Androgenetic and Non-Androgenetic Alopecia Treatments

IMG_2640Dr. Mejia recently spoke at the American Academy of Cosmetic Surgery in Hollywood, FL. His topics were “Diagnosing and Managing Male and Female Androgentic Alopecia and Non-Androgenetic Alopecia Treatments: When to Biopsy and or refer. Below is a recap of his presentation.

Many people embrace being bald and can live under the mantra that “bald is beautiful”. For many other people, their hair is fundamental to their confidence and the burden of hair loss is great. For these patients, hair restoration or a hair transplant utilizing follicular unit transplants or follicular unit extraction may be an option. Many patients would rather have a hair transplant without surgery if it is possible. In these situations, we attempt to grow hair with laser caps or low level laser treatments in combination with medical therapy. However, a good patient history and clinical diagnosis is essential to ensuring the best possible treatment for the patient. The majority of cases in women are often caused by telogen effluvium, or shedding, and when possible it should be a priority to reassure the patient that everything WILL BE OK!! Patients often experience telogen effluvium 3 months after experiencing stress. For these patients, their hair will come back! In these cases they do not need the Neograft or ARTAS or any other type of laser implants. They do not need to visit Hair Club for men or women as the hair will naturally regrow on its own.

There are many different types of hair loss diseases and it is important for any physician to be able to recognize these diseases. One of these diseases, on the verge of epidemic, is lichen planopilaris. These diseases have treatment plans, but a physician inexperienced with them must be able to know when it is necessary to biopsy or refer a patient to a specialist.

There are many alternative treatment options to androgenetic alopecia when a patient prefers a non-surgical solution. Products such as cosmetic camouflage, micropigmentation, and hair systems are growing in popularity and should be discussed as a possible treatment plan. Other solutions, such as laser therapy and PRP injections are garnering greater and greater support and research but are still relatively experimental and patients should be educated on the fact that these treatments are still new and may or may not lead to hair growth.

When a hair transplant is the best treatment for a patient, it is essential to give a realistic consult. Patients often need multiple surgeries to reach their expectations and that must be conveyed.

Could There Be A New Cure For Baldness Through Cloning?

 

A new study reveals a new possible cure for baldness as shown in this CNBC video this week. The promise of cloning hair is becoming a closer reality. As we discover new genes and treatments for hair loss, the success of being able to grow new hair and make it last may soon be a reality. I am traveling today to the International Society for Hair Transplantation annual meeting where I will be lecturing and educating other physicians about the advances in recipient site techniques for hair transplantation. Scientist and physicians from all over the world will congregate this week to learn about the new and exciting discoveries that make the field of hair restoration possible for many patients.

New Cure for Baldness

There is a new treatment to prevent ongoing hair loss. Prostaglandin or PGD2 is now thought to play a significant role in the development of Baldness.

Researchers and dermatologists Dr. Luis Garza and Dr. George Cotsarelis of the University of Pennsylvania recently identified a form of prostaglandin, or PGD2, in both mice and men scalp areas where baldness exists. This gives hope that the ability to block the action of PGD2 or its recently identified targeted receptor, GPR44, early in the process of hair loss could prevent or stop hair loss altogether.

In a language both you and I can understand, this means no more male pattern baldness and possibly no more female pattern hair loss.

While the study tested the hair loss causing effects of prostaglandin on the bald areas of mice and men’s heads, future studies may indicate a similar effect in women.

Currently approved therapies for hair loss consist of an orally taken once-a-day tablet called Propecia or Finasteride combined with the topical solutions Rogaine or Minoxidil which is applied to the scalp twice a day as a liquid or foam. Finasteride blocks testosterone from being converted into dihidrotestorone, which has been found to play a significant role in male pattern baldness. Rogaine or minoxidil reinvigorates the hair follicle to prevent it from shrinking or miniaturizing.

The exact mechanism through which dihidrotestorone causes male hair loss is unclear. However, with this key development, we might soon see topical solutions of prostaglandin inhibitors applied to scalps to stop the balding process.

Will it work better than minoxidil or finasteride?

This is not clear yet, but test results are certainly promising. Current studies are testing the effectiveness of topical prostaglandin inhibitors. Test results suggest they work but before we can use prostaglandin inhibitors to treat baldness they must pass tests for safety and efficacy standards. Though even before the safety tests have been completed, we will likely see an explosion of topically applied products claiming to block prostaglandins without full scientific testing of whether those products actually work.

Not all prostaglandins are alike. This study specifically looks at the PGD2 pathway coupled with the GPR-44 receptor but not the PGD2 receptor 1 (PTGDR). Consequently it is necessary to test the right topical product on the pathway described. While studies were done in mice and men, we can not jump to the conclusion that any known substance that has the ability to block prostglandins will actually penetrate through the scalp and get into the hair follicle at the cellular level to block prostaglandin D2 in the right concentration to get the action described in this study.

So buyer beware of any future topical product claims. There is new hope in the horizon with this study for gene therapy and possibly the ability for directed gene therapy to completely stop the balding process. Time will tell.

Kudos to Dr. Garza and Cotsarelis for their research and dedication to combating hair loss.

Hair Loss Solutions – Dr. Mejia’ Opinion On Fox News Show


Hair Loss Solutions for both men and women with hair loss include Rogaine, laser therapy and hair transplantation that can produce natural results. For men, another hair loss treatment is Propecia. In this video, Dr. Mejia discusses some options after a TV show segement he saw today on Fox News. The causes can be many and there are many treatable causes that a board certified physican can help you with.

Dr. Mejia explained many of these causes in the prior post in which he explains telogen effluvium in depth. This will explains the reasons for hair loss and what you can do about it. Many of these hair loss solutions don’t require surgery or medical therapy. It is a basic understanding of what is going on.

However , for those patients that desire more intense density or reconstruction of their hair line or just want to get their hair back that they have lost, then that is when they need to visit their dermatologist and hair restoration surgeonn to help them plan the best alternative and treatment for medical and hair restoration treatment.

Telogen Effluvium And Causes Of Hair Falling Out In Women

Before I explain Telogen Effluvium, we need to differentiate between the two major causes of hair falling out in women.

  • 1) Genetic – Typically a slow gradual progression of hair loss over time in which most patients don’t see a significant amount of shedding. They notice most of the thinning in the frontal area. The back of the hair looks pretty good. This occurs in a variety of different women and a variety of patterns. Mostly, it is the thinning in the front. They usually retain the frontal hair line.
  • 2) Shedding Type of Hair Loss – This is a distressing type of hair loss which is called telogen effluvium. This is the type of hair loss that comes out in globs.
    There are many different reasons for a shedding type of hair loss.

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