Thank you for your question.
You submitted your question with several photos. And you state in your question that you’re
22-years-old and you want to know how to regrow your hair. And you’re stating also that
your father has no hair loss and so since it seems that you’re a little bit wondering
why you do. And you’re asking again about how to regrow your hair.
Well, I can certainly share with you my treatment strategy in my 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.
Hair loss treatment has been a big part of my practice. In fact, I am the founder of
TrichoStem™ Hair Regeneration Centers, a system we developed to help people with male
and female pattern hair loss using a technology combining platelet-rich plasma (PRP) and Acellular
matrix. We’ve been doing this for the past 7-8 years and helping people from all over
the world and certainly have derived a lot of knowledge in helping provide strategies
to patients who come to us for similar situations like yours.
So to begin with, it’s very important to understand the genetics of hair loss and why
it’s often bewildering for a lot of people who come in and say that no one else in their
family has hair loss, why are they the one who has hair loss. And the reality is that
it is a genetic role of the dice and it is hardwired in your DNA to have the process
that you are experiencing.
So what do we do to help people with hair loss? Well to begin with, it’s important
to understand that no one is being cured, that whatever treatment strategy it is whether
it’s pharmaceuticals, regenerative medicine, hair transplant, it is managing hair loss.
So what I, as a physician, have to work with my patients on is an optimal treatment strategy.
So when a patient like you comes in and has such an aggressive hair loss pattern and essentially,
I define almost anyone who starts losing hair in their early 20s and specifically someone
who has lost as much hair as you have. Patients have come in who started losing hair when
they were 15 or 16-years-old and it’s genetics.
So, when we think of hair loss from that perspective, you have to understand further that hair that
is lost, most of it cannot come back. When it’s lost, it really is lost. There’s
a common misconception that hair follicles are potentially always there that can be reactivated
but that’s not the case. There’s a distinction between terminal hairs which are the hairs
that grow to a length that provide coverage and vellus hairs. And vellus hairs are fine
hairs that are throughout the body but never grow beyond 2 millimeters and are really imperceptible.
So when someone has hair loss, what is happening is the anagen, the growth cycle, the active
growth phase gets shorter. The resting phase gets longer.
Now in men, it has been well understood that one variable has an impact on hair growth
when there is male pattern hair loss is something called dihydrotestosterone or DHT. DHT blocking
with a drug like finasteride, I feel is important in helping particularly a younger person manage
hair loss. DHT sensitivity is something that I have essentially created an algorithm of
when I look at a patient such as yourself and I would think of someone like you as having
high DHT sensitivity. It doesn't mean that you have high DHT but it may mean that your
hair follicles are highly sensitive to the effects of DHT. So generally speaking, I recommend
a DHT blocker.
Now of course, thanks to a certain issue with the labeling of finasteride, a lot of people
have been influenced by the activity on the internet of the perception of finasteride
being a very harmful drug. I would say that as a clinical doctor prescribing this drug
since 1997 since it entered the market and my colleagues all over the world, we still
prescribe this drug and we of course inform our patients of the relative risks but I would
say that the risks are relatively low. But of course a lot of younger men come to our
practice are concerned about sexual side-effects. But I would say that it is still important
for you to consider a DHT blocker as part of your treatment strategy.
Now in our practice, we’ve developed a treatment called Hair Regeneration. As I described earlier,
we essentially developed this from the intention to help patients who were doing hair transplants
for. And basically, we wanted to see the hair grafts as well as the donor area heal better.
Well, a fortunate side-effect was that thinning hair became thicker. And from that, we derived
and developed a system of dosing and methods and a whole algorithm for both men and women
with genetic pattern hair loss. And so with that comes a treatment plan based on the predictability
of an individual’s profile and that profile is a combination of different variables including
gender, age, age of onset of hair loss, rate of progression, degree of progression, other
medical issues as well as other variables that can be influencing the hair loss such
as hormonal issues.
So a strategy that I would typically would use is using a DHT blocker like finasteride
to slow down your hair loss progression. And we would use a treatment like Hair Regeneration
to stimulate hair growth. Essentially, it’s important for you to understand that hair
loss is treated and managed. It's not cured. Eventually, the progression will march on.
But if you want to try to maximize scalp coverage well my opinion, the approach is optimal to
reduce the effect of DHT while stimulating the growth of hair with this treatment. And
we’ve had many examples of patients who came to us who were already on finasteride
but were still progressing and when we did our treatment, hair got thicker. So we were
able to make that distinction that finasteride can help prolong the lifespan of the hair
while Hair Regeneration from a different mechanism can stimulate regrowth, strengthen the hair
as well as increase the lifespan as well. And this has been well recognized in the medical
literature when it comes to PRP as the effect on the anagen phase of the hair growth cycle.
So in that combination approach, it can probably help you maximize coverage for as long as
is possible for you. I always explain to my younger patients that the aggressive hair
loss is that essentially, we have to observe and see how much of a benefit we get. But
when I provide a patient with a treatment plan, it’s with this understanding that
we want to use every tool we can to essentially work around the predetermined plan to extend
the lifespan of the hair for as long as is possible.
So meet with doctors who can assist you with this type of planning. I would say that it
is a little too early for you to get a hair transplant given how aggressive the hair loss
is. It’s a separate topic but I would say that first medical management to optimally
maximize stability before considering anything else that is more in the surgical side.
So I hope that was helpful, I wish you the best of luck and thank you for your question.