Tonsure or head shave does it help hair growth?

Well there is religious reasons why many people tonsure there head ( in Hindus at times it a sacrifice of symbol of aeasthetics esp. in females). But it is a common belief esp. in some parts of India that if you are losing hair and have thin baby hairs and if you repeatedly shave your head you may grow new hairs or better hairs.
Well shaving or tonsure is only external to skin and does not directly affect the roots which are responsible for the hair growth. The hairs outside the skin does not get the blood supply or nutrition and does not even have any repair capacity and may even be affected by environment.
By removing the outside hairs you are not actually stimulating hair follicle to grow hair. As in case after of shaving of the beard hair the initial stubble feels thorny strong and sharp the initial hair growth after shaving of the head feels thorny sharp and that has perhaps given this belief. But within few days again when the hairs grow little longer that feeling disappears.

Perhaps the benefit of shaving head is the ease of using or applying Minoxidil. Other thing is the illusion of less hair fall because the small hair are not visible when they fall but the long hairs are apparently visible. So person with shaved head or short hair may be psychologically benefited.

In some religion young babies are tonsured with the belief that it will grow new or better hairs. This is not true. In many religions they do not tonsure/shave off their child's hair. At 1 year, the babies usually get mature hair with baby hair falling off. On the other hand, it is know of kids who still have baby hair even after a few tonsures. Shaving does not help hair growth is controlled by genes and hormones.

Trichophytic Closure

In the Strip Surgery (FUT /FUSS) after removal of the hair bearing strip of skin from the back side the gap is closed by stitches or by staplers. Well the suture mark or linear scar due to this remains permanently in the donor area and very often remains visible if the hairs are kept short or the scar becomes wide.

 


This linear scar does not grow the hair and therefore the scar visibility of this hair less line is more with wet hair, oiled hair or short hair. Trichophytic closure is a special technique of closure of the gap. The advantage of this closure is the linear scar of stitches will grow the hairs though it and therefore the line has a better concealing capacity even when hairs are short or wet. This is because the technique brings the hair roots ( Follicular Units) under the stitch line; as a result the hairs grow through the linear mark.If done properly, and the outcome successful, the hair growing through the scar will camouflage the typical straight linear appearance of the scar. What this means is that the scar will still be present but less visible. The quality of the scar may also improve with this closer.Generally, after the fourth post-operative month, trichophytic closure yielded better cosmetic results than subcutaneous closure.

There are 4 methods which involves trimming off the upper edge of the incision and then closing the wound in such a way the hair near the edge can grow through the scar. The skin is de epithelized to less than 0.5 mm so as not to damage the sebaceous glands and stem cells close to bulge and remove the burial of epithelium ( Best executed by Dae-young Kim technique)  1. Upper edge  (Marzola) 2. Lower Edge ( Fretchet) 3. Lower edge ledge ( step) shaped trimming ( Paul Rose) 4.  Both upper and lower edge trimmimng (Kazuhito Yamamoto)

Well some times because of partially cut Follicular Units at the edge of the wound cyst formation may be a problem in this closure. If due to fibrous skin or tension on the wound the scar line become wide the Trichophytic closure becomes ineffective in its purpose.when the hair is growing through the scar during the healing phase, there may be more inflammation and discomfort, ingrown hair, itching, scabs, numbness, pain, peri-lesional redness and edema as compared to the standard closure.It is a good policy to prefer not to use a trichophytic closure when it is anticipated that you will need several strips harvested over the long term, preferring to use the trichophytic closure on the “final” procedure.
 




It is not likely that the person will be able to shave their head without any apparent difference between the strip site and the non-scarred skin in the area. The reason for this is that the scar tissue is still somewhat different in appearance from non-scarred skin and there is a subtle but definite change in the direction the hair that grows through the scar making the scar line stand out from the surrounding scalp.It becomes very difficult sometimes to use this technique when the pt. has had previous work and we are struggling to obtain enough grafts and still be able to close the incision without excessive tension. Since you have to overlap the incision by 1-2 rows of follicles, there has to be enough elasticity to safely close the incision. If there isn't, the patient must decide what is more important too him, more grafts or a trichophytic closure. the trichophytic closure transects hair follicles this results in no better than a 60% survival rate in the donor area scar. It kills hair. It has been also claimed that the trichophytic closure is a sales tool for strip surgery for those who do not want to offer FUE.

AHRS meet at Mt. Abu ON 11TH SEPTEMBER

At the 2nd Annual scientific meet of Association Hair Restoration Surgeons (AHRS) of at Mt. Abu ON 11TH SEPTEMBER DR. Mahadevia presented his 2 PAPERS 1. various techniques and instrumentation of FUE ( FOLLICULAR UNIT EXTRACTION) and 2. Can FUE megasession replace Strip method in Future? Both papers were highly appreciated by eminent faculties from India and Abroad and Dr.Mahadevia was personally congratulated by many about the high quality of the papers. The PowerPoint presentations can be viewed here

Dilemma fue

View more presentations from DrBishanMahadevia.

Fue megasession

Video of FUE on Unshaven Head by Dr. Mahadevia