Archive for the ‘Hair’ Category
The Most Effective Methods Of Treating Laser Hair Removal
Although one laser session can produce long-term hair removal, as a rule multiple treatment sessions are necessary to obtain optimal results. At each successive laser hair removal procedure, less hair should be found in the treatment area. For the same body area, two individuals could require different times and therefore different costs of treatment for laser hair removal. There is also other hair laser information to see which hair removal treatment is right for you.
This laser and ipl hair removal uk treatment is one of the most effective methods of treating long term removal of unwanted hair. Understanding this natural cycle, it will help you to appreciate how laser hair removal works, and why you may require more than one treatment. The most basic, primary benefit of laser hair removal is found in the fact that for most people only one treatment is required. The fact that unwanted hair can be removed permanently in most cases through laser hair removal contrasts starkly with other treatment regimens. Benefits of laser hair removal include ease of treatment and duration of results.
Shaving the area to be treated several days before laser hair removal is worthwhile and will increase the effectiveness of the treatment. Apex 800 laser treatment is a safe, fast, gentle and effective method for hair removal. Conclusions The treatment intervals chosen for laser hair removal strongly affect the efficacy of long-term results. Long-term evaluation of the long-pulsed alexandrite laser for the removal of bikini hair at shortened treatment intervals. Treatment with this device is sometimes popularly referred to as laser hair removal, though the device is not a laser per se. Our lasers are used for laser hair removal, non-ablative skin treatment, laser removal of veins, birthmarks, scars, stretch marks, redness and pigmented lesions.
A special hand piece cools the surrounding skin while the laser energy is absorbed, resulting in virtually painless hair removal. Laser Hair Removal is effective on almost any area of the body where smoother, younger, hair-free skin is desired. People that have dark hair and light skin are the ideal candidate for laser hair removal. Lyra is the first laser FDA approved for hair removal of all skin types. TS facial hair removal is extremely difficult to achieve without damaging surrounding skin, and some lasers and practitioners are better than others.
Light skin and darker hair, generally, make the laser hair removal procedure easier to perform. Certainly, there will be some mild yet temporary redness of the skin following laser hair removal. Pain management, choosing a laser hair removal practitioner, and using Tend Skin for reducing shaving bumps and ingrowns. We have 3 different hair removal lasers that are used for different skin types and hair colors. Those laser hair removal candidates with fair, untanned skin almost never experience pigmentation change as a result of laser hair removal.
Some laser hair removal side effects include pigmentation change in the skin of the treated area. Looking aheadAlthough laser hair removal technology has advanced, more research is needed to determine which lasers are best for different skin types. The best candidate for laser hair removal has dark hair and light skin. Recovery and Maintenance After laser hair removal, your skin may be slightly swollen for about a day and appear irritated for about a week. As such, skin color must be taken into consideration when lasers are used in hair removal.
If you’re considering laser hair removal, the following information will provide you with a good introduction to the procedure. Although laser hair removal is the second most common cosmetic procedure, many clinics promise results that are just not realistic. Although called laser hair removal the procedure does not remove all hair, but permanently reduces the total number of hairs in the area treated. You’ve also heard the claims that the laser hair removal procedure is the ultimate in permanent hair removal. The laser hair removal procedure is designed to permanently remove unwanted facial and body hair by using the light energy from a laser.
Still in the long run, the laser facial hair removal procedure is more cost effective as well as permanent. As with any medical or surgical procedure there are risks although with laser hair removal they are minimal. Studies by dermatologic researchers indicate that laser hair removal is a procedure of choice for selected patients. The laser hair removal procedure is quite simple. This is, in large part, what makes laser hair removal the most costly hair removal procedure. Laser hair removal is now the second most common cosmetic procedure, behind Botox injections. Because people tend to vote with their dollars, laser hair removal was listed as 2004’s most requested non-surgical procedure. “Laser hair removal is very safe,” she says, adding that the procedure has such minimal discomfort that a numbing cream really isn’t even needed.
The cost of Laser hair removal depends on a number of factors. Ultimately, the cost of the laser hair removal will be different for each person. The cost of facial laser hair removal varies from person to person. Most laser hair removal clinics will carefully detail cost estimates for you. The only major drawback to professional laser hair removal really appears to the cost associated with the process. Fatigue, laser hair removal cost dark colored stools. These include the laser hair removal cost entire contents of the tablets azithromycin laser hair removal cost dihydrate is lipitor.. Is laser hair removal cost unavoidable. And grapefruit juice may require laser hair removal cost larger initial doses of changing your cholesterol laser hair removal cost foods. The drug information laser hair removal cost multum does not be used. Increases laser hair removal cost may be administered with dizziness. http://www.laser-vision.info/laser-hair-removal/
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10 Proven Tips On How To Reduce Hair Loss
Article by Kristy Klien
Your hair enhances your overall personality and also reflects your health. But, healthy hair and scalp needs proper care right from the beginning. If you neglect your hair for long, it might turn brittle with split-ends and also cause dandruff. You may even experience untimely hair loss if you don’t take timely precautions.
Studies indicate that in 95 percent cases, hair loss is genetic, but many other factors such as diet, general health, vitamin and hormonal deficiencies, overuse of hair dye, physical and emotional stress also lead to uncontrolled hair loss. However, it is possible to control most of these factors that lead to untimely hair fall among individuals.
Though hair loss is not a life-threatening situation, but it may imply internal health problems. Besides, it may also spoil the level of self-confidence in the long run. As there is no permanent cure for hair loss, but it is possible to take some preventive measures to ensure healthy and shining hair. Some of these tips are listed below:
1) Role of Diet
A nutritious diet, which contains all essential vitamins and minerals, helps in minimizing the hair loss. Therefore, you must include green, leafy vegetables, raw oats, and whole grain cereals, eggs, dates, and raisins in your daily food regime. As the hair is made of protein, you are advised to stick to protein-rich diet, such as calves liver, brewer’s yeast, and wheat germ. These foods also contain Vitamin B, which is an important nutrient for hair. Outer coverings of potatoes, cucumbers, and green and red peppers are high in silica, which is essential to maintain the beauty and strength of your hair. Vitamin E also promotes hair growth and reduces hair fall. A person may experience hair fall due to thyroid dysfunction also. Therefore, you must include foods, which are good sources of vitamin A and iodine.
2) Washing routine
Your hair cleansing routine largely depends on your hair-type. People having oily hair may need to wash their hair regularly, while people having dry hair can wash it twice a week. Never use too hot or too cold water to wash your hair. While cleaning or massaging your hair, you should always use your fingertips and not your nails to gently clean your scalp.
3) Proper combing
You should use a wide-tooth comb to untangle your hair and comb in downward direction. Using a wooden or tortoise shell comb is a better idea than using a rubber comb. Avoid combing wet hair, as wet hair can easily break.
4) Drying your hair
If possible, allow your hair to dry naturally. Avoid using blow dryer as its heat can damage your hair, and also make it look coarse and lifeless.
5) Using proper conditioner
Protect your hair from sudden environmental changes, while going out to a beach or a pool. You must use an effective conditioner as it protects your hair from the sun, chlorine, and sea water. You should also wear a protective hat or a cap to avoid overexposing your hair to the sun, salt or chlorinated water and pollution.
6) Use of shampoo and conditioner
Always choose a simple formula shampoo, which costs you less money. Remember, the basic purpose of a shampoo is to wash away the dirt and the oil. Therefore, use a milder shampoo, which is less expensive and more beneficial for your hair. Apply a good quality conditioner once you clean your hair with the shampoo, but do not over-condition your hair.
7) Choose a comfortable hair style
Choose a hair style that truly reflects your style and taste while significantly enhances your personality. Often traditional hair styling products are rich of alcohol and other harsh chemicals, which may again harm your hair.
8) Knowing your sleeping pattern helps control hair loss
Comb your hair gently while going to bed. You should also gently remove all bands or clips used during the day. Do you know that your sleeping pattern also affects the life and health of your hair? People who are restless even while they are sleeping may actually end up breaking their hair. So, if you belong to the restless community of sleepers, you should use s satin pillowcase, which allows your hair to move smoothly and thus cause less breakage.
9) Limit the use of alcohol and smoking products
Reduce alcohol consumption and also avoid using it on your hair. Avoid using hair care products that contain alcohol. This is because alcohol can make your hair look dry, brittle and prone to breakage.
10) Avoid using harsh chemicals
Certain harsh chemicals such as permanent hair color and perms can also affect the health and growth of your hair. Therefore, you must avoid coloring your hair more than once every 2-4 months.
About the Author
Kristy is a professional hair stylist and writer for My Hair Styling Tools a leading supplier of Hair Straightening Irons Visit us at: http://www.myhairstylingtools.com
Can Vitamins Regrow Hair?
Having a luxurious head of hair is associated with attractiveness, as reinforced by countless shampoo advertisements with women swinging their thick, shiny head of hair around while groaning ecstatically! That’s not to mention scores of advertisements for prescription medications, over-the-counter creams and hair transplant surgeries. Many would be willing to stand on their heads in a bowl full of green Jell-O for 15 minutes a day if they were told it would regrow their hair!
Most of us lose around 100 hairs a day – this is perfectly normal, just look your hairbrush! However, at least 50 percent of all adults will experience hair loss or thinning hair by age 60, and this affects approximately 40 million men and 20 million women. There are many types of hair loss:
Androgenetic alopecia, or pattern baldness. This is the most common type of hair loss. Male pattern baldness usually occurs in the front, crown and sides of the hairline. It’s not uncommon for male hair loss to begin in the 20’s. An androgen receptor gene on the X chromosome explains why a man’s baldness resembles that of his maternal grandfather more than his father. However, baldness can be inherited from the mother’s or father’s side of the family with equal frequency. Female thinning is most likely to occur on the crown and in the front. In both men and women, this type of hair loss is heredity and permanent.
The hormone dihydrotestosterone, or DHT, is also related to male pattern baldness. DHT binds with receptor sites on hair follicle cells to cause balding and decreases the length of the hair growing cycle so that each new regeneration of hair becomes smaller and thinner. That’s why you see so many advertisements for hair loss products extolling their virtues as DHT blockers, such as Propecia. DHT blockers also include natural supplements for thinning hair such as saw palmetto, nettles, pumpkin seed oil, green tea, emu oil, and soy isoflavones.
Telogen effluvium occurs in response to stress. This can be triggered by childbirth, major surgery, serious psychological stress, or serious illness such as high fever or severe flu. However, hair loss may not occur until three to six months following the stressful incident, so it’s difficult to connect the stress with the loss. Hair usually regrows within six to nine months.
Alopecia areata is temporary hair loss characterized by round patches of hair falling out of the scalp. This hereditary disease of the immune system can affect children or adults and is caused by white blood cells attacking the hair follicle.
Hair loss can also be affected by these other factors:
· Side effects of medications or treatments, including medications to treat arthritis, depression, heart problems, high blood pressure and gout – plus chemotherapy and radiation therapy.
· Symptoms of illness, such as diabetes, lupus or thyroid disorders.
· Overuse of hair treatments and products such as hair dye, permanents, straighteners, hot rollers, curling irons and blow dryers. This is called traumatic alopecia.
· Poor nutrition. This is especially true if you don’t get enough protein or iron in your diet.
Given all this, is vitamin E good for hair? Despite what all those exciting commercials say, current research shows that there is no absolute direct correlation between taking vitamin supplements and permanent hair regrowth. There’s a popular misconception that Vitamin E regrows hair. You can take all the Vitamin E supplements you want to, and even rub it on your head, but it won’t magically transform you into a Muppet in dire need of a haircut!
However, non-hereditary hair loss is an indicator of poor health. As a result, you should ensure that you’re eating a healthy diet and taking the right vitamins and minerals that help to prevent hair loss. Unexplained hair loss should be evaluated as a symptom of other health problems – if you experience this, check with your physician.
Although no particular vitamin or product will give you a head of hair like Cher’s in the 70’s, you should take minerals and vitamins that help prevent hair loss to complement your nutritious diet. Good nutrition is important to overall health and healthy hair growth. The following vitamins and minerals have been shown to help to prevent hair loss:
Vitamin A: This antioxidant produces healthy scalp sebum. Daily dose is 5,000 IU. Caution: Ingesting more than 25,000 IU of vitamin A daily is toxic – it can cause hair loss and other serious health problems. Food sources include fish liver oil, spinach, broccoli, cabbage, carrots, apricots and peaches.
Vitamin B 3, or Niacin: Promotes scalp circulation. Daily dose is 15 mg. Food sources include brewer’s yeast, wheat germ and fish.
Vitamin B 5, or Pantothenic acid: Helps prevent graying and hair loss. Daily dose is 4 to 7 mg. Food sources include whole grain cereals, brewer’s yeast and egg yolks.
Vitamin B 6: Helps prevents hair loss and assists in the production of melanin, which gives hair its color. Daily dose is 1.6 mg. Food sources include brewer’s yeast, whole grain cereals, vegetables and egg yolks.
Vitamin B 12: Helps prevents hair loss. Daily dose is 2 mg. Food sources include fish and eggs.
Vitamin C: This antioxidant maintains healthy skin and hair. Daily dose is 60 mg. Food sources include citrus fruits, strawberries, kiwi, cantaloupe, pineapple, tomatoes, green peppers, potatoes and dark green veggies.
Vitamin E: Does vitamin E promote hair growth? Well, this antioxidant does encourage scalp circulation. Daily dose is up to 400 IU. Food sources include cold-pressed vegetable oils, wheat germ oil, soybeans, raw seeds and nuts, dried beans, and leafy green veggies.
Biotin: Helps produce keratin, which may prevent graying and hair loss. Daily dose is 150 to 300 mcg. Food sources include brewer’s yeast, whole grains, egg yolks and rice.
Inositol: Keeps hair follicles healthy at the cellular level. Daily dose is up to 600 mg. Food sources include whole grains, brewer’s yeast and citrus fruits.
Calcium: An essential mineral that boosts hair growth. Daily dose is up to 1,500 mg. Food sources include tofu, fish, nuts, brewer’s yeast, beans, lentils and sesame seeds.
Chromium: Helps prevent hyperglycemia and hypoglycemia, which can cause hair loss. Daily dose: Up to 120 mg. Food sources include brewer’s yeast and whole wheat bread.
Copper: Helps prevent hair loss and defects in color or structure. Daily dose is up to 3 mg; but more than that can lead to dry hair, hair loss and severe health problems. Food sources include shellfish, green vegetables, whole grains, eggs and beans.
Iodine: Prevents dry hair and hair loss. Daily dose is 150 mcg. Food sources include fish, seaweed, kelp, iodized salt and garlic.
Iron: Prevents hair loss. Daily dose is 15 mg. Food sources include eggs, fish, whole grains, green vegetables and dried fruits.
Magnesium: This is one of the vitamins to regrow hair; it works in tandem with calcium to promote healthy hair growth. Daily dose is 280 mg. Food sources include green vegetables, wheat germ, whole grains, nuts, soy beans, chickpeas and fish.
Potassium: This is another one of the vitamins that make hair regrow; potassium promotes healthy hair growth. Daily dose is 3,500 mg. Food sources include avocados, bananas, lima beans, brown rice, dates, figs, dried fruit, garlic, nuts, potatoes, raisins, yams and yogurt.
Selenium: Keeps scalp supple and elastic. Daily dose is 55 mcg, but more than that can cause hair loss. Food sources include brewer’s yeast, grains, tuna and broccoli.
Silica: This natural supplement for thinning hair strengthens hair and prevents hair loss. Daily dose is 55 mcg, but excessive amounts can lead to hair loss. Food sources include seafood, rice, soybeans and green vegetables.
Sulfur: Sulfur is a main component in hair structure. Daily dose is 1 to 3 g. Food sources include onions, garlic, eggs, asparagus, fish and dairy products.
Zinc: Zinc works in tandem with vitamin A; a deficiency in either can cause dry hair. Daily dose is 12 mg. Food sources include spinach, sunflower seeds, mushrooms, whole grains and brewer’s yeast.
In addition to vitamins and minerals that boost hair growth, you should also include omega-3 fatty acids in your diet to prevent hair loss. Good sources include wild Alaskan salmon, sardines, herring, mackerel, flax seeds and walnuts.
Instead of trying to take each one of these vitamins and minerals separately each day, consider a complete multivitamin. A good one will provide all these nutrients in the sufficient, yet safe dosages. In addition, here are some helpful hair care tips:
· Use all-natural biotin-based shampoo and conditioner to help your hair appear thicker.
· Be easy with your hair; brush it gently, starting from the bottom and working your way up. Don’t ever harshly tug downward on tangles.
· Don’t blow dry your hair, use curling irons or hot rollers. Try some firm hair gel and a round styling brush instead; style your hair, then let it air dry.
· Don’t frequently put your hair in ponytail holders or barrettes, and never use rubber bands on your hair!
· Shorter hairstyles make hair look thicker.
· Avoid the Donald Trump comb over style at all costs!
To improve your hair’s health and the overall physical condition of your body, take the next step and improve dietary nutrition, take the right vitamin and mineral supplements, and minimize the stress in your life.
Want to learn more about the most complete MultiVitamins? Visit us at NaturalFitSupplements.com
How to Maintain a Healthy Hair using Hair Conditioner
Article by Kelly
Our hair suffers from the harmful effects of polluted environment. It is, therefore, important to “>condition our hair. Hair conditioners help to improve shine and elasticity of the hair. They also help us manage hair easily. They rejuvenate our hair and so using the right one is an important aspect of hair care.
Various types of hair conditioners are available in the market like dry hair conditioner, frizzy hair conditioner, hair growth conditioner, damaged hair conditioner and so on. It is advisable to select a hair conditioner that suits our hair type. For instance, if the hair is dry and frizzy, choose a conditioner that moisturizes and reconstructs your hair. If the hair is thin, select a conditioner that adds the volume of the hair. It is also advisable to change the brand of the conditioner frequently so that hair is protected from build-ups and specific formula effects.
Conditioner that contains humectants is able to hold moisture into the hair. Conditioner that has hydrogenated keratin protein is good for reconstructing our hair. Since keratin has low molecular weight, it is able to penetrate the hair shaft and strengthens the hair deeply. There are some special hair conditioners that help safeguarding our hair from heat. These products contain effective heat absorbing polymers and thus protect our hair from heat damages. Some special conditioners help treating chemically processed hair and people having color treated hair can get more benefits by using this product.
A “>good hair conditioner ought to have moisturizer, reconstructor, detangler, acidifier, thermal protector and glosser. Apart from this, some chemicals like fatty acids, panthonal, sequestrants and preservative. These chemicals are active ingredients that induce better functioning of conditioner even in hard water.
Hair conditioners come in different types also. Pack conditioners are heavy and creamy and they are highly useful in treating damaged hair. It is sensible to leave such conditioners for long time in hair. This type of conditioner helps to cure split ends and other problems. Leave-in conditioners are lightweight and contain oily surfactants. Generally, good conditioner has a balance between these two.
Most of us think that conditioner should be used daily to keep our hair healthy. However, it is not a real thing. It is preferable to use hair conditioners once or twice a week. We need to cleanse the hair with a normal shampoo first and then apply the conditioner distributing it thoroughly with a wide-toothed comb. It is essential to leave it for five minutes before rinsing.
It is important to “>apply Hair conditioners on the hair shaft and ends and not to apply them on the scalp. Applying conditioner on scalp creates a limp look and leads to build-ups. Since the ends and hair shaft are dead proteins, applying conditioner there can create smoothness and thickness.
Though conditioning is specially meant for dry hair, it is wise to use it on all types of hair to keep it gleam and strong. It gives the hair an intense type of nourishing treatment. Treating the hair with conditioner helps to correct the poor hair care effects. If the outer cuticle is damaged, applying conditioner can help recover from it.
There are some hair conditioners that utilize essential oils and botanical extracts like avocado, aloe Vera, shea butter and so on. Using such products help to replenish the look and feel of the hair after shampooing and so, the hair looks smooth and glossy.
About the Author
Kelly is a hair care expert, who regularly blogs on hair loss and hair care remedies.
Dramatics Of Hair Loss In Women
Have you noticed a gradual and progressive increase in the number of hairs lost when combing or brushing? Perhaps after months or years of vain denial, you have realized that the mirror does not lie, visible thinning has occurred. You’re not alone if you’re experiencing breakage, increased hair shedding or significant hair loss.
Many women may cover it up with wigs, hair extensions, hats or scarves. Others choose one of the several approved medications or surgical procedures that are available to treat baldness.
Excessive hair loss or balding is mistakenly perceived as a strictly something that happens to men although women actually make up to forty percent of American hair loss sufferers. In America, one in four, or over 30 million women will seek solutions and treatment for hair loss annually.
First of all, don’t panic! Hair loss or hair shedding is consistent within the hair growth cycle and it is normal to lose some scalp hair each day. The average human scalp has roughly 100,000 to 150,000 individual hairs and the normal hair growth cycle results in the loosening or shedding of about 100 to 150 hairs on a daily basis. New hair growth then emerges from these same previous dormant hair follicles, growing at the average rate of about half an inch per month.
Hair is composed of two separate parts: the follicle and the hair shaft. The follicle lies below the scalp and produces the hair strands that we see growing out of our head. The follicle is alive, however the hair strand is simply composed of dead cells that have no regenerative ability.
For most people, 90% of our scalp hair is always in a to six year growth phase (anagen) while the remaining 10% is in a dormant period (telogen), which lasts about three months. When the dormant period ends the hair is shed; these are the worrisome hairs we obsess over in our comb, hairbrush, on our pillow or down the shower drain. Relax, some hair loss is perfectly normal.
Baldness or Alopecia happens when the normal pattern of hair growth is disrupted. The normal pattern of human hair growth is growing, resting, shedding and growing again. If the growth pattern is out of balance, hair does not grow back as readily as it falls out. A family history of androgenetic alopecia increases your risk of balding. Heredity also affects the age at which you begin to lose hair and the development, pattern and extent of your baldness.
What concerns us is not these normally shed hairs, but the noticeable thinning we confront in the mirror. For a woman, thick, vibrant hair is our crowning glory, our vanity visible. A luxuriant full mane epitomizes the beauty of a woman and is integrally woven into our self image. Our culture strongly identifies femininity with a thick, silky head of hair. Throughout recorded history, images of shining, full bodied hair are associated with female beauty, youth, desirability and good health. Society unfairly identifies dry, lack luster and thinning hair with old age, sickness and poverty.
A dramatic decrease in self esteem is evident in women when their hair begins to fall out. Hair shedding is not physically painful, however it often causes severe emotional distress. We obsess over our thin tresses as we battle depression and self loathing. Women frequently become introverted and withdraw from the world. We avoid intimate contact and make futile attempts to disguise the quality and quantity of our hair.
Hair loss is especially injurious to those who have professions or careers where physical appearance plays a significant role. A young woman is especially vulnerable to the stigma of balding. Not until we are confronted with the loss of our hair do we fully realize how essential hair is to our overall perception of ourselves.
A woman’s hair is at its thickest by age 20. Once we pass 20, however, our hair gradually begins to thin, shedding more than the normal 100-150 hairs a day. With aging, hair strands hold less pigment and become smaller so that what was once the luxuriant and thick hair of our youth becomes thin, fine and lighter in color. For even the elderly woman, significant hair loss can threaten self image. A woman’s sense of sexuality and femininity as well as her establish place in family and society are often undermined by hair loss.
It is hardly surprising when a man starts balding. By the age of thirty-five about 25 percent of American men will experience some degree of appreciable hair loss and about 75 percent are either bald or have a balding pattern by age 60.
In men, hair loss is often perceived as a sign of virility, a demonstrable sign that his male hormones are functioning at maximum capacity. To project strength and masculinity, men often choose to shave their heads.
Although many men are quite dismayed by a receding hairline, research indicates that the phycological pain of hair loss does not affect men as adversely as it impacts women. What makes coping with hair loss so difficult is the frightening lack of control, the feeling of the inability to do anything to make our hair stop falling out.
Causes Of Hair Loss In Women
As we age, women face a multitude of changes and challenges: wrinkles, a widening waist, cellulite deposits and thickening ankles. It does not seem fair that for many of us hair loss is yet another blow to our self esteem.
Female pattern baldness or Androgenetic Alopecia is the most common type of hair loss in women and is genetic in nature. This type of female balding is caused by the chemical Dihydrotestosterone or DHT which builds up around the air follicle and over time destroys both the hair shaft and the hair follicle. Pregnancy or the onset of menopause may cause a fluctuation in the production of estrogen. Lacking sufficient estrogen to produce testosterone-blocking enzymes, testosterone is then converted to DHT on the scalp. The result is a shorter hair growth cycle, finer hair and excessive hair loss from shedding and breakage. Some women experience an increase in hair loss several months after delivering a baby.
Genetics aside, there are many other reasons why women lose hair. Surgery, extreme physical or emotional stress, hormonal imbalances, chemotherapy and scalp infections are but a few. Female hair loss can also be triggered by birth control medications, certain prescription drugs or result from the use of harsh chemicals or aggressive styling that can cause permanent damage to the fragile hair follicle. Excessive hair shedding may also be symptomatic of rapid weight loss from dangerous fad-dieting or an eating disorder such as anorexia. The use of street drugs such as cocaine will also exhibit sudden and severe hair shedding.
When To Contact A Medical Professional
Reacting intensely to the physical state of our thinning hair may seem like excessive vanity, but it is not. Baldness is not usually caused by disease, but is more commonly related to heredity, aging and hormone function. However, changes in hair appearance, texture and growth patterns may indicate serious health concerns. Hair is one of the first areas, along with skin and nails, to reflect nutritional deficiencies, hormonal imbalance and illness. It is wise to pay attention.
Women’s hair seems to be particularly sensitive to underlying medical conditions so it is important that women with undiagnosed hair loss be properly evaluated by a physician. If your thinning hair is a result of a medical condition, your doctor will treat these ailments and as a result you may experience significant growth of new hair.
Once you and your doctor have identified the cause of your hair loss you may be referred to a hair specialist or implant surgeon to learn about the treatment options available such as or hair transplant procedures to promote growth or hide loss. For some types of alopecia, hair may resume normal growth without any treatment.
A healthy balanced diet, regular exercise, hydration and rest can go a long way towards preventing hair loss and maximizing the potential of your hair growth cycle.
Although medical research is on going, the following have proved beneficial in growing and maintaining a healthy head of hair.
Nutrition
Poor nutrition is often an underlying cause of hair loss as the hair is a reliable indicator of nutritional well being. Discuss with your health care provider your diet, all medications and any supplements you may be taking. Dull hair color or dry and brittle hair may be indicators of a deficiency in essential fats in the diet, oily hair may be a sign of a B vitamin deficiency.
Recent medical studies have found that a high percentage of women with thinning hair are deficient in iron and the amino acid lysine. It is difficult to obtain sufficient lysine through diet alone. Lysine is important in the transport of iron and necessary to support hair growth. Lysine is found in eggs and red meat so vegetarians needs to be aware of this potential shortfall in their diets.
The amino acids L-Cysteine and L-Methionine are believed to improve hair texture, quality and growth.
Low-fat foods that rank high in protein, low in carbohydrates, can play a vital role in sustaining healthy hair growth and aid in preventing hair loss. Important essential fatty acids for maintaining hair health are found in walnuts, sunflower seeds, sardines, spinach, soy and canola oil. Omega 3 and Omega 6 Oils protect the heart as well as your hair so include salmon in your diet on a regular basis.
Herbal Remedies Offer Hope For Hair Loss
Discuss with your nutritional advisor or medical professional the benefits of herbs. The following natural plant derivatives have properties to encourage a healthy head of hair.
Aloe
Arnica
Birch
Burdock
Catmint
Chamomile
Horsetail
Licorice
Marigold
Nettles
Parsley
Rosemary
Sage
Hair Care
Always choose organic natural products to avoid the chemicals and toxins found in many hair care products. Harsh chemicals may strip the natural oils from your hair and lead to breakage and poor hair growth. Dye, hair straightening and permanent solutions are highly destructive to the hair shaft and follicle as well as the delicate sebum balance of the scalp.
Be gentle with your hair. Allow hair to dry naturally rather than using a hair dryer. A natural bristle brush is helpful in preventing damage. Do not style until completely dry. Wet hair is weak hair so handle with care.
Avoid or break any bad habits you may have that pull or twist the hair. Try not to constantly run your fingers through your hair, tug at the hair and avoid hair clips or rubber bands that pull at and break off the hair. Minimize the usage of mousse, gels and hair sprays. These products dry and weigh down the hair shaft and dull the natural luster of your hair.
Avoid salt and chlorinated water when swimming. If exposed, always wash the hair with cool water and an organic gentle shampoo and apply a mild conditioner. Sun worshippers should make sure that hair care products have sunscreen properties to protect hair from the damaging affects of UV rays. Remember to wear a hat to prevent sunburn of the scalp.
Healthy Lifestyle
Hair loss is traumatic, however our hair is only part of who we are. I remind myself to keep my obsession with my hair loss in perspective and be happy with all the other areas of my life that are going right and in balance. Focus on the positive, eat well, rest well and be at peace with who you are. Remember, that for some, hair grows back as mysteriously as it disappeared.
Marlene Affeld writes for the Nandu Green Team. Plant a Tree! Celebrate Life! Nandu Green is your portal to Eco-Friendly Living!
Avoiding Pitfalls in Planning a Hair Transplant (part 2)
Patient Assessment
Donor Supply
In performing a hair transplant, the physician must balance the patient?s present and future needs for hair with the present and future availability of the donor supply. It is well known that one?s balding pattern progresses over time. What is less appreciated is that the donor zone may change as well.  Â
The patient?s donor supply depends upon a number of factors including the physical dimensions of the permanent zone, scalp laxity, donor density, hair characteristics, and most importantly, the degree of miniaturization in the donor area – since this is a window into the future stability of the donor supply.
The size of the donor area is determined by both its width (height) and its length. When assessing the potential width of the donor area, doctors usually assess the lowermost point that the balding will reach, i.e. the top part of the permanent zone. However, it is equally important to pay attention to the inferior margin as well. It is common for the hair to thin significantly at the nape of the neck as a person ages, producing an “ascending hairline.” Since this can significantly diminish the width of the donor area, any evidence that this process may occur should be taken into account in the planning. Loss of the temporal points is another process that has a significant impact on the donor supply. Not only does it foreshorten the potential length of the donor strip but it often portends very significant baldness.  Â
Scalp laxity is another variable that affects the amount of available donor hair. Very tight scalps significantly limit the amount of donor hair that can be removed through strip harvesting. The constraint imposed by a tight scalp is not always apparent in the first session, but can plague the hair restoration down the line; therefore, it should be evaluated carefully in the initial patient assessment. A very loose scalp can present its own set of problems, as patients with very loose scalps often heal with widened donor scars. [18]  Â
The average donor density of a Caucasian is about 225 hairs/cm2. This can easily be measured using a hand-held instrument called a densitometer. (2) When the density of a Caucasian is below 180, a hair transplant should be undertaken with great caution. In this author?s opinion, when the maximum donor density is below 150/hair mm2, a person should generally not be transplanted, as there will not be enough donor hair to make the procedure cosmetically worthwhile and the risk of a visible donor scar is too great. (3) Exceptions would be an older person with very limited expectations and in races where the normal density is lower (i.e. Asians and Africans).Â
Hair characteristics, particularly hair shaft diameter, are as important as the absolute number of hairs in determining the outcome of a procedure. The amount of transplantable hair is related to both the number of movable hairs (determined by the size of the donor area, scalp laxity and donor density), multiplied by the hair shaft cross sectional area. Since each hair in a person with coarse hair can have over 5 times the volume as a person with fine hair, the estimate (or actual measurement) of hair shaft diameter is important in determining the overall donor supply. Â
Miniaturization, the progressive diminution of hair shaft diameter and length (the result of the action of DHT on the hair follicle) produces thinning on the front, top and crown of the scalp and is the hallmark of androgenetic alopecia. But the back and sides of the scalp can miniaturize as well and when a significant portion of a patient?s donor area is miniaturized, the hair in this area can be rendered useless for a hair transplant. (Figures 1 and 2)
This condition, called diffuse unpatterned hair loss (or DUPA), is the most common type of hair loss seen in women and it is not uncommon in men. It goes without saying, that every patient, male or female, in whom a transplant is being considered, should be evaluated for donor miniaturization using densitometry to make sure that the donor hair to be transplanted is stable.Â
Recipient Demand
One should never assume that a person?s hair loss is stable. Hair loss tends to progress over time. Even patients who show a good response to finasteride will eventually lose more hair. It is always best to consider the reasonable worst-case scenario when assessing how bald the patient may become, so that the finite donor hair can be allocated properly. Although the Norwood classification is very helpful in staging the hair loss, it doesn?t take into account actual scalp dimensions. Just like the donor site, the recipient area should actually be measured. Even within a single Norwood class, there is a vast difference between a patient with a narrow forehead and one with a very broad head with respect to the actual surface that needs to be covered, and thus the number of grafts required for the restoration.Â
Designing the HairlineÂ
Hairline Position
In the adolescent, the hairline sits just above the upper brow crease formed by the upper border of the frontalis muscle directly below it. The position of the normal adult male hairline is approximately 1.5cm above this crease at the midline). A common error is to place the newly transplanted hairline at the adolescent position, rather than one appropriate for an adult. Although the younger patient, first experiencing hair loss, may put considerable pressure on the doctor to place hair in the lower position, the physician should not yield to this demand.Â
Under normal circumstances, as a patient ages, his density decreases and the natural hairline will move back somewhat. However, a transplanted hairline is immutable. Therefore, when the transplanted patient continues to thin or bald (which he invariable will) the fixed low frontal hairline will begin to look out of place, since it is natural for a person with decreased overall hair volume to have a slightly receded hairline, rather than one that is still in the adolescent position.Â
Hairline Shape
A similar logic applies when choosing the shape of the hairline. As a male passes from adolescence to adulthood, his broad, flat hairline evolves into a more tapered shape with some recession at the temples. A persistent low, broad hairline is enjoyed by those who also maintain their adolescent density. This situation is not present in those who are suffering from androgenetic alopeica; therefore, a transplanted flat hairline will not “age well” over time and will look unnatural as the patient?s overall density decreases and particularly as the crown begins to thin.Â
If a person is older, has maintained a high donor density, and has a small risk of extensive hair loss, a broader hairline is possible. However, this is not this case for the person who is starting to bald at a young age, since he has a significant risk of extensive baldness and, more importantly, the extent of his future hair loss can not be known at the time the surgery is planned.Â
Graft Distribution
The nuances of graft distribution and the multitude of problems that result from distributing grafts improperly are beyond the scope of this writing; however, there are two main but related themes that the hair transplant surgeon should be cognizant of when deciding where to place grafts. The first is to set a target area of coverage that takes into account the patient?s future balding pattern, as well as, his total donor hair supply. The second is to forward weight the grafts, rather than distributing them evenly over the top of the scalp.
Extent of Coverage
The problem of deciding how much bald scalp a hair transplant should cover can be illustrated as follows. As an example, take a patient whose total number of follicular unit grafts available to harvest is around 5,500. The front part of the scalp has a surface area of about 50 cm2. The top or mid-scalp has an area of about 150 cm2 and the vertex or crown about 175 cm2. However, the size of the bald crown can vary dramatically depending upon the extent of hair loss, reaching over 200cm2 in a Norwood Class VII patient.Â
If the front and top of the scalp were transplanted using all of the patients donor hair, the transplanted density would be only 5,500grafts/200cm2 or 27.5 grafts/cm2 (less than 1/3 the density of the patient?s original hair). If the crown were covered as well, that would be 5,500 grafts/400cm2 or 12.5 grafts/cm2 (only 15% the density of the patient?s original hair). Using various manipulations, such as creating different densities in different parts of the scalp, a skilled surgeon can make 1/3 of the overall density look like a substantial amount of hair. However, working with only 15% of the original density, can make the job of creating a natural look significantly more difficult, if not impossible.   Â
The way to avoid having a hair transplant with a look that is too thin, or see-through, is to limit the extent of coverage to the front and mid-scalp until an adequate donor supply and a limited balding pattern can be reasonably assured - an assurance that can only come after the patient ages. Until that time, it is best to avoid adding coverage to the crown. Â
Another problem with transplanting the crown early is that as the crown expands additional hair will be needed to follow the expanding area of baldness outward, just to keep the first hair transplant looking natural. This may require considerable amounts of hair that will not be available to cover the front and mid-scalp if that were too bald as well. On the other hand, if the hair transplant was limited to the vertex transition point or VTP (see figure above), the restoration would look natural without further surgery no matter how far the hair loss in the crown progressed. The reason is that the front and top of the scalp represent a complete cosmetic unit, with the VTP as the natural posterior boundary – so it is natural for hair to cover this region of the scalp but not beyond. Â
Density Gradients
Another way for surgeons to prevent a thin, see-through look is to avoid distributing the grafts evenly over the transplanted area. It goes without saying that only 1-hair grafts should be used at the hairline, with larger grafts behind them, but there are additional ways to produce the gradations of density to mimic the way hair grows in nature. Specifically, the greatest density should be in the front part of the scalp (shown in brown) and particularly in the frontal forelock area (shown in dark brown).
The greater density in the front of the scalp forelock area can be created in two ways; by placing the recipient sites closer together in this location and by using larger follicular units in the area (i.e. 3- and 4- hair units rather than 1s and 2s). These techniques may be use in combination to achieved greater density but, as will be discussed in the following section, if done to excess, may compromise growth. Â
Summary
Follicular unit transplantation is a powerful hair restoration technique that allows the surgeon to create natural hair patterns and produce results that mimic nature. The success of the procedure depends greatly on proper patient selection, accurately assessing the patient?s donor supply, and distributing the grafts in a way that is appropriate for a person who will continue to age and eventually thin over time. With thoughtful planning, major mistakes can be avoided and our patients will be able to achieve the full benefit of this remarkable procedure.Â
References
1. Orentreich N: Autografts in alopecias and other selected dermatological conditions. Annals of the New York Academy of Sciences 83:463-479, 1959.
2. Bernstein RM, Rassman WR, Szaniawski W, Halperin A: Follicular Transplantation. Intl J Aesthetic Restorative Surgery 1995; 3: 119-32.
3. Bernstein RM, Rassman WR: Follicular Transplantation: Patient Evaluation and Surgical Planning. Dermatol Surg 1997; 23: 771-84.
4. Bernstein RM, Rassman WR: The Aesthetics of Follicular Transplantation. Dermatol Surg 1997; 23: 785-99.
5. Gandelman M, et al: Light and electron microscopic analysis of controlled injury to follicular unit grafts. Dermatol Surg 2000; 26(1): 31.\
6. Bernstein RM, Rassman WR, Rashid N, Shiell R: The art of repair in surgical hair restoration – Part I: Basic repair strategies. Dermatol Surg 2002; 28(9): 783-94.
7. Bernstein RM, Rassman WR, Rashid N, Shiell R: The art of repair in surgical hair restoration – Part II: The tactics of repair. Dermatol Surg 2002; 28(10): 873-93.
8. Bernstein RM, Follicular Unit Hair Transplantation. In: Robinson JK, Hanke CW, Siegel DM, Sengelmann RD, editors: Surgery of the Skin, Elsevier Mosby, London UK. 2005.
9. Unger WP, Shapiro R. Hair Transplantation. New York: Marcel Dekker, Inc. 2004.
10. Bernstein RM, Rassman, WR. Follicular Unit Transplantation. In: Haber RS, Stough DB, editors: Hair Transplantation, Chapter 12. Elsevier Saunders, 2006: 91-97.
11. Norwood OT. Male pattern baldness: classification and incidence. So. Med. J 1975; 68:1359-1365.
12. Haas AF, Grekin RC: Antibiotic prophylaxis in dermatologic surgery. J Am Acad Dermatol 1995; 32: 155-76.
13. Otley CC. Perioperative evaluation and management in dermatologic surgery. J Am Acad Dermatol 2006; 54: 119-27.
14. Gandelman M, Bellio R, Barretto M: Beta-blockers and local anesthetics with vasoconstrictors: A dangerous association. Intl J Aesthetic Restorative Surgery 1995; 3 (2): 143-45.
15. Bernstein RM, Rassman WR: Limiting epinephrine in large hair transplant sessions. Hair Transplant Forum International 2000; 10(2): 39-42.
16. Skidmore RA, Patterson JD, Tomsick, RS: Local anesthetics. Dermatol Surg 1996; 22:511-522.
17. Phillips KA, Menard W: Suicidality in body dysmorphic disorder: A prospective study. Am J Psychiatry, 2006; 163:1280-82.Â
18. Bernstein RM, Rassman WR. The scalp laxity paradox. Hair Transplant Forum International 2002; 12(1): 9-10.
Dr. Bernstein is Clinical Professor of Dermatology at the College of Physicians and Surgeons of Columbia University in New York. He is recognized world wide for pioneering Follicular Unit Hair Transplantation. Dr. BernsteinÂ?s hair restoration center in Manhattan is devoted to the treatment of hair loss using his state-of-the-art hair transplant techniques.
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Article by ukbeautystyle
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Article by Kim Price
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About the Author
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Avoiding Pitfalls in Planning a Hair Transplant (part 1)
Although many technical advances have been made in the field of surgical hair restoration over the past decade, particularly with the widespread adoption of follicular transplantation, many problems remain. The majority revolve around doctors recommending surgery for patients who are not good candidates. The most common reasons that patients should not proceed with surgery are that they are too young and that their hair loss pattern is too unpredictable. Young persons also have expectations that are typically too high – often demanding the density and hairline of a teenager. Many people who are in the early stages of hair loss should simply be treated with medications, rather than being rushed to go under the knife. And some patients are just not mature enough to make level-headed decisions when their problem is so emotional.
In general, the younger the patient, the more cautious the practitioner should be to operate, particularly if the patient has a family history of Norwood Class VII hair loss, or diffuse un-patterned alopecia.
Problems also occur when the doctor fails to adequately evaluate the patient?s donor hair supply and then does not have enough hair to accomplish the patient?s goals. Careful measurement of a patient?s density and other scalp characteristics will allow the surgeon to know exactly how much hair is available for transplantation and enable him/her to design a pattern for the restoration that can be achieved within those constraints.
In all of these situations, spending a little extra time listening to the patient?s concerns, examining the patient more carefully and then recommending a treatment plan that is consistent with what actually can be accomplished, will go a long way towards having satisfied patients. Unfortunately, scientific advances will improve only the technical aspects of the hair restoration process and will do little to insure that the procedure will be performed with the right planning or on the appropriate patient.
Five-year View
The improvement in surgical techniques that have enabled an ever increasing number of grafts to be placed into ever smaller recipient sites had nearly reached its limit and the limitations of the donor supply remain the major constraint for patients getting back a full head of hair. Despite the great initial enthusiasm of follicular unit extraction, a technique where hair can be harvested directly from the donor scalp (or even the body) without a linear scar, this procedure has added relatively little towards increasing the patient?s total hair supply available for a transplant. The major breakthrough will come when the donor supply can be expanded though cloning. Although some recent progress had been made in this area (particularly in animal models) the ability to clone human hair is at least 5 to 10 years away.
Key Issues
1. The greatest mistake a doctor can make when treating a patient with hair loss is to perform a hair transplant on a person that is too young, as expectations are generally very high and the pattern of future hair loss unpredictable.
2. Chronic sun exposure over one?s lifetime has a much more significant negative impact on the outcome of the hair transplant than peri-operative sun exposure.
3. A bleeding diathesis, significant enough to impact the surgery, can be generally picked up in the patient?s history; however OTC medications often go unreported (such as non-steroidals) and should be asked for specifically.
4. Depression is possibly the most common psychiatric disorder encountered in patient?s seeking hair transplantation, but it is also a common symptom of those persons experiencing hair loss. The doctor must differentiate between a reasonable emotional response to balding and a depression that requires psychiatric counseling.
5. In performing a hair transplant, the physician must balance the patient?s present and future needs for hair with the present and future availability of the donor supply. It is well known that one?s balding pattern progresses over time. What is less appreciated is that the donor zone may change as well.
6. The patient?s donor supply depends upon a number of factors including the physical dimensions of the permanent zone, scalp laxity, donor density, hair characteristics, and most importantly, the degree of miniaturization in the donor area – since this is a window into the future stability of the donor supply.
7. Patients with very loose scalps often heal with widened donor scars.
8. One should never assume that a person?s hair loss is stable. Hair loss tends to progress over time. Even patients who show a good response to finasteride will eventually lose more hair.
9. The position of the normal adult male hairline is approximately 1.5 cm above the upper brow crease. Avoid placing the newly transplanted hairline at the adolescent position, rather than one appropriate for an adult.
10. A way to avoid having a hair transplant with a look that is too thin is to limit the extent of coverage to the front and mid-scalp until an adequate donor supply and a limited balding pattern can be reasonably assured – an assurance that can only come after the patient ages. Until that time, it is best to avoid adding coverage to the crown.
Introduction
Hair Transplantation has been available as a treatment for hair loss for over 40 years. [1]
Through a majority of that time, hair transplantation was characterized by the use of plugs, slit grafts, flaps and mini-micro grafts. Although these were the best tools available to physicians at the time, they were incapable of producing consistently natural results.
With the introduction of Follicular Unit Transplantation (FUT) in 1995, doctors were finally able to produce these natural results. [2] But the mere capability to produce them did not necessarily ensure that these natural results would actually be achieved. The FUT procedure presented new challenges to the hair restoration surgeon and only when the procedure was properly planned and perfectly executed, would the patient truly benefit from the power of this new technique.[3]
The ability of follicular unit grafts to mimic nature soon produced results that were completely undetectable. This is the hallmark of Follicular Unit Hair Transplantation. [4] Of equal importance, however, is hair conservation – the one to one correspondence between what is harvested from the donor area and what ultimately grows in the recipient scalp. Since a finite donor supply is the main constraint in hair transplantation, the preservation of hair is a fundamental aspect of every technique. However, unlike the older procedures that used large grafts, the delicate follicular units are easily traumatized and very susceptible to desiccation, making follicular unit transplantation procedures, involving thousands of grafts, particularly challenging. [5]
As of this writing, the vast majority of hair transplants performed in the United States use Follicular Unit Transplant techniques. Due to limited space, this review will focus on only this technique and not on the older procedures. Nor will it focus on Follicular Unit Extraction, since this technique is still evolving and the ways to avoid the major pitfalls of this procedure are still being worked out and a subject onto itself. As the title suggests, this paper will focus on the prevention of the various problems encountered in FUT, rather than its treatment – an equally important subject, but one that has already been covered in an extensive review. [6, 7]
For those not familiar with Follicular Unit Transplantation, there is a concise review of the topic in the dermatology text Surgery of the Skin [8]. For more detailed information, several hair transplant textbooks have sections devoted to this technique. [9, 10]
The most common types of problems that occur in FUT procedures can be grouped into two broad categories; those involving errors in planning the hair transplant and those caused by errors in surgical technique. Of the two, errors in planning often lead to far more serious consequences for the patient and will be the subject of this paper.
Patient Selection
Age
The single greatest mistake a doctor can make when treating a patient with hair loss is performing a hair transplant on a person that is too young. Although, there is no specific age that can serve as a cut off (since this will vary from person to person), understanding the problems associated with performing hair restoration in young persons can help the physician in deciding when surgery may be appropriate. Getting it wrong can literally ruin a young person?s life.
When someone is beginning to lose hair in their teens or early 20s, there is a significant chance that he (or she) may become extensively bald later in life and that the donor area may eventually thin and become see-through over time. Although miniaturization (decreased hair shaft diameter) in the donor area is an early sign that this may occur, and can be picked up using densitometry, these changes may not be apparent when a person is still young.
If a person were to become very bald (become a Norwood Class 6 or a Class 7) then he would often not have enough hair to cover his crown. A transplanted scalp with a thin or balding crown is a pattern acceptable for an adult, but totally unsuitable for a person in his twenties. [11] In addition, if the donor area were to thin over time, the donor scar might become visible if the hair were worn short – a style that is much more common in people who are young.
Expectations
This subject is very closely related to age. For surgical hair restoration to be successful, expectations must match what can actually be accomplished. The expectations of a young person are usually to return to the look they had as a teenager; namely to have a broad, flat hairline and to have all of the density they had only a few years before.
The problem is that a hair transplant neither creates more hair (and therefore can?t increase overall density) nor prevents further hair loss (so the pattern must be appropriate as the person ages). But since receded temples and a thin crown is not an acceptable look for a young person, the surgery should best be postponed in a person in whom this is not acceptable. As a person ages, he often becomes more realistic and is happy with what a hair transplant can actually achieve. And, over time, if a person?s donor area proves to be stable and his hair loss limited, more ambitious goals can be attained.
Chronic Sun Exposure
Although it is common wisdom to avoid sunburns after a hair transplant, in fact, significant chronic sun exposure over one?s lifetime has a much more significant negative impact on the outcome of the hair transplant then peri-operative sun exposure.
Actinic damage alters the collagen and elastic fibers so that the grafts are not grasped as securely and the alteration to the vasculature decreases the ability of the recipient tissue to support the transplantation of a large number of grafts. Even with the very small recipient sites used in follicular unit transplantation, making sites too close can result in a compromised blood supply and result in poor growth.
Another issue is that a hair transplant will cover areas of sun damage and make cancer detection more difficult. When the actinic related growths are finally treated, the involved sections of the hair transplant will be destroyed.
The best approach in a person with significant sun damage is to first treat the entire scalp aggressively with 5-flurouracil to remove all of the pre-cancerous lesions before hair transplant is contemplated. One should wait at least 6-12 months after the treatment for the scalp to completely heal, as the tissue will be more friable during this period. Although this treatment can set the surgery back a year or more, it will result in better graft survival and less problems with future skin cancer detection.
Medical Conditions and Medications
Although not necessarily an absolute contraindication to surgery, a number of medical conditions make the follicular unit hair transplant procedure more problematic and need to be taken into account. Whenever significant medical conditions are present, it is always prudent to obtain medical clearance from the patient?s primary care physician or appropriate specialist.
Because the scalp is quite vascular, and FUT procedures involve a large surgical team, patients that are known to have blood born pathogens, such as HIV and Hepatitis B and C, pose some increased risk to the staff, despite the fact that universal precautions are used. It is useful if the team is aware of the medical histories of hair transplant patients so that they can proceed with a higher degree of alert when necessary.
In an HIV positive patient, it is important to make certain that the patient?s immune status is adequate, so that the patient does not have a greater risk of infection. In patient?s with Hepatitis, it is important to assess their liver function so that the dosing of medications is appropriate.
Patients with diabetes mellitus may be at greater risk of having a peri-operative infection. In this case the normal aseptic conditions that most hair transplants are performed under might be changed to a modified sterile technique (modified in that it is difficult to prep the scalp). This should also be considered in patients with cardiac valvular disease, implanted devices and others in whom bacterial seeding might have more severe consequences. Antibiotic coverage should also be administered in high risk individuals, although it is not needed in routine hair restoration procedures. [12]
A bleeding diathesis, significant enough to impact the surgery, can be generally picked up in the patient?s history; however medications often go under the radar and should be asked for specifically. Patient?s often don?t think to report taking aspirin and this must be asked about as well as other non-steroidal anti-inflammatory medications. Plavix, in particular can significantly increase bleeding during the procedure. Alcohol, of course increases bleeding as well. [13]
One should make adjustments in a patient?s anti-coagulant medication in conjunction with his/her cardiologist or regular physician. As a general rule, one should stop anti-platelet medications one week prior to the hair transplant, but the interval will vary depending upon the specific drug, the size of the procedure, and the importance of the medication to the patient?s health. They can be resumed three days after the procedure. If the anticoagulants cannot be stopped, it may be reasonable to proceed with a smaller session.
Since epinephrine is used in most hair restoration procedures, if a person has a history of arrhythmias or other cardiac disease that could be exacerbated by epinephrine, medical clearance from the patient?s primary care doctor, or cardiologist, should be obtained. Epinephrine can also interact with broad-beta blocking agents such as propranolol, causing a hypertensive crisis; therefore, it is best to have the patient switch to a selective beta-blocker for the surgery. [14]
A number of manipulations can be used during the procedure to control bleeding and decrease the need for epinephrine. Among the most useful, is to scatter the recipient sites broadly over the area to be transplanted (allowing the extrinsic pathway to begin coagulation) and then filling in the areas with additional sites when the bleeding has subsided. [15]
If patients have a history of seizures, it is important that they do not discontinue their medication for the procedure and that medical clearance is obtained. One should also remember that otherwise normal patients can have a vaso-vagal episode during the procedure; particularly during the administration of the local anesthetic. This can be avoided by immediately placing the patient in Trendelenberg as soon as the patient complains of nausea or begins to sweat, or look pale.
A patient should be monitored with a pulse oximiter if a significant amount of sedatives or other respiratory depressants are used. The patient should be monitored closely to be sure that local anesthetics are administered in safe amounts and that the warning signs of lidocaine overdose are well known to all members of the surgical team. [16]
Finally, it is helpful to have a pre-printed summary of all the medications and their doses commonly used during the procedure. This can be given to the patient?s regular physician when seeking medical clearance.
Psychological Factors
Hair loss can take a psychological toll on a person?s self-esteem and cause considerable emotional distress. When a person has underlying psychiatric issues, the impact can be more severe and, therefore, management of hair loss considerably more difficult. It is important to identify these problems as well as other psychological factors that may play a role in a patient?s ability to clearly understand both the hair restoration process and its anticipated outcome.
In some cases, counseling can be done in conjunction with hair restoration, but often it should precede treatment, especially when surgery is contemplated. It is prudent to obtain clearance for surgery from a psychiatrist or clinical psychologist when there is a history of mental illness, or when it is suspected at the time of the consultation.
A number of psychiatric conditions are particularly relevant to the successful outcome of a hair transplant. These include Trichotillomania, Obsessive-Compulsive Disorder (OCD), Body Dysmorphic Syndrome (BDS), and Depression.
Trichotillomania is a relatively common condition characterized by the persistent urge to pull out one?s hair. It most commonly involves scalp hair, but can also involve the eyelashes, facial hair or other body hair. It often results in bald patches and can be identified by short hairs in the affected area that are not long enough to grasp. Active trichitollomania on any part of the body is an obvious contraindication to a hair transplant, but if a person has a history of this condition, the doctor should also be cautious and only consider surgery if the therapist is confident that the condition has little chance of recurring.
Obsessive-compulsive disorder (OCD) is a condition characterized by recurrent, intrusive thoughts (obsessions) and related behaviors (compulsions) which attempt to neutralize the anxiety or stress caused by the obsessions. In consultation, the OCD patient often asks a litany of questions and often asks the next question before listening to the answer to previous one. OCD patients are extremely difficult to satisfy and even in a very successful hair transplant can focus on a minor imperfection seeming oblivious to the good overall result.
Body dysmorphic disorder (BDD) is a mental disorder that involves a distorted image of one?s body. The person is extremely critical of their physical self, despite the fact there may be no actual defect. It should be obvious that patients with BDD will not be satisfied with a hair transplant, or other forms of cosmetic procedures, and the condition is best treated by a psychiatrist rather than a surgeon. Another note of caution is that patients with BDD have a much higher suicide rate than the general population, even greater than patients with depression. [17]
Depression is possibly the most common psychiatric disorder encountered in patient?s seeking hair transplantation, but it is also a common symptom of those experiencing hair loss. The doctor must differentiate between a reasonable emotional response to balding and a depression that requires psychiatric counseling. It is important to realize that a hair transplant will be ineffective in curing a medical depression and unfulfilled expectations may lead to a worsening of the condition.
References
1. Orentreich N: Autografts in alopecias and other selected dermatological conditions. Annals of the New York Academy of Sciences 83:463-479, 1959.
2. Bernstein RM, Rassman WR, Szaniawski W, Halperin A: Follicular Transplantation. Intl J Aesthetic Restorative Surgery 1995; 3: 119-32.
3. Bernstein RM, Rassman WR: Follicular Transplantation: Patient Evaluation and Surgical Planning. Dermatol Surg 1997; 23: 771-84.
4. Bernstein RM, Rassman WR: The Aesthetics of Follicular Transplantation. Dermatol Surg 1997; 23: 785-99.
5. Gandelman M, et al: Light and electron microscopic analysis of controlled injury to follicular unit grafts. Dermatol Surg 2000; 26(1): 31.\
6. Bernstein RM, Rassman WR, Rashid N, Shiell R: The art of repair in surgical hair restoration – Part I: Basic repair strategies. Dermatol Surg 2002; 28(9): 783-94.
7. Bernstein RM, Rassman WR, Rashid N, Shiell R: The art of repair in surgical hair restoration – Part II: The tactics of repair. Dermatol Surg 2002; 28(10): 873-93.
8. Bernstein RM, Follicular Unit Hair Transplantation. In: Robinson JK, Hanke CW, Siegel DM, Sengelmann RD, editors: Surgery of the Skin, Elsevier Mosby, London UK. 2005.
9. Unger WP, Shapiro R. Hair Transplantation. New York: Marcel Dekker, Inc. 2004.
10. Bernstein RM, Rassman, WR. Follicular Unit Transplantation. In: Haber RS, Stough DB, editors: Hair Transplantation, Chapter 12. Elsevier Saunders, 2006: 91-97.
11. Norwood OT. Male pattern baldness: classification and incidence. So. Med. J 1975; 68:1359-1365.
12. Haas AF, Grekin RC: Antibiotic prophylaxis in dermatologic surgery. J Am Acad Dermatol 1995; 32: 155-76.
13. Otley CC. Perioperative evaluation and management in dermatologic surgery. J Am Acad Dermatol 2006; 54: 119-27.
14. Gandelman M, Bellio R, Barretto M: Beta-blockers and local anesthetics with vasoconstrictors: A dangerous association. Intl J Aesthetic Restorative Surgery 1995; 3 (2): 143-45.
15. Bernstein RM, Rassman WR: Limiting epinephrine in large hair transplant sessions. Hair Transplant Forum International 2000; 10(2): 39-42.
16. Skidmore RA, Patterson JD, Tomsick, RS: Local anesthetics. Dermatol Surg 1996; 22:511-522.
17. Phillips KA, Menard W: Suicidality in body dysmorphic disorder: A prospective study. Am J Psychiatry, 2006; 163:1280-82.
18. Bernstein RM, Rassman WR. The scalp laxity paradox. Hair Transplant Forum International 2002; 12(1): 9-10.
Dr. Bernstein is Clinical Professor of Dermatology at the College of Physicians and Surgeons of Columbia University in New York. He is recognized world wide for pioneering Follicular Unit Hair Transplantation. Dr. Bernstein?s hair restoration center in Manhattan is devoted to the treatment of hair loss using his state-of-the-art hair transplant techniques.
Help, I Want My Hair To Grow
Hair has an overwhelming importance in many cultures. It is seen as a crown of beauty, shaped to create beautiful things, and even adorned with jewels to highlight its magnificence. In Western cultures, hair styles, cuts, and care pervades fashion, style, and even health magazines, all seeking to pump a new product or an adventurous celebrity hair cut. Yet, despite our endless search for the ultimate hair fitness or the perfect hairdo, men and women alike often find their hair in shambles, destroyed from gels, mousses, sprays, heat styling, and bad cuts from over zealous stylists. Before you read another Allure’s best article, borage yourself with new drugstore products, or quote the newest celebrity stylist hair tip, here are some myths and truths about hair and hair care.
As a trichologist and former cosmetic chemist, I have heard and, unfortunately, seen some of the hair and scalp horror stories. While I champion personal grooming and loving and discovering your hair, brilliant hair care should not come at a risk to your hair or scalp health. Here are some things that you should be know.
Truth # 1 Your Hair is Dead, But Your Scalp and the Hair Follicles that Push From the Scalp are ALIVE
Secretly, the most top reputed cosmetic companies will tell you that there is nothing you can do to remedy your hair woes because in reality the hair is dead. And, frankly, this is true if you are using about 98% of the products on the synthetic or non-prescriptive products on the market. Generally, all products are virtually the same, so much that they are created by the same companies and masked under different brands. For example, Estee Lauder is Aveda, Origins and Bumble & Bumble. Loreal is made by the same company as Matrix, Mizani, The Body Shop, Keratese, Garnier, Soft Sheen Carson, Redken, Lancome and Nexxus. This list goes on forever and generally all the products contain the same chemically derived ingredients in a different concentrations. The only difference is the packaging, the fragrance, the chemical dye of the product, or the list of extracts dashed inside. Because many consumers buy frequently off of packaging, they are often duped and run into buying the same products under different names over and over. This causes you to feel that there is nothing that you can do to help your hair, and the message is only hammered home when someone tells you that your hair is dead, your hair cannot repair itself, your hair cannot grow.
But, what you must remember is that scalp health and the providing of nutrients to the scalp is critical for healthy tresses. The hair at the scalp root is quite alive. Have you ever pulled a hair from your scalp? It hurts quite a bit because that is hair is hooked to the follicle and is receiving nourishment from the follicle, which is receiving its nourishing from what is applied to the scalp and what you give the body internally. However, if you feed you hair what it needs to thrive, as it sprouts, its health will show. So what can you do?
TIP# 1 Eat for your hair and overall body scalp.
I have discovered that patients who are often plagued repeatedly with dry scalp and scalp fungus have anti-inflammatory difficulties and dry skin overall. Introduce moisturizing and anti-inflammatory supplements into your diet, such as Evening Primrose Oil, Flax Seed Oil, Biotin, Olive Oil, Sea Buckthorn Oil, Pantothenic Acid, and Green Tea. I have truly seen tremendous results in patients’ hair and scalp shine, texture, health, and moisture within 4 weeks of changing their diet or adding oils rich in essential fatty acids to their daily supplement cocktail. To further increase the health of the hair and scalp, apply oil rich products that are water based to your scalp. Yes, oils have gotten a harsh wrap in hair care, but in many cultures, especially those with luxurious hair, oils are a necessary requirement. As an Indian myself, Amla, Brahmi, Coconut, Neem, and many other oils are in daily application to my hair to maintain its beauty. I personally love Beauty 4 Ashes’ Mango Scalp Nourish Hair Cream and their Ayurvedic Scalp Food Cream. These creams are lightweight and very soothing to the scalp, especially if you are not comfortable mixing oils yourself and have trouble styling your hair after the application of the oil. A few of my patients have also documented increased hair fullness after increasing their intake of fruits, oils, and nuts and applying Beauty 4 Ashes’ Ayurvedic Scalp Food Cream, which can be found in the UK at mybeauty4ashes.com. These products have had quite a success rate in the States at discoverb4a.com and also in Canada at myb4a.com
Truth # 2 Your Hair Can Grow if You Do Not Cut It
I love the versatility of long hair, and many others do as well. But, there is also beauty in a wonderful cut. Yet, many of my patients come to me expressing deep sadness about their hair thickness or length. I often hear them stating that they desire longer hair, but their hair cannot grow and when it does, their stylist cuts it because it has some form of splitting ends or breakage. It often strikes me as absurd. In India, I went years without hair cuts. It was simply braided or just worn. Further, individuals who have dredlocks may cut their hair very infrequently, and may even burn the ends of the hair to create uniformity and neatness, yet their hair still increases length. I desire more than anything to dispel this lie. You hair can grow without frequents trims to it. While it may grow uneven or even have some splitting, this is common because each hair that sprouts from the hair follicle is on its own timeline. Since some sprouted yesterday and some today, of course they will be different lengths and may split. But, since the hair grows from the root, not the end, your hair can grow, even if you do not cut the end.
Tip #2: If you want your hair to see more length, do not cut your hair, instead nourish it gently to prevent as much damage as possible.
If you want your hair to grow, and you plan on not trimming it, understand that it may not look celebrity like—perfectly even and shaped. But, it still can have volume, shine, and health. During this time, make sure you moisturize the ends, using something as simple as Olive Oil, Coconut Oil, Beeswax, Lanolin Butter, or even natural hair cream. Natural works best for the hair. Because your hair is a part of you, and you work best on natural nutrients, such as vitamins, proteins, oils, nuts, and the like, it is best to give your hair what you would give your body. Make sure you gently comb your hair during this time as well. This will prevent breakage. And, as mentioned above, do not neglect your scalp.
Truth # 3: Chemicals can hurt the hair
Natural works best for the hair. Because your hair is a part of you, and you work best on natural nutrients, such as vitamins, proteins, oils, nuts, and the like, it is best to give your hair what you would give your body. Products that contain chemicals can create amazing momentary effects. But, they are only hair bandages that use silicones, polymers, plasticizers, straighteners, softening agents, and chlorides to alter the feel and look of your hair for a very temporary period. For this sweet moment of gratification, you often live with years of hair damage or have to endure chemicals that canb negatively impact your health. A constant scalp condition I encountered due to chemicals is purple and red bumps on the scalp from chemical hair dyes. I also often see thick patches of the scalp from the repeated use of shampoos containing SLS, Behetrimonium Chloride, and ALS. Despite the hoorah about chemicals not being bad, many of the chemicals used in hair care products are derived from petroleum or alcohol. Petroleum is toxic and alcohol is very drying and damaging.
Tip #3 Buy Natural, Change Your Hair
Salon quality and great products can be found with all natural products. Of course, be cognizant of semi natural products and those that use parentheses to indicate something is derived from a natural ingredient. 100% natural products are out there. And, if anyone tries to discourage you, and they will (I had a patient tell my that Paula someone wrote about how herbs, fruits, and oils are awful for your hair —how absurd the things we will believe), just ignore them. As a trichologist, I am personally privy to the reality that over 25% of pharmaceutical products are made of plant compounds. As doctors, we search from cures to the hair, skin, and body from rain forests and then apply for the patent, label it as a drug, and rename the plant so that our consumers are not privy to the plant origins. Trust me, your hair will behave better by using natural products. Aubrey Organics and Beauty 4 Ashes make excellent 100% natural products. If you have specific hair care needs, Beauty 4 Ashes has more variety in its product selection and makes products that are suitable for all hair types.
I am a trained trichologist and has studied and successfully completed a recognised Trichology Educational Program. I am a registered member of the International Association of Trichologists.
