*My hair is falling out in clumps. Will I get it back?
*My mother’s hair went very thin during the menopause. Will it happen to me too?
*Is hair transplant just for men?
Far from our being resigned and suffering hair loss in silence, trichologists, specialists belonging to the branch of tricólogos, rama de la Dermatology that focuses upon the study and treatment of hair loss, remind us that science provides us with medical, cosmetic and surgical solutions to alleviate the effects of evident loss of hair. “In the consulting room we have to act rather like psychologists. The woman who comes to us with a serious problem of hair loss feels depressed, excluded from society and tends to cut herself off.
But solutions exist and then it is very gratifying when in 3-4 months, our patients see that they look much better, note the clinical improvement and say to you: ‘you have changed my life’”, explains Dr. Meyer, of the Capillary Dermatology Unit of HC Marbella, pioneer in Spain in hair transplants. The first thing is to make the correct diagnosis. “Hair loss is not only caused by a lack of iron or minerals as a result of a poor diet, but it may be caused by hormones and so require a full study”.
Some years ago, even Caroline of Monaco suffered alopecia areata, the loss of hair in patches/locks which may be associated with periods of acute physical or psychological stress. This may act as a trigger of the disease, which has an autoimmune basis. Once the crisis is over, the hair grows again quite normally, in most cases.
Overuse of extensions or wearing tight plaits may cause alopecia through pulling. This is the case of top model Naomi Campbell, who has a fair expanse of hair missing from her forehead. It is one of the forms of female alopecia, though the most frequent are telogen effluvium (transitory hair loss through psychological stress, physical stress after surgery, a hospital stay or a resulting pathology; after giving birth or through poor diet) and androgenetic alopecia, which is caused by hormones.
As we said before, effluvium is the most frequent cause of hair loss in women. One of the causes is childbirth. It is quite normal to suffer a period of telogen effluvium after giving birth. The hairs that did not fall out during pregnancy suddenly drop out about two to three months after the birth, which alarms the patient. However, they usually grow back within a few months, in some cases without treatment, but in others medical treatment may be required.
Androgenetic alopecia is, though, the baldness that most obsesses women because the hair that is lost does not grow back. It is a chronic alopecia. According to the Spanish Tricology Group, it affects 35% of women at age 50, as they see how their hair is beginning to thin on the top of their head.
The treatment usually includes topical solutions of Minoxidil at 2%- 5%, ofinasteride 0.5-1% and, “in the case of women, good results can be obtained with oral contraceptive pills alone or associated with oral antiandrogen medications. However, there are new therapies being used that are showing good results in clinical practice, such as the use of dutasteride in mesotherapy (in micro-injections directly into the area to be treated), specially apt for those patients who suffer side effects caused by oral antiandrogen medicines or in combination with other treatments, notes Dr. Mota, a dermatologist at the Capillary Dermatology Unit of HC Marbella.
There are complementary treatments such as PRP: PLASMA RICH IN PLATELETS. This treatment consists in the use of platelets taken from the patient in order to stimulate the growth and thickness of the hair. The use of platelet serum in medicine and its benefits in the regeneration of tissues have been known for several years. The plasma with the growth factors goes straight to the hair follicle and contributes to the regeneration of the hair, since its application on the tissues promotes the formation of collagen and the appearance of new blood vessels vital for the stimulation of new hair growth, explains Dr. Alcaide of the Capillary Dermatology Unit of HC Marbella. It consists of micro-injections of this plasma rich in platelets directly into the scalp. It is used for areas where there is still some hair, but also baldness, in order to stimulate the growth of the hair and its thickness. It is a process that is performed for outpatients and can be carried out in the consulting room.
Then the remaining option is surgery: an autologous hair transplant. There are two techniques: one is the FUSS method (from the English, Follicular Unit Strip Surgery), in which a strip of skin with hair is extracted from the nape of the neck and the side of the head (a strip of scalp that goes from ear to ear); this strip is cut under the microscope, separating the piece into individual follicular units and these separate units are implanted one by one in the area where there is no hair. The other is the FUE technique (Follicular Unit Extraction): unlike the strip, in this case, the follicular units are extracted one by one directly from the scalp and are implanted also one by one in the bald area. It is the most advanced technique, and the one most practised today, since it avoids leaving a scar on the scalp, though in fact, with the two techniques we get the same results in the transplant, adds Dra. Mota.
The future is follicular cloning: “Research is being done into cloning follicles, but it is still in its infancy! It would be a great advance because we would no longer be conditioned by the quantity of hair in the donating area, that is, by our “reserves of hair”, which at present are limited, explains Dra. Meyer.
Let us study your case. Our specialists at the Capillary Dermatology Unit at HC Marbella will evaluate your it and tell you if you can benefit from any of the treatments available.
There are many alternatives for alopecia. Don’t give up hope!
Fuentes: Dra. Mota / Dr. Alcaide / Dra. Meyer.
Unidad de Dermatología Capilar HC Marbella.
Grupo Español de Tricología AEDV
April 1, 2019
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