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 TrichoStemâ„¢

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.