FAQs on medically-proven treatments for hair
loss
By Dr Vanessa Phua
Q: There are various types of hair rejuvenation methods
such as pills, lasers, transplants, etc. Can you briefly explain
what these treatments are supposed to do?
Dr Phua: Hair rejuvenation is divided into medical and
surgical.
Medical hair rejuvenation includes tonics and oral medication
for hair restoration. All these are evidence-based medicine and
have been approved by the dermatological associations from around
the world.
After excluding any medical causes of hair loss, the commonest
cause of hair loss is actually male pattern baldness or
androgenetic hair loss, which has a genetic preponderance, but
affects men and women.
Men manifest hair loss via a grading system called the Norwood
scale. This grading system outlines the different
stages and extent of hair loss in men. In women, the Lockwood scale
is used.
The standard treatment of hair loss for men with androgenetic
hair loss is oral Propecia tablets - 1 mg once a
day. This acts to suppress the male hormone, testosterone.
Testosterone is usually converted to Di-Hydrotestosterone, which
is the culprit hormone for attacking the hair follicles on the
head, causing a shrinking of the hair follicle, regression, and a
cessation of hair growth, eventually leading to hair loss in
genetically susceptible individuals.
The tablet suppresses the production of the hormones, and hair
loss is suppressed. Propecia can only be taken by men, not by
women.
A topical application of hair growth/hair loss suppression is
Minoxidil 5% hair tonic, which is medically-proven
to halt hair loss by opening up ion channels in the scalp and
encouraging hair growth. It is a twice-a-day application, and is a
lifelong treatment.
Laser hair rejuvenation uses diode laser - a
medium wavelength laser - as an adjunct with other methods of hair
rejuvenation. It works poorly on its own. Its results are extremely
variable and inconsistent.
Oral supplements for hair growth are available freely over the
counter and in clinics. These include Pantogar,
which contain potent anti-oxidants, vitamin B complex, biotin, etc
to encourage hair and nail keratin development.
Q: I understand that there are some machines
for hair transplant. Can you tell us a bit more about them and who
can operate them?
Dr Phua: Surgical hair transplant is the
foolproof way of hair restoration. Its success rate is 95-97%.
It uses a donor graft from the patient's scalp, which is usually
the area at the back of the head. This area is surgically excised,
and hairs from this strip graft are planted into the area of hair
thinning or hair deficiency. These areas are genetically programmed
to lose hair but when they receive the hairs from the back of the
scalp, the hairs there will retain their characteristics and
continue to grow on the transplanted recipient sites.
This is known as the strip graft method and is
my preferred method.
Another way is the Follicular Unit Extraction
method, which uses a machine to extract hairs from the scalp and
plant them to other areas. This is done without removing a strip of
skin of the scalp.
This has a disadvantage of causing multiple pitted scars - salt
and pepper or a moth-eaten appearance - of the donor area, and
hence may be unsightly and uneven in appearance. This method is
suitable only for small areas such as eyebrow transplant, but is
not my preferred choice.
High transection rates are prevalent with the machine - hairs
are broken and divided during extraction - and only trained
aesthetic physicians/dermatologists/plastic surgeons can use the
machine. No nursing staff or beauticians or the like can operate
the machine.
Q: I understand that demand for hair transplant surgery
is on the rise. Has there been an increase in the number of people
seeking treatment at your centre?
Dr Vanessa Phua: The demand for hair transplant
surgery is rising, as people are more aware of its presence in the
aesthetics industry. Moreover, hair loss is a prevalent problem
which is on the rise.
Since we started our hair restoration centre here, we have seen
a three-fold increase in the number of cases, and our success rates
have remained consistently high at 95-97%. We have a trained team
comprising two doctors and six nurses, and have a specialised
centre set aside for this at our clinic.
Q: There have been reports about doctors making the news
for the wrong reasons. What kind of advice would you give to
someone who is seeking a reputable doctor for hair loss treatments?
Are there any tell tale signs that a patient should leave as soon
as possible if he/she sees/feels or senses something
amiss?
Dr Vanessa Phua: My advice to them would
be:
- Avoid anything that sounds like a hard sell.
- Avoid any centre that does not underscore the premise of
evidence-based medicine
- Avoid any centre that does not have trained staff
- Avoid any centre which subscribes to alternative theories of
thought that are manned by non-medical personnel
Do seek professional help for hairloss from a qualified and
reputable medical practitioner.
Dr Vanessa Phua is a Physician with an interest in Aesthetic
Medicine & Beauty. She practices at Asia HealthPartners at 304
Orchard Road, Lucky Plaza, #05-06. Tel: 6235 7888
