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    THE DEFINITIVE GUIDE TO HAIR LOSS

EVERYTHING YOU NEED TO KNOW ABOUT HAIR LOSS

(AND HOW TO TREAT IT)

From age-old myths to the latest advancements, we’ve got you covered.

Taking care of your hair is more than a simple matter of vanity. Cultures around the world have placed a lot of value in hair, and today it links to confidence, self-image, and even good mental health.

It only makes sense, then, that hair loss is a genuine problem for the millions of people around the world who have to contend with it.

It’s normal to feel distressed, and it’s normal to find solutions to the condition—which is why we’ve prepared this comprehensive guide. It covers the nature and symptoms of hair loss in its most common forms.

Better still, it covers the many different forms of treatment available in the market; now that it’s 2019, baldness is optional.

I. WHAT IS HAIR LOSS

Hair loss is common, and you’re not alone

Millions of people around the world suffer from hair loss.

It’s a fact of life that two thirds of the male population will have to deal with by the time they reach age 50. Drastic baldness doesn’t necessarily come with age either, as studies show that around 25% of men with male pattern baldness will see symptoms before the age of 21.

On the other hand, roughly 50% of women will have to deal with hair loss over the course of their lives. It’s especially frequent in women over 40, women who wear their hair in tight ponytails, and women who have recently had children.

Hair Loss Statistics

Hair loss is a medical concern.

Hair loss is a broad term that covers a range of possible medical conditions, each with their own symptoms, causes, and treatments. The medical name for hair loss is alopecia, and it’s defined by the partial or complete absence of hair in places where hair would typically grow.

Hair Loss In Men:

The Norwood Scale

1. The first stage of male pattern baldness is a receding of the hairline, beginning at the temples.

The Norwood Scale

2. The second stage is known as type II baldness. During this stage, the hairline continues to recede and may be accompanied by thinning of the frontal area.

The Norwood Scale

2. The second stage is known as type II baldness. During this stage, the hairline continues to recede and may be accompanied by thinning of the frontal area.

The Norwood Scale

3. This pattern becomes more pronounced in the third stage: the hairline at the temples recedes further, and the frontal hairline may also recede.

The Norwood Scale

3. This pattern becomes more pronounced in the third stage: the hairline at the temples recedes further, and the frontal hairline may also recede.

The Norwood Scale

3. This pattern becomes more pronounced in the third stage: the hairline at the temples recedes further, and the frontal hairline may also recede.

The Norwood Scale

4. The deepening of the hairline at the temples combines with thinning at the crown and front of the head.

The Norwood Scale

4. The deepening of the hairline at the temples combines with thinning at the crown and front of the head.

The Norwood Scale

5. These processes continue at stage V with a tendency for the two balding areas at the front and back of the head to enlarge and run together.

The Norwood Scale

5. These processes continue at stage V with a tendency for the two balding areas at the front and back of the head to enlarge and run together.

The Norwood Scale

6. At stage six, the band of hair at the back of the head becomes narrower as more hair is lost from the crown.

The Norwood Scale

7. The final stage of alopecia in men is “Hippocratic” baldness, where only a low wreath of hair around the sides and back of the head remains.

Hair Loss In Women:

The Ludwig Scale

1-1 - 1-3. It begins with diffuse alopecia, a mild thinning of the hair, initially around the parting area, but the frontal hairline is unaffected

The Ludwig Scale

1-4 - 2-2. Thinning of the hair around the parting area worsens, hair loss is most obvious at the crown, but an unaffected band of hair that extends at least 3 cm behind the frontal hairline remains.

The Ludwig Scale

3. At the final stage, almost no hair remains along the parting, the alopecia extends over most of the crown, and although the frontal hairline remains, the band has narrowed to a depth of less than 3 cm.

It’s much more than a simple case of vanity, as hair loss—especially sudden and drastic cases—can lead to a decline in self-image, and potentially one’s overall mental health. Fortunately, specialist doctors can help you grow back your confidence.

A certain amount of hair loss is to be expected.

It might surprise you to know that the human scalp sheds up to 100 strands on an average day thanks to the natural cycle of hair loss—don’t worry, though, as natural hair fall follows an even distribution across the scalp.

Hair loss can be treated.

Even though hair loss may run in your family’s genetics, hair loss isn’t a life sentence. Scientists have been hard at work for decades looking for a solution, and this has led to some stunning medical breakthroughs.

II. THE EFFECTS OF HAIR LOSS

Physiological Concerns

It’s rare for hair loss to be the cause of other, potentially dangerous medical conditions. More often than not, it’s simply a gradual decrease in hair density along the scalp.

However, rapid hair loss in a short period of time may be a sign of conditions worth looking into, such as poor nutrition or a hormonal imbalance. In the event that you notice hair fall in large amounts over a short period of time, we recommend seeking the opinion of a doctor.

Impact on Mental Health

The effects of alopecia vary from patient to patient. Some may find themselves adapting quickly to the changes, while others might struggle with their new reality.

In some cases, those who suffer from hair loss may seclude themselves out of embarrassment, avoid social situations, or even experience depression.

The impact of the condition is closely tied to social norms. While both male and female hair loss patients have reported negative feelings, the emotional toll on women tends to be higher due to the external pressure to conform to (often unrealistic) beauty standards.

Conversely, people who are happy with their hair are likelier to be happy; a healthy body image corresponds with better mental health, and a more positive outlook on life.

Before & After

III. HOW HAIR SHOULD NORMALLY GROW

To better understand hair loss, it helps to understand the biology behind hair growth.

Hair growth begins with follicles, which are small organs found nestled along the dermis layer of the skin. Follicles cycle through three phases of hair growth: anagen, catagen, and telogen.

The Anagen Phase

The anagen phase is the growth phase of the cycle, during which our blood supply nourishes the roots of our follicles, allowing them to produce additional cells. As these cells accumulate, they eventually breach the skin and continue to grow outward - resulting in hair growth as we see it.

Anagen Phase Facts

The Catagen Phase

The catagen phase is the transition phase of the cycle, during which hairs are detached from the blood supply and growth comes to a halt. Hairs in the catagen phase are referred to as, “club hairs.”

Catagen Phase Facts

The Telogen Phase

The telogen phase is the resting phase of the cycle, during which the hair is considered dead and fully keratinized. Club hairs are dormant on the scalp, resting in their roots while new hair begins to grow beneath it. Eventually, the cycle ends as the dead hair is ejected from the scalp, leading to normal hair fall.

Telogen Phase Facts

IV. THE MOST COMMON FORMS OF HAIR LOSS

1. Androgenic Alopecia

Androgenic (or androgenetic) alopecia, also referred to as pattern baldness, is the most common type of alopecia. It affects roughly 50% of men by age 50, and around 25% of all women by age 50.

This condition is caused by a sensitivity to the hormone dihydrotestosterone (DHT). In people with pattern baldness, DHT binds with the hair follicles and shortens the anagen (growth) phase. This causes the follicles to grow shorter, thinner hairs and results in visible baldness.

There are various treatments for pattern baldness.

2. Alopecia Areata

Alopecia areata is an autoimmune condition where the body’s own cells mistakenly attack the hair follicles, preventing hair from growing. It’s characterized by round bald patches along the scalp of varying sizes, which may change in size and number over time.

Alopecia Areata

Cases of alopecia areata vary in severity. People with this condition may find themselves losing all the hair on their scalp (alopecia totalis), or all the hair on their body (alopecia universalis). In most instances, however, the affected area is limited to small, circular patches and can even go unnoticed in people with longer hair.

While the medical community has yet to determine the precise cause for alopecia areata, treatment for the condition exists in the form of steroid injections and topical agents like Minoxidil.

3. Telogen Effluvium

Telogen effluvium is a temporary form of hair loss that can happen due to a wide range of lifestyle factors. People who suffer from telogen effluvium experience shorter anagen (growth) phases, leading to a larger number of follicles entering the shedding phase at once (from 5-10% to a whopping 30%!)

Hair Loss

Among the many causes of telogen effluvium include:

 
Intense and prolonged stress
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Sudden weight loss and “crash dieting”
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A deficit in key nutrients (B-vitamins, iron, protein, and zinc)
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Certain medical and recreational drugs
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Pregnancy and childbirth
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Menopause
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Since telogen effluvium is a temporary form of hair loss, treatment usually involves addressing its underlying causes. Those with the condition are advised to seek counseling for stress-management, improve their diets, and in the cases of menopausal women, consider hormone therapy.

4. Other Common Forms of Hair Loss

There are plenty of other, less common forms of hair loss, and to cover them all would require a much longer article. These include fungal infections, traction alopecia from tight hairstyles and excessive hair-pulling, scarring alopecia from injuries to the scalp, and so on.

If you suffer from any kind of thinning or baldness (whether it was covered by this article or not), we urge you to consult with a medical specialist for a proper diagnosis.

For more information on the causes of hair loss, read this article.

V. DEBUNKING HAIR LOSS MYTHS

1. Baldness is Inherited from Your Mother

There’s a common misconception that baldness is inherited from the mother’s side of the family—likely because it was discovered some time ago that the gene for pattern baldness exists in the X chromosome, which is passed on by the female parent.

In truth, the gene that causes DHT sensitivity and pattern baldness is polygenetic, meaning both your parents’ genetics factor into your odds of inheriting the condition.

2. Wearing Hats Can Cause Baldness

Some believe that wearing hats can put a strain on a person’s hair follicles, causing an increase in hair fall.

Generally speaking, covering the head doesn’t automatically lead to hair loss, and most well-fitting hats come without the risk of baldness. Hats are fine as long as they’re clean and fit snugly without being overly tight (as tight hairstyles and headwear can cause traction alopecia).

Man In Hat

3. Gray Hairs Last Longer

Contrary to what some believe, gray hairs are not stronger or fated to last longer than hair that looks younger. All hairs follow the natural follicular growth cycle, regardless of their pigmentation.

4. Only Older People Go Bald

As we’ve mentioned earlier, baldness can happen to people as young as their early - to - mid twenties. While age does correspond with slower rates of hair growth, hair loss isn’t exclusive to those in their later years.

5. Hair Transplants are Just Hair Plugs

Hair transplants have come a very long way from the unsightly, plug-like grafts we’ve seen in the past. Today’s transplants feature much smaller grafts (under a centimeter in diameter!) and provide far more natural-looking results.

VI. TREATMENT FOR HAIR LOSS

Hair loss isn’t always a life sentence. For many, treatment options can go a long way towards restoring a youthful volume and density.

The following section covers a number of popular hair loss treatments, ranging from the cutting-edge to the timeless.

1. Finasteride

Finasteride is a popular treatment for hair loss treatment, known in many circles as the “gold standard” for hair loss prevention. Millions of men around the world take finasteride, with an estimated 90% of users undergoing some improvement in their hair loss.

Finasteride often takes the form of an oral tablet, and it works by blocking 5α-Reductase: the enzyme responsible for converting testosterone into DHT. Users often see improvement after 6 months of starting on the drug.

While finasteride has proven effective in many cases, one major drawback to the treatment is the fact that it has to be taken in consistent doses over a long period of time. It isn’t a one-and-done solution, but a regimen that demands commitment and adjustment.

2. Minoxidil

Minoxidil has been around for decades and is still the most tried and tested topical medication for androgenic alopecia. It helps to open up the blood vessels, which in turn nourishes the follicles for thicker growth.

The product is used (normally in 5% doses) as a topical lotion on the scalp, twice a day after cleaning the hair, and dries to an invisible film.

Occasionally, some scalps will develop some dryness or redness, in which case, reducing the dose with the guidance of your doctor is recommended.

3. Collagen Mesotherapy

Platelets are the component of blood that are primarily responsible for clotting, but also contain several growth factors when isolated from the red blood cells. These growth factors have been scientifically proven to improve the collagen, improve the collagen content of the skin, and improve blood supply.

The effect is significant hair growth, shine and thickness. The best evidence recommends three treatments spaced three months apart, and then quarterly thereafter. Most clinics will use painful intradermal injections straight into the scalp, but more sophisticated ones will use mesotherapy devices for improved comfort.

Platelet Mesotherapy
How are the white blood cells collected?

A small amount of your blood (10ml) is extracted into a centrifuge tube. It’s then centrifuged at 3400 revolutions per minute for 5 minutes, to isolate the plasma from your red and white blood cells.

How do the injections happen?
Platelet Mesotherapy Injection

To inject the platelets into the scalp, we use a ultra fine needle that distributes the plasma evenly all over the entire scalp. This ‘mesotherapy’ device performs painless micro-injections, allowing full control of the injection depth.

How long does a platelet mesotherapy treatment take?

A single session takes about an hour to complete. We recommend that booster treatments take place over the period of 4 weeks (minimum) to 6 weeks (maximum).

How long until I see results?

Improvements can already be seen from the 2nd session onwards with patients reporting significantly shinier, thicker and silkier hair.

What are the benefits of platelet mesotherapy?
 
Less hair fall
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Increased hair density and caliber
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Improved hair texture
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Healthier scalp
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Diminished wrinkles
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More radiant skin
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Ideal complement to a hair transplant procedure
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4. Hair Transplants

Gone are the days of embarrassingly obvious hair plugs of the 1990’s. Today’s leading clinics are forging new innovations to deliver increased density, natural results and minimal downtime for transplant patients.

The follicular unit transplant (FUT, or ‘strip’) method requires the surgical removal of a skin flap from the base of the scalp but is is bloody, painful and requires removal of stitches a week later.

FUT Scar

Next came follicular unit excision (FUE), which was the mainstay of treatment for several decades. FUE harvests plugs using tools with an average diameter of 1cm and implants them into the forehead using ‘pre-holes’ cut into the skin. While a step above FUT, this led to irregular directions for growth and clear evidence of a transplant.

The DHI group of clinics have innovated the latest technique in hair transplant surgery, Direct Hair Implantation (DHI). Since 2010, DHI specialists have managed to extract individual grafts without risk of scarring and implant them directly into the hairline.

Robson COsta, DHI Patient

This method currently offers the highest industry hair graft survival rate (97% vs 60-70%) as well as high density and wider options for artistic placement.

To learn more about the history of hair transplant surgery, read this article.

5. Scalp Micropigmentation

Also known as SMP, scalp micropigmentation involves the application of an ink solution onto thinning areas of the scalp (such as the crown), to give the illusion of greater density.

Unlike normal tattoo ink, which has a tendency to blot together and fade to an unsightly greenish hue, proper SMP artists will use a black/grey mix and apply the ink in microscopic strokes to mimic normal hair.

The results are immediate, last up to 7 years before requiring a touch-up, and are very affordable.

Scalp Micropigmentation

6. Prosthetic Hair and Hair Replacement

Wigs, toupees, and synthetic hair fibers remain to be a popular option among people seeking to recover from hair loss. These options have been around for much of human history, and the industry is always at work, innovating achieve more natural results.

Artificial hair has the benefit of being generally affordable and available to a mass market, many who choose it find themselves living with the persistent anxiety of it being dislodged by strong winds or body movements.

The Future of Hair Restoration

Despite the advancements in hair transplants, doctors are still pushing the boundaries of science to produce thicker hair, or reverse hair loss for men and women suffering from androgenic alopecia.

Labs are investigating the cloning of hair follicles using stem cells, though this innovation has yet to enter the human trial phase. Others are isolating the genes for hair loss (and even graying hair) to edit and prevent progression.

Both are expensive ventures, and not yet approved by regulatory agencies—though we look forward to updating this list as the technology advances.

Implanter

Like all areas of medicine, seeking professional advice early is the key to successful treatment. Guessing with medications can be costly and dangerous. Your doctor should carefully explain if you are a good candidate for a hair transplant.

VII. CONCLUSION

If you suffer from hair loss, it’s vital that you know that 1) you are not alone, and 2) you have options. Hair loss is a very common condition for men and women around the world, and the medical community has developed a number of options to prevent, mask, and reverse it.

Likewise, if hair loss causes you any degree of discomfort or distress, know that your suffering matters. We urge you to seek diagnosis and treatment from certified doctors and professionals.

If you have further questions about hair loss, or want to start on the path to treatment, contact us or give our clinic a call at +632-8893-6175. Our experts are always ready to help.

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