The expert: «Before deciding, it is always better to consult a specialist. Artificial hair? The treatment is by no means definitive, nor without side effects.”
The singer Marco Masini said he had faced the problem of hair loss, resorting to “thickening with artificial hair”. But what are artificial hairs, how are they transplanted and what is their real effectiveness? “Before to carry out any type of intervention, it is necessary to contact the specialist and seek advice » warns the Professor Santo Raffaele MercuriHead of Dermatology and Cosmetology at the IRCCS San Raffaele Hospital in Milan: «Artificial hair transplantation has a number of problems: not everyone can do it and in any case there is a risk that the body activates a dangerous rejection reaction. So I wouldn’t recommend it to my patient.” Let’s see first what are the causes of hair loss And what are the really effective remedies and scientifically proven to counter a problem that is not only aesthetic, but has strong psychological implications for those who suffer from it.
Always contact a specialist doctor
What is best to do if there are signs of hair loss? “You always have to go to doctors. In particular to the specialist doctor, dermatologist or trichologist (there is also a register of trichologists and a scientific society, the Sitri
ed). It is essential to undergo a specialist visit to understand what type of baldness you have and then get a proper diagnosis. Then, based on this, receive the right suggestions. For example if a man has a round patch on the scalp it is an alopecia areatalinked to a dysfunction of the immune system. There are cytotoxic T lymphocytes and Natural Killer lymphocytes, which do not recognize the hair bulb because it is altered – and also in this case there may be a genetic predisposition – they attack and destroy it. It’s an autoimmune disease.”
When should you start worrying? «As regards androgenetic alopecia, problems begin at the age of 16: the hair and scalp become oilier and the hair begins to fall out. Many adolescents come to us in these conditions. The thinning is seen in the temporal, frontal and occipital regions, the so-called “cleric”, and the hair loses its consistency”.
The causes and different types of hair loss
What are the most common causes of hair loss? «There are on average about 100,000 hairs on the scalp. Every day 50 to 100 are lost which are then replaced by new hair. When there is significant baldness, it is referred to as alopecia. The most common is theandrogenic alopeciamasculine and feminine, the telogen effluvium and thealopecia areata. «Androgenetic alopecia is the most common form and is determined by male hormones, even if it does not exclusively affect males. It occurs around the age of 16-17 and in men who are genetically predisposed.
Where does this predisposition come from? «From the presence in the pilosebaceous follicle of an enzyme called 5 alpha reductase which converts testosterone – which is the male hormone in men produced by specialized cells present in the testicles – into its active form which is the dihydrotestosterone, main cause of hair loss.
What are the consequences? “Because of this hormone the hair weakens, until it almost disappears, the so-called “miniaturization of the hair” which from thick becomes thinner, then very thin, then falls out and a scar is formed”.
What is meant by scar? «Below the pilosebaceous follicle there are no longer the stem cells contained in the bulge (the suprabulbar area which forms a swelling where the adult mesenchymal stem cells responsible for the continuous renewal of the follicle, ed) and the hair can’t grow anymore».
What needs to be done in this case? And «At that point the only treatment that can be done on the scar of androgenetic alopecia it is hair transplantation. In this regard, a premise must be made. In males, the enzyme 5 alpha reductase is more prevalent in the crown and sides and less present in the occipital region. This is why the hair does not fall out on the nape of the neck. This alopecia has a hereditary character that is transmitted by maternal line, therefore on the mother’s X chromosome ».
Other causes? « It depends on the type of fall. In the telogen effluvium, a very common form, hair loss is linked to stress, which is not the only cause. It is due to an early transition to the telogen phase. The hair regrowth cycle has three phases: anagen, catagen and telogen (hence the name). The first, of active growthlasts from 2 to 7 years in women and 2 to 4 years in men. The second, in which the follicle stops its proliferative activity and the hair doesn’t stretch anymore, it lasts 2-3 weeks. The third, in which the hair falls out mainly when washed and combed, it lasts 3 months and usually marks the beginning of a new cycle. When there is a sudden transition from anagen to telogen, therefore a shortening of this phase, there is telogen effluvium and this occurs mainly due to stress».
How to fight hair loss: drugs
There are different types of remedies to combat hair loss. “We have it available topical treatments such as minoxidil
, drug that increases the blood supply to the hair follicle, to be applied to the affected area, and which is the most used worldwide. It can be applied to the scalp in the form of a lotion or a foam. Concentrations vary from 2 to 5%. Then we have oral drugs such as finasteride, which acts on the 5 alpha reductase enzyme by blocking the transformation of testosterone into its active form, to be taken by mouth”
With what results? «It depends on the individual response, but finasteride could give some problems such as the reduction of sexual desire. The patient must always be informed of what could happen, however in 80% of cases this side effect does not occur”. Today we have monoclonal antibodies, the Jak inhibitors which work very well in alopecia areata. And they are treatments that the National Health Service passes.
Platelet gruel (PRP)
Another technique that we have been using for more than 10 years is PRP, which stands for platelet-rich plasma. It consists of a blood sample directly from the patient from which a serum rich in platelets is obtained (up to seven times higher than normal) useful for cell regeneration. This serum will then be injected, using very thin needles, a few millimeters deep into the scalp in the areas to be regenerated. It is a natural substance that is obtained by centrifugation of blood. This therapy exploits the platelet content for increase growth factors and consequently accelerate the regeneration of pilosebaceous follicles that are not yet atrophic, where we still have stem cells. The result of this therapy is seen within 3-6 months. Somehow the hair is thus “fertilized”. We usually recommend 5 sessions, one a month. The PRP goes to create both a new blood vessel formation and more importantly, it goes to stimulate adult mesenchymal stem cells in the bulge to produce hair. The indications are: for all types of alopecia as long as there is hair. It is not an alternative to a transplant but an aid: all those who do it are then subjected to Prp”.
When is transplantation indicated?
When can there be an indication for a transplant? «Transplantation is the last resort. The hair follicles are harvested from a donor area with a high density of hair such as the nape of the neck where it is genetically not predisposed to hair loss because the enzyme 5 alpha reductase is less present and move to areas with no active follicles. The follicles they can be transplanted one by one or in strips so that there is no void in the area where the hair was harvested. It is an autotransplant and gives more results. Today there are specialists only for this type of intervention and we at San Raffaele do it. We have lots of requests. Many people also go abroad to have a transplant but we must remember that it is a real surgery.
The two techniques available today are: the so-called Fue (Follicular unit extractio, Follicular Unit Extraction) is a method of autotransplantation which involves the extraction of the bulbs individually, follicle by follicle. This technique has evolved up to the high intensity hair transplant (Micro Fue) which employs instrumentation of such small dimensions as to leave no trace of the follicular explantation that took place. Then, there is the FUT (Follicular Unit Transplantation) is a hair transplant technique that consists of taking a strip of leather
scalp in the occipital region. Then these strips are dissected and the hair is implanted one by one.
The results? “They are very good. In expert hands and in valid hygienic conditions, the transplant gives excellent results”.
Synthetic hair graft
As for synthetic hair, what is the situation? “So long as transplantation in areas where the skin tissue is very thin is strictly avoided, patients who would like to have surgery in these areas cannot even undergo a hair transplant. So who does the hair transplant synthetics, if problems should then arise, they could not even undergo an autotransplant in the same area”.
The side effects
What kind of problem could a synthetic hair graft cause? “Practically the body perceives the artificial fibers as a foreign bodyinstead in an organic hair transplant procedure the body recognizes that the tissue belongs to the person and therefore no reaction of the immune system occurs ».
«Another important aspect of artificial hair transplantation is that i canals in which the artificial hair is inserted never heal completely. This means that there is always an open entrance to the outside creating an ideal environment for bacteria and other microbes. This causes the body to have a constant immune reaction which can inevitably lead to infections or inflammation of the scalp. Whether the hair is then inserted with a knot, with a Japanese or Korean technique or something else, the problem always remains the same. Over time, moreover, the hair gets damaged. Since they fall, you have to constantly undergo a transplant», concludes Professor Mercuri.
April 1, 2023 (change April 1, 2023 | 2:30 pm)
© REPRODUCTION RESERVED
#Hair #transplant #transplant #techniques #results #side #effects
Leave a Reply