Thank you for your question.
You submitted a question with two photos and you state that you’re 40-years-old and that
you are dealing with some hair loss and you underwent a microneedling treatment. And soon
thereafter, your hair has been coming out in clumps and so naturally, you’re trying
to understand what is going on and what to expect. Well, I can certainly share with you
my opinion on what you’re going through even though I don’t know the exact details
of your treatment.
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. This
is a system that we developed in our practice starting seven years ago that is a non-surgical
solution for hair loss for both men and women using PRP and Acellular matrix and certainly,
I will elaborate further as it may be relevant to your current concerns.
So to begin with, when it comes to just hair loss, it’s very important to have an understanding
of what the underlying cause is. When we think about hair loss in women around the age of
40, basically the two things I think of first are female pattern hair loss and telogen effluvium.
Female pattern hair loss is genetic pattern loss. So when I evaluate patients, I look
at their family history to see if other women in either side of the parents’ families
had hair loss around that particular age, the nature of the hair that is being lost
in terms of the degree of shedding and just the characteristics of the awareness of the
quantity of hair over the course of time. Basically, female pattern hair loss is slow
progressive thinning of hair. Now, in contrast to something like telogen effluvium is very
often preceded within two to five months by a significant stress which can result in significant
hair shedding.
Now, let’s say you have female pattern hair loss, well, where microneedling has a somewhat
limited but a significant role in the treatment of hair loss for both men and women is based
on an observation that when the skin is traumatized with either a needle like a dermaroller or
a microneedling device that is adjustable, you get a healing response and sometimes that
healing response involves the short fine hairs often referred to as vellus hairs. And so
a lot of people come to our practice saying that they regularly microneedle their scalp
to try to stimulate hair growth and they are so convinced of the effectiveness. However,
when I ask them how long does the hair grow and they answer, not very long because it’s
not like a hair that will continuously grow like what we refer to as a terminal hair.
Now when microneedling is done, depending on the depth and the aggressiveness of the
treatment, what you are experiencing is not uncommon. And my perception generally is that
the process of microneedling at the superficial level in the hair in women may induce some
inflammation which causes the hair to go into telogen phase, a shedding phase or the microneedling
can actually penetrate the skin deep enough to break the shafts of hair. I think it will
be difficult to actually damage the follicles even though not necessarily impossible. But
if the hair breaks, it of course sheds out and then the hair will continue to grow. So
I would say to you that if you have a question about whether or not you have female pattern
hair loss then explore that question and get a proper diagnosis before you go and have
any treatment.
To help you understand our approach with female pattern hair loss, I would explain a little
about Hair Regeneration referred to earlier as TrichoStem™ Hair Regeneration Centers.
When we were doing a lot of hair transplants, we were trying to expedite the healing process
and stimulate the growth of the grafts, we discovered that thinning hair became thicker
and what we figured over time and this started about 7 years ago is a way to actually treat
female pattern hair loss with a combination of platelet-rich plasma which is derived from
your blood combined with a material called Acellular matrix which is used for advanced
wound healing. What we’ve been able to do is essentially stop the progression of thinning,
reactivate hair that is not growing as well as induce the shed of thinning hairs so that
thicker hairs grow in.
This has been a major milestone in the treatment of female pattern hair loss and we treat patients
from all over the world. Essentially, this approach actually has been sustainable where
one injection or at most 2 injections over the course of up to 18 months can sustain
growth for 5 years according to data that we have been accumulating for the past 7 years.
And the largest bulk of patients being in the past 5 years. So we have an alternative
that you might be interested in pursuing besides microneedling to help you with your hair loss.
But again, it’s very important that there would be a proper diagnosis.
I would discourage you from doing microneedling for hair loss. I realize that there are a
lot of people who believe in it and they put topical PRP and they feel that’s an effective
treatment. I don’t mean to offend anybody but I think that when I look at my practice
and how I help my patients, clinically speaking, this Hair Regeneration treatment which is
an injection, there’s been no comparison to doing microneedling.
We do microneedling in our practice. We use it for fine lines and wrinkles and we do it
for acne scars and it definitely has a very good role. In fact, it has a lot of benefits
that can be employed in the skin. But when it comes to hair thinning, I think that it’s
not quite that effective and we’ve done microneedling in the early to middle stages
of this development of our hair loss treatment and there is still some potential value but
I feel like it may have role in non-hair-bearing skin or areas where it doesn’t look like
there’s any existing hair. But where there is existing hair and density, my feeling is
that the trauma of microneedling is likely to create an issue like yours where hair can
break and shed and we’ve had the long-term data to be able to make these observations.
So although microneedling has been and can occasionally be part of our process, we generally
feel that it has to be for the right situation. But generally speaking, I think that in our
case, I think that microneedling probably is unnecessary moving forward.
So I hope that was helpful, I wish you the best of luck and thank you for your question.