Alope­cia Bar­bae is also called bald­ness. This is the exceed­ingly rec­og­nized ail­ment encoun­tered by many today. The vic­tims of this dis­or­der belong to both gen­ders. How­ever, research reveals that the causative agents of Alope­cia Bar­bae are respon­si­ble for the appar­ently dif­fer­ent effects too in men and women.

Bald­ness is wide­spread across the globe, vic­tim­iz­ing 50% of males and a sim­i­lar per­cent­age of females above the age of 40 years. How­ever, in this group of females, 13% of pre­menopausal patients express only slight signs of the dis­ease. Nonethe­less, the chances of falling prey to Alope­cia Bar­bae increases after menopause that 75% women over the age of 65 years of age get affected by this prob­lem. Before reach­ing the age of 40 years, the suf­fer­ers bear signs of Alope­cia Bar­bae, and some depict this even before they turn 30. 

Alope­cia is a psy­cho­log­i­cal tor­ment for the suf­fer­ers. Hair loss allows the head to be exposed to the UV rays, giv­ing rise in actinic inflic­tion. Car­diac ail­ments could be accel­er­ated by Alope­cia in males, and increase in mild pro­sta­tic hyper­tro­phy could be asso­ci­ated with this prob­lem too. If the ongo­ing research stud­ies evi­dence that the above rela­tions are valid, then the clin­i­cal impli­ca­tions with Alope­cia would increase too.

White males are the most affected by bald­ness in terms of fre­quency and sever­ity while the sec­ond most affected are Asians and African Amer­i­cans. The least affected are Native Amer­i­cans and Eskimos.

Onset of the Ailment

Alope­cia Bar­bae begins slowly. In men, it starts with hair loss in the tem­po­ral region which reshapes the pos­te­rior hair­line. Then, it devel­ops with the usual ante­rior and apex hair loss. While in case of women, it begins with scat­tered hair loss in the crown. The tem­po­ral hair loss is sim­i­lar to men, but gen­er­ally, females retain their ante­rior hairline.

Phys­i­cal Changes

The suf­fer­ers of both gen­ders expe­ri­ence the tran­si­tion from healthy, pig­mented ter­mi­nal hair to weak, short and scat­tered hair. The end result is stunted, flimsy, non-pigmented hair in the affected areas. With time, the ana­gen step decreases while the tel­o­gen part is unaf­fected. It gives rise to the hair fall among the vic­tims. Though it pro­vides a gen­er­al­ized pic­ture, the dif­fer­ences in the devel­op­ment of ail­ment always per­sist among dif­fer­ent indi­vid­u­als. In case of females, usu­ally, the patch of hair loss can­not be spec­i­fied. Gen­er­ally they lose hair in all areas over the crown. The core dif­fer­ence is that the ante­rior hair­line is safe in case of females while that is lost right at the onset of the prob­lem in case of males.

Sci­en­tist and doc­tors have for­mu­lated var­i­ous drugs, pills, solu­tions, and sur­gi­cal pro­ce­dures just to stop hair loss. In many cases sci­ence has suc­cess­fully con­trolled the rate at which DHT has been caus­ing hair loss with prod­ucts. Many of these prod­ucts are also used to stop the onset of hair loss caused by cer­tain body hor­mones such as DHT. These prod­ucts included:

• Provil­lus
• Rogaine
• Nioxin
• Fol­li­cle revitalizers

While these treat­ments may stim­u­late faster hair growth there may be also some side effects that users have to antic­i­pate. Aside from the pro­duc­tion of hair-regrowth sub­stances, doc­tors have also devel­oped hair trans­plant surgery as a means to stim­u­late new hair growth. Hair trans­plant surgery involves trans­fer­ring fol­li­cles from areas where there are no pres­ence of DHT to the bald­ing areas of the head. For patients who pre­fer a nat­ural solu­tion, there are treat­ments that don’t involve the use of tech­nol­ogy or med­ica­tions. Aloe Vera, sting­ing net­tle green tea red pep­per and dong quia are some of the many herbal based treat­ments that users can either apply to their scalp or ingest. It is pointed out that these herbal – based treat­ments also con­tain sub­stances, which inhibit the spread of DHT. How­ever, no mat­ter what treat­ment option is cho­sen, it is always rec­om­mended that hair loss patients con­sult with a doc­tor to get the par­tic­u­lar med­ical diag­no­sis of his/her hair con­di­tion. The specifics of the patient’s case are vital so that he/she can get the most suit­able hair regrowth treatment.

Make sure to pick up NEWSWEEK dou­ble issue: MAY 24 & 31, 2010

John Kahen, M.D the founder and med­ical direc­tor of Bev­erly Hills Hair Restora­tion is cur­rently fea­tured in NEWSWEEK mag­a­zine, an exclu­sive issue fea­tur­ing BEST DOCTORS IN THE GREATER LOS ANGELES.

Hair restora­tion pro­ce­dures have changed in the decades since they were first done. The ear­lier meth­ods of using hair plugs were not accept­able to soci­ety. Hair trans­plant patients appeared to have doll like hair. Now hair trans­plants are more nat­ural look­ing due to the inno­v­a­tive meth­ods being used, such as micro grafting.

In gen­eral, most hair trans­plant surg­eries today involve micro graft­ing. Micro grafts hold about 1–3 or four hair fol­li­cles. Older style hair grafts often held on aver­age a dozen hair fol­li­cles. These new micro grafts are only pos­si­ble because skilled sur­geons have refined their method of extract­ing them.

Micro grafts are use­ful in hair trans­plant surgery because they can give the hair a quite nat­ural appear­ance. The hair emerges from the scalp in the most nat­ural way, with the same num­ber of hairs that nature intended. If the pro­ce­dure is done cor­rectly, no one can tell the difference.

Pre­vi­ously, when hair plugs were used, doc­tors did the hair trans­plant surg­eries much dif­fer­ently. They used an instru­ment called a trephine to cut cir­cu­lar grafts from 2mm to 5mm in diam­e­ter. These plugs were inserted into the bald­ing area.

Finally, the micro grafts will be fin­ished by being divided into indi­vid­ual grafts by using a stere­omi­cro­scope. The sur­gi­cal team will make a vari­ety of grafts from eight-shaft mini grafts to one or two shaft micro grafts. These will be moved dur­ing hair trans­plant to the recip­i­ent sites so that the hair will have a nat­ural hair­line with full­ness on top.

There are sev­eral vari­a­tions avail­able and the most pop­u­lar and effec­tive of which include:

Hair Trans­plant Surgery

Hair trans­plan­ta­tion is a pro­ce­dure in which the sur­geon removes areas of hair-bearing scalp from the back or sides of the head and inserts the grafts  to the bald­ing areas. The rec­og­niz­able term for this tech­nique is ‘graft­ing’. The newly relo­cated hairs grows in the trans­planted areas that were pre­vi­ously bald. Once the hairs are trans­planted they are per­ma­nent and can be treated such as you would normally.

Hair flap surgery

Best choice for men with severe bald­ness. It involves a large flap of skin, on which hair is alive and grow­ing, to be pulled from the back and sides over the top sur­face area of the bald spot. It is then sur­gi­cally attached into place. The hair re-roots and begins to grow from its new loca­tion, ulti­mately elim­i­nat­ing any hair­less area.

Scalp tis­sue expansion

A balloon-type mech­a­nism is care­fully inserted under the scalp through an inci­sion. A salt-water con­coc­tion is added to slowly fill this bal­loon over time even­tu­ally caus­ing a swelling and stretch­ing of the scalp. The loose­ness actu­ally causes new skin cells to grow. After about two months this skin can be relo­cated to the area of bald­ness effec­tively mov­ing the hair to cover the spot.

Scalp reduc­tion surgery

 Also known as ‘advanced flap surgery’ since it is sim­i­lar in prin­ci­ple except a sec­tion of the bald scalp is actu­ally removed; rather than just pulling the skin over the hair­less spot. With the reduc­tion the sur­round­ing areas are actu­ally pulled up and con­nected in place of the absent scalp.

1. DHT Hair Loss: A Chem­i­cal Process

Dihy­drotestos­terone (DHT) is a nat­ural metabo­lite in the human body that is the main cause for hair loss.  The trou­ble starts once testos­terone com­bines with an enzyme present in the oil glands found in hair fol­li­cles. DHT shrinks the hair fol­li­cle which causes the hair fol­li­cle gets smaller and finer. This is referred to as minia­tur­iza­tion with which the hair ulti­mately falls off. This is how DHT is respon­si­ble for about 95% of hair loss. The men or women who lose more hair are those who are genet­i­cally pre-disposed in pro­duc­ing more DHT than others.

2. Mir­a­cle Hair Care Prod­ucts for Baldness?

 There is no mir­a­cle hair care prod­uct that will stop bald­ing. How­ever, if a prod­uct blocked enzyme pro­duc­tion in the oil glands and DHT it should result in block­ing the hor­mone that causes balding.

3. FDA Approved Prope­cia for DHT Hair Loss

 Finas­teride is a drug that was used to treat prostate can­cer but the FDA has tested this drug and found that it reduces the pro­duc­tion of the enzyme 5 alpha thereby reduc­ing DHT lev­els. Hair loss is pre­vented when using this drug, how­ever it is only intended for males to use as a pre­ven­ta­tive hair loss solution.

Hair Fol­li­cles

Hair has two dis­tinct struc­tures — first, the fol­li­cle itself, which resides in the skin, and sec­ond, the shaft, which is what is vis­i­ble above the scalp.

Two sheaths, an inner and outer sheath, sur­round the fol­li­cle. These struc­tures pro­tect and form the grow­ing hair shaft. The inner sheath fol­lows the hair shaft and ends below the open­ing of a seba­ceous (oil) gland, and some­times an apoc­rine (scent) gland. The outer sheath con­tin­ues all the way up to the gland. A mus­cle called an erec­tor pili mus­cle attaches below the gland to a fibrous layer around the outer sheath. When this mus­cle con­tracts, it causes the hair to stand up which also causes the seba­ceous gland to secrete oil.

Hair Shafts

The hair shaft is made of a hard pro­tein called ker­atin and is made in three lay­ers. This pro­tein is actu­ally dead, so the hair that you see is not a liv­ing struc­ture. The inner layer is the medulla. The sec­ond layer is the cor­tex and the outer layer is the cuti­cle. The cor­tex makes up the major­ity of the hair shaft. The cuti­cle is a tightly formed struc­ture made of shingle-like over­lap­ping scales. It is both the cor­tex and the medulla that holds the hair’s pig­ment, giv­ing it its color.

Hair Growth Cycle

Hair on the scalp grows about .3 to .4 mm/day or about 6 inches per year. Unlike other mam­mals, human hair growth and shed­ding is ran­dom and not sea­sonal or cycli­cal. At any given time, a ran­dom num­ber of hairs will be in one of three stages of growth and shed­ding: ana­gen, cata­gen, and telogen.

Causes of hair loss induced by scalp infections.

Fol­li­culi­tis

Fol­li­culi­tis is a term for inflam­ma­tion of hair fol­li­cles. It looks like acne with lit­tle rings of inflam­ma­tion sur­round­ing the open­ing of a hair fol­li­cle. In the early stages of a fol­li­culi­tis, the hair fiber may still be present, but as the fol­li­culi­tis pro­gresses the hair often falls out. There are non-infectious forms of fol­li­culi­tis, such as those caused by oils and greases applied to the skin that clog up the hair fol­li­cles, but fol­li­culi­tis is usu­ally due to a bac­te­r­ial infec­tion. Non­pre­scrip­tion top­i­cal antibi­otics such as bac­i­tracin, myc­i­tracin, or neomycin can be used to treat minor folliculitis

Piedra

Piedra (tri­chomy­co­sis nodu­laris) hap­pens when the hair fibers are infected by a fun­gus. The vis­i­ble indi­ca­tor of a piedra infec­tion is devel­op­ment of hard nod­ules on hair fibers. Indeed, “piedra” is Span­ish for stone. Piedra infec­tion may affect hairs of the scalp, body, and gen­i­tal areas. Usu­ally the infec­tion is rel­a­tively benign. In parts of Malaysia, the nod­ules of black piedra are con­sid­ered attrac­tive and tra­di­tion­ally women encour­aged its growth by sleep­ing with their hair buried in the soil. Treat­ment gen­er­ally involves shav­ing off affected areas. Anti-fungals such as keto­cona­zole or terbinafine are also used.

Demodex fol­licu­lo­rum

Demodex is a lit­tle worm-like crea­ture that likes to live on skin and in hair fol­li­cles. It feeds on dead skin and oils, so it par­tic­u­larly likes to live in hair fol­li­cles where there are lots of both.

Humans are born free of Demodex, but dur­ing child­hood, through con­tact with oth­ers, the skin can become infected with it. For the most part, we never know they are there. They are benign, if repul­sive, lit­tle crea­tures. The most com­mon prob­lem with Demodex is that they may cause irri­ta­tion, par­tic­u­larly in the eye­lashes. If you have itchy eye­lashes, Demodex may be the problem.

Patients should be very care­ful if they pull scabs off and should be aware that they put them­selves at risk of remov­ing the graft. There are actu­ally two types of scabs; one of the two is stuck only to the hair and the other type is stuck to the actual sur­face of the graft. In a study it showed that for the first two days, pulling on a scab always resulted in a lost graft, the chances of the graft being com­pletely removed startes to decrease by the third day. Pulling on scabs that were stuck to the sur­face always resulted in a lost graft through day 1–5 how­ever, by days 10 – 14 post– op, grafts are at a lower risk of  being dis­lodged. You must be gen­tle with scabs if you are going to chose to pull them off, regard­less of the time frame you still risk the chance of pulling the graft out as well. If you fol­low the wash­ing tech­nique we out­line for you in our post-op instruc­tions the scabs should come off on their own. The use of Graft­Cyte which is a copper-peptied moist dress­ing, hydrates the area, as well as pro­vides micronu­tri­ents to speed the heal­ing of the fol­li­cles and will be able to elim­i­nate sur­face crust­ing while allow­ing the coag­u­lum that formed around the graft, to hold it firmly in place.

Grafts need to be prop­erly cared for imme­di­ately after being taken from the donor strip, if not they could which will cause the grafts not to grow.

There are numer­ous rea­sons that can con­tribute to poor hair growth after a hair trans­plant how­ever it is very unpre­dictable and has been reported with every tech­nique uti­lized in hair trans­plant surgery. One belief is the grafts planted are dying before they are placed into the recip­i­ent site. The rea­son is, dur­ing the hair restora­tion process the grafts that are left out of the hold­ing solu­tion for a long period, or kept under the micro­scope for an extended period of time and dry out. It is also thought that grafts can be injured in the dis­sec­tion processes or can be trau­ma­tized while they are being placed. If the grafts are grasped too tightly or manip­u­lated too much, the injury maybe to server and the graft will die, which in this cause the hair does not grow. Prop­erly hydrated, grafts will sur­vive out­side the body for many hours.