Hair Disorders

November 24, 2024
7:00 am

Hair Loss

Hair loss is a complex medical issue and could be due to genetics, underlying medical medical conditions, certain medications, hormonal imbalance or a combination of few reasons. Hair loss can be difficult to talk about. Hair loss can be seen in all age’s groups and on both genders. Here you will find information that can help you take steps to stop hair loss and promote hair growth.

Hair loss can be broadly divided into 3 categories

Non scarring hair loss

Non scarring hair loss means hair follicles are preserved,therefore hair loss is potentially reversible, with treatment of underlying cause hair growth is possible.

Androgenetic alopecia (AGA) is the most common type of non scarring alopecia.In men it is called male pattern hairloss (MPHL) and in women female pattern hair loss(FPHL).It can start as early as teens, and risk increases with age with more than 50% of men over age 50 have some degree of hair loss.In women,it is more likely after menopause. Hair loss particularly in men is related to hormones called androgens more specifically to androgen called dihydrotestosterone (DHT).Androgens also play role in female hair loss,but other less know factors also involved.Hair growth begins under the skin in hair follicles.Each strand of hair normally grows for 2-6 years, then goes into resting phase for several months and then falls out.The cycle starts all over and a new hair grows in the follicle.This cycle is controlled by androgens,however too much stimulation by androgens result in shorter and thinner hair strands,also the growth of new hair to replace shed hair is delayed.The outcome of this is visible hair thinning.

Research has confirmed the variations in AR genes to play a role in AGA.This causes increased activity of androgen receptors in the hair follice.It remains unknown how these genetic changes increase the risk of hair loss in AGA.Having a close relative with AGA appears to be a risk factor for developing this condition.

3) Alopecia areata (AA)

Alopecia areata (AA) is a condition which causes round patches of hair loss and can lead to total hair loss. This condition occurs when the immune system attacks the hair follicles. Our immune system protects us from foreign bodies like bacteria, virus and expels them. For some unknown reason, the immune system senses the hair follicle as foreign and starts destroying them. The first symptom of alopecia areata is hair loss, typically causing completely smooth round bald patches on the scalp. Rarely, patients may develop complete and total hair loss including body hair. It is unpredictable to determine the course of alopecia areata. In some patient’s hair loss can be permanent if they develop alopecia at early age/pre puberty, alopecia which lasts for a year or longer, have family history of AA, suffer from an auto immune condition, suffer from allergies on regular basis or have abnormal finger or toe nails. It affects both men and women. People with certain autoimmune diseases, such as psoriasis, atopic dermatitis, thyroid diseases or vitiligo are more likely to get AA. It is possible that emotional stress or an illness can bring AA in people who are at risk.

Types of AA

Patchy AA: most common type. Coin shaped patches on the scalp or other body parts.

Alopecia Totalism: all or nearly all scalp hair is lost.

Alopecia universalis: complete or nearly complete hair loss over all body.

AA primarily affects hair, but in some cases, nails change as well. People with disease are usually healthy with no symptoms. It can begin as sudden loss of hair in round patches over scalp but any part may be affected like beard area in men, eyebrows/eyelashes. When a patch appears, it is hard to predict what will happen next. Hair can regrow within few months, additional new patches may appear, small patches may join to form large ones and eventually hair may be lost from entire scalp or body. In most cases hair regrows, but there may be few more episodes of hair loss.

There is no cure for alopecia aeronaut there are treatments that help to grow hair back quickly. Some patients with severe hair loss opt to forego treatment and may consider hairpieces.

If you choose to get treated, our doctor will take into account you age and extent of hair loss when making treatment plan for you. A can be treated with corticosteroids, immunosuppressants and other medications which stimulate hair growth. AK inhibitors like baricitinib, Ritlecitinib have been recently approved to treat severe AA. Main goal of treatment is to stop the immune system attacking the hair follicles and to stimulate hair regrowth. A can cause emotional problems leading to depression and anxiety. Having a support network can help you deal with difficult time. Sign up for National Alopecia Areata Foundation which supports people with AA.

telogen Effluvium (TE)

Normally hair growth is a continuous cycle divided into three phases.

Anagen phase

Hair goes through anagen phase which is active growing phase lasting two to six years. Inability to grow hair beyond a certain length is due to short anagen phase. Length of anagen hair is different is different parts of body. Eyebrow, eyelashes and body hair normally have very short anagen phase.

Catagen phase

In this phase hair growth stops. The outside root sheath of the hair follicle shrinks and attaches to the root of the hair.

Telogen Phase

This is the resting phase of the growth cycle lasting around 100 days, the follicle is at rest and club hair is completely formed, with whitish bold at the root. It is normal to shed 25-100 telogen hair every day.

In TE large number of hair follicles on the scalp go into resting/telogen phase and next growth phase doesn't begin. These hairs fall out without new growth’s causes diffuse hair loss especially over the crown and temples. This hair loss can be due to childbirth, nutritional deficiencies such as iron deficiency, medical illness like thyroid disease, certain medications such as isotretinoin prescribed for acne, blood thinner warfarin, starting or stopping oral contraceptive pills. TE usually begins after 3 months of triggering event. If the cause is temporary and is corrected, hair usually grows back after 6 months. Sometimes TE can last beyond 6 months resulting in chronic TE which may last for years. Our hair expert doctor will identify the underlying cause of your hair loss and offer medications that help.

4) Anagen Effluvium (AE)

AE is a rapid hair loss due to medical treatments such as chemotherpy. These medications destroy rapidly growing cancer cells but may also damage healthy hair follicles resulting in hair loss. This hair loss is reversible and once chemotherapy is stopped, hair grows back. Our doctor will help you deal with hair loss and in regrowth.

5) Tinea Capitis

This is a fungal infection, commonly seen in children. It causes patchy hair loss over scalp and area may be itchy, red, scaly and oozing pus. Diagnosis can be confirmed by examining hair under microscope. If treated early, it responds well to treatment and complete hair regrowth is possible.

6) Seborrheic dermatitis /Dandruff

Seborrheic dermatitis is a common condition that mainly affects scalp. Exact cause isn't clear. It may be due to the yeast Malassezia, excess oil or a problem with immune system. It causes scaly patches, inflamed skin and dandruff. It usually affects the oily area of body such as face, sides of the nose, eyebrows, ears and chest. When it occurs in infants, it is called cradle cap.

It causes flakey skin(dandruff) on scalp, hair, eyebrows, beard or mustache. Patches of greasy skin covered with flaky white or yellow scales or crusts may be seen on the scalp, face, chest or under breast. Condition can be irritating but is not contagious and doesn't cause permanent hair loss. Signs and symptoms tend to flare up with stress, fatigue or a change in season.

For adolescents and adults’ treatment is medicated shampoos, creams and lotions. In severe cases our doctor might prescribe other medications that control inflammation.

If your child has cradle cap, wash scalp with a mild baby shampoo once a day. Gently loosen the scales with a cloth or an infant hairbrush before rinsing the shampoo. Cradle cap usually disappears in few weeks to months.

Scarring Alopecia

In scarring or cicatricial alopecia hair follicle is destroyed permanently by inflammation, replacing it with a scar tissue, hence hair loss is permanent. It can affect any age group and is seen both in men and women. It is very important to diagnose and treat scarring alopecia on time to prevent permanent bald patches. Scarring alopecia is seen in following conditions:

1) Discoid Lupus Erythematosus (DLE)

DLE is an autoimmune disease that affects skin causing red, scaly, itchy patches over face, ears and scalp. If diagnosed late, patches over scalp can heal with scarring leaving permanent areas of hair loss.

2) Lichen Planopilaris (LPP)

Lichen planus is a skin condition that causes skin and mucous membrane inflammation, when it occurs on scalp, it is called LPP.Exact cause of LPP is unknown. It is thought to be an autoimmune disorder of hair follicle. It affects more women than men. It can present as perifollicular scaling and redness. Patient may feel pain, itching or burning in scalp.LLP can cause scarring if treatment is delayed resulting in permanent hair loss in involved areas. Diagnosis is made based on clinical findings and confirmed by scalp biopsy. Based on pattern and location LPP has 3 types - classic LPP, frontal fibrosing alopecia, and Lassueur Graham-Little Picardi syndrome.

3) Folliculitis decalvans (FD)

Folliculitis decalvans (FD) is a rare, chronic scarring alopecia that occurs in adults. It presents as an expanding patch of alopecia with peripheral pustules on the scalp. Patients may have associated itching or pain.

The cause of FD is unknown.It is thought to be the result of an abnormal immune response to Staphylococcus aureus, although this is not yet proven. The inflammatory process targets the hair follicle, resulting in follicular destruction and permanent hair loss. Folliculitis decalvans typically affect the scalp, often around the crown, but may affect the beard area, axillae, limbs, and pubic hair. It presents as irregular, atrophic white patches of scarring and hair loss — solitary or multiple with follicular pustules and perifollicular crusts at the patch periphery.Follicular hyperkeratosis, scale, and erosions with "Tufting"— multiple hair shafts emerge from a single hair follicle, resulting in a ‘doll’s hair’ appearance.

Folliculitis decalvans is a clinical diagnosis. A scalp biopsy helps to differentiate from other scarring alopecias if required.

Treatment for folliculitis decalvans involves topical antibiotics and shampoos. Oral antibiotics are the first line treatment options like tetracyclines.Other (off-label) medications are used in severe or treatment resistant cases. Folliculitis decalvans usually follow a chronic fluctuating course of exacerbations and remissions over many years. Early diagnosis and treatment are important.

4) Frontal Fibrosing Alopecia (FFA)

It is most commonly seen in women especially affects postmenopausal women. It causes progressive recession of frontal hair line, may also be associated with loss of hair in eyebrows and underarms.

It is important to stop the disease progression to prevent permanent hair loss. Once diagnosis is confirmed, oral medications are prescribed to stop the inflammation in hair follicles and stop disease progression.

5) Central Centrifugal Cicatricial Alopecia (CCCA)

CCCA is a unique scarring alopecia seen mostly in women of African descent. It causes patches of permanent hair loss on the vertex or crown of the scalp and progresses centrifugally. Cause of CCCA is not clear. Use of hair care products such as chemical relaxers, hot combs, traction hairstyles may contribute to CCCA. An environmental and genetic factor may also play a role. Literature also suggests role of infections and autoimmune diseases seems to be multifactorial.

Treatment is often started with medications to reduce inflammation. Minimal hair grooming is recommended and also avoiding excessive traction of hairs.

Hairshaft Abnormalities

The visible part of the hair that comes out of skin is called hairshaft.The hair root is deeper in the skin and is covered by hair follice (sheath of skin and connective tissue).Hair shaft comprises of cuticle,cortex and medulla. Cuticle is the protective layer of overlapping cells that envelops the hair. Gentic and environmental factors can lead to hair shaft abnormalities make hair thin, brittle and weak resulting in breakage and causing overall hair thinning.

Patients with hair fragility should avoid physical or chemical trauma to their hair.Use of hair aggressive brushing,blow dryer,flat irons,certain stying products,wearing hair extensions/weave,pulling hair back tightly,coloring,perming or relaxing your hair all can lead to very dry,brittle hair resulting in breakge of hair shaft and hair loss.

1) Trichotillomania (TTM)

Trichotillomania is a psychological condition that leads to self-induced hair loss, most commonly affecting individuals between the ages of 9 and 13, though it can occur in adults as well, with women being more frequently affected. The scalp is the most common area where hair is pulled, followed by the eyebrows, eyelashes, and other body parts. Individuals with TTM find it difficult to stop pulling their hair, often due to a combination of genetic and environmental factors. Stress or anxiety may trigger episodes of pulling. Hair examination often reveals broken hair of varying lengths. Treatment typically involves cognitive behavioral therapy (CBT), which focuses on identifying stress triggers and the underlying psychological causes of the hair-pulling behavior. A psychotherapist will work with you to address the cause of the stress and help manage the urge to pull hair.

2) Traction Alopecia

Traction alopecia is caused by the chronic pulling of hair, often seen in individuals who wear tight ponytails, braids, or hairstyles that place excessive tension on the hair. This is particularly common in people with chemically relaxed hair, as it increases hair breakage and hairline recession. Traction alopecia is also observed in individuals who wear tight head coverings, such as nurses with tight caps, Sikh men and women with tightly tied hair under turbans, or those who wear hijabs or safety helmets. If the cause of traction is addressed early, hair may regrow. However, in chronic or severe cases, where scarring and fibrosis occur, a hair transplant may be considered as a treatment option.

3) Hypotrichosis

Hypotrichosis is a genetic condition characterized by sparse or absent hair from birth. The hair tends to be coarse, dry, and may not grow longer than a few inches. Eyebrows, eyelashes, and other body hair may also be sparse. In some cases, this condition may progress to complete scalp hair loss. There is no specific treatment for hypotrichosis, and counseling is often the main approach to managing the condition.

4) Loose Anagen Syndrome (LAS)

Loose Anagen Syndrome (LAS) is a self-limiting condition that predominantly affects young girls, usually between the ages of 2 and 6 years, though it can also occur in boys. Hair is poorly anchored and falls out easily, often due to friction, especially from rubbing against the pillow at night. Hair affected by LAS appears sparse, thin, and frizzy, and may not grow as expected. A gentle pull test will often result in hair coming out painlessly. LAS can be associated with certain hereditary disorders but typically resolves spontaneously with age.

Hair loss can be diagnosed through a comprehensive evaluation that includes a detailed medical history, physical examination, pull test, card test, trichometric analysis, and blood tests. In some cases, additional tests may be necessary to confirm the diagnosis. A scalp punch biopsy is often performed to confirm scarring alopecia. This is a simple procedure performed under local anesthesia. If necessary, our doctor will discuss the procedure with you in detail.

Hair Loss Treatments ( Male pattern/Female Pattern )

1) Male Pattern Hair Loss (MPHL)

MPHL is the most common type of hair loss in men.It is realted to your genes and male sex hormone.Typically starts at the hairline in the front of the head, gradually hairline moves backwards and forms an M shape.Over the vertex a circular area shows thinning and expands in size over time.The hair eventually becomes finer,shorter and thinner.Classic MPHL is a clinical diagnosis based on the appearance and pattern of hair loss.Hair loss can be due to other conditions.Our hair expert will examine your hair and discuss with you the diagnosis,need to perform any tests and management plan to stop the progression of hair loss and promote hair regrowth. Treatment is not necessary if you are comfortable with your appearance. Medicines use to treat MPHL, are topical/oral minoxidil and finasteride.Dutasteride is similar to finasteride may be more effective or for those who don't respond well to finasteride. Other treatments which are added to above include PRP,mesotherapy,stem cell treatments,use of laser light to stimulate hair follicles.

2) Female Pattern Hair Loss (FPHL)

Androgenic alopecia in females is called FPHL affecting upto 40% of females by age 50.It can be a traumatic expereince.Women with FPHL, can experience more hair shedding and develop thinning all over scalp with hair loss in front causing widening of the central part but it rarely causes complete baldness as it does in men.Genetics and hormonal changes contribute to FPHL.If your family member like mother ,father,grandmother suffered from FPHL, you are more likely to develop the condition.Women undergoing menopause or those diagnosed with PCOS due to changes in androgen levels can not only have hair loss but increase in coarse hair on other body parts.It is important to consult a hair expert to rule out other contributing factors.FPHL can co- exsist with telogen effluvium.

Good news is there are treatment options available including a hair transplant.Female hair transplant is performed without shaving the recipient area.

Medical Treatment

Topical Applications

Topical treatments are commonly used to address hair loss, particularly in conditions such as androgenetic alopecia (pattern baldness), alopecia areata, and telogen effluvium. These treatments are applied directly to the scalp to stimulate hair growth, reduce inflammation, or address the underlying causes of hair loss. Below are some of the most commonly used topical applications in dermatology for treating hair loss:

Oral Medications

Oral medications are often prescribed for various types of hair disorders, especially when the underlying cause involves hormonal imbalances, genetic factors, or systemic conditions that topical treatments cannot address effectively. These medications help in regulating hair growth cycles, reducing hair loss, and promoting regrowth. Below are some commonly prescribed oral medications used in the treatment of hair loss and other hair disorders:

Finasteride
Dutasteride
Spironolactone
Oral Contraceptives
Cyproterone Acetate
Minoxidil
Iron Supplements
Zinc Supplements
Vitamin D Supplements
Biotin

Non surgical Treatments

Intralesional steroids

It involves giving giving injection of corticosteroid such as triamcinolone directly into a lesion.It is used to treat alopecia areata , acne cystic, hypertrophic scar or keloid.It delivers a high concentration of medicine into the site maximising its efficacy and minimising the systemic side effects of a drug.

Intralesional injections are given into the site minimizing systemic side effects. Warts are injected by medication bleomycin when they fail to respond to other treatments. This treatment uses patients own immune system to fight the warts. Our doctor will ask you about your general health and examine you before recommending this treatment option.

PRP

PRP transforms the appearance of the skin by improving signs of ageing. It is a natural treatment as patients are treated with their own blood platelets and plasma. It is also known as Vampire facial as it performed with patients’ blood.

PRP increases collagen production, improves hydration, reduces wrinkles, enhances skin texture and makes skin tighter and firm.

Our blood has 4 components -white and red blood cells, lama and platelets. Platelets are blood cells and plasma are liquid which holds these cells. Platelets are important for wound healing. For rejuvenation, platelets are concentrated by centrifuging the blood which separates the 4 components of blood by density. White and red blood cells are discarded, only plasma containing platelets is used.

PRP increases collagen production and repairs the existing collagen making skin firm, reduces wrinkles, improves scars, improves texture and tone of skin. Skin continues to improve several weeks post treatment.

Patient may notice same side effects as with other injectables like bruising, redness and swelling which resolve in few days. Results are seen in few days with tighter and healthier appearance. For acne scars 4-6 sessions at 2-week interval are recommended.

PRP is a revolutionary hair restoration therapy for some patients. It protects and enhance hair growth has been used as a regenerative medicine modality for decades in the areas of sports medicine, orthopedics, dentistry, cardiothoracic surgery, dermatology and many others. What PRP does in the specialty of hair restoration is limited to its effects on follicles that can still be rejuvenated and are not yet ‘beyond repair.’ It can also be used in hair transplant surgery to improve the graft take-rate, as well as accelerate the healing and hair growth results of the transplanted area.” Studies show that PRP works best as a treatment for androgenetic alopecia (AGA). The best results are seen in patients with mild-to-moderate patterned hair loss, who are early in the process. PRP is for the person who wants to maintain and thicken the hair they have. It can be given alone or If patients are on Propecia and they want more, I will certainly give them PRP and let them continue on Propecia.

Mesotherapy

Mesotherapy is a technique by which lower doses of therapeutic agents and bioactive substances are administered by intradermal injections to the skin. Through intradermal injections, mesotherapy can increase the residence time of therapeutic agents in the affected area, thus allowing for the use of lower doses and longer intervals between sessions which may in turn improve the treatment outcome and patient compliance.

Mesotherapy is rejuvenating treatment that delivers antioxidants, plant extracts, enzymes, vitamins into the skin. It is the fastest way of delivering the product where it is needed with microinjections. Needles cause micro-injury which triggers body's own healing process by producing new collagen and elastin which adds to the firmness of skin. Cocktail of meso solutions containing peitides, growth factors, hyaluronic acid and other elements are used to address various skin and hair concerns.

With time skin matures and shows signs of ageing. Wrinkles particularly around the eyes and mouth become visible as one approaches age of 30. Collagen starts breaking with age resulting in saggy skin. Many patients’ men and women start with mesotherapy in their mid-20's to delay signs of ageing.

Mesotherapy is used to treat wrinkles/fine lines around eyes, mouth, neck and forehead. It brightens the skin, reduces pigmentation, treats acne and acne scars and restores skin glow. Mesotherapy is also used to treat cellulite, stretchmarks, alopecia, and localized fat deposits.

Mesotherapy with dutasteride, minoxidil, growth factors or autologous suspension, botulinum toxin A, stem cells, and mesh solutions/multivitamins are used for hair loss. Several sessions are needed to see improvement.

Procedure Details

At BW, highly trained staff will examine patients’ skin and rule out any contraindications to performing the procedure. It is important to avoid unwanted side effects. Doctor will create a custom-made plan to address patients concerns.

Treatment can be performed after using topical numbing cream. Tiny injection pricks are given into the targeted skin areas. Treatment takes almost 30 minutes. Post procedure some patients might have redness, bruising, swelling or reaction to injection which generally subsides in 48 hours. It is advised to avoid sun exposure and vigorous exercise for a day. Swelling and redness can be reduced by using cold compresses.

For optimal improvement 3 to 6 treatment sessions are recommended depending on the severity. Session can be repeated at 2 weekly intervals. Results are noticeable after 2-3 sessions. Skin looks more radiant, well hydrated and rejuvenated.

Microneedling/ Dermapen

Microneedling stimulates collagen production. It is performed with a handheld device which has ultra-fine needles at the tip which are sterile and made of stainless steel. These needles create tiny injuries which trigger collagen production and improve blood circulation. Microneedling is performed with Dermapen.It can safely treat delicate areas around the eyes, lips and nose. Depth of micro needles can be adjusted from 0-25 to 2.50 mm depending on the target area. Patients can have light superficial treatments or deeper sessions depending on the skin concern that is being addressed. Deeper sessions target acne scar and saggy skin. It makes skin younger looking, rim and smooth.

Microneedling’s helps with fine lines/wrinkles, acne/surgical/traumatic scars, enlarges pores, stretch marks, hyperpigmentation, saggy skin. It can be performed on other body areas like neck, decolletage and hands. Some hair loss medications like exosomes can also be delivered by microneedling.

Exosomes/stem cells

Exosomes and stem cells are at the forefront of regenerative medicine, offering groundbreaking potential for healing and rejuvenation. Exosomes, tiny vesicles released by cells, act as powerful messengers, delivering growth factors and proteins to stimulate repair and regeneration. Stem cells, with their unique ability to develop into various cell types, work synergistically to restore damaged tissues and promote natural healing. Together, they are being used in cutting-edge treatments for skin rejuvenation, hair restoration, and joint repair, unlocking new possibilities for non-invasive, effective therapies that harness the body’s innate ability to heal itself.

Procedure Details

Dermapen Microneedling is safe for most skin types. Patients with skin illnesses should consult a doctor first. Pregnant ladies should avoid the procedure.

It is a minimally invasive procedure. If patient is sensitive to pain local numbing cream is applied before procedure to ease the discomfort. Patient can feel mild tingling, tenderness and tiny drops of blood may show on surface during deeper sessions.

Post procedure skin may appear red, swollen, dry and feel hot for few hours. It is very important to hydrate the skin at this stage. It is better to avoid make up for a day and avoid sun exposure. Deeper sessions can take almost a week to be fully recovered.

For saggy skin, acne scars 4-8 treatments are recommended spaced at 4–6-week intervals. Some patients can see significant improvement after first treatment. The effect of treatment can continue for 6 months.

Low level laser Therapy

Another treatment alternative is the use of light devices with wavelengths of between 630 and 660 nm, known as low-level laser therapy. These devices can be used at home every day for 15-30 min.

Deep Scalp Cleansing

Deep scalp cleansing is a transformative treatment that revitalizes your scalp and hair by removing excess oil, dirt, product buildup, and impurities. This process promotes healthier hair growth, reduces dandruff, and improves the overall health of your scalp. By using specialized products and techniques, deep scalp cleansing ensures your follicles remain unclogged and your scalp feels refreshed. Incorporating this into your hair care routine can lead to shinier, more manageable hair while creating the perfect foundation for optimal scalp health.

Surgical Treatment

Hair Transplant

This commonly involves taking hair from back and sides of your head ( donor area) and planting it on the areas showing hair thinning (recipient area).The transplanted hair is permanent and grows naturally like your rest of the existing hair. Hair transplant surgery may be an option if other hair growth treatments didn't work for you or if you have already lost significant volume of hair.It is important to work with a hair loss and hair restoration expert.Hair transplant is a team work requiring skilled technicians.Our technicians can match the skill of very best extraction physicians.They perform their work without any time constrain unlike physicians who have likely busy practices.Before undergoing hair transplant consider practical aspects like cost and healing time.The procedure can take several hours.It is performed under local anaesthesia and a routine health check is performed before hair transplant.

Hair Transplant patient assessment

Several factors like current status of your hair, likely progression, density, size of your donor area and your expectations are taken into account during your initial consultation. It is important to consider medical treatment to prevent future hair loss.

Hair transplantation techniques:

The density of your donor area and your expectations are considered when planning which method of extraction is most suitable for you.If you are not available for a personal discussion, send your pictures along with some personal history.We will get back to you within few days providing you a free assessment.

Follicular Unit Extraction (FUE)/Punch Extraction

Follicular Unit Extraction (FUE) is performed using a very fine, motorized punch-like device to individually extract one graft at a time. It is a far less invasive alternative to traditional strip surgery. Unlike the strip method, FUE does not involve the use of a scalpel or sutures, so there is no long scar across the back of the head. Instead, FUE leaves tiny scars at the extraction sites, which are not easily visible. In the procedure, the donor area—genetically resistant to hair loss—is shaved to expose individual follicular units (FUs). These units are then carefully extracted using a specialized motorized punch. Once extracted, the follicular units are trimmed of excess tissue and refined to fit the size of the recipient area. We use high-quality punches to minimize trauma to the grafts and reduce scarring in the donor area. FUE is a minimally invasive technique, with less visible scarring, a larger donor area, and the flexibility to harvest grafts from other body sites such as the beard, mustache, eyebrows, or even scars. FUE offers quicker recovery times, fewer complications, and greater versatility compared to FUT. However, it is crucial to consult a hair restoration expert to rule out other contributing factors to hair loss before proceeding.

Follcular Unit Transplantation (FUT)/Strip Excision

Strip Excision (FUT) involves removing a narrow strip of scalp skin from the donor area at the back of the head. This strip contains hundreds to thousands of grafts, and the shape and size of the strip determine the number of grafts harvested. The donor strip is then meticulously processed under a microscope to prepare each follicular unit for transplantation.

The grafts are transplanted as intact units, meaning if a graft contains three hairs when extracted, all three hairs will remain together when implanted. Our goal is to produce healthy and viable grafts for the recipient area. We use a lateral slit technique to replicate the natural growth direction of your hair, ensuring the most natural-looking results possible.

Concerns about scarring: In FUT, patients often worry about the scar in the donor area. However, this scar is typically concealed under the surrounding hair and is generally not a major concern.

Procedure Day:

On the day of surgery, the doctor will review your previously discussed goals and expectations.
Once you are prepared in the procedure room, the operation begins with the injection of local anesthesia into the donor area to ensure a pain-free experience.
After the donor area is numbed, grafts are harvested according to the chosen technique.
While the grafts are being prepared by technicians, you can take a short break.
Next, recipient sites are created, and the technicians will carefully implant the grafts into these sites.
After the procedure, you will receive detailed post-operative instructions and a care kit containing antibiotics, mild pain relievers, and other essentials to ensure your comfort. You’ll also be asked to return for a follow-up to check progress and learn how to wash your hair during the initial recovery phase.

Post-Operative Timeline

First Week:

2nd–3rd Week:

1–3 Months:

5–6 Months:

8–10 Months:

1 Year After Surgery:

Stem cell transplant

Stem cells are unique cells with the potential to develop into various types of cells found in the body. They can divide, renew, and repair or replace damaged cells, making them essential for regenerative medicine.

In a stem cell hair transplant, a small skin sample is taken from the scalp using a punch tool. Hair follicles are extracted from this sample and replicated in a laboratory to produce a large number of hair follicles. These replicated follicles are then injected into the bald areas of the scalp.

One limitation of traditional hair transplants is that the donor area may not always have sufficient hair density to provide good coverage for bald areas. Stem cell hair transplants could solve this problem by enabling hair growth in both the donor and recipient areas. Although this technique is still under research, it offers a promising solution and is a ray of hope for individuals who are not ideal candidates for current hair transplant methods.

Current Techniques in Stem Cell Hair Therapy

Offered in many clinics, this procedure involves taking small scalp skin samples (usually three) using a 2.5 mm punch from behind the ear.
Cells from these samples are separated in a centrifuge and injected back into areas of hair loss.
The growth factors in the sample stimulate and promote hair growth.

Stem cells are harvested from body fat, typically from areas like the abdomen or hips, using liposuction.
The stem cells are then isolated from the fat and injected into areas of hair loss on the scalp.
This outpatient procedure usually takes a few hours, and results vary from person to person, often requiring multiple sessions.

Important Notes:

Hair care tips

If your hair is falling due to breakage/brittle dry hair following tips will help.

Air dry your hair or wrap in towel after a wash to absorb water.
Rinse shampoo from your scalp without rubbing hair. Use conditioners after every shampoo.
Wear a swim cap, rinse hair soon after swimming. Use special formula shampoo and deep conditioners after a swim.
Use wide-tooth comb. If you have straight hair, let your hair dry before you gently comb it. If you have curly hair, comb your hair while it is still wet.
Use blow dryers, irons at lowest possible setting. Use these tools less frequently. Limit the time hot comb or iron touches your hair.
Try to avoid styling products that offer long-lasting hold.
Wear hair loosely, avoid traction.
Wear weaves or extensions that are light, keep up scalp hygiene, use them for 2-3 months at the most.
Coloring/perming or relaxing hair
Coloring/perming or relaxing hair
Try to limit touch ups. especially when weather is dry.
Have one service at a time. Perm or relax, wait for 2 weeks before you color your hair.
Use conditioners after shampoo and protect hair from sunlight by using conditioner with zinc oxide or by wearing hat.
Limit the number of times your brush or style your hair.