Hair Transplantation

Hair transplantation is a surgical technique that moves hair follicles from a part of the body called the 'donor site' to a bald or balding part of the body known as the 'recipient site'. It is primarily used to treat male pattern baldness. In this minimally invasive procedure, grafts containing hair follicles that are genetically resistant to balding, (like the back of the head) are transplanted to the bald scalp. Hair transplantation can also be used to restore eyelashes, eyebrows, beard hair, chest hair, pubic hair and to fill in scars caused by accidents or surgery such as face-lifts and previous hair transplants. Hair transplantation differs from skin grafting in that grafts contain almost all of the epidermis and dermis surrounding the hair follicle, and many tiny grafts are transplanted rather than a single strip of skin.

Since hair naturally grows in groupings of 1 to 4 hairs, current techniques harvest and transplant hair "follicular units" in their natural groupings. Thus modern hair transplantation can achieve a natural appearance by mimicking original hair orientation. This hair transplant procedure is called follicular unit transplantation (FUT). Donor hair can be harvested in two different ways: strip harvesting, and follicular unit extraction (FUE).

How does Finasteride work?
Finasteride is a 5?-reductase type 2 inhibitor. It reduces the conversion of testosterone to DHT.

What is the benefit of taking Finasteride?
In 80% of those undergoing Finasteride treatment, significant increases in hair count and fiber size are observed along with prolonged hair growth periods.

How long will it be before improvements are noticed through the use of Finasteride?
Improvements are noticed 6-12 months from the commencement of treatment. Two years of use are required to achieve the maximum effect, and continuous use is recommended in order to maintain this benefit. The discontinuance of the treatment will cause undesirable results.

Where on the scalp is Finasteride more effective?
Finasteride is more effective over the vertex and superior-frontal regions of the scalp. However, it is potentially effective wherever miniaturized hair is present.

What is the recommended dosage?
The average dosage is 1 mg/day, but with a dosage of 0.2 mg/day significant improvement is observed.

Is there a potential for reaction with other drugs?
No known drug interaction exists.

Is there any disease or condition that contraindicates the use of Finasteride?
Finasteride use should not be used by women who are pregnant and by patients with liver disease.

What are the adverse effects?
Reported adverse effects of Finasteride use include: decreased libido (1.9%), erectile dysfunction (1.3%), and ejaculatory dysfunction (1%). In some patients, the adverse effects of the medication persisted for at least 3 months after discontinuing use. Although clear causation has not been determined, the FDA has warned about its potentially persistent adverse sexual effects, despite discontinuation. Finasteride works to reduce prostate-specific antigen (PSA) levels and gynecomastia has been reported in rare cases. A recent study investigated the association between 5-ARI’s and male breast cancer. The result revealed a lack of positive association.

How does Finasteride work?
It is still unclear how Minoxidil works. It may prevent or delay follicular miniaturization.

What is the recommended dosage of Minoxidil?
With MPHL, a 5% solution is superior to a 2% solution. With FPHL, both 1% and 2% Minoxidil solutions increase hair count. The recommended dosage is 1 ml (25 drops) for both 2% and 5% formulation, or half a cap full of foam applied twice daily.

How long is the Minoxidil treatment?
Minoxidil treatment is long-term. The discontinuation of Minoxidil will cause the shedding of all Minoxidil-dependent hair within 4 to 6 months.

What are the adverse effects of Minoxidil?
The adverse effects of Minoxidil include skin irritation, hypertrichosis on the face and hands, and tachycardia. A propylene glycol–free foam preparation of 5% is potentially less irritating and less messy. Hypertrichosis is totally reversible. The adverse effects of Minoxidil include skin irritation, hypertrichosis on the face and hands, and tachycardia. A propylene glycol–free foam preparation of 5% is potentially less irritating and less messy. Hypertrichosis is totally reversible.

Is there any disease or condition that contraindicates the use of Minoxidil?
Minoxidil should not be used in pregnant or nursing women. It should be used with caution in patients with cardiovascular disease as well.

How does Dutasteride work?
Dutasteride inhibits both type I and II 5?-reductase consequently increasing hair count and hair weight by improving the ratio of anagen to telogen hairs, and resulting in improvement in scalp coverage.

What is the recommended dosage?
The Dutasteride dosage of 0.5 mg/day is considered adequate to improve or prevent the progression of MPHL.

What are the adverse effects of Dutasteride?
The adverse effects of Dutasteride are impotence, decreased libido, breast tenderness, breast enlargement, and ejaculatory disorders.

Is there any disease or condition that contraindicates the use of Dutasteride?
Because of its long half-life, men who are being treated with Dutasteride should not donate blood. Dutasteride should not be used in women of a reproductive age without the use of effective contraception. Additionally, liver function should be monitored while taking this drug.

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