Thank you for your question.
You’re 25-years-old. You’ve submitted several good photos of the top of your scalp.
You state that you’ve been losing hair in the past 2 years and you’re aware about
PRP of maybe having a stimulatory effect to strengthen existing hair but you want to know
the best strategy to help your thinning hair and prevent future balding.
Well, I can certainly share with you my approach to helping patients like yourself in our practice.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island
for over 20 years. I am also the founder of TrichoStem™ Hair Regeneration Centers, a
system we developed over the course of the past 7 years using PRP and Acellular matrix
as well as other modalities to help people with male and female pattern hair loss. So
I can certainly share with you certain conclusions I have come to based on this extensive experience.
Essentially, over the course of time, we have learned of the invaluable benefit of Hair
Regeneration and as you refer to as this stimulatory effect on hair growth that can be significant
with PRP and Acellular matrix. And in patients your age, we certainly had dramatic improvement
in outcomes.
However, you’ve certainly focused in on the one significant challenge which is the
genetics. Your genetics clearly demonstrate a fairly aggressive rate of progression. To
give you some perspective, in the early years of developing this, we looked at people at
different stages of hair loss and saw that the overwhelming majority of patients responded
to the treatment of just the injection alone. However, with time, we got to see different
clinical profile trajectories.
Yes, with PRP, with Hair Regeneration, we can stimulate growth and we can make a big
impact. However, when I think of patients especially younger patients with aggressive
progression, there are certain concepts that I think are important to consider and to have
some perspective on. Is it possible that genetically, your hair growth cycles are going to be limited?
In other words, how many times will your hair grow before it stops growing altogether? Another
perspective to this is what is the relative sensitivity of hair to dihydrotestosterone
or DHT.
For many patients, especially during the early years of the fears about sexual side-effects,
a lot of our patients were able to use our procedure as an alternative to finasteride
successfully for the 3-4 years after we did our injections. However, when I look at a
younger person, I think well beyond what’s going to happen in a 3-5 year timeframe. I
feel particularly challenged if someone’s genetics is so aggressive. So a lot of times,
I do have a discussion with our patients who are younger about a DHT blocker like finasteride
and provide them with information that is a context of current state of knowledge based
on current published data about the drug finasteride and whether or not there is some potential
value.
Unfortunately, there is no cure for hair loss. And what you are facing is an aggressive pattern
that without any intervention will naturally lead to the permanent loss of your hair. When
I am treating younger people, I have certainly seen patients who even with a DHT blocker,
even with Hair Regeneration, PRP, multiple treatments, they will still lose hair and
there are some people who have aggressive pattern. Others, we are able to prolong the
lifespan but the effects may ultimately be limited by the genetic programming.
Compliance with DHT blockers is also a challenge. A lot of people, a lot of men who take DHT
blockers will stop taking these drugs for a variety of reasons. And so, you are essentially
in that group of younger people with rapid rate of progression. Essentially, seeking
the guidance of a doctor who’s going to provide you guidance in terms of management
and understanding the limitations of any strategy is still based on genetics and some unknown
variables until you actually try the clinical intervention. The art of medicine is ultimately
treat and observe. And the way I look at it, in a younger person, you do everything you
can to slow down this rapid progression. And ultimately, you want to get maximal coverage
for the maximal time that is your potential based on your genetics. That is the reality
as it is currently.
So I hope that was helpful, I wish you the best of luck and thank you for your question.