Medical Treatment Protocol
There are numerous documented reasons for hair loss. It is difficult to pinpoint a particular reason responsible in a person.The hair loss becomes extensive only when multiple reasons are acting in tandem. Instead of chasing the reasons and trying to correct them individually, we use a multi pronged approach to protect and strengthen the hair, which can then withstand any cause.
To understand our philosophy of treatment of hair loss with cyclical medicine and hair transplant one has to understand a few pertinent facts.
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There are numerous documented reasons for hair loss. It is difficult to pinpoint a particular reason responsible in a person.The hair loss becomes extensive only when multiple reasons are acting in tandem. Instead of chasing the reasons and trying to correct them individually, we use a multi pronged approach to protect and strengthen the hair, which can then withstand any cause.
To understand our philosophy of treatment of hair loss with cyclical medicine and hair transplant one has to understand a few pertinent facts.
The most common mode of hair loss is by miniaturization of the follicle. The hair gradually becomes slow growing, reduces in diameter, becomes thin, short, looses the pigment and eventually falls off. After sometime the follicle undergoes fibrosis and is finally dead. This is known as the process of minituarization. It is scientifically proved that miniaturization is caused by effects of DHT (dihydrotestosterone) on the hair roots.
You may loose 10 to 200 strands of hair per day. But this hair is not dead. All the hair that falls gets replaced with new growing hair. The hair goes through a generation, growth and fall cycle which continues again with generation of new hair. Therefore, you do not become bald because you are loosing more hair, you will become bald when the lost hair is not replaced with new hair.
Having a positive family history only means that you are born with weak hair. It does not mean that all this weak hair must be lost. You can strengthen the hair, prevent it from being affected by DHT and prevent hair loss, even if it is hereditary. Miniaturization is a slow process, a gradual process. The short, vellus hair remain for a long time before falling off and most importantly miniaturization is reversible.
Apart from DHT there are other factors that can affect hair and cause hair loss. This is called pseudo miniaturization of hair.
Pseudo miniaturization is caused by the lack of general factors essential for hair growth. Therefore it can affect all the hair roots, sensitive or non sensitive. Correction of these factors can improve the growth of all the hair
Not all hair roots can be affected by DHT. There are two kinds of hair roots, sensitive and non sensitive. All the hair roots sensitive to DHT are distributed on the front and top of the head. While all the non sensitive roots are placed on the sides and the back of the head. Therefore you loose hair only from the front and the top, whereas even till the later years of life the hair on the sides and the back is always preserved. The sides and the back have permanent hair roots and these are used to replace the lost roots in a hair transplant.
The approach is as follows:
- Protect the hair from DHT: Effects of DHT are reversible with the use of specific FDA approved medicines like finasteride
- Super saturation with nutrients: Hair has very low priority in the body. You can live a healthy life without a single hair on your head! All the nutritional intake is primarily utilized to maintain the vital systems of the body. The hair does not receive much of this because hair is not essential for survival. Therefore we need to use additional nutritional supplements to make sure there is more than enough nutrition which can ultimately reach the hair.We recommend the use of antioxidants, diet modification and nutritional supplements to provide an environment suitable for the growing cells.
- Increase the blood supply to the hair roots: Minoxidil increases the blood supply to the hair roots and ensures their growth. The increased blood supply also ensures the delivery of the nutrients to the hair.
- Good scalp hygiene: Persons having oily skin, excess sweating, increased formation of ear wax are likely to loose more hair. The sebum and sweat glands are the site where the type 2 alpha reductase enzyme that converts testosterone to dihydrotestosterone is stored. These glands are the site of the DHT forming activity. Hyperactivity of the glands can indirectly lead to excess activity of the enzyme and high levels of DHT formation. We therefore feel it necessary to reduce the activity of the oil and sweat glands in order to prevent hair loss.
Good scalp hygiene and providing all nutrition required for hair growth can ensure that new hair keeps growing and replacing the lost hair. These medicines also protect the hair from further damage. The combination of treatments (Cyclical Medicine) put together by the eminent Hair Restoration surgeon Dr.Rajesh Rajput, show significant improvement within one natural hair growth cycle of 4 months, and changes are evident as early as 2 months following medication.
Combination of several medicines.
Since we want to block the formation of DHT, improve the blood flow to the roots, create an environment for rapidly dividing cells and provide all nutritional support, no single medicine works. You need a combination of several medicines.
Keep the side effects away.
Persons who lose hair are born with weak hair or have abused their hair and not taken good care of it. Such weak hair requires prolonged treatment. One natural hair growth cycle is of 4 months. If you have to take the medicines for a few cycles it easily goes on for a year. Many of these medicines taken on long term basis could have a possibility of potential side effects. But we have a novel way of keeping the side effects away by using the medicine only once in 3-days. The 3-day cycle makes sure that the drug is metabolized and washed away from the system before taking the next dose. Thus no residual medicine accumulates in the body and there are no side effects
Efficient absorption and utilization of the drugs.
The next problem is that all medicines given together will not get absorbed through the gut at the same time. They interfere and compete for the absorption on one another. The absorption is also dependent on the prevailing drug levels in the blood. If the medicine taken on the previous day is still in circulation its absorption on the very next day will be less. The dose given on the very next day may be wasted. All nutritional supplements contain doses much higher than the recommended daily allowance. We have made selected combinations that do not interfere with the absorption of one another so that the absorption is complete. The combinations are given in 3-day cycles. Thus, there is a gradient available for good up take from the gut. It also ensures that the medication is completely utilized and metabolized in the system before the next dose is delivered. Therefore there is no residual accumulation of the drug and no chances of side effects.
Equally beneficial in males and females.
Cyclical medicine is equally effective in males and females. In females instead of finasteride, an additional supplement of iron or any other indicated anti androgen can be used. Post pregnancy hair loss, thyroid related hair loss, PCOD, post menopausal hair loss, all respond well to cyclical medicine.
Pre conditions the hair before a transplant.
Patients planning to undergo a hair transplant will have better results if their hair is pre conditioned with cyclical medicine. The hair loss stops, hair becomes thicker and growth rate is improved. The resultant post transplant hair growth also is better and there is no shock loss after the transplant.
Ensure good growth after a hair transplant.
Hair pre conditioned with 2-4 months of cyclical medicine before the hair transplant is seen to grow better and thicker.
The pre conditioned follicles are easy to work.
Diameter and length of the follicle are improved with cyclical medicine. Pre conditioned hair is thus found to be easy to dissect, easy to handle and easy to implant. The hair also withstands handling, bending and crushing ensuring a good result.
Pre treatment of the follicle prevents post transplant telogen effluvium or shock loss.
Cyclical medicine improves the strength and growth of all the miniaturized hair in the recipient area. Therefore the patients do not suffer post transplant telogen effluvium or shock loss. The pre conditioned hair can withstand the surgery better. Cyclical medicine reverses the miniaturization in the recipient area and improves hair growth. When these new terminal hair grow in the recipient zone, the total requirement of grafts is reduced. Patients can now get the transplant done at a much lower cost and with a guaranteed result. The surgery becomes affordable and more patients are willing to sign in for the procedure. Patients in stage 3 and stage 4 of hair loss may not require any surgery at all.
Pre treatment reduces the number of grafts required.
Sameer Karkhanis, MD
Board-Certified Mumbai Plastic Surgeon
Chief Plastic Surgeon & the Director at CCRS is a qualified Aesthetic Plastic and Reconstructive Surgeon. He is Board Certified, with the qualification of DNB Plastic Surgery (Diplomate of National Board). He is an active member of the International Society of Aesthetic Plastic Surgery.
