For young patients with hair loss in the crown, many physicians will advise waiting until later before beginning a restoration program in this area. The physician’s objective is to see how the hair loss progresses, to see what the demand for hair will be. Since the crown is also the least visible area of the scalp and the easiest area to conceal with proper styling, there is usually no harm in waiting.
The current medical treatments for hair loss, Rogaine and Propecia, have shown their greatest clinical efficacy in the crown. The physician may recommend one of both of these treatments in lieu of transplantation, at least in the short-term.
G. Corrective Procedures
1. Prior Transplants
Today, among the best surgeons, the art of hair transplantation is approaching technical perfection. In other words, the transplants are undetectable from natural hair. Many patients who had the less natural-looking grafts from years ago can seek corrective work to achieve a more natural appearance. The physician can soften “pluggy” or “dolls head” type grafts through the use of smaller grafts around the old and through greater variation in the placement. The older grafts tended to be placed in a straight line, which is contrary to the way a natural hairline appears. Another option to correcting prior transplants is “deplugging” which involves extracting a portion of the old plug and redistributing the hair in a more natural way.
2. Facelift Scars
Hair transplants can be used to minimize or eliminate scars produced by other cosmetic procedures, perhaps the most common being facelift scars. Brow lift scars can also be made less visible through the use of transplants. Importantly, many plastic surgeons who perform facial plastic procedures do not perform hair transplants, so check with your physician.
Hair loss may result from some hair dressing techniques. Chemical treatments, hot irons treatments and the long-term wearing of tight braids can all cause permanent hair loss. In addition, severe burns to the scalp can result in hair loss. Hair transplantation may help with a condition resulting from these types of trauma, but only a physician can tell for sure.
4. Eyebrow Restoration
It is possible to reconstruct eyebrows with hair transplantation procedures, but not every doctor is proficient in this type of procedure. It is important to check with your local physician.
H. Grafts v. Plugs
1. Latest Restoration Technology
Samson Hair Restoration’s physicians utilize state-of-the-art technology such as follicular units placed into slit apertures instead of traditional punch grafts placed into holes. These techniques offer higher quality density, shorter recovery times and virtually undetectable results.
2. Old Plug Procedures
Most people have seen the old plug transplant procedures. They were hard not to notice. With those types of procedures, surgeons would transplant tissue containing generally 10 – 20 hairs. This tissue, taken from the donor area (the area around the back and sides of the head) in a circular “plug,” was then “planted” in the recipient area (the balding area). While these transplants did grow, if performed properly, they were very unsightly. They were not at all natural looking, and terribly obvious. In addition, these procedures left large scars in the donor area and very visible scarring in the recipient area.
3. Follicular Unit Procedures
As hair transplantation evolved, the “plugs” got smaller and less obvious and the harvesting techniques got much better. In time, physicians recognized that hair grew in natural clusters of one, two, three and occasionally even four hairs. By transplanting the natural cluster (a follicular unit), rather that a circular “plug,” the physician could produce an even more natural looking result. And, by placing the follicular unit into a small slit rather than a hole, the results were even better still. Today, with state of the art technology and the right surgeon, it is possible to produce results so natural, they are undetectable even upon close inspection. And, in some cases, old plug procedures can be repaired or significantly improved.
I. Non-Surgical Treatments
Over the years, there have been literally hundreds of thousands of non-surgical treatments for hair loss, from the simple hair piece which itself has been around in some form for thousands of years to, “miracle” cures that seem to pop up from time to time. Of course, the vast majority are of no benefit whatsoever. According to the United States Food and Drug Administration (FDA), over 300,000 hair treatment drugs have been marketed since 1996 and only two have been approved by the FDA as treatments for hair loss. The two approved treatments are minoxidil, and finasteride.
This is the active ingredient of Rogaine, the most common topical solution for the treatment of hair loss. Rogaine is applied twice per day to the thinning area and claims a 59% success rate in increasing hair count after 4 months of continual use. It is most effective in the crown area and must be use continuously. If one discontinues the treatment, then any hair that resulted from the drug will soon fall out. Rogaine is an over the counter medication that is available in most drug stores. Side effects are mild and include headaches and rashes. There is a formulation for women as well as men.
This is the active ingredient of Propecia, the most common oral medication for the treatment of hair loss. Propecia, a pill manufactured by Merck, must be taken daily or as with Rogaine, any resulting hair growth will soon fall out. According to Merck, most men can expect no further hair loss. In clinical studies, 83% of those taking Propecia showed no further hair loss after two years of treatment. 66% showed some hair growth. Side effects occurred in less than 2% of men and included loss of libido, reduced sperm count and impotence. All side effects completely resolved once the medication was discontinued. This drug, which is recommended for men only, must be prescribed by a physician and appears to be most effective at retarding future loss.
3. Cosmetic Treatments
There are a number of cosmetic treatments that give one the appearance of having more hair. Perhaps most popular of these is Toppik. Toppik is an all-natural powder made of keratin fiber that is sprinkled onto the hair and gives the appearance of a fuller head of hair. It is available in a number of different colors and may be used by both men and women.
4. Hair Replacement
Wigs, toupees, hair pieces, weaves, hair extensions, hair systems and a variety of products of similar name are all artificial devices that are attached to the scalp. Some use human hair in the construction, some use animal hair and some use artificial hair. The method of attachment to the scalp varies greatly from glues and tape to actual weaving of the artificial hair together with the person’s native hair.
This hair loss solution has been around for thousands of years and is very effective at recreating the look of a very full head of hair. As with any product or service, there is considerable variation in the quality of hair pieces so it is necessary to shop around. For best results, hair piece wearers need to have service (hair cuts and cleaning of the hair piece) every four to six weeks and need to purchase new systems annually.
5. Scalp Treatments
There are a number of treatments, such as Nioxin, that purport to promote healthy hair growth by cleansing the scalp. While none have been approved by the FDA, as a hair growth aid, some of these treatments are quite effective at cleaning the scalp of excessive oils.