Thank you for your question.
You’re 28-years-old and you submitted a photo of the top of the scalp showing your
hair part. And you say you were starting to lose hair a year ago. And you’ve been on
minoxidil for about 10 months or so and you are looking into Acell and PRP and you’ve
learned that it doesn’t work for everybody. And so you want to learn more about other
options.
Well, I can certainly share with you how I approach patients like yourself in my practice
who have similar concerns and issues. 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 transplant and hair
loss have been a very big part of my practice. In fact, I am the founder of TrichoStem™
Hair Regeneration Centers. This is a system we developed that evolved from hair transplant
surgery using Acellular matrix and PRP. And we’ve been treating patients from all over
the world, men and women of a very wide range of ages. So I think I can help you to just
understand the landscape of what you are dealing with.
So to begin with, it is certainly a little bit less common for a woman your age to have
hair loss and therefore, it’s actually very important to have a proper medical evaluation
before you undergo any treatment. So what does that mean? Well, for a young woman, you
want to make sure that hormonal levels are appropriate. So, whether it’s seeing an
endocrinologist or your gynecologist, you want to check hormones such as testosterone,
estrogen. You want to check vitamin D3. You want to check thyroid levels. There’s essentially
a hair loss work-up panel, a combination of the hormone levels as well as complete blood
count, making sure you’re not anemic. In fact, you can even look at certain inflammatory
markers.
So once you have a proper medical work-up, in addition, we also look at family history.
When we have treated younger women, we often see a certain consistency with family history.
Not every time but for example, one of our youngest patients was 16-years-old. When I
was being told about her in the hall by my nurse before I went into the room, I was ready
to do biopsies and other things to try to figure what’s going on. And then I learned,
because her mother had exactly the same condition with the same onset, it became clear that
this was a familial trait. Nonetheless, it doesn’t mean that you still don’t get
medical work-up but it means that at least you may fall in what is usually the 95% likelihood
of something called androgenetic alopecia or genetic pattern hair loss.
Now doing Hair Regeneration treatment now for more than 7 years in our practice, we
have had a wide range of patients of all ages. And in women, we are seeing large groups of
women in their 20s and early to mid 30s who previously were not really being paid attention
to because there weren’t really that many options. There’s essentially, the only FDA
approved drug is minoxidil and most patients, most women who come to us will feel basically
indifferent about the benefits of minoxidil.
So as far as the question of Acellular matrix and PRP, it is something that I am very happy
to see that more people are validating the benefits of these treatments. The challenge
is, what we had to overcome over many years being in the front of the parade and being
the first to really or first of a handful of doctors to be pursuing this for more than
7 years ago, essentially what the challenge is the formulation, the method of placement
and the strategy for the individual patient. And what we developed was an algorithm for
patients based on gender, age of onset, degree of hair loss and rate of progression. And
from that, I developed formulations and systems based on my clinical experience.
So the question is about whether or not ACell and PRP always works, well I can tell you,
as of recently, for the past several years of treating women, we almost basically haven’t
had any treatment failures for women with androgenetic alopecia which means genetic
pattern loss. Now, as I often tell my patients is your scalp didn’t read a textbook. So
you don’t always get to have just one diagnosis. You can have androgenetic alopecia with telogen
effluvium, you can have it with alopecia areata, you can have it with lichen planopilaris.
You can have a lot of things happening concurrently. So there are times when I would take a patient
like yourself and I would even do biopsies in three separate areas just to confirm the
diagnosis. Our strategy is to develop a treatment plan based on those particular characteristics
as I mentioned and do treatments based on that strategy. So we’re actually managing
hair loss. We’re not just doing injections and just hoping for the best. We actually
have strategies based on our clinical experience.
So I think it’s reasonable for you to still pursue this injection type of treatment but
be confident about who is doing it for you so you feel like they have the experience
needed to do the best job they can for you. Understanding hair loss is a progressive condition
and there is nothing that will work forever. But essentially, if you can reactivate hair
growth and improve coverage then you are better off at any given point of time after the injection.
Let’s say in our practice, we tell our patients, expect improvement generally for women at
around 9 months. And we follow our patients every 3-6 months. And a lot of times, we see
growth earlier but in terms of getting density and coverage, it takes about 9 months for
most women.
So I think it’s important to learn more and do some more research. Get your medical
work-up done and decide if you want to go ahead and try something other than minoxidil.
So I hope that was helpful, I wish you the best of luck and thank you for your question.