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.

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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.

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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.

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