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Dr.
B.L. Limmer |
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 HAIR LOSS - PREVENTION AND RESTORATION By the age of fifty, hair loss affects approximately fifty percent of males and thirty percent of females to a cosmetically problematic degree. The vast majority of these hair loss cases are genetic in basis. The minority of cases may be due to underlying illnesses, endocrine problems, scalp disease, medications, or other more rare causes. The medical therapy of androgenetic alopecia (male pattern alopecia, female pattern alopecia) currently produces favorable responses in over fifty percent of those treated. Early therapy is critical to the success. The highest response rates occur with combination therapy consisting of 2% or 5% Minoxidil topically applied twice daily and Finasteride 1 mg daily. Some individuals feel that Nizoral shampoo, because of its anti-androgen effect is worthwhile as well. The combination of Minoxidil topically and Finasteride orally produces a synergistic response in experimental animals of approximately forty percent greater hair growth than the sum total of these products used individually. For that reason, those seriously interested in retaining or improving their hair growth should combine therapy for a minimum of one year and then evaluate the response. Shorter time courses of therapy do not permit appropriate evaluation of response. Photographs before and every twelve months after initiation of therapy are highly advisable. For those who do not respond to therapy, three options remain: Accept the genetic fate dealt, wear hair systems, or proceed to hair restoration by transplantation. The use of naturally-occurring follicular groupings in the restoration process referred to as follicular unit transplantation methodology has made it possible to transplant virtually any case with a resultant natural and undetectable result. The only limiting factor is the availability of donor hair and the emotional and financial commitment to the process. Over ninety percent of the hair follicles transplanted survive the relocation process and produce normal hair growth for the remainder of the individual's life. The process of transplantation works equally effectively in males and females. Because the follicular unit grafts are placed in very small needle stick sites (19-22 gauge needles), the healing process is complete within seven days. Follicular unit transplantation is also effective for other hair loss problems including loss of eyebrows, traumatic, surgical, or radiation scars, and a very effective repair method to improve the appearance of plug graft cases from prior methodology. On the future horizon lie a number of interesting possibilities. The first of these is medical therapy Dutasteride (Avodart). The side effect profile in relation to sexual dysfunction has prevented most physicians from off-label prescribing of this drug. A number of ongoing research projects involving the use of stem cells of follicular and perifollicular origin offer promise, but such research is relatively embryonic at this point, and initial attempts utilizing such methods have met with little success to date. However, because this field represents a substantial market, expect to hear more about these research areas in the coming years. Dr. Bobby Limmer Photographs of restoration cases.
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