Hair Cosmetics for the Hair Loss Patient

Medical professionals that treat patients with alopecia usually lack knowledge about hair cosmetics. Trichologists focus on hair cycling and growth problems and not on the hair shaft integrity. This may lead to abandon of the use of the prescribed treatment, such as topical minoxidil or to inadequate traumatic grooming habits that may jeopardize hair follicle health. Shampoos, hair dyes, and hair-straightening products may alter hair fiber structure, remove lipids, and elude protein. Hair procedures such as hair dying and straightening have side effects and health concerns, especially for pregnant women or sensitive hair and scalp patients. Hair breakage, follicle traction, frizz, contact dermatitis, and mutagenicity are possible side effects of hair cosmetics misuse. The proper use of hair care products may help to increase patients'' adherence to alopecia treatments and avoid health problems related to inadequate application of hair cosmetics and procedures.     

Hair restoration

The impact of male hair loss as a personal and social marker of aging is tremendous and its persistence as a human concern throughout recorded history places it in the forefront of male concern about the physical signs of aging. Restoration of the frontal hairline has the visual effect of re-establishing facial symmetry and turning back time. Follicular unit transplantation has revolutionized hair restoration, with its focus on redistributing large numbers of genetically stable hair to balding scalp in a natural distribution. Follicular unit hair restoration surgery is a powerful tool for the facial plastic surgeon in male aesthetic facial rejuvenation because it offers high-impact, natural-appearing results with minimal downtime and risk for adverse outcome.     

Hair restoration

The introduction of micrografts (1-2 hair follicular unit grafts) and minigrafts (3-4 hair follicular unit grafts) has made a most significant advancement in the care of male pattern baldness and female androgenic alopecia. Finally, natural and aesthetically pleasing results are possible. Additionally, many other applications in the reconstruction of facial hair and scalp have been found, some of these include: restoration of hair loss due to (iatrogenic) post-surgical causes, ie, after facial rejuvenation procedures or procedures involving incisions on hair bearing facial skin or scalp; scalp and facial hair due to burns or to traumatic injuries; post-oncologic resections; hair loss due to congenital reasons such as in cases of complete bilaterial cleft lips (no mustache hair in the prolabium).     

Recipient Area Hair Direction and Angle in Hair Transplanting

BACKGROUND: A variety of recommendations for creating "natural" hair directions and angles in hair transplanting have been described. Objective. A method of accomplishing that goal is outlined. METHODS: Hair direction and angle are determined by multiple partings of the hair during the course of making recipient sites. Incisions are made to mimic such directions and angles. The direction is usually somewhat coronal and the use of grafts containing more than one follicular unit is particularly advantageous in producing a denser appearance. RESULTS: If the above technique is employed, one does not accelerate the rate at which existing hair in the recipient area is lost and the hair flows in a natural easy to manage fashion. CONCLUSION: Surgeons should nearly always mimic the scalp hair directions and angles seen in nature.     

Hair Repair Surgery

Background. Implanted hair follicles generally take and grow well. This can be desirable or undesirable, depending on the skill and aesthetic eye of the surgeon. Older methods employing larger grafts often produced pluggy, bristle brush, or "Barbie doll" hairlines that were unsightly and conspicuous.
Objective. Since patients possessing these outcomes often seek corrective measures, a search was undertaken to find effective, corrective repair methods. Unfortunately, relatively little has been published on this subject.
Methods and results. Discussion will center on recipient site repair, donor site repair, and scar repair. Recipient sites can be improved with a combination of laser ablation, electrolysis, punch removal, and fill-in micrografting. Donor sites can be improved by reexcision, undermining, tissue expansion, and layered closure. Anterior scalp scars may be improved by punch excision and micrografting.
Conclusions. Satisfactory improvement for untoward hair transplantation outcomes may be obtained with one or more corrective procedures in many patients.     

Laser Hair Removal

BACKGROUND: The mechanism and permanence of laser-assisted hair removal remains a formidable task in the medical community. OBJECTIVE: The purpose of this study was to determine the safety and long-term efficacy of the long-pulsed or normal mode alexandrite infrared laser for hair depilation. METHODS: Beginning in October 1996, a total of 31 anatomic sites on 22 patients ranging in age from 25 to 59 years (mean 42 years) were evaluated to assess hair removal. Treatment sites included 17 upper lips, 9 legs, 2 backs, and 3 bikini regions. Eligible patients were of Fitzpatrick skin types I-III. Patients were treated using the long-pulsed alexandrite infrared laser at 755 nm, single-pulse technique, 10 mm spot size, 10% overlap, pulse durations of 5, 10, and 20 msec, and a fluence of 20 J/cm2. Subjective patient improvement and objective, blinded graded improvement was assessed at 1, 2, 3, and 6 months. RESULTS: Objective blinded grading at 6 months revealed that hair reduction varied both with the pulse duration and anatomic location. Maximum reductions observed were 40%, 56%, 50%, and 15% for the lip, leg, back, and bikini areas, respectively. Upper lip hair reduction increased from 40% to 54% at 6 months when a second treatment was performed 8 weeks after the initial treatment. CONCLUSION: The long-pulsed alexandrite laser is safe and effective in reducing hair growth. Treatment efficacy varies with the anatomic location, pulse duration, and number of treatments. A single-pulse technique utilizing a 10 msec pulse duration at 20 J/cm2 produced the greatest hair reduction. No permanent adverse effects occurred on skin types I-III at the parameters tested.     

The Changes in Hair Growth Pattern After Autologous Hair Transplantation

BACKGROUND: Recently donor dominance has been emphasized in autologous hair transplantation while the influence of the recipient site has been considered negligible. In fact, there have been few studies that show this. OBJECTIVE: This study was performed to examine the influence of the recipient site on transplanted hairs. A clinical study of 19 leprosy patients was performed. These patients had received single hair transplantation due to madarosis and were admitted to The Leprosy Mission, Jesus Hospital, Taegu, Korea, or had visited its outpatient clinic. METHODS: In this study, the rate of growth, thickness of shaft, and graying rate between the transplanted eyebrow hair in the recipient site and scalp hair near the donor site were compared to observe the changes in the growth pattern of the hairs after transplantation. RESULTS: For most of the patients, the growth rate and graying rate of transplanted hairs were lower than those of hairs in the donor site. CONCLUSION: It seems that the recipient site may have an influence on the transplanted hairs. Further studies are needed, including clinical, histopathologic, and molecular biological methods.