Let's Talk Hair Restoration - What you Need To Know

Written By Dr. John Frederick MD, Facial Cosmetic Surgeon Nassif MD Beverly Hills

ABOUT THE AUTHOR

In his practice, Dr. Frederick focuses on comprehensive facial rejuvenation. This includes face-lift, neck-lift, eyelid rejuvenation, skin resurfacing, hair restoration, and rhinoplasty. His approach is centered around facial harmony and a subtle, natural aesthetic.  This often requires addressing not only the skin of the face, but also the deep supporting structures of the face and neck. In-office procedures and surgical interventions are often performed in concert to achieve unrivaled results with minimal downtime.

www.nassifmd.com @drjohnfrederick

Hair! Most of us have it, and most of us want to keep it, so let’s talk a little about things we can do to improve hair quality, prevent loss, and the options for anyone who already has hair loss. The reasons behind losing your hair are often multifactorial, a fancy way of saying that it can involve many things.The most common causes include overall scalp health, mental health such as stress levels, and of course genetics.  

Scalp health is important and also easily addressed. Removing hair products nightly, using high-quality shampoos, and avoiding excessive blow-drying, straightening, and tight braiding all help.  Using a ketoconazole shampoo is also an excellent option to help prevent hair loss due to low-grade fungal infections.

Now, let’s talk about medical options for hair loss. The basics include first starting a hair-formulated multivitamin.  There are tons of brands on the market that will have all sorts of supplements added – but really, any hair-formulated vitamin rich in Biotin and vitamin C, D, and A is better than nothing. The vitamins will provide improvement in hair quality, growth, and texture, but - it will not return lost hair.  

The next step in treatment is topical minoxidil (Rogaine). Minoxidil is an excellent treatment, especially for any loss near the center of the scalp and the crown. With twice daily application, most patients will notice thicker appearing hair with a loss reduction. It can, however, cause scalp irritation and dryness. Also, as with most hair treatments, consistency is key. Finally, there is Finasteride (Propecia). This daily medication can stop most hair loss in its tracts. It is usually very well tolerated with minimal side effects. But again, this will not regrow lost hair; if the medication is stopped, many patients will experience “catch-up” loss. This means that if the medication is stopped, all of the hair that would have fallen out while you were taking the medication starts to fall out very quickly, and it is as if you never took it in the first place. 

So, what options do not involve lifelong medication? Well, there are plenty!  One of the first steps in this category is platelet-rich plasma injections (PRP injections). A small amount of blood is drawn from the patient, and the platelet-rich plasma is harvested from the blood. The plasma is then injected into the scalp. The entire treatment takes around 30-45 minutes, and there is no downtime. The injections have been shown to stop hair loss and actually promote new hair growth. For early loss, this is an excellent option. Recently, additional factors have been used in combinations with PRP, such as exosomes, nano-fat, and stem cells, with similar results.

For significant hair loss, or anyone interested in changing the hair line, a hair transplant is the best option.  Historically this has required taking a large strip of skin off the back of the scalp, which leaves a large scar.  Luckily, that is no longer required. Now, individual hairs are harvested from the back of the scalp, a technique known as follicular unit extraction (FUE). Those individual follicles are then implanted into the areas of loss, providing an excellent, natural result with long-lasting improvement. The transplant is done in the office with local anesthesia and takes around 5 hours. Most patients have some swelling the next day but feel great otherwise.   

Hopefully, this was helpful is giving a quick overview of hair loss and the current options.

In short, there are tons of options and utilizing multiple treatments (and being consistent) is often key.