms of iron, such as ferrous sulfate, can oxidize vitamin E.  Only about 10% of ingested iron is absorbed into the blood each day, and this is dependent on the type of food in the diet. Take after food to reduce GI side effects. Continue treatment for 3 months after the hemoglobin reruns to normal so as to ensure replenish the storage.

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