MALE HAIR LOSS ::: Hair Loss Help :::
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Causes and Effects
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It is important to note that the doctors here charge for the number of grafts made, not the number of hairs placed. Some clinics charge by the HAIR. A graft may contain between 1-5 hairs (depending on the extraction method) so the number of hairs transplanted will always be more than the number of grafts placed. For the follicular unit extraction method, there will be about twice as many hairs as grafts and for the multiple follicular extraction method there will be almost three times as many hairs as the number of grafts implanted.

It is surprising what a difference hair can make to your appearance and the way you feel about yourself.

One of the photographs above is of natural hair with natural density. The other photograph is of hair transplanted using the Micro-Dense-Pack T-T technique used by the Plastic Surgeons you are able to consult here. To see which is which, click the link.

No. The donor area can have up to 50% of hairs removed before it starts to show. With a normal head of hair this means that up to 10,000 hairs can be taken for transplantation. The pictures above show, on the left, a patient before and after transplantation and on the right, the back of the head - the donor area - after the donor hair has been removed.

A hair transplantation in which a large area of baldness is covered using a large number of grafts is referred to as a mega-session. Up to 10,000 hairs can be transplanted in one session using multiple follicular extraction depending on the availability of sufficient donor hair. Using the Micro-Dense-Pack T-T technique perfected by the doctors here, it is possible to completely transform extensive baldness into a respectable head of hair in just one session lasting about 4 hours.

Hair on the back and sides of the head is unaffected by hair loss and can be transferred to areas of hair loss where it will remain permanently. The photograph above shows the donor area - capable of yielding 10,000 hairs for transplantation. The diagram below shows how a new, natural-looking 'frontline' is established with single follicles. The space on the top of the head is transplanted with mixed-size follicular groups, from 1-6 hairs per graft.

95 bald men out of one hundred can blame their parents. Their hair loss was predetermined by their genes in the same way as the colour of their eyes or the length of their fingers. There is nothing they can do to change their genes but the good news is that there is now a lot they can do to put hair back on their head.

For thousands of years men have searched for ways to overcome loss of hair. Hippocrates, the father of Western medicine, studied the nature of male hair loss in Greece, in 400BC, but failed to prevent himself from losing most of his hair. But he was the first to observe a link between male hair loss and the qualities of maleness provided by the male sex organs - they didn't know about testosterone in those days.

We have learnt a lot more since then. Today there is a far greater understanding of the process of hair growth and hair loss. Some types of hair loss are temporary, for example Symptomatic Alopecia, whereby hair will grow back in time. However, by far the most common cause of hair loss and baldness in men is Androgenetic Alopecia which is permanent. Hair will never grow back.

This does not mean, however, that nothing can be done, that a bald head is inevitable. The solution to hair loss lies in another of the observations of Hippocrates, namely, that hair on the sides and back of his head seemed permanent, resisting the process which caused the rest of his hair to fall out. Follicular relocation is the answer, moving hair from the area of the permanent zone and spreading it over the areas of hair loss. 'But won't the hair just fall out again?' you ask. The surprising answer is 'No'. Hair from the permanent zone is resistant to the causes of hair loss and, importantly, it retains this resistance wherever it is moved. If the hair was going to last a lifetime tucked away on the back of your head it is also going to last a lifetime if it is placed proudly on the front or top of your head.

Hair follicles in the donor area are extracted and inserted into areas of hair loss. There are two methods of extraction - Multiple Follicular Extraction and Follicular Unit Extraction. Multiple Follicular Extraction (1) provides a natural ratio of sizes of follicular group, Follicular Unit Extraction is selective, smaller groups suffer less damage during extraction, larger groups are therefore avoided. Each method yields tissue from which the follicular units are isolated (2) for individual insertion. To achieve a natural-looking hairline, single-follicular units are used to establish a slightly uneven frontline (3) with units of 4-5 follicles used to build up density behind. A skilled Plastic Surgeon makes the best use of available hair, creating the highest density in areas which are most noticeable.
Hair transplantations were first carried out successfully about 60 years ago. Since then, medical science, medical techniques, medical equipment and the accumulated experience of hundreds of thousands of transplants means that an awful lot can be done to help men suffering from the stigma of hair loss. Today there is no need to be bald. As you can see from the pictures on this site, there are men today who look in the mirror and brush their hair each morning, something they thought they would never do again. All of these men have been helped by the skills of the Plastic Surgeons you can contact here.

Types of alopecia (hair loss) and therapy
There are two categories of hair loss, permanent or temporary. If the hair root is damaged either by trauma or by the effect of DHT, hair loss is permanent. If the hair falls out and is not replaced but the root is left intact, loss is temporary and hair will usually re-grow after the cause of the condition has been treated.

Permanent types of hair loss include: Androgenetic Alopecia; Traumatic Alopecia; Pseudopelade of Brocq; Monilethrix Alopecia.

Types of temporary hair loss include:Pharmaceutical Alopecia; Symptomatic Alopecia.

It is important to establish the real cause of hair loss before making any decisions about treatments. Understanding a bit about the different causes and effects can help to identify the reasons for your own hair loss. It is also helpful to establish exactly where your hair loss has occurred and what stage of hair loss you have reached - see Stages of hair loss.

Androgenetic Alopecia
The most common form of male hair loss, androgenetic alopecia is responsible for significant hair loss in 50% of men by the time they reach the age of 50. There are three factors which govern the development of this type of hair loss - family history of baldness, the presence of hormones and age. Baldness appears to run in families, passed from generation to generation through the genes. It is thought that the genes involved in hair loss can come from either the father's or mother's side (autosomal) although there seems to be statistical evidence to suggest baldness in the mother's father is more likely to be inherited than from the father's father.

But family history is only part of the equation. Of its own, it cannot result in baldness. Hormones (androgens) play a part too. Your genes may have given you follicles with a higher sensitivity to the effects of hormones but hair loss will only occur if hormones are present in the necessary quantity.

Testosterone is the major androgen which circulates in the blood stream, bringing it into contact with the hair root (follicle). An enzyme (5 alpha-reductase) is present in the tissue of the follicle and metabolises testosterone into the more potent DHT (dihydrotestosterone) which acts through receptors on the hair follicle. Although DHT stimulates hair growth in the face and body, it also causes shrinkage of hair follicles which are sensitive to it (due to genetic predisposition). In these cases, the result is a progressive effect on the capacity of the follicle to produce hair and, through a process of miniaturisation, the follicle produces shorter, thinner and less pigmented hairs in shorter growth cycles until it ultimately ceases hair production irreversibly. Hormone levels on their own are not an indicator of potential hair loss. In fact, some studies have shown that bald men seem to have slightly lower levels of androgens in their blood than men with hair. It is the sensitivity of the follicle to the destructive effects of DHT which determines whether hair loss will result.

The third factor in Androgenetic Alopecia is time. The number of hair follicles each of us has is fixed from before our birth - we don't make new follicles. Over time, the growth cycle of hair means that a follicle is required to constantly generate new hair to replace the one which falls after the telogen phase. In a lifetime, a single follicle on the head (and there are up to 150,000 of them) could produce more than nine metres of hair. Inevitably, some follicles become weakened, reduced in size, incapable of making new hair. The hair produced later in life is usually thinner, less pigmented and the follicle, though not damaged, spends more time in the telogen phase (resting), waiting to produce the next hair. Over the years, everyone suffers some degree of hair loss but it does not become noticeable until the hair density is reduced to less than half the normal level.

Androgenetic Alopecia does not occur in pre-pubescent males, the hormones involved in this type of hair loss only appear after puberty. Those with a genetic predisposition to have sensitive follicles and whose bodies produce hormones in potent quantities will, after puberty, see their hair loss develop following a recognisable pattern. Some men start losing their hair in their late teens, others later in their life. By the age of 30, nearly a third of men are suffering from baldness.

The alopecia (baldness) which occurs usually follows a recognised pattern known as Male Pattern Hair Loss. The areas most susceptible to the degenerating effect of DHT are the front line and the crown of the head and it is in these areas where hair starts thinning. Every new generation of terminal hair becomes thinner and shorter until, in the end, the only remaining hair is extremely fine like down or fluff (velos hair) and the skin becomes shiny. Hair loss often occurs in cycles, a period of increasing loss followed by a period of stability. Your stage of baldness and rate of change can be assessed by referring to the Male Pattern Hair Loss illustrations and keeping a personal, dated, record of your condition.

There are, in all of us, areas of the head which contain hair which is resistant to the effects of DHT. These areas are found on the back of the head and on the sides of the head around the ears. These areas are called the 'Permanent Zone' as the hair here will never fall due to Androgenetic Alopecia.

The first signs of hair loss are usually noticed in the hair brush or in the shower drain. Next, the hair on the top of the head becomes thinner and shorter and no longer seems to grow between hair cuts. After this, there are places where the skin of the scalp becomes more noticeable than the hair it contains. The interval between first noticing hair loss and total baldness can be as long as 20 years or more. In other cases, hair loss can happen relatively quickly and stabilise after a few years.

Therapy: The only way to treat permanent hair loss such as androgenetic alopecia is by hair transplantation. Once you have decided to do something about your hair loss, the best approach is to plan how to use your existing hair most effectively considering your rate of hair loss. One strategy is to maintain your appearance over time with a number of limited sessions. Another strategy is to cover a larger area in a session of 1,000-2,000 grafts to establish a new front line at a stage when hair loss has become significant or has reached a stage of stability.

Traumatic Alopecia
A trauma to the head which destroys the tissue deep beneath the surface of the skin damaging the roots of the hair can cause baldness. This condition is called traumatic alopecia. The types of traumas which could cause this type of baldness are scarring left after major surgery, burns or exposure to radiation from the sun.

Therapy: When the roots of the hair have been damaged, hair loss is permanent. Transplantation is the only way to cover the damaged area with hair. The surgery required for this type of treatment is best done by a Plastic Surgeon. Unfortunately, this type of alopecia can deprive the areas normally used as donor hair. The extent of the transplantaion could therefore be determined by the availability of donor area.

Pseudopelade of Brocq
This type of alopecia isa rare disorder whereby the roots of the hair are often affected by inflamation caused by bacterial, viral or fungal infections. This form of alopecia starts with inflammation of cells around the follicle which induce its destruction and replacement with scar tissue. The condition is very hard to identify as there are few outward signs other than patches of hair loss. If the condition is suspected, often a small biopsy is taken to be studied microscopically. The inflammation which causes the problem invariably burns itself out and hair loss ceases. The areas of baldness, however, will remain as the follicles have been destroyed.

Therapy: Hair transplantation is the only way to cover areas of hair loss. Provided there is sufficient donor hair, this form of hair loss can be successfully treated by a Plastic Surgeon.

Monilethrix Alopecia
Monilethrix is a rare, inherited disorder characterised by sparse, short hairs no longer than 2.5 centimetres in length. The hairs are often dull, dry and brittle and break easily. If examined with a microscope, the hair shaft displays signs of periodic narrowing spaced evenly less than 1mm apart so that the hair resembles a string of beads. The condition can also affect the hair of the eyebrows and eye lashes. The extent of the alopecia varies from person to person and also varies from time to time in the same individual.

Therapy: Hair transplantation is not possible for patients with this condition as there is no donor area, the condition affects all of the hairs so none are suitable for transplantation.

Temporary alopecia
Temporary forms of alopecia are, in most cases, able to be treated pharmaceutically rather than requiring hair transplantation.

Pharmaceutical Alopecia
One of the side effects of medicines taken over a prolonged period of time is alopecia. Medications with this side-effect include cytostatic drugs used in chemotherapy, Vitamin A, some anti-depressants and some of the medications used for treating thyroid disorders. Exposure to poisons and heavy metals like arsenic, tin and thallium can also trigger this type of condition. Alopecia can occur immediately after starting a medicine or after a period of 3-4 months.

Therapy: Usually your doctor will be able to identify the cause and remedy the situation with different medication. Hair will re-grow once the cause of alopecia has been removed.

Symptomatic Alopecia
Also known as Telogen Effluvium, this is a short-term, reversible, form of hair loss caused primarily by stress. Telogen is the resting phase of the growth cycle. Normally, 10% of the hairs on the head at any one time are in this phase which lasts for about 3 months. When the body suffers shock or is put under stress it stops making new hair, thus conserving its limited resources. Consequently, a greater percentage of hair is put into the resting phase and fallen hair is not replaced. This type of hair loss occurs from any area of the head. Instead of the normal loss of about 100 hairs, up to 400 hairs could be lost daily. In some cases, the hair loss becomes apparent weeks or months after the event which triggered the condition. Hair can continue to fall for a period of months. The chronic form of symptomatic alopecia can result in hair loss continuing for many months or even years after the triggering event. There are numerous possible causes of this type of hair loss: sudden weight loss; under-active thyroid; high fever; major surgery; psychological stress; internal disease, iron or protein deficiency.

Therapy: Symptomatic Alopecia is reversible in most cases. Often hair re-grows naturally after the cause of stress has been removed.
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