About Hair Loss
Hair loss is very common in both men and women, affecting 50 percent of men and 21 million women in the United States alone. Although we tend to lose about 100 hairs a day, it’s usually not noticeable due to new hair growth. But if that balance is upset, the most common pattern of loss is a gradual thinning on the top of the head. This affects both men and women, but women usually retain their hairline and have a broadening of the part in their hair. The most common cause for this is male pattern baldness or female pattern baldness. In both groups, it is referred to as androgenic alopecia. A minority of hair loss is due to medical conditions such as thyroid problems and hormonal changes such as pregnancy, childbirth and menopause. Hair loss can also be a side effect of certain drugs such as those for arthritis, depression, heart problems, gout, high blood pressure, diabetes, lupus, significant weight loss and stress.
Hair Regrowth with our own Growth Factors and Stem Cells
At present, topical minoxidil and oral finasteride are the only two drugs approved by the Food and Drug Administration for the treatment of androgenic alopecia. Both must be used lifelong and daily. Hair transplant surgery is quite effective, but many cannot afford it and many more are not good candidates. There are no oral supplements or vitamins proven to be effective. If so, the demand worldwide would be overwhelming, and we would all be aware. Overall androgenic alopecia is an unsolved problem.
What it is
Modern medicine has recently delivered some exciting new options. With the discovery of growth factors almost every medical specialty is studying adaptations to their own unsolved challenges. Research in many fields recently has found striking benefits from these agents we have in our own blood and tissues. They are proven to be active in stimulating the proliferation of blood vessels, collagen and elastin production, with stimulation of fibroblast proliferation and improvement in amount and quality of the substance between human cells called extra cellular matrix. Among the many actions of growth factors found recently is their effect on the regulation of the hair growth cycle. Some researchers are beginning to think that androgenic alopecia is similar to tissue damage in that growth factors with all their healing influence can change the microenvironment around the hair follicle. Maybe the growth factors stimulate stem cells in the follicles. Maybe more important is an increase in blood flow to the follicle area. Growth factors also attract cells from the blood stream needed for repair. One thing for sure is that this is not an experimental application but one that is absolutely proven to work in the majority of patients. Research does continue in what are the best preparations, optimal timing, etc.
Whatever the exact mechanism, growth factors are readily accessible in our own blood in platelets and white blood cells and in our own fat. Growth factors in platelets are obtained by spinning blood in a centrifuge. Layers based on density separate out and the proper layer is used for the concentrated platelets called PRP or platelet rich plasma. More recently, there is increasing attention to a different preparation of one’s own blood and that is PRF, or platelet rich fibrinogen. The steps are a little different since the white cells are harvested as well as platelets. Further, this type of preparation leaves the cells in a web of fibrin that makes for slower release of the growth factors over days. There is evidence this may be more effective.
Turning to the other recently proven treatment for hair loss, the source is not blood but our own fat. Between the actual fat storage cells are cells formally called adipose derived stem cells, now called adipose derived stromal cells. They have been shown to stimulate hair follicle regrowth and have positive effects on the hair cycle. The mechanism could be their own production of growth factors.
What to expect
Dr. Hubbard uses local anesthetic to obtain an adequate amount of fat. He and his staff then process this to isolate the stromal cells in what is called nanofat! Dr. Hubbard has experience with all types of fat grafting including nanofat. This is a part of fat that doesn’t enlarge with weight gain and doesn’t even look like fat. A recent study in Italy compared the results of injection with PRP mixed with nanofat to PRP alone. Trichoscopy measured density and thickness of hairs. The combination treatment area was significantly superior at three months follow-up peaking at six months. There was partial recurrence at 12 months. Patient satisfaction was noted to be increased in a similar way with a maximum at 6 months and decreasing at 12 months follow-up. This is especially significant as there was only a single treatment session. There were no complications in his study.
Overall it appears all these modalities are effective for thinning hair. Although totally lost hair cannot be regrown, it can revitalize “minimized” hair follicles (withering but not dead hair follicles) to give thicker, fuller hair. It appears PRP or PRF may be preventative and some patients as young as 18 years old are undergoing treatment (preventative for both genders at any age group). PRP or PRF can stop hair loss with maintenance every 8 months or so. These again come from the patient’s own body and have no side effects.
If someone has no noticeable thinning, but a strong family history, there is a software that offers computer analysis of hair density and hair shaft diameter. Using trichoscopy (measuring hair density and shaft diameter under magnification we take these microphotographs prior to the injections and then later to document objectively the improvement in hair count and shaft diameter.
Why Choose Dr.Hubbard?
For something so clearly proven to work, we are interested in being extremely objective with results. This is especially important since the appearance of more hair is greatly influenced by styling, hair length and lightening. We use trichoscopy, but not just for viewing highly magnified scalp photos, but also to have computer analysis to know the hair density and actual hair shaft diameters. This is routine before and after a series of treatments.
Hubbard Plastic Surgery offers a number of state-of-the-art mechanisms using one’s own tissues-either from blood or fat to stimulate hair regrowth.