Hair Restoration Blog

Hi
I am 36 year old from Faridabad.  I have had Alopecia Areata (AA) since12, I took Ayurvedic treatment & after about 5 years alopecia areata appeared again since then it is continuous almost. Hairs goes in patches from all over the body including eye brow and eye lashes, but additional thing with me is that I feel itching on the place from where hairs are going to fall with pain on the itching area too, then consequently within 1-2 days hairs falls and leaves red patch behind pains also gets disappeared.  After that I start using Diprovate lotion twice daily on affected area.  Hair comes within month then I stop using Diprovate.  But normally hair length goes to only 8-10 inches and then again hair loss same process going on since 1980. One thing I observed is that places of hair loss patches are almost fixed.  One thing I also used some hormonal injections too but as usual no permanent remedy.  Do you also feel pain before falling of hair on the place of hair fall on the scalp?  Generally I felt pain on scalp only though hair loss periods.  Pain is only on scalp.

A:

It seems like you are experiencing episodes of patchy baldness.  Although hair loss in a patchy form is usually considered alopecia areata or AA, your condition is not a typical one.  Alopecia areata is usually painless and the changes in skin shape and color is not that noticeable except for the hair loss.  There are some other hair loss conditions that may present themselves as patchy hair loss such as Cicatricial Alopecia in which an inflammatory reaction causes hair loss.  A diagnosis could be established through direct examination and biopsy of the scalp from hair loss lesions.  My recommendation to you is to see a good dermatologist and confirm the diagnosis of your condition.  Hair transplant is not indicated in many types of patchy hair losses, but your hair transplant doctor can discuss it further after reviewing your scalp biopsy results.

Q:

My question is based on a hair transplant that wasn’t successful.  I received a hair transplant at [blocked hair transplant clinic name] and my hair never grew in the area and I followed all the directions carefully. Is there any other solutions to bring back my hair?
A:

The survival of transplanted hair is usually a concern among the patients who undergo hair restoration.  Transplanted hair might never grow or have suboptimal growth in several conditions.  We can categories those into two major groups:  1. Technical problem and 2. Patient factor.

• Hair Transplant Technical Problems:

  • Hair graft preparation and handling problems:  inexperienced technicians may manipulate hair grafts more than what they can tolerate.  That may damage the proliferated follicle cells during slivering, graft harvesting or implanting so the transplanted hair can never grow.
  • Graft maintenance problems:  Hair follicles should be kept in suitable physiologic solutions from the moment they are removed from body till the time that they are placed in their destination.  The temperature of the solution should always be kept between 0 - 4 degree Centigrade to lower the cell metabolism and prolong the longevity of follicular cells.
  • Problems during implantation phase:  If the sites are too tight, technicians may manipulate hair grafts too much that may affect the final potential of hair cells to grow.

• Patient Factors:

  • Many skin conditions may restrict or stop the growth of transplanted hair.  Some of those conditions are Alopecia Areata, Alopecia Cicatricial and many other medical conditions that may have caused hair loss in the first place.  Preoperative microscopic and macroscopic evaluation of hair and scalp is crucial to rule out any condition that may limit the growth of transplanted hair.  Hair transplant surgeons should raise questions for these in atypical hair loss conditions especially in patients who do not have a family history of similar hair loss condition.  The diagnosis should be confirmed by scalp biopsy.
  • Care after hair transplant play a major role in the final results of a hair transplant procedure.  Physical trauma to the transplanted hair may cause losing newly transplanted hair, including pulling hair, scratching head or psychological conditions such as trichotillomania in which patient pull hair due to an obsessive compulsive disorder.

If you experienced less than desirable results from your hair transplant surgery after one year from your hair transplant surgery, you need to see a good hair transplant surgeon to reevaluate your condition and potentially treat the disorder that has caused your less than desirable growth.