The Classification of Hair Loss

Hair transplant surgeons describe hair loss in patients using classification systems. Classification systems can provide several advantages. They can help to determine what therapies or surgical procedures to use and help to standardize hair loss terminology, enabling better communication between hair transplant surgeons. Some systems are more comprehensive than others and the majority of systems are gender specific^1–4. The most common classification system used to describe hair loss in men is the Hamilton-Norwood system and in women, the Ludwig system is typically used⁵.

In the 1950s, Hamilton categorized hair loss into eight types (I-VIII). Non-balding men were categorized as type I to III and balding men were categorized as type IV to VIII^2,5. Hamilton based these categories on frontal hair recession and thinning patterns that were observed in over 300 men who were experiencing hair loss⁵. In 1975, Norwood revised this system based on where hair thinning starts such as in the temple and crown areas and then progresses along the top of the scalp^4,5. The main hair loss classification system used in women, the Ludwig system, was developed in 1977 by Ludwig³. Women's hair loss was classified into three different grades (I-III). A grade 1 women typically experienced thinning along the crown region and a grade 3 women experienced complete baldness³. Other classification systems that focus on hair loss in women include a five-stage classification system developed by Ebling and Rock, an eight stage system developed by Savin (nicknamed the Savin scale), and a self-reporting photographic based scale developed by Sinclair^5,6.

If you are curious about what class your hair loss might be considered be sure to ask your hair transplant surgeon at your next consultation.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Koo SH, Chung HS, Yoon ES, Park SH. A new classification of male pattern baldness and a clinical study of the anterior hairline. Aesthetic Plast Surg. 2000 Feb;24(1):46–51.


2. Hamilton JB. Patterned loss of hair in man; types and incidence. Ann N Y Acad Sci. 1951 Mar;53(3):708–28.


3. Ludwig E. Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex. Br J Dermatol. 1977 Sep;97(3):247–54.


4. Norwood OT. Male pattern baldness: classification and incidence. South Med J. 1975 Nov;68(11):1359–65.


5. Gupta M, Mysore V. Classifications of Patterned Hair Loss: A Review. J Cutan Aesthetic Surg. 2016 Mar;9(1):3–12.


6. Sinclair R, Jolley D, Mallari R, Magee J. The reliability of horizontally sectioned scalp biopsies in the diagnosis of chronic diffuse telogen hair loss in women. J Am Acad Dermatol. 2004 Aug;51(2):189–99.

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Free PRP & Laser Hair Therapy For New Hair Transplant Patients

For a limited time Sure Hair International is offering FREE Platelet Rich Plasma therapy and 3 months of laser hair therapy.

• 1 Platelet Rich Plasma Treatment (Valued at $1,500)


• 3 Months of Laser Hair Therapy (Valued at $1,500)

This promotion will be available for transplants performed until the end of November, 2016. Check out the following blog posts for more information on the benefits of laser hair therapy and platelet rich plasma therapy.

Advanced Laser Hair Therapy – 90% Effective Regrowth Treatment

The Vampire Treatment

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Ruxolitinib – A Treatment for Alopecia Areata

Hair loss can be caused by many different conditions such as chemotherapy-induced alopecia, androgenetic alopecia (male pattern baldness) and alopecia areata (spot baldness). Alopecia areata  or 'spot baldness' is an autoimmune disease where actively growing hair follicles are attacked by the body's own immune system¹. This condition can lead to total scalp hair loss (alopecia totalis) or total scalp and body hair loss (alopecia universalis)². Alopecia areata is a relatively common form of hair loss, second to androgenetic alopecia³.

As alopecia areata can impact the quality of life, potential treatments for this hair disorder have been examined⁴. For instance, ruxolitinib has been recently evaluated⁵. Ruxolitinib is currently approved to treat disease of the bone marrow (e.g., myelogibrosis)⁶. In a recent open-label clinical trial, 12 moderate to severe alopecia areata patients were given 20 mg of ruxolitinib, twice a day for 3 to 6 months⁵. At least 50% hair regrowth occurred in 9 of these patients by week 12 and 7 of these patients obtained over 95% regrowth by the end of treatment⁵.  Bacterial skin infection, upper respiratory tract infection, and urinary tract infection are some of the adverse effects reported in this study⁵.

Ruxolitinib is just an example of the many off label emerging therapies being developed. Other off-label therapies for alopecia areata include topical or systemic steroids, and topical immunotherapies⁷. Talk to your doctor if you are interested in finding out more information on hair loss treatments.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Paus R, Slominski A, Czarnetzki BM. Is alopecia areata an autoimmune-response against melanogenesis-related proteins, exposed by abnormal MHC class I expression in the anagen hair bulb? Yale J Biol Med. 1993 Dec;66(6):541–54.


2. Islam N, Leung PSC, Huntley AC, Gershwin ME. The autoimmune basis of alopecia areata: a comprehensive review. Autoimmun Rev. 2015 Feb;14(2):81–9.


3. Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update: part II. Treatment. J Am Acad Dermatol. 2010 Feb;62(2):191–202, quiz 203–4.


4. Masmoudi J, Sellami R, Ouali U, Mnif L, Feki I, Amouri M, et al. Quality of life in alopecia areata: a sample of tunisian patients. Dermatol Res Pract. 2013;2013:983804.


5. Mackay-Wiggan J, Jabbari A, Nquyen N, Cerise J, Clark C, Ulerio G, et al. Oral ruxolitinib induces hair regrowth in patients with moderate-to-severe alopecia areata. JCI Insight. 2016 Sep 22;1(15):e89790.


6. Jakafi (ruxolitinib) tablets, for oral use [Internet]. U.S. Food and Drug Administration. 2016 [cited 2016 Oct 10]. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/202192s012lbl.pdf


7. Delamere FM, Sladden MM, Dobbins HM, Leonardi-Bee J. Interventions for alopecia areata. Cochrane Database Syst Rev. 2008;(2):CD004413.

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Are Robots Taking Over Hair Transplants?

Hate waiting for lines at the bank? How about waiting in line at the theatre? Debit machines and movie ticket kiosks are what I gravitate towards when I'm at the bank or seeing a movie as they dramatically shorten wait times. These technology based shortcuts can also be used in hair transplants.

Follicular unit extraction (FUE) is a donor harvesting technique that removes hair follicles from a donor region without creating the need for linear incisions (1). FUE can be quite time consuming as only one follicular family (a group of 1 – 4 hair follicles) is removed at a time (2). The amount of time required to remove hair follicles from a donor region is decreased when adding robotic technology and automation to FUE (2).

Robotic FUE systems are made up of three major components. The first is a robotic arm that contains two different types of punches; a sharp punch and a blunt punch. The sharp punch makes a superficial 1 mm incision around the hair follicle and the blunt punch then creates follicle detachment through a second deeper incision (2). The next major component is the suction system. Suction is used to help move the hair follicle above the skin surface to allow for easier extraction (2). Cameras are also a major component of robotic FUE systems. These cameras are equipped with processing software that helps direct punch incision, ensuring punches are correctly placed at the right angle for effective extraction (2). This imaging software can also prevent overharvesting; only allowing follicles to be extracted when they are 1.6 mm apart from each other (2).

There are several different robotic and automated devices on the market today such as the NeoGraft automated hair transplant system, the surgically advanced follicular extraction (SAFE) system and the ARTAS Robotic System (Restoration Robotics Inc., San Jose, CA) (3-6). Be sure to speak with your hair transplant surgeon if you are interested to learn about robotic or automated devices in your upcoming hair transplant consultation.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Rassman WR, Bernstein RM, McClellan R, Jones R, et al. Follicular unit extraction: minimally invasive surgery for hair transplantation. Dermatol Surg 2002;28:720-8.


2. Avram MR, Watkins SA. Robotic Follicular Unit Extraction in Hair Transplantation. Dermatol Surg 2014;40(12):1319-26.


3. NeoGraft web site. Available from: http://neograft.com/. Accessed July 14, 2014.


4. Rose PT. The latest innovations in hair transplantation. Facial Plast Surg 2011;27:366-77.


5. Gupta A. Microrefined microfollicular hair transplant: a new modification in hair transplant. Ann Plast Surg 2014;73:257-65.


6. Harris JA. New methodology and instrumentation for follicular unit extraction: lower follicle transection rates and expanded patient candidacy. Dermatol Surg 2006;32:56-61; discussion 2.

 

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A Hair Transplant for a Younger, More Attractive, More Successful, More Approachable Appearance

Hair loss is a common phenomenon which will affect most of us, especially men, as we age. There are a few treatment options, particularly in the early stages. Medications such as finasteride¹ and minoxidil² can help to prevent any future hair loss. Aesthetic camouflages such as thickeners, specialized tattooing³, scalp micropigmentation, and hair systems are also available. Finally, there is hair transplant surgery.

Among men, one of the most common cosmetic surgeries is a hair transplant. Accordingly, a team of researchers from Johns Hopkins University has recently released a report which investigated some of the benefits received from investing in a hair transplant⁴.

The research team recruited 122 participants online to rate age, attractiveness, successfulness and approachability in men. The participants were shown 13 sets of photographs. Each set was composed of two images of the same man. In half of the sets, the photographs were before and after shots of a man who had received a hair transplant. The other set of photographs included two images of the same man who had not had a hair transplant. The participants who performed the rating were roughly half women and half men, between the ages of 18 – 52 years, with the majority being Caucasian with some post-secondary education.

After analyzing all of the ratings, the study authors concluded that a hair transplant could improve a man's general perception in all four categories (age, attractiveness, successfulness and approachability). Therefore this study seems to suggest that a hair transplant can deliver some very effective results. There are a few points to consider however. This was a small study, with only 13 men rated. Also important, the photographs that were used were not standardized for characteristics such as lighting and background. For instance in the example shown in the report, it is difficult to see the eyes in the pre-transplant image as the man appears to be squinting; however, they are open wide in the post-transplant image. Moreover none of the images included a man's smile as all images were of a neutral face. All of these variables could have affected the results of the study, although the authors are confident in their conclusions.

Overall, there are multiple treatments for hair loss. Hair transplant surgery probably requires one of the biggest investments but it can also be one of the more effective.

Article by: Dr. J.L. Carviel, PhD, Mediprobe Research Inc.

References

1. Gupta AK, Charrette A. The efficacy and safety of 5α-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit-risk assessment of finasteride and dutasteride. J Dermatol Treat. 2014 Apr;25(2):156–61.


2. Gupta AK, Charrette A. Topical Minoxidil: Systematic Review and Meta-Analysis of Its Efficacy in Androgenetic Alopecia. Skinmed. 2015 Jun;13(3):185–9.


3. Rassman WR, Pak JP, Kim J, Estrin NF. Scalp micropigmentation: a concealer for hair and scalp deformities. J Clin Aesthetic Dermatol. 2015 Mar;8(3):35–42.


4. Bater KL, Ishii M, Joseph A, Su P, Nellis J, Ishii LE. Perception of Hair Transplant for Androgenetic Alopecia. JAMA Facial Plast Surg. 2016 Aug 25;

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Tools of the Trade

A wide range of tools, instruments and devices are used during a hair transplant. These instruments can include punches, robotic devices, suction-assisted devices and implanters.

Punches have been used in hair transplants since the 1930s. These instruments allow hair follicles to be released from their surrounding tissues. Punches can have a wide range of characteristics (e.g., shape, sharpness and size) that can influence their capabilities. Sharp punches, for example, can be inserted along the hair follicle, cutting the connecting tissues that hold the follicle in place. Unsharpened punches can help prevent trauma or deformation of surrounding follicles during harvesting¹. Excessive laxity (looseness) and the need for specific angles (e.g., curly hair) can increase the difficulty of punch extraction².

Robotic devices can also be used in hair transplant procedures. These devices contain sharp punches that cut around the follicle, making graft removal easy and fast³. Using robotic technology specific characteristics (e.g., follicle density, hair angle etc.) can be controlled by the physician⁴.This can help create high quality grafts and limit the time required for harvesting⁴. The ARTAS system is an example of such a device and is in use all over the world.

Suction-assisted devices can also assist a surgeon during a transplant. These devices are commonly used during follicular unit extraction (FUE) to partially or fully remove a hair follicle. Suction-assisted devices give physicians better control during harvesting, allowing punch penetration to be deep without increasing the risk of hair follicle injury⁵.

Implanters are also used during hair transplants. As the name suggests they are used to help implant harvested grafts. Sharp or dull implanters can be used in hair restoration procedures such as eyebrow and scalp restorations⁶.

If you have any questions about what type of instruments will be used during your procedure ask your hair transplant surgeon during your consultation.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Devroye J. Powered FU Extraction with the Short-Arc-Oscillation Flat Punch FUE System (SFFS). Hair Transpl Forum Int. 2016;26(4):129, 134–6.


2. Poswal A. Expanding needle concept for better extraction of body hair grafts. Indian J Dermatol. 2013;58(3):240.


3. Bernstein R. Integrating robotic FUE into a hair transplant practice. Hair Transpl Forum Int. 2012;22(6):228–9.


4. Harber R. Notes from the Editor Emeritus. Hair Transpl Forum Int. 2013;23(4):121.


5. Trivellini R. An Innovation in Suction Assisted FUE. Hair Transpl Forum Int. 2016;26(2):58–9.


6. Elliott V. Commentary on “FUE Graft Placement.” Hair Transpl Forum Int. 2016;26(2):56.

 

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Hair Transplant Terminology Cheat Sheet

To help you prepare for your upcoming hair transplant consultation, here is a cheat sheet of hair transplant options and techniques your hair transplant surgeon might suggest.

Follicular unit. Scalp hair grows in groups, with up to 4 hairs per group¹. These groups are referred to as follicular units. These follicular units contain more than just hair follicles but also contain nerves, blood vessels, collagen and muscle (erector pilorum)¹. Since these follicular units contain all the required material for survival and growth a fully intact transplanted follicular unit should flourish after being implanted.

Strip. Strip is a harvesting method that will likely be one of the first hair transplant options brought up by your surgeon. Strip is a term used to describe the removal of hair bearing skin from the back of the scalp. Follicular units are then removed from this strip through the use of a microscope and then implanted into the desired areas². You should be aware that a linear scar will be created if this method is used.

FUE. FUE stands for follicular unit extraction. It's a term that describes a harvesting technique that removes hair follicles directly from the scalp³. FUE can be used to transplant hair follicles into thinning areas as well as camouflage previous hair transplant scars^4,5.

The untouched strip. The untouched strip technique, a combination of strip and FUE, could be another option suggested by your surgeon⁶. This technique is quite an attractive option as you don't need your hair to be shaven to 1 mm in length to undergo this type of hair transplant. The strip part of this technique is very similar to the normal strip harvesting however FUE is additionally used above and below the strip border⁶. This can allow for better coverage and greater density⁶.

Non-shaven FUE. The non-shaven follicular unit extraction technique (NSFUE) may not be offered at all hair transplant clinics. In this technique the donor hair is cut short and hair follicles removed⁷. Hair follicles are then implanted in a similar fashion as the traditional FUE method.

SMP. Scalp micropigmentation (SMP) is not a hair transplant technique but it may come up as an option for those who may not meet hair transplant criteria. It's a tattoo technique that can give the impression of hair^8,9. SMP can help with camouflaging scarring and thinning areas^8,9.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Bernstein RM, Rassman WR. Follicular unit transplantation: 2005. Dermatol Clin. 2005 Jul;23(3):393–414, v.


2. Avram M, Rogers N. Contemporary hair transplantation. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2009 Nov;35(11):1705–19.


3. Dua A, Dua K. Follicular unit extraction hair transplant. J Cutan Aesthetic Surg. 2010 May;3(2):76–81.


4. Avram MR, Rogers N, Watkins S. Side-effects from follicular unit extraction in hair transplantation. J Cutan Aesthetic Surg. 2014 Jul;7(3):177–9.


5. Gho CG, Martino Neumann HA. Donor hair follicle preservation by partial follicular unit extraction. A method to optimize hair transplantation. J Dermatol Treat. 2010 Nov;21(6):337–49.


6. Crisostomo M. The Combined Technique (FUE + FUT) Without Fully Shaving Hair: Executive Untouched Strip. Hair Transpl Forum Int. 24(3):90–1.


7. Park J. Direct Non-shaven FUE Technique. Hair Transpl Forum Int. 2014;24(May/Jun):103–4.


8. Rassman WR, Pak JP, Kim J, Estrin NF. Scalp micropigmentation: a concealer for hair and scalp deformities. J Clin Aesthetic Dermatol. 2015 Mar;8(3):35–42.


9. Rose PT. Hair restoration surgery: challenges and solutions. Clin Cosmet Investig Dermatol. 2015;8:361–70.

 

 

 

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Is exposure to hair spray and other hair cosmetic products a problem?

Is hairspray popular? In a study using consumption data gathered in France, the frequency and amount of hair styling products was evaluated¹. It was found that 52% of women (294/565) used hair styling products like lacquers, gels, foams, waxes and sprays¹.  Of these hair styling products, the amount used per use for women was highest with hair spray as compared to the other styling products¹.

Is hair spray safe? Exposure to hair cosmetics can be evaluated with consumption data gathered from surveys and laboratory tests. Exposure levels of eleven hair cosmetic products (e.g., hair spray, shampoos and conditions) have been calculated in France based on the frequency of use, amount per use and body wieght². For women, between the ages of 15-39 years old, the exposure assessment found with styling foam was 4.6 times higher than their exposure assessment found with styling lacquer. Styling sprays and waxes were found to have exposure levels that did not exceed the maximum daily exposure rate established by the Scientific Committee on Consumer Safety (SCCS)^2,3. For those that may not know, the SCCS is a committee that is used in Europe to help assess health and safety risks of non-food consumer products (e.g., cosmetic products) and services (e.g., tattooing, tanning)⁴.

Can hairspray alter hair properties? A recent study demonstrated that hair spray can alter hair shine, the shine that occurs when light is reflected off the outer surface of the hair follicle^5,6. In this study, mannequin heads were treated with hair spray and placed outdoors to mimic the shine created by the sun. The mannequin hair was then judged by 15 individuals in a consumer study. As we would have guessed, the unsprayed mannequins had the least shine⁵. A volume lift hair spray showed the most shine and allowed for much thicker hair spray deposits to accumulate on the hair surface⁵.

If you would like to know more about hair spray or other hair cosmetic products be sure to ask your hair stylist at your next appointment.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Ficheux AS, Chevillotte G, Wesolek N, Morisset T, Dornic N, Bernard A, et al. Consumption of cosmetic products by the French population second part: Amount data. Food Chem Toxicol Int J Publ Br Ind Biol Res Assoc. 2016 Apr;90:130–41.


2. Ficheux AS, Morisset T, Chevillotte G, Postic C, Roudot AC. Probabilistic assessment of exposure to nail cosmetics in French consumers. Food Chem Toxicol Int J Publ Br Ind Biol Res Assoc. 2014 Apr;66:36–43.


3. Scientific Committee on Consumer Safety SCCS Opinion on decamethylcyclopentasiloxane (cyclopentasiloxan, D5) in cosmetic products [Internet]. European Commission. 2016 [cited 2016 Sep 1]. Available from: http://ec.europa.eu/health/scientific_committees/consumer_safety/docs/sccs_o_174.pdf


4. The SCCS Notes of Guidance for the Testing of Cosmetic Ingredients and their Safety Evaluation 9th Edition [Internet]. European Commission. 2016 [cited 2016 Sep 2]. Available from: http://ec.europa.eu/health/scientific_committees/consumer_safety/docs/sccs_o_190.pdf


5. Puccetti G, Thompson W. Effects of hair sprays on color perception: A hyperspectral imaging approach to shine and chroma on heads. Int J Cosmet Sci. 2016 Aug 17;


6. Guiolet A, Garson JC, Levecque JL. Study of the optical properties of human hair. Int J Cosmet Sci. 1987 Jun;9(3):111–24.

 

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What's the difference between 2% minoxidil solution and 5% minoxidil foam when it comes to women's hair loss?

Thinning hair, starting at the centre part and then continuing throughout the scalp, is the main symptom of female pattern hair loss, a condition shared by 40% of women¹. No matter how normal or common it is, hair loss is never fun, and it's especially difficult for women, likely because it's usually associated with age. This makes it all the more frustrating that most medications and treatments are targeted towards men.

The first medication approved to treat women's hair loss was a 2% minoxidil topical solution that is applied directly to the scalp twice-daily². In more recent years, a 5% once-daily minoxidil topical foam has become available^3–5. Requiring half the number of applications, the 5% foam no doubt offers a less time consuming and more convenient option. Maybe more importantly though, does the 5% foam work as well, or possibly better than the 2% solution?

A previous clinical trial has concluded that once-daily 5% minoxidil topical foam had a similar effect as compared with the twice-daily 2% solution for stimulating hair growth in women experiencing pattern hair loss⁵. Recently, results from a new phase III trial which compares the two products on 322 women has become available⁶.

Once-daily 5% minoxidil topical foam was used by 161 women for 52 weeks with the same number of women given twice-daily 2% minoxidil topical solution for the same duration. Both products induced hair regrowth similarly with an increase in about 24 hairs/cm² in the target area by 24 weeks into treatment. An expert panel review also concluded that there was an overall modest improvement for both treatment groups. The majority of improvement was seen prior to 12 weeks of treatment and lasted throughout the 52 week study period.

Side effects were mild and similar between treatments as well. In the once-daily 5% minoxidil foam group, there was one report each of brittle/breakable hair, hypertension, skin irritation and itching. In the twice-daily 2% minoxidil topical solution group, there was one report of itchy rash and eczema. There were reports of stinging/burning, skin reddening, dryness and inflammation in both groups.

Therefore, according to this recent study, you are likely to see the same results whether you choose the foam or the solution.

Article by: Dr. J.L. Carviel, PhD, Mediprobe Research Inc.

References

1. Santos Z, Avci P, Hamblin MR. Drug discovery for alopecia: gone today, hair tomorrow. Expert Opin Drug Discov. 2015 Mar;10(3):269–92.


2. Price VH. Treatment of hair loss. N Engl J Med. 1999 Sep 23;341(13):964–73.


3. 5% Minoxidil: Treatment for Female Pattern Hair Loss [Internet]. [cited 2016 Jul 27]. Available from: http://www.skintherapyletter.skin.ca/2014/19.6/2.html


4. Olsen EA, Whiting D, Bergfeld W, Miller J, Hordinsky M, Wanser R, et al. A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2007 Nov;57(5):767–74.


5. Blume-Peytavi U, Hillmann K, Dietz E, Canfield D, Garcia Bartels N. A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women. J Am Acad Dermatol. 2011 Dec;65(6):1126–34.e2.


6. Blume-Peytavi U, Shapiro J, Messenger AG, Hordinsky MK, Zhang P, Quiza C, et al. Efficacy and Safety of Once-Daily Minoxidil Foam 5% Versus Twice-Daily Minoxidil Solution 2% in Female Pattern Hair Loss: A Phase III, Randomized, Investigator-Blinded Study. J Drugs Dermatol JDD. 2016 Jul 1;15(7):883–9.

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Flame Hair

There are some amazing tricks that can be performed with fire. For instance you create the illusion of breathing fire using flammable fuels. You could also make handheld fireballs, my personal favorite, by using a lower temperature flame. But what you don't want is flame hair.

Flame hair is a term used to describe hair breakage¹. Hair breakage is common in hair conditions such as centrifugal cicatricial alopecia, a permanent form of hair loss². Injuries, due to hair pulling, damage and inflammation can cause breakage^1,3.When a hair is pulled, a wavy, cone-shaped hair, also called a residue can remain behind³. This uniquely shaped residue is referred to as flame hair due to its match-like characteristics (e.g., thin, short and has a distal tip)¹. Flame hair can be commonly found in trichotillomania patients, a hair pulling disorder³. This has been found in a recent study, where hair characteristics (e.g., broken hairs, coiled hairs etc.) were examined in 370 patients with varying hair conditions (e.g., trichotillomania, alopecia areata and tinea capitis) ³. Flame hairs were found in 25% of trichotillomania patients (n=44)³.

Along with trichotillomania, flame hair has also been found in other hair conditions. In an additional study that consisted of 454 patients with 11 different scarring and non-scarring hair loss conditions flame hair was discovered¹. Flame hairs were found in all patients who had chemotherapy-induced alopecia (n=6) and radiotherapy-induced alopecia (n=2)¹. In traction alopecia (hair loss due to extended force) and central centrifugal cicatricial alopecia patients, it was rare to find flame hair (4% and 3%, respectively)¹.

Hair breakage might be an early sign of a hair condition (e.g., central centrifugal cicatricial alopecia)⁴. With breakage difficult to spot, you may need a hairstylist's assistance to keep track of any new hair breakage developments⁵. You can also talk to a Sure Hair representative for more information.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Miteva M, Tosti A. Flame Hair. Skin Appendage Disord. 2015 Sep;1(2):105–9.


2. Mhaskar S, Kalghatgi B, Chavan M, Rout S, Gode V. Hair breakage index: an alternative tool for damage assessment of human hair. J Cosmet Sci. 2011 Apr;62(2):203–7.


3. Rakowska A, Slowinska M, Olszewska M, Rudnicka L. New trichoscopy findings in trichotillomania: flame hairs, V-sign, hook hairs, hair powder, tulip hairs. Acta Derm Venereol. 2014 May;94(3):303–6.


4. Callender VD, Wright DR, Davis EC, Sperling LC. Hair breakage as a presenting sign of early or occult central centrifugal cicatricial alopecia: clinicopathologic findings in 9 patients. Arch Dermatol. 2012 Sep;148(9):1047–52.


5. Gathers RC, Jankowski M, Eide M, Lim HW. Hair grooming practices and central centrifugal cicatricial alopecia. J Am Acad Dermatol. 2009 Apr;60(4):574–8.

 

 

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Does spaceflight affect hair?

Can you imagine soaring across the stars? Or getting to see the dark side of the moon? Astronauts may get to experience these amazing opportunities but at quite a sacrifice. And I'm not just referring to the dehydrated packages they call food. There are a number of serious health implications associated with spaceflight. Examples of health implications can include calcium loss and deterioration of muscles^1,2. But does spaceflight affect hair?

The Japan Aerospace Exploration Agency (JAXA) has been trying to address this question since 2009. They have been taking hair samples from astronauts before, during and after spaceflights³. These scientists are hoping to use hair as a tool for monitoring the health of the astronauts during missions. Through examining hair they hope to discover the stress level of astronauts, as well as mineral and calcium levels³. Hair can also reflect the type of sleep schedules the astronauts keep during the mission. This is based on the fact that hair can imitate a person's circadian rhythm, their biological clock⁴.

This is just one of the many hair studies conducted during spaceflight. Astronauts as well as mice have had their hair examined during their visits at the International Space Satiation (ISS). Mice, during their 3 month visit to the ISS, showed alterations in their hair follicle cycle⁵. It was found that these mice had an increased amount of hair follicles in the growth phase⁵.

Additionally, the astronauts at ISS also participated in a hair study. During a 6 month mission, ten astronauts periodically took samples of their hair⁶. These samples were studied when they returned to earth. It was found that some astronauts had experienced changes in their hair follicles that differed according to gender⁶.

Overall it does seem like spaceflight does impact hair. With a trip to Mars on the horizon, further information on the effect of spaceflight on hair follicles might be upcoming.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Sekiguchi C. Issues of health care under weightlessness. Acta Physiol Scand Suppl. 1994;616:89–97.


2. Greenleaf JE, Bulbulian R, Bernauer EM, Haskell WL, Moore T. Exercise-training protocols for astronauts in microgravity. J Appl Physiol Bethesda Md 1985. 1989 Dec;67(6):2191–204.


3. Ohshima H. Space Medicine: Ultimate Preventive Medicine for Human Space Flight [Internet]. Japan Aerospace Exploration Agency. [cited 2016 Jul 26]. Available from: http://global.jaxa.jp/article/special/experiment/ohshima01_e.html


4. Akashi M, Soma H, Yamamoto T, Tsugitomi A, Yamashita S, Yamamoto T, et al. Noninvasive method for assessing the human circadian clock using hair follicle cells. Proc Natl Acad Sci U S A. 2010 Aug 31;107(35):15643–8.


5. Neutelings T, Nusgens BV, Liu Y, Tavella S, Ruggiu A, Cancedda R, et al. Skin physiology in microgravity: a 3-month stay aboard ISS induces dermal atrophy and affects cutaneous muscle and hair follicles cycling in mice. Npj Microgravity. 2015 May 27;1:15002.


6. Terada M, Seki M, Takahashi R, Yamada S, Higashibata A, Majima HJ, et al. Effects of a Closed Space Environment on Gene Expression in Hair Follicles of Astronauts in the International Space Station. PloS One. 2016;11(3):e0150801.

The post Does spaceflight affect hair? appeared first on ARTAS Robotic Hair Transplant In Toronto, ON | Sure Hair International.

Treating Hair Loss: The Top 5 Reasons to Choose a Hair System

5) Side-Effect Free

Using a hair system means no drugs are required. There are only two medications currently approved for common causes of hair loss such as pattern baldness¹. These medications have been shown to decrease further loss and improve new growth, but both have their downsides and only one is approved for use in women^2,3. Minoxidil is the topical foam/solution which is approved for both sexes; however users commonly find the daily applications cumbersome¹. The second option, finasteride, is only recommended for use in men. Furthermore, there is some growing concern about sexually-related side effects with finasteride use, although clinical trials report that it is safe and well-tolerated⁴. Both products can also be used in combination with a hair system.

4) Non-Invasive

Surgery is not for everyone. Choosing a hair system is a great option for those who are not comfortable with the procedure. Moreover surgery is obviously a big decision.  A hair system can also be used as an interim fix for those who are considering surgery but are not quite ready to move forward.

3) Cost

The high price tag of a hair transplant can understandably be a large deterrent. Because of this, a hair system can be a great economical choice. Hair systems are available in a wide price range, mostly depending on whether you choose to order a custom piece. Fortunately, even without customization, most high quality hair systems can provide good results when applied by an experienced hair restoration specialist.

2) Available for Men and Women

As mentioned above, hair restoration options are more limited for women. A definite advantage of hair systems is that they are safe and effective for both sexes.

1) Results

As the main reason why people seek treatment in the first place, good results is definitely one of the most important considerations when choosing your method of hair restoration. With hair systems available in all shapes, sizes, textures, lengths, densities and colours, it's possible to cover bald patches and thinning while blending with existing hair, making the system undetectable. Choose a high quality system for best results and go about your normal day including shampooing and styling with a full head of hair.

Article by: Dr. J.L. Carviel, PhD, Mediprobe Research Inc.

References

1. Semalty M, Semalty A, Joshi GP, Rawat MSM. Hair growth and rejuvenation: an overview. J Dermatol Treat. 2011 Jun;22(3):123–32.


2. Gupta AK, Charrette A. Topical Minoxidil: Systematic Review and Meta-Analysis of Its Efficacy in Androgenetic Alopecia. Skinmed. 2015 Jun;13(3):185–9.


3. Kaufman KD, Olsen EA, Whiting D, Savin R, DeVillez R, Bergfeld W, et al. Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group. J Am Acad Dermatol. 1998 Oct;39(4 Pt 1):578–89.


4. Gupta AK, Charrette A. The efficacy and safety of 5α-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit-risk assessment of finasteride and dutasteride. J Dermatol Treat. 2014 Apr;25(2):156–61.

 

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How to Prepare Your Child for Chemotherapy-Induced Alopecia

Cancer. Just the word can bring chills to those that know what it's like to battle this relentless disease. You wouldn't wish it upon anyone. But what happens when a child gets diagnosed with cancer? Should hair loss be an expected side effect of treatment?

Treatment, such as chemotherapy, can be an option for children diagnosed with cancer. For parents, the decision to treat their child can be influenced by many factors such as family members, the cost of treatment and length of hospitalization¹. Additionally, there are also many side effects that need to be considered such as hair loss. Hair loss is a common side effect of cancer treatments and has been reported in 80% of children treated with chemotherapy (n=51)^2,3. Hairs in the anagen (growth) phase are commonly lost during chemotherapy. Chemotherapy-induced alopecia is reversible, with re-growth typically occurring within a few months after treatment.

It has been found that parents, on average, don't ask their child's oncologists about the possibility of hair loss, with only 26% of parents seeking information on side-effects (n=40)². Chemotherapy-induced alopecia can be difficult to deal with and can discourage children from playing with friends or playing outdoors⁴. Alopecia has also led to bullying at school⁴. Preparing for the possibility of hair loss through educating both your child and their classmates is a good first step in the preparation process. Purchasing a hat for your child before treatment can also help as hats are a common and affordable strategy to hide temporary hair loss⁴. Purchasing a hair system can also be another way to help build your child's confidence as they wait for their hair to grow back.

Resources, strategies to hide hair loss and further information on chemotherapy-induced alopecia in children can be found through support groups, other parents on your cancer ward as well as your oncologist⁵.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Mostert S, Njuguna F, Langat SC, Slot AJM, Skiles J, Sitaresmi MN, et al. Two overlooked contributors to abandonment of childhood cancer treatment in Kenya: parents' social network and experiences with hospital retention policies. Psychooncology. 2014 Jun;23(6):700–7.


2. Gunawan S, Wolters E, van Dongen J, van de Ven P, Sitaresmi M, Veerman A, et al. Parents' and health-care providers' perspectives on side- effects of childhood cancer treatment in Indonesia. Asian Pac J Cancer Prev APJCP. 2014;15(8):3593–9.


3. Sitaresmi MN, Mostert S, Purwanto I, Gundy CM, Sutaryo null, Veerman AJP. Chemotherapy-related side effects in childhood acute lymphoblastic leukemia in Indonesia: parental perceptions. J Pediatr Oncol Nurs Off J Assoc Pediatr Oncol Nurses. 2009 Aug;26(4):198–207.


4. Gunawan S, Broeke CT, Ven P van de, Arnoldussen M, Kaspers G, Mostert S. Parental Experiences with Chemotherapy-Induced Alopecia among Childhood Cancer Patients in Indonesia. Asian Pac J Cancer Prev APJCP. 2016;17(4):1717–23.


5. Njuguna F, Mostert S, Seijffert A, Musimbi J, Langat S, van der Burgt RHM, et al. Parental experiences of childhood cancer treatment in Kenya. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 2015 May;23(5):1251–9.

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How to cover hair transplant scars – FUE & SMP

Hair transplants are a common way we can adjust our hairlines and create coverage in our thinning areas. There are many different techniques used in hair transplants. Strip excision, follicular unit extraction (FUE) and partial longitudinal-follicular unit transplantation are examples of some techniques used today. Although all of these can leave scars, some are significantly more noticeable than others.

During strip excision, a strip of tissue is removed from the donor area, and hair follicles are harvested under the microscope¹.  These hair follicles are then inserted into desired locations in the recipient areas of the scalp. A long and possibly wide linear scar is created with this technique, which can be noticeable for those who prefer shorter hairstyles². Fortunately, if you have a linear scar from a past hair transplant there are a few options you can use to conceal your scar.

FUE can help hide scars from previous hair transplants. The FUE technique removes the hair follicle directly from the scalp using sharp instruments such as punches and forceps³. These hair follicles are then placed on to or near previous scars to help hide their appearance. Robots can also be used to assist this procedure, helping to obtain large amounts of hair follicles if required⁴.   FUE does not produce any additional linear scars. It can also be performed so that growth of hair follicles are preserved in the donor region^5,6. This will help to maintain good coverage in the donor area as you wait for your hair to grow back. To get more information on FUE procedures currently available, ensure to speak to your hair consultant.

Scalp micropigmentation (SMP) is another technique that can be used to cover scars. SMP is essentially a stippling patterned tattoo created with different sized and shaped needles⁷. This tattoo can give the impression of hair⁸. It can be useful to conceal and improve scars created by both strip and FUE harvesting⁸. This technique has been quite successful with high patient satisfaction⁷.

These are just a few techniques that can be helpful to hide scars. With technology and methods always advancing there might not be linear scars to hide in the future.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Gupta AK, Lyons DCA, Daigle D, Harris JA. Surgical hair restoration and the advent of a robotic-assisted extraction device. SkinMed. 2014 Aug;12(4):213–6.


2. Avram MR, Watkins SA. Robotic follicular unit extraction in hair transplantation. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2014 Dec;40(12):1319–27.


3. Dua A, Dua K. Follicular unit extraction hair transplant. J Cutan Aesthetic Surg. 2010 May;3(2):76–81.


4. Rashid RM. Follicular unit extraction with the Artas robotic hair transplant system system: an evaluation of FUE yield. Dermatol Online J. 2014;20(4):22341.


5. Avram MR, Rogers N, Watkins S. Side-effects from follicular unit extraction in hair transplantation. J Cutan Aesthetic Surg. 2014 Jul;7(3):177–9.


6. Gho CG, Martino Neumann HA. Donor hair follicle preservation by partial follicular unit extraction. A method to optimize hair transplantation. J Dermatol Treat. 2010 Nov;21(6):337–49.


7. Rassman WR, Pak JP, Kim J, Estrin NF. Scalp micropigmentation: a concealer for hair and scalp deformities. J Clin Aesthetic Dermatol. 2015 Mar;8(3):35–42.


8. Rose PT. Hair restoration surgery: challenges and solutions. Clin Cosmet Investig Dermatol. 2015;8:361–70.

The post How to cover hair transplant scars – FUE & SMP appeared first on ARTAS Robotic Hair Transplant In Toronto, ON | Sure Hair International.

Treating Alopecia Areata – Platelet-Rich Plasma

Alopecia areata, a condition where a person's own immune system attacks their hair follicles, can sometimes be difficult to treat. That's because the treatment options that we have traditionally relied on are unfortunately not effective for everyone¹. Those that are unresponsive to therapy may develop bald patches which could progressively worsen with the potential to lose all hair, including body hair. Moreover the disease progression is somewhat unpredictable as it's also possible for any lost hair to regrow spontaneously, with no treatment necessary². Fortunately for those who do wish to move forward with therapy, new research has led to some innovative medications, devices and procedures which may encourage hair growth.

One potential new option is platelet-rich plasma (PRP) therapy. PRP has become widely used in medicine, with its advantages demonstrated in dentistry³, orthopedic surgery⁴, aesthetics and skin rejuvenation⁵ as well as sports medicine. It is a procedure where no medication is required. A small amount of blood is removed from the arm. Platelets are then collected from the blood. A concentrated dose (approximately three to seven times the amount present in your blood) of platelets is then injected in areas of hair loss. PRP therapy is believed to encourage new hair growth by releasing a plethora of natural growth factors that were contained in the platelets^6–11.

In clinical trials, 60% of patients with patchy alopecia areata achieved complete remission in under a year⁹. Evidence has been more variable for those with severe alopecia¹² but some success has been reported¹³. An additional benefit to PRP treatment is that because it is your own blood being used to stimulate hair growth, experiencing side-effects is unlikely¹⁴.

Overall, if previous treatments have been unsuccessful, or you are interested in a drug-free treatment, PRP therapy may be worth investigating further. Speak with your doctor or dermatologist for more information about the procedure.

Article by: Dr. J.L. Carviel, PhD, Mediprobe Research Inc.

References

1. Delamere FM, Sladden MM, Dobbins HM, Leonardi-Bee J. Interventions for alopecia areata. Cochrane Database Syst Rev. 2008;(2):CD004413.


2. MacDonald Hull SP, Wood ML, Hutchinson PE, Sladden M, Messenger AG, British Association of Dermatologists. Guidelines for the management of alopecia areata. Br J Dermatol. 2003 Oct;149(4):692–9.


3. Watt-Smith S. Dental and craniofacial applications of platelet-rich plasma. Br Dent J. 2005 Dec 24;199(12):799–799.


4. Lin SS, Montemurro NJ, Krell ES. Orthobiologics in Foot and Ankle Surgery. J Am Acad Orthop Surg. 2016 Feb;24(2):113–22.


5. Bhanot S, Alex JC. Current applications of platelet gels in facial plastic surgery. Facial Plast Surg FPS. 2002 Feb;18(1):27–33.


6. Tomita Y, Akiyama M, Shimizu H. PDGF isoforms induce and maintain anagen phase of murine hair follicles. J Dermatol Sci. 2006 Aug;43(2):105–15.


7. Takakura N, Yoshida H, Kunisada T, Nishikawa S, Nishikawa SI. Involvement of platelet-derived growth factor receptor-alpha in hair canal formation. J Invest Dermatol. 1996 Nov;107(5):770–7.


8. Li ZJ, Choi H-I, Choi D-K, Sohn K-C, Im M, Seo Y-J, et al. Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2012 Jul;38(7 Pt 1):1040–6.


9. Trink A, Sorbellini E, Bezzola P, Rodella L, Rezzani R, Ramot Y, et al. A randomized, double-blind, placebo- and active-controlled, half-head study to evaluate the effects of platelet-rich plasma on alopecia areata. Br J Dermatol. 2013 Sep;169(3):690–4.


10. Sohn K-C, Shi G, Jang S, Choi D-K, Lee Y, Yoon T-J, et al. Pitx2, a beta-catenin-regulated transcription factor, regulates the differentiation of outer root sheath cells cultured in vitro. J Dermatol Sci. 2009 Apr;54(1):6–11.


11. Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 2004 Apr;62(4):489–96.


12. Ovidio R d'. Limited Effectiveness of Platelet-Rich-Plasma Treatment on Chronic Severe Alopecia Areata. Hair Ther Transplant [Internet]. 2014 [cited 2016 Feb 18];04(01). Available from: http://www.omicsgroup.org/journals/limited-effectiveness-of-plateletrichplasma-treatment-on-chronic-severe-alopecia-areata-2167-0951.1000116.php?aid=24661


13. Singh S. Role of platelet-rich plasma in chronic alopecia areata: Our centre experience. Indian J Plast Surg Off Publ Assoc Plast Surg India. 2015 Apr;48(1):57–9.


14. Gkini M-A, Kouskoukis A-E, Rigopoulos D, Kouskoukis K. Platelet-rich Plasma as a Potential Treatment for Noncicatricial Alopecias. Int J Trichology. 2015 Jun;7(2):54–63.

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What is red, has scales and is itchy?

What is red, has scales and is itchy? The answer is psoriasis. Psoriasis is a chronic inflammatory condition. Individuals who struggle with psoriasis have lesions that form on their skin. These lesions are usually red in color with white scaling. Other typical symptoms include itchiness, skin flaking, and swelling ¹. If you struggle with psoriasis, you are not alone. Approximately 0.6% to 4.8% of the population has this condition ².

Psoriasis can occur on several parts of the body. Scalp involvement can occur in upwards of 80% of people with psoriasis ^3,4. With psoriasis of the scalp, hair grows through the scales creating a very rough texture to the touch. These scales are much thicker than those scales that can develop in other body locations. The location and the amount of lesions formed on the scalp can vary depending on the individual.

Not all cases of psoriasis are the same. The more severe the psoriasis, the greater impact on the physical and mental status of the individual ⁵. There are many risk factors involved with this condition. Several studies have looked at depression as a possible risk factor. It was found that nurses who had displayed symptoms of depression had an increased risk of developing psoriasis as compared to those who were not depressed (n=2,000)⁶. A possible connection between depression and psoriasis may be the underlining pathways of inflammation found in both conditions ⁷. Weight might also be a risk factor. Weight gain and an increased body mass index can increase the risk of psoriasis ⁸. It's been found that women who are physically active had a decreased risk of developing this condition ⁸. A family history of psoriasis can also increase the likelihood of developing this condition.

There are many different types of treatments available. Please stay tuned for a future blog that will cover all the different treatment options for this condition. If you have any questions, ensure to speak with you doctor or a hair care professional to get the resources you need.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Esposito M, Saraceno R, Giunta A, Maccarone M, Chimenti S. An Italian study on psoriasis and depression. Dermatol Basel Switz. 2006;212(2):123–7.


2. Naldi L. Epidemiology of psoriasis. Curr Drug Targets Inflamm Allergy. 2004 Jun;3(2):121–8.


3. Merola JF, Li T, Li W-Q, Cho E, Qureshi AA. Prevalence of psoriasis phenotypes among men and women in the USA. Clin Exp Dermatol. 2016 Feb 18;


4. Guenther L. Current management of scalp psoriasis. Skin Ther Lett. 2015 Jun;20(3):5–7.


5. Rapp SR, Feldman SR, Exum ML, Fleischer AB, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol. 1999 Sep;41(3 Pt 1):401–7.


6. Dominguez PL, Han J, Li T, Ascherio A, Qureshi AA. Depression and the risk of psoriasis in US women. J Eur Acad Dermatol Venereol JEADV. 2013 Sep;27(9):1163–7.


7. Bremmer MA, Beekman ATF, Deeg DJH, Penninx BWJH, Dik MG, Hack CE, et al. Inflammatory markers in late-life depression: results from a population-based study. J Affect Disord. 2008 Mar;106(3):249–55.


8. Frankel HC, Han J, Li T, Qureshi AA. The association between physical activity and the risk of incident psoriasis. Arch Dermatol. 2012 Aug;148(8):918–24.

 

 

 

 

 

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Horrible Hair Transplant? Using FUE to Correct Bad Hair Transplants

Hair loss is a problem that people have been dealing with for a very long item. In those times, men and women had to settle for wigs, weaves, hats, scarves, and anything else possible to hide a balding scalp.

Then came the hair transplant technology. People now have more than enough options to correct the effects of different hair loss conditions. However, not every transplant yields the expected results. You may have made the mistake of rushing into a transplant procedure and end up with unsatisfactory results.

Why Get Restorative Surgery

Maybe you got the procedure from a doctor without the necessary expertise, or the procedure wasn't the right one for you. Whatever the case, it is possible to make some corrections with an FUE hair transplant. Toronto has well-trained hair specialist with experience in FUE transplant procedures.

Camouflage

One of the options that a specialist can pick to correct a bad hair transplant is camouflage. This technique involves covering up the section that looks unattractive after an initial transplant. An FUE hair transplant procedure can use individual grafts to pad up the volume of hair or correct poorly angled transplants. Camouflage can be used as a standalone procedure or in combination with other techniques if the situation calls for it.

Using FUE

Hair transplant technology has changed dramatically and FUE hair transplant offer better results if there was a problem with your previous procedure. There can be challenges when it comes to reversing the damage caused during a previous transplant.

It helps to consult a hair specialist in Toronto to find out if the problem you are facing can be solved using FUE hair transplant. Ensure that the doctor you are working with has experience fixing bad hair transplants.

Excision and Reimplantation

Sometimes it may be necessary for a surgeon to excise the existing grafts and re-implant them properly. Such a procedure may be required if the existing grafts are in the wrong position, the direction of the grafts is incorrect or if there is a need to fix grafts around the temple area.

Hair restoration specialists in Toronto can explain to you the problems that may call for an excision and re-implantation process. As hair transplant techniques improve, more solutions are available for patients that need to get restorative hair transplant surgery.

Sources

Can Transplanted Hair Be Removed and Repositioned?, www.realself.com

What are My Options after a Bad Hair Transplant?, www.regrowhair.com

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How to treat alopecia areata: Topical Immunotherapy

Alopecia areata is the autoimmune disease that can lead to hair loss. Since this is an autoimmune disease, it is the body's own immune system that is attacking the hair follicles. It sometimes appears as mild and patchy hair loss but if more than half of your head is affected, hair loss has reoccurred many times, hair loss has persisted for over a year or incidences of hair loss began in childhood, it is usually considered severe. Treatment can be difficult, especially in the more severe cases. There are currently no approved therapies as success rates have varied with individual cases but good results are possible¹.

For these severe cases, topical immunotherapy is often used^2,3. A sensitizing agent (usually diphenylcyclopropenone or squaric acid dibutylester) is applied to the scalp to cause an allergic reaction⁴. It is not completely understood why this reaction causes the immune system to stop attacking hair follicles although it is believed that the appearance of a new immune target or an increase in cells that regulate the immune response could be contributing factors⁵.

Be prepared for possible side effects which include a burning sensation, blistering, irritation, darkening of the skin, enlargement of the lymph nodes, itchy rash, facial swelling, redness^6,7 and brown patches⁸. The second downside to this type of treatment is that relapses are not uncommon¹.

Topical immunotherapy is usually not recommended for pregnant women⁹, use in eyebrows¹⁰ or for those with mild¹¹ or rapidly expanding alopecia areata¹². This treatment is also less likely to be successful in those with complete hair loss, those experiencing body hair loss, those that have experienced thyroid disease or those that have affected nails^1,7,10. If you are interested in learning more about topical immunotherapy for your alopecia areata, speak with your doctor or hair restoration expert.

Article by: Dr. J.L. Carviel, PhD, Mediprobe Research Inc.

References

1. Rokhsar CK, Shupack JL, Vafai JJ, Washenik K. Efficacy of topical sensitizers in the treatment of alopecia areata. J Am Acad Dermatol. 1998 Nov;39(5 Pt 1):751–61.


2. Wiseman MC, Shapiro J, MacDonald N, Lui H. Predictive model for immunotherapy of alopecia areata with diphencyprone. Arch Dermatol. 2001 Aug;137(8):1063–8.


3. Ro BI. Alopecia areata in Korea (1982-1994). J Dermatol. 1995 Nov;22(11):858–64.


4. Orecchia G, Perfetti L. Alopecia areata and topical sensitizers: allergic response is necessary but irritation is not. Br J Dermatol. 1991 May;124(5):509.


5. Happle R. Antigenic competition as a therapeutic concept for alopecia areata. Arch Dermatol Res. 1980;267(1):109–14.


6. Pan R, Liu J, Xuan X, Li B. Chinese experience in the treatment of alopecia areata with diphenylcyclopropenone. J Dermatol. 2015 Feb;42(2):220–1.


7. Chiang K, Atanaskova Mesinkovska N, Amoretti A, Piliang MP, Kyei A, Bergfeld WF. Clinical efficacy of diphenylcyclopropenone in alopecia areata: retrospective data analysis of 50 patients. J Am Acad Dermatol. 2014 Sep;71(3):595–7.


8. Tosti A, Piraccini BM, Misciali C, Vincenzi C. Lentiginous eruption due to topical immunotherapy. Arch Dermatol. 2003 Apr;139(4):544–5.


9. Wilkerson MG, Connor TH, Henkin J, Wilkin JK, Matney TS. Assessment of diphenylcyclopropenone for photochemically induced mutagenicity in the Ames assay. J Am Acad Dermatol. 1987 Oct;17(4):606–11.


10. van der Steen PH, Happle R. Topical immunotherapy of alopecia areata. Dermatol Clin. 1993 Jul;11(3):619–22.


11. Tosti A, De Padova MP, Minghetti G, Veronesi S. Therapies versus placebo in the treatment of patchy alopecia areata. J Am Acad Dermatol. 1986 Aug;15(2 Pt 1):209–10.


12. Iorizzo M, Tosti A. Treatments options for alopecia. Expert Opin Pharmacother. 2015;16(15):2343–54.

 

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Which hair system should I choose?

If you are concerned with hair loss or its prevention, you are not alone. In Europe approximately $1 billion dollars has been spent on preventing or treating hair loss¹. This number jumps to approximately $2.2 billion dollars in the USA¹.

Hair systems (this can include wigs as well as other non-surgical hair replacement options) are commonly used by individuals who have medical conditions that cause hair loss. Some examples can include individuals who struggle with trichotillomania as well as patients undergoing chemotherapy². Using hair systems have actually increased self-esteem in women who struggle with alopecia areata (N=49)³.

There are quite a few options you can use to conceal hair loss. Today we are going to examine just two of the many non-surgical hair replacement options available at Sure Hair International; cranial prosthesis and hair integration systems. Cranial prosthesis can either be a full piece, covering the whole head, or it can be a partial piece. This prosthesis can allow your scalp to show through, making the hair system look more natural⁴. This type of hair system can be trimmed to specifically fit you, avoiding the need to remove the piece before any water activity (e.g., swimming, showering etc.) like other hair systems⁴. This type of prosthesis also contains a specially designed foundation that can have hair easily inserted and locked into place without the need for knots. Knots are traditionally used to keep the hairs attached to the foundation making the hair bulky and unnatural looking⁴.

There are some downsides however with this type of hair system. Cranial prostheses are not available at all retail outlets and they are more expensive than traditional synthetic hair systems⁴. In order for the prosthesis to remain on the scalp, medical adhesives (e.g., medical glue) needs to be applied on the head⁴. Oil and sweat can influence proper attachment of the prostheses⁴. However, with medical adhesives we have available at Sure Hair International, athletes, active individuals and those that perspire more often can enjoy cranial prostheses as well.

Hair integration systems are another option to consider. They involve adding synthetic or human hair to balding areas. This system is more natural looking and is custom made for you⁴. The color of the hair used can be hand matched to blend with your natural hair. ⁴ This hair system is not for everyone. Hair loss needs to be localized in order to successfully use this system⁴.

The key to wearing a hair system is skill, knowledge and effort⁵. Information, support, coloring and styling can be supplied from hair care professions such as Sure Hair International (located in Toronto, London, and Hamilton, Ontario). Don't be afraid to come in and ask about what system would work best for you.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Rushton DH, Norris MJ, Dover R, Busuttil N. Causes of hair loss and the developments in hair rejuvenation. Int J Cosmet Sci. 2002 Feb;24(1):17–23.


2. van den Hurk CJG, van den Akker-van Marle ME, Breed WPM, van de Poll-Franse LV, Nortier JWR, Coebergh JWW. Impact of scalp cooling on chemotherapy-induced alopecia, wig use and hair growth of patients with cancer. Eur J Oncol Nurs Off J Eur Oncol Nurs Soc. 2013 Oct;17(5):536–40.


3. Inui S, Inoue T, Itami S. Psychosocial impact of wigs or hairpieces on perceived quality of life level in female patients with alopecia areata. J Dermatol. 2013 Mar;40(3):225–6.


4. Banka N, Bunagan MJK, Dubrule Y, Shapiro J. Wigs and hairpieces: evaluating dermatologic issues. Dermatol Ther. 2012 Jun;25(3):260–6.


5. Goffman E. The Presentation of Self in Everyday Life. Doubleday: Anchor Books; 1959.

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Am I a good hair transplant candidate: Top 5 considerations when choosing a hair transplant for scarring hair loss

Scarring hair loss, or cicatricial alopecia, is a form of permanent hair loss whereby hair follicles are destroyed and replaced with scar tissue^1,2. Once the disease has been stable for at least two years, there are several treatment options which can be considered³. These include hair transplant, excision of the hairless region, and flap procedures (an intact blood supply is extracted from the donor site)^4,5. When choosing the best option for you, there are a few important individual characteristics to investigate. For example, when choosing a hair transplant, here are the top 5 considerations:

Availability of Donor Hair

Very simply, how much donor hair is available? How large is the recipient area?

Properly assessing donor and recipient regions is especially important in younger individuals as pattern hair loss may develop over time. This could lead to gradual loss of the transplanted hair or “islands” of hair in a balding region. An experienced hair surgeon should be able to anticipate this possibility and operate accordingly.

Scalp Laxity

Scalp laxity refers to the looseness of the affected area of the scalp. Greater laxity allows for a low-tension wound closure. Strip or follicular unit extraction (FUE) hair transplants may be the better option for those with less laxity while excision may be preferable in cases with greater laxity or smaller affected areas.

Patient's Healing Characteristics

Some people are better at healing than others. Those with a history of producing highly visible scars or who have experienced greater than average postoperative bleeding may benefit from hair transplant over the alternative surgical options.  Another option is FUE hair transplants.

Vascular Circulation        

Scar tissue in the areas of hair loss can lead to reduced blood flow. Your hair transplant surgeon should be able to test for a sufficient supply to nourish the newly transplanted follicles. Larger scarred areas are most at risk for low blood flow.

Area of Involvement

If the affected area is highly visible, such as the hairline, a hair transplant is most likely the way to go. Alternatively, hair transplantation can be used as an additional procedure to hide scars in visible areas.

Overall, there are multiple treatments available for scarring hair loss. However as they mainly consist of surgical options, there are many considerations, making individual assessments by an experienced surgeon important.

Article by: Dr. J.L. Carviel, PhD, Mediprobe Research Inc.

References

1. Siah TW, Shapiro J. Scarring alopecias: a trichologic emergency. Semin Cutan Med Surg. 2015 Jun;34(2):76–80.


2. Harries MJ, Sinclair RD, Macdonald-Hull S, Whiting DA, Griffiths CEM, Paus R. Management of primary cicatricial alopecias: options for treatment. Br J Dermatol. 2008 Jul;159(1):1–22.


3. Saxena K, Saxena DK, Savant SS. Successful Hair Transplant Outcome in Cicatricial Lichen Planus of the Scalp by Combining Scalp and Beard Hair Along With Platelet Rich Plasma. J Cutan Aesthetic Surg. 2016 Mar;9(1):51–5.


4. Unger W, Unger R, Wesley C. The surgical treatment of cicatricial alopecia. Dermatol Ther. 2008 Jul;21(4):295–311.


5. Fan J-C, Wang J-P. [Plastic surgical management of large cicatricial scalp alopecia]. Zhonghua Yi Xue Za Zhi. 2009 Apr 28;89(16):1098–101.

The post Am I a good hair transplant candidate: Top 5 considerations when choosing a hair transplant for scarring hair loss appeared first on ARTAS Robotic Hair Transplant In Toronto, ON | Sure Hair International.

Do you know where the hair on your head came from?

Wigs have been around for thousands of years and originated in Egypt¹. Egyptian women used wigs to shield themselves from the intense heat of the sun¹. Since then, wigs have been used frequently throughout history. By the 16^th century, wigs debuted as a method for concealing hair loss¹. Is hair loss a big deal? Approximately 22% of over 1,500 men surveyed on hair loss replied that it impacted their social life and 21% reported feelings of depression².

It is cosmetically imperative that wigs look like natural hair. By using high quality wigs or hair systems, the common complaint that “wigs look wiggy” can be eliminated³. What makes up a wig? Hair is obviously a major part of the equation but the foundation of the wig is also another key part.  Depending on the style of the wig the foundation could be a net or made from other breathable material¹. There are a few main types of hair that can be included in wigs; human hair fibers, synthetic hair and high heat synthetic fibers.

There are quite a few benefits to synthetic wigs. Synthetic wigs are generally less expensive and can be purchased at a retail store¹. This type of hair does well in the sun; unlike real hair that can undergo bleaching when exposed to sunlight⁴. However synthetic wigs are 'one size fits all', which really means it really won't fit everyone perfectly¹. This type of hair can be 'unnatural' looking but does have a long life span. ¹ Be careful not to use your blow drier with these wigs since heat can melt them¹.

Human hair can also be used in the creation of wigs. Using this type of hair in wigs allows the hair to be dyed to match your natural hair color¹. Traditional styling, like blow driers, can be used to style these wigs. The main issue with this type of hair is that it requires a donor to give up their lovely locks. Virgin hair is the most desired type of donated hair. This is hair that hasn't been previously dyed or processed and is cut from one donor.

High heat synthetic fibers can also be used as well. These fibers can be flat ironed and even curled with heat, up to a certain temperature. High heat synthetic fibers are as soft as human hair with color that doesn't fade. However, this type of hair does cost as much or even more than human hair and must be specially ordered by a trained professional.

There are lots of options out there but don't feel overwhelmed. Come in and talk with us for advise on wigs or hair systems that will best fit your needs.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Banka N, Bunagan MJK, Dubrule Y, Shapiro J. Wigs and hairpieces: evaluating dermatologic issues. Dermatol Ther. 2012 Jun;25(3):260–6.


2. Alfonso M, Richter-Appelt H, Tosti A, Viera MS, García M. The psychosocial impact of hair loss among men: a multinational European study. Curr Med Res Opin. 2005 Nov;21(11):1829–36.


3. Wiggins S, Moore-Millar K, Thomson A. Can you pull it off? Appearance modifying behaviours adopted by wig users with alopecia in social interactions. Body Image. 2014 Mar;11(2):156–66.


4. Nogueira ACS, Nakano AK, Joekes I. Impairment of hair mechanical properties by sun exposure and bleaching treatments. J Cosmet Sci. 2004 Dec;55(6):533–7.

 

The post Do you know where the hair on your head came from? appeared first on ARTAS Robotic Hair Transplant In Toronto, ON | Sure Hair International.

Iron & Hair – A Confusing Topic

In a previous blog post, we discussed iron and its' possible role in hair loss. The focus of this blog post is to re-visit the role of iron, presenting evidence supporting the role of iron in hair loss as well as evidence suggesting iron does not have a role in hair loss. Looking at both sides of the fence will allow for a well-rounded argument with the sales person in the vitamin aisle at the grocery store.

There is evidence that hair loss may occur in individuals that have low iron.

A study conducted of 50 women with chronic telogen effluvium (CTE) reported that these individuals increased hair shedding over long periods of time¹. In this study, 72% of the women who had CTE also had very low iron². To give some perspective, in the US, only about 9 to 11% of women are iron deficient³. In a hospital based study, 116 patients who had telogen effluvium (TE), showed a much lower percentage of women with low iron⁴. Only about 34% of the women had low iron levels (below 12 µg/l)⁴.

There is evidence that iron supplements help with hair loss.

A group of 22 women who were treated with a combination of iron and an essential amino acid for 6 months showed a decreased amount of hair preparing to shed⁵. This represents a 39% reduction in hair shedding⁵.

There is evidence that iron is not involved in hair loss.

In another study only 6% of almost 200 women, ages 11 to 72 years old, complaining of hair loss were shown to have low iron⁶. When five of these women with low iron levels then took iron supplements, there was no reversal or changes in their hair loss⁶.

So there you have it, both sides to the story. Iron levels may or may not contribute to hair loss.  Perhaps in the future we will be able to tease out the truth about iron as it relates to hair.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Rushton DH. Nutritional factors and hair loss. Clin Exp Dermatol. 2002 Jul;27(5):396–404.


2. Rushton DH, Ramsay ID, James KC, Norris MJ, Gilkes JJ. Biochemical and trichological characterization of diffuse alopecia in women. Br J Dermatol. 1990 Aug;123(2):187–97.


3. Looker AC, Dallman PR, Carroll MD, Gunter EW, Johnson CL. Prevalence of iron deficiency in the United States. JAMA. 1997 Mar 26;277(12):973–6.


4. Malkud S. A Hospital-based Study to Determine Causes of Diffuse Hair Loss in Women. J Clin Diagn Res JCDR. 2015 Aug;9(8):WC01–4.


5. Rushton DH, Norris MJ, Dover R, Busuttil N. Causes of hair loss and the developments in hair rejuvenation. Int J Cosmet Sci. 2002 Feb;24(1):17–23.


6. Sinclair R. There is no clear association between low serum ferritin and chronic diffuse telogen hair loss. Br J Dermatol. 2002 Nov;147(5):982–4.

The post Iron & Hair – A Confusing Topic appeared first on ARTAS Robotic Hair Transplant In Toronto, ON | Sure Hair International.

Difficulties and solutions for treating scarring hair loss with hair transplantation

Scarring hair loss, or cicatricial alopecia, is a form of permanent hair loss whereby hair follicles are destroyed and replaced with scar tissue⁵. There are many conditions which can lead to scarring hair loss such as dissecting cellulitis, eosinophilic pustular folliculitis, follicular degeneration syndrome, folliculitis decalvans, lichen planopilaris and pseudopelade of Brocq as well as isolated events including trauma, burns, infection, radiation or surgery. Non-surgical treatment options aim to halt further hair loss and relieve signs and symptoms of disease. Unfortunately once the follicles are lost, there are few treatment options to restore hair outside of surgery.

Nonetheless, treating scarring alopecia through a hair transplant can be tricky for multiple reasons. One of which is the reduced blood flow in the affected areas. The remaining scar tissue may impede blood flow to any new transplanted follicles resulting in insufficient nutrients to stimulate hair growth². Scarring can also affect the donor area, greatly reducing the number of potential grafts¹.

Platelet-rich plasma (PRP), or the vampire treatment, is a relatively new treatment option which can be used in combination with hair transplantation. A small amount of your own blood is extracted. The portion of blood which contains an abundance of growth factors is then injected back, directly into your scalp. These growth factors are known to both encourage the development of new blood vessels³ as well as increase the number of surviving transplanted hair follicles⁴ therefore potentially improving both issues of reduced blood flow and donor grafts.

A recent case study describes a 24-year-old male with lichen planopilaris who was treated with a combination of PRP and hair transplantation (FUE method)¹. An 80% survival rate of transplanted follicles was reported leading to reasonable coverage, despite what was described as extensive alopecia. There have not been many similar cases reported as of yet, but PRP is rapidly gaining popularity in the hair restoration industry.

Overall, there are multiple treatment options, including hair transplant, available for scarring hair loss.  Generally, hair transplants should not be considered if the disease process has not been stable for at least two years. If you are concerned about the appearance of your scarring hair loss, book a consultation with a hair restoration expert to help assess your individual situation.

Article by: Dr. J.L. Carviel, PhD, Mediprobe Research Inc.

References

1. Saxena K, Saxena DK, Savant SS. Successful Hair Transplant Outcome in Cicatricial Lichen Planus of the Scalp by Combining Scalp and Beard Hair Along With Platelet Rich Plasma. J Cutan Aesthetic Surg. 2016 Mar;9(1):51–5.


2. Unger W, Unger R, Wesley C. The surgical treatment of cicatricial alopecia. Dermatol Ther. 2008 Aug;21(4):295–311.


3. Li ZJ, Choi H-I, Choi D-K, Sohn K-C, Im M, Seo Y-J, et al. Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2012 Jul;38(7 Pt 1):1040–6.


4. Uebel CO, da Silva JB, Cantarelli D, Martins P. The role of platelet plasma growth factors in male pattern baldness surgery. Plast Reconstr Surg. 2006 Nov;118(6):1458–66; discussion 1467.


5. Siah TW, Shapiro J. Scarring alopecias: a trichologic emergency. Semin Cutan Med Surg. 2015 Jun;34(2):76–80.

The post Difficulties and solutions for treating scarring hair loss with hair transplantation appeared first on ARTAS Robotic Hair Transplant In Toronto, ON | Sure Hair International.

6 simple tips to ensure your hair is healthy and happy

Having long flowing locks can be more than just wishful thinking, you can make it happen.

There are several different ways you can help keep your hair healthy. Here are 6 practical and easy to do tips that limit hair loss:

 

1. Use a comb. Avoiding pulling your hair aggressively with plastic bristle brushes.


2. Use a hair consultant, hair and scalp specialist (trichologist), or doctor for advice when deciding to color hair or when purchasing a wig. Another great place to check out is Sure Hair International for advice and resources.


3. Use towels like sponges when drying hair. Avoid rubbing or aggravating the scalp.


4. Be careful when buying and using shampoos and conditioners. Some of these items can be detergent based. Detergent based shampoos when tested in the laboratory, have been shown to damage hair. (1) Sodium laurel sulphate is an example of an ingredient to watch out for.


5. Use that pool side shower. When using chlorinated pools or when swimming in the ocean it is good practice to rinse your hair after. Chlorine can discolor hair, can make your cuticles (outermost part of the hair shaft) and make your cortex layers (thickest hair layer) worn out. (2) If you want your hair to be strong and protected you'll want to keep your cortex layer and hair cuticles healthy.


6. A balanced healthy diet can help with hair loss. (3) Some ingredients to a healthy diet include amino acids, which make up the protein found in hair. (4) Other key ingredients include fatty acids, iron and vitamin A which could influence hair health. (4–6) When in doubt try to stick with Canada's Food Guide as an outline. Another resource to check out is your family doctor or nutritionist who can cater your diet to meet your personal needs and goals.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Bellare J, Iyer R, Mainkar AR, Jolly CI. A study on the conditioning effects of natural shampoos using the scanning electron microscope. Int J Cosmet Sci. 2001 Jun;23(3):139–45.


2. Nanko H, Mutoh Y, Atsumi R, Kobayashi Y, Ikeda M, Yoshikawa N, et al. Hair-discoloration of Japanese elite swimmers. J Dermatol. 2000 Oct;27(10):625–34.


3. Hughes W. Achromotrichia in Tropical Malnutrition. Br Med J. 1946 Jul 20;2(4463):85–7.


4. Rushton DH. Nutritional factors and hair loss. Clin Exp Dermatol. 2002 Jul;27(5):396–404.


5. Holman, R.T. Essential fatty acid deficiency. Progress in the Chemistry of Fats and Other Lipids. Part 2. Vol. 9. Oxford: Pergamon Press; 1968. 280 p.


6. Everts HB, Silva KA, Montgomery S, Suo L, Menser M, Valet AS, et al. Retinoid metabolism is altered in human and mouse cicatricial alopecia. J Invest Dermatol. 2013 Feb;133(2):325–33.

The post 6 simple tips to ensure your hair is healthy and happy appeared first on ARTAS Robotic Hair Transplant In Toronto, ON | Sure Hair International.

Your Medicine Cabinet Could Hold the Secret to Your Hair Loss

We have all watched infomercials describing the latest and greatest drugs on the market. You know that part right at the end, where they talk really fast and list hundreds of possible side effects of this amazing drug, while watching the actors walk into the sunset? Well that's the topic of today's post.

When designing a drug to be effective in treating a disease or condition there can be side effects. Side effects, also called adverse effects are unintentional effects on the body that are due to the drug's presence and can vary in severity. Some examples of side effects that are encountered with many medications are constipation, ulcers, influenza and headaches.  (1) Hair loss is a common side effect of certain types of medication. For example, chemotherapy is known to lead to hair loss. (2)

Several acne treatments have also been reported to induce hair loss. Isotretinoin is an effective acne treatment and does have several possible side effects including dry eyes, nose bleeds, tiredness and in twelve percent of patients, hair loss. (3)

Depression is another medical condition in which treatment may lead to hair loss. Data from WHO (World Health Organization) and major American pharmaceutical manufactures implicated the anti-depressant fluoxetine, better known as Prozac, had 725 cases of hair loss. (4)

Cimetidine is used to treat ulcers and stomach acidity. Over 60 case reports of hair loss have been associated with the use of this drug and the duration of hair loss has ranged from 2 days to 2 years. (5)

Acne treatments, anti-depressants and ulcer medication aren't the only types of drugs that can induce hair loss. Several cholesterol lowering agents, diet pills, glaucoma medication and thyroid medication are also treatments with hair loss as a side effect. (4) To avoid medically induced hair loss, speak to your doctor about the side effects of any prescribed medication you are taking or are interested in taking.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. Toledo-Bahena ME, Bucko A, Ocampo-Candiani J, Herz-Ruelas ME, Jones TM, Jarratt MT, et al. The efficacy and safety of tavaborole, a novel, boron-based pharmaceutical agent: phase 2 studies conducted for the topical treatment of toenail onychomycosis. J Drugs Dermatol JDD. 2014 Sep;13(9):1124–32.


2. Botchkarev VA. Molecular mechanisms of chemotherapy-induced hair loss. J Investig Dermatol Symp Proc Soc Investig Dermatol Inc Eur Soc Dermatol Res. 2003 Jun;8(1):72–5.


3. Hull PR, Demkiw-Bartel C. Isotretinoin use in acne: prospective evaluation of adverse events. J Cutan Med Surg. 2000 Apr;4(2):66–70.


4. Pillans PI, Woods DJ. Drug-associated alopecia. Int J Dermatol. 1995 Mar;34(3):149–58.


5. Khalsa JH, Graham CF, Jones JK. Cimetidine-associated alopecia. Int J Dermatol. 1983 Apr;22(3):202–4.

The post Your Medicine Cabinet Could Hold the Secret to Your Hair Loss appeared first on ARTAS Robotic Hair Transplant In Toronto, ON | Sure Hair International.

Trichotillomania Part Four – Ok so I have Trichotillomania. Now what?

Trichotillomania is a hair pulling disorder that was first described in the 1889. There can be some ritual behaviors connected with this condition. Rolling the hair, running the hair over one’s lips, and pulling out specific hairs based on color, length and texture are all possible behaviors. (1) This condition is quite tricky to treat. There are several treatment options to consider. Some examples of treatments include comprehensive behavior treatment, and medication. (2–5)

Habit reversal training (HRT) is a type of comprehensive behavior therapy. This therapy focuses on one’s feelings, thoughts and behavior. Examples of items included in HRT are awareness training, reaction training and social support. When this type of therapy was evaluated in a large scale behavioral outcome study there was over a 90% reduction in hair pulling. (5)

There are also several different types of medications that are currently being tested for safety and efficacy. An example of a drug that has been looked at in the treatment of Trichotillomania is N-acetylcysteine. When trichotillomania patients were given this drug, they showed decreases in hair pulling symptoms with 56% of patients that were “much or very much improved”. (4) A possible issue in treating Trichotillomania with medication is side effects. Examples of side effects include constipation, dry mouth, and tremors. (6) Caution should be taken as anxiety and depression are already linked to this condition. (7)

The amount of options to try might seem overwhelming but with a discussion with your doctor and checking out some resource centers (such as Trichotillomania Learning Center www.trich.org) a right treatment plan can be made. Families and friends can play a major role as well in your treatment success. Using effective communication to correctly inform family members of your condition can be a great start on your way to recovery. Please stay tuned for a follow up blog on trichotillomania in children.

Article by: Sarah Versteeg MSc, Mediprobe Research Inc. 

1. du Toit PL, van Kradenburg J, Niehaus DJ, Stein DJ. Characteristics and phenomenology of hair-pulling: an exploration of subtypes. Compr Psychiatry. 2001 Jun;42(3):247–56.


2. Falkenstein MJ, Mouton-Odum S, Mansueto CS, Golomb RG, Haaga DAF. Comprehensive Behavioral Treatment of Trichotillomania: A Treatment Development Study. Behav Modif. 2015 Dec 7;


3. Ducasse D, Fond G. [Acceptance and commitment therapy]. L’Encéphale. 2015 Feb;41(1):1–9.


4. Grant JE, Odlaug BL, Kim SW. N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study. Arch Gen Psychiatry. 2009 Jul;66(7):756–63.


5. Azrin, N.H, Nunn R.G., Frantz, S. E. Treatment of hairpulling (Trichotillomania): A comparative study of habit reversal and negative practice training. J Behav Ther Exp Psychiatry. 1980 Mar;11(1):13–20.


6. Rothbart R, Amos T, Siegfried N, Ipser JC, Fineberg N, Chamberlain SR, et al. Pharmacotherapy for trichotillomania. Cochrane Database Syst Rev. 2013;11:CD007662.


7. Teng, Ellen J, Woods, Douglas W, Marcks, Brrok A, Twohig, Michael P. Body-Focused Repetitive Behaviors: The Proximal and Distal Effects of Affective Variables on Behavioral Expression. J Psychopathol Behav Assess. 2004 Mar;26(1):55–64.

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My top 5 hair vices and how I overcame them, (plus one I’m still working on)

When it comes to our hair-growing abilities (or inabilities,) one of the main factors is genetics. A predisposition for conditions such as pattern-baldness or alopecia areata can obviously have a significant impact on your life¹ however there are some good and bad habits which can contribute to the hair that you do have to work with. And even though I should know better with the career path I chose, here are some of my past and present challenges with my own hair:

Traction alopecia

Everyone is super busy these days so I’m sure that you can appreciate that sometimes, (translation: always,) I feel pressed for time. My coping mechanism was to cut the time I spent in front of the mirror every morning by pulling my hair into the same bun on top of my head, often when it was still wet, putting me at risk for traction alopecia.

Traction alopecia occurs when there is enough pressure put on the hair follicle to pull out the hair strand prematurely². Repeated instances can affect the ability of the hair to grow back and extreme cases can lead to permanent hair loss. Very tight hairstyles such as braids and ponytails can result in traction alopecia. In my case, having wet hair made it heavier and more prone to breakage and pulling.

When my hair dresser gave me a very stern lecture, I did learn to change my habits. I now have a few quick and easy hairstyles that I alternate between so that I avoid putting pressure in the same spots every day. I have also replaced my use of hair elastics which were causing a lot of damage with some gentler accessories such as soft headbands and various smooth plastic clips.

Cosmetic over-processing

In the past, I have tried some lightening treatments which led to some very noticeable damage. Going forwards, I just decided to avoid the use of permanent dye altogether. For those who really enjoy experimenting with colour, there are some options to keep damage to a minimum. Researchers recommend waiting a minimum of six weeks between harsh chemical treatments such as dyes or straighteners/relaxers³. A second option is to choose a non-permanent dye. Permanent dyes are designed to penetrate the outer layer of the hair strand, the hair cuticle, which can be damaged in the process⁴. A non-permanent dye will need to be applied more frequently and generally provides less colour options, however it will be designed to coat the hair strand, thus avoiding possible penetration damage.

Spring shed

Spring is pretty much the worst time of the year for my vacuum. Although not directly within my control, I definitely experience seasonally-related shedding^5–8 and springtime is the most noticeable for me.

Hair growth normally follows a cycle where at any given moment in time there will be follicles actively growing, resting or shedding. During seasonally-related shedding, many of the follicles become synchronized, meaning more hair than usual is shed at the same time, however those follicles also return to the growth cycle so there is no concern for hair loss⁹.

With three females in my household who prefer Rapunzel-inspired hair styles, (and I am by far the worst offender,) we make sure all of the drains have hair traps and wait it out. The shedding usually stops by the time my grass allergies kick in and all the hair seems to have grown back in time for the fall shed making this one more annoying than a problem.

Fall shed

Very similar to the spring shed, just maybe a slightly milder version.

Itchy scalp

This one seems to be a result of my sedentary lifestyle. While I’m sitting at my desk thinking my hardest I will often literally put my hands on my head, (maybe I’m subconsciously trying to encourage my thoughts or something?). This can lead to some mild scratching/pulling and damage.

Dandruff as well as the presence of microorganisms including yeast can also potentially lead to an itchy scalp. There are a plethora of products and shampoos targeted at reducing dandruff and likewise shampoos containing anti-microbial ingredients such as ketoconazole or salicylic acid can help to reduce microbe populations. Reducing the amount of styling products you use could also be beneficial.

Now that I am aware of the habit though I’m thinking that I can just cut it out. I will let you know when that happens.

References

1. Santos Z, Avci P, Hamblin MR. Drug discovery for alopecia: gone today, hair tomorrow. Expert Opin Drug Discov. 2015 Mar;10(3):269–92.


2. Khumalo NP, Jessop S, Gumedze F, Ehrlich R. Determinants of marginal traction alopecia in African girls and women. J Am Acad Dermatol. 2008 Sep;59(3):432–8.


3. Ahn HJ, Lee W-S. An ultrastuctural study of hair fiber damage and restoration following treatment with permanent hair dye. Int J Dermatol. 2002 Feb;41(2):88–92.


4. Marsh J, Gray J, Tosti A. Root-to-Tip Hair Health. In: Healthy Hair [Internet]. Cham: Springer International Publishing; 2015 [cited 2016 Feb 29]. p. 29–44. Available from: http://link.springer.com/10.1007/978-3-319-18386-2_2


5. Ebling FJG. The Hormonal Control of Hair Growth. In: Orfanos CE, Happle R, editors. Hair and Hair Diseases [Internet]. Berlin, Heidelberg: Springer Berlin Heidelberg; 1990 [cited 2016 Mar 14]. p. 267–99. Available from: http://www.springerlink.com/index/10.1007/978-3-642-74612-3_12


6. Messenger AG. The control of hair growth: an overview. J Invest Dermatol. 1993 Jul;101(1 Suppl):4S – 9S.


7. Courtois M, Loussouarn G, Hourseau S, Grollier JF. Periodicity in the growth and shedding of hair. Br J Dermatol. 1996 Jan;134(1):47–54.


8. Wehr TA, Duncan WC, Sher L, Aeschbach D, Schwartz PJ, Turner EH, et al. A circadian signal of change of season in patients with seasonal affective disorder. Arch Gen Psychiatry. 2001 Dec;58(12):1108–14.


9. Headington JT. Telogen Effluvium: New Concepts and Review. Arch Dermatol. 1993 Mar 1;129(3):356.

The post My top 5 hair vices and how I overcame them, (plus one I’m still working on) appeared first on ARTAS Robotic Hair Transplant In Toronto, ON | Sure Hair International.