I'm 23yrs Old.
I am sending you my Baldness Photo.
Am I a Good Candidate for HT as Chances of Shock loss are High?
In my case, hair needs to be transplanted in between existing hair so chances of shock
loss are high.
I'm using minoxidil since 6 months ago to reduce shock loss chances.
I'm just 23 years old and shock loss makes my look further worse.
Should I go for transplantation now???
And if yes, how many grafts are needed in my case???
Thanks in advance.
Thank you for your question!
At the age of 23, you're going through a very aggressive pattern of hair loss.
And you submitted some photos that are very helpful.
Essentially, your question begins with this concern about shock loss while undergoing
a hair transplant and you're using minoxidil to try to prevent that.
Well, I think you're in the right path as far as the shock loss concept but I'm going
to introduce to you a little bit something different that is not actually a hair transplant
to help you understand why we do what we do in our practice.
First of all, in terms of hair transplantation, for most practices in the field of hair transplant,
there is hesitation in doing hair transplant in patients as young as yourself ant that's
one main reason.
When people are losing their hair so quickly, then the desire for volume or the ability
to create the volume with transplant alone is not likely to work out because when you
think about hair loss, when you first noticed hair loss, you've already lost about 50% of
your hair.
Now, the typical number that we use in our field is, at most, you have a hundred thousand
hairs.
And when you are losing hair, you're noticing it, you're down to 50000 hairs.
Well, when you are at a point where you are ready to have a transplant, you have to understand
the limitations of the donor area.
Now, the donor area is the area at the back of the scalp which is permanent.
That is, resistant to the genetic effects of male pattern hair loss.
So, the donor area at a given time can yield 1500-2000 hairs.
And although people claim to have mega sessions where they do more than that, 2500 hairs,
it's a significantly lower percentage to cover an area where's there's a lot of loss.
So in general, being able to a move a maximal during maybe 3 or 4 sessions of hair transplant
procedures, you're not going to move 10000 hairs.
That's being very optimistic.
In our practice, we have had an opportunity to actually reverse hair thinning and thicken
hairs that are thinning using a technique called hair regeneration.
It just so happens that we have learned a lot in the past of couple of years about the
cells and signals related to hair loss.
And if you look at the literature in the medical literature, you can actually see there is
this initial perception where minoxidil and finasteride were the only pharmacological
treatment where dihydrotestosterone or DHT was considered the enemy and if you took
finasteride, you can decrease the enemy that's attacking the hair follicles.
But even with finasteride, people would continue to lose hair.
And a lot younger males who are taking finasteride would still continue to lose hair very aggressive.
So clearly, there's another part of the process that remain to be figured out.
So initially, in the course of 2-3 years, from 2011 or so onward, there are a couple
of things that we have learned: One is that the cell layer under the skin called the fatty
cell layer actually send signals to a part of the hair follicle called the dermal papilla.
Now, the dermal papilla then communicates with the part of the hair called the bulge
area where there are cells called progenitor cells.
And in the studies done in the University of Pennsylvania, they showed that the progenitor
cells are diminished in men who have male pattern hair loss.
So, serendipitously, a wound healing material called Extracellular matrix which heals by
duplication of cells was actually discovered to reverse thinning of hair.
So, some of the best discoveries of medicine happen to be by accident.
Right now, there are several companies that are biotech companies looking for the magical
cure of baldness and unfortunately, the concept of hair cloning still remains evasive because
the hair follicles is actually very complex.
You know, duplicating a hair follicle is like duplicating a kidney.
So what we have done over the past couple of years, is we have worked on developing
a formulation and a method of using extracellular matrix with platelet-rich plasma and other
factors including Vitamin D based on research in the University of Tokyo and we have been
very successful in reversing hair thinning.
Now, there is a limit.
This is not a perfect solution.
It is however a tremendous step in the treatment of hair loss and has helped patients who have
come to us from all over the world.
So what I would do for people who come to my practice, for someone like yourself, is
I would not do a transplant first.
I would first do the hair regeneration injection, see how much we can reverse and in so many
ways, it appears, we are restoring the critical cells.
It might be through an injury model that these cells are being restored that are protecting
the hair follicle from dihydrotestosterone and restoring the hair cycle that causes the
hairs to grow.
So essentially, for someone like yourself, I would wait to do a hair transplant.
I would do hair regeneration first, see how much you are able to restore through this
treatment and then if you still want to have more hair, then we can be very strategic.
It's very important when you are doing a transplant that you are dealing with a limited source
of hair.
So when we place these hairs, we want to get the most benefit in terms of coverage and
in framing the face.
So I realized that this is different from what you are considering but I think that
you should learn as much as you can about this newer technology.
Unfortunately, the hair field has lots and lots of false claims and a lot of hype of
a lot of things that don't work and it feeds on the desperation of people who are losing
hair.
So learn from this.
I advise that you incorporate this in the decision-making process and take the appropriate
steps in finding the right doctor for you.
So, I hope that was helpful for you and thank you for your question.