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Although much is know now about hair loss there is still a lot of debate as to what factors are most important. Our doctors believe that hair loss is multi-factorial which means several issues may be at work causing your hair loss. Certainly studies have proven that there is a correlation between between the immune system and pattern loss (Androgenetic Alopecia). Inflammation is the key.
Male hormones (DHT) trigger an autoimmune response where the body's own defense cells attack the hair follicle. This can be seen microscopically. The hair progressively miniaturizes under an onslaught by the body's own immune system. This autoimmune attack results in inflammation which slowly destroys the follicle's capacity to produce terminal hair. With each successive growth cycle the hair gets shorter and thinner until it finally turns into "peach fuzz" or disappears completely when the follicle scleroses (scars). Ultraviolet radiation and excessive sebum (oil) production can also trigger bacterial (P. Acnes) and parasitic infections leading to further inflammation.
Some myths about hair loss include wearing a hat, too much shampooing, lack of blood flow, or clogged pores.
In men the particular pattern of hair loss is called Androgenetic Alopecia and is the typically classic horseshoe pattern. It has been noted that both the number of androgen receptors and the level of 5-alpha reductase, which converts testosterone to DHT, are higher in susceptible areas than in the rest of the scalp. Women's hair loss tends to be diffuse but is also primarily hormonally driven.
The story of balding is, however, not the story of androgens alone. Rather pattern hair loss appears to have multiple contributing factors once the process is underway. For instance, damage to blood vessel linings can inhibit a growth factor that ordinarily produce: endothelium-derived relaxing factor (EDRF) or nitric oxide (NO). Minoxidil probably works in part by mimicking this growth factor. Similarly it has been noted that severe baldness is strongly correlated with heart disease and even diabetes, so there appears to be some common etiology outside of the strictly androgen paradigm for pattern loss. There are likely other factors as well.
Ladies have a specific pattern of hair loss and thinning that is unique to women just as men have a pattern that is specific to men. For most women the hair thins mainly along the center hair part in the middle of the scalp. The top of the head and the crown are most affected and it usually starts with a widening of the part in the hair. The front of the hairline remains the same and the progression is rarely to total or near total baldness, as it is in men.
There may be several underlying medical causes to female pattern baldness. These include:
- Medication side effects (e.g. chemotherapy)
- Nutritional deficiencies such as iron or Biotin
- Breakage of hair from over treatment with hair products
- Hormonal issues (too much testosterone or too little thyroid hormone)
- Polycystic Ovarian Syndrome
- Psychological tics of constant pulling on the hair or twisting of the hair.
- Skin disorders that damage the hair follicle
- Autoimmune diseases
- STDs such as Syphilis
- Alopecia Areata (temporary patchy hair loss usually due to stress)
- Loss of hair after a major trauma such as surgery, accident, or illness
Hair transplants take hair from areas where the hair is unaffected and transplant it to where the hair is thinning or lost. Today's innovative Follicular Unit Extraction (FUE) allows hair follicles to be transplanted one follicle at at time. This used to be very time consuming, expensive, and needed several sessions. However, with the state-of-the-art techniques using the NeoGraft system the procedure is now affordable, fast, and safer. And the results are often excellent and permanent.
Today there are many FDA approved products that can help stop hair loss and even regrow lost hair with little or no side effects. There are also several FDA approved products that are not currently approved for hair restoration but many expert doctors are already using them off-label to treat . For example Dr. Hashemiyoon was using finasteride capsules at 1.2mg doses especially compounded for his patients back in 1993 about 4 years before Propecia was FDA approved for hair loss in 1997. His patients had the benefit of getting treatment almost half a decade before the rest of the United States.
Now he and Dr. Keswani have developed proprietary medical treatments that are unavailable anywhere else in the world. Again their patients are having the benefit of these pioneer physicians treating them with hair restoration formulas that are not available to the general public.
Currently there are several medications under investigation for hair loss treatment. Dr. Hashemiyoon and Dr. Keswani are already providing some of these treatments to their patients. Dr. Hashemiyoon's position is that by the time these treatments are generally available in about 5-7 years some of his patients may be beyond help!
Dr. Hashemiyoon states, "If it were my hair I would not want to wait. And I personally began using Finasteride nearly half a decade before it was approved. I knew what the research was showing and I didn't want to wait and neither did many of my patients. We enjoyed the benefits of tomorrow today."
Dr. Hashemiyoon predicts that within the next 5 years there will be at least one product available that will restore hair color. That means your hair will no longer be gray or white; it will return to its natural color.
According to Dr. Hashemiyoon, "Within the next 10-15 years with advanced stem cell and cloning techniques we can give anyone a full head of hair even if they haven't a single live follicle left on their head."