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Dermatol Surg 2002 Nov;28(11):1035-42; discussion 1042
A philosophy and strategy for surgical hair restoration: a 10-year experience.
BACKGROUND: Three principal strategies have evolved for surgical hair restoration: follicular grafting, scalp reduction, and flap rotation. OBJECTIVE: Although grafting techniques have assumed a preeminent rank as the cornerstone of modern hair-replacement therapy, scalp reduction and rotation methods should not be entirely dismissed. METHODS: Over the past 10 years of clinical experience, the authors have relied on all three methods of hair restoration, carefully tailoring the optimal surgical approach to the patient's expressed concerns and particular regional hair deficit. RESULTS: We have found that scalp reduction and rotation provides a considerable density of hair unmatched by any grafting technique for the vertex and frontotemporal regions, respectively. CONCLUSION: Also we have concluded that the former yields the most natural result for a patient with significant crown baldness who desires hair restoration in that area. However, micro- and minigrafting still represent the overwhelming majority of our operative cases. This article attempts to review the surgical methodology and philosophy that have guided our approach to hair restoration.
Dermatology 2002;205(4):374-7
Hair pain (trichodynia): frequency and relationship to hair loss and patient gender.
Background: Patients complaining of hair loss frequently claim that their hair has become painful. Objective and Methods: The aim of the study was to evaluate the frequency of this phenomenon and its relationship to hair loss. Patients seeking advice for hair loss either spontaneously reported or were questioned about painful sensations of the scalp. Hair loss activity was quantified by a hair pull, daily count and wash test. Telogen percentage was obtained by a hair pluck. The scalp surface was examined by dermatoscopy. Results: Of 403 examined patients, 20% of women and 9% of men reported hair pain, irrespective of the cause and activity of hair loss. A minority presented scalp telangiectasia. This strongly correlated with hair pain. Conclusions: Hair pain (trichodynia) affects a significant proportion of patients complaining of hair loss and may increase the anxiety. The symptom neither allows discrimination of the cause nor correlates with the activity of hair loss. A higher prevalence of female patients might be connected to gender-related differences in pain perception in relation to anxiety. The role of vasoactive neuropeptides in the interaction between the central nervous system and skin reactivity is discussed. In the absence of any correlation with quantitative parameters of hair loss or specific morphologic changes of the scalp, management remains empiric and tailored to the individual.
Dermatol Surg 2002 Sep;28(9):804-7
A random study of Asian male androgenetic alopecia in Bangkok, Thailand.
BACKGROUND: Androgenetic alopecia remains the most common cause of male pattern baldness (MPB) in all races. The prevalence of MPB in Caucasians is well documented. The prevalence of MPB in Asians is believed to be very low, only one-fourth to one-third on average compared to Caucasians. However, according to my previous study, there is a clear trend indicating that it is approaching that of Caucasians. OBJECTIVE: To assess the prevalence of MPB in the Asian population in Bangkok, Thailand; to compare this prevalence to previous studies conducted on Asians; and to compare the results to previous studies conducted on Caucasian. METHODS: This study was conducted by two physicians and assisted by two registered nurses. The questionnaire included age, sex, Norwood classification, diet, family history of baldness, income, and education. The physicians examined the scalp of each interviewee upon completion of each questionnaire. The ethnic focus group in this study was Thai and Chinese who reside in Bangkok, Thailand. The interviews were conducted in hospitals, nursing homes, classroom, medical meetings, temples, parks, and villages. RESULTS: A total of 1124 men were randomized in this study. The prevalence of cosmetically significant MPB (Norwood III-VII) was 38.52% and steadily increasing with age, approaching that of Caucasians. Variant MPB was found to be 0.67% and other types of androgenetic alopecia was 0.6%. From an ethnic point of view, the majority of the groups were of mixed blood and mostly of Chinese origin, thus we were unable to distinguish between Chinese and Thai. CONCLUSION: This study shows that the prevalence of MPB in Asians is not as low as previously thought. The cause of this increasing prevalence is uncertain. There are no past studies in Thailand for comparison, however, it can be extrapolated that the socioeconomic environment and westernized diet may contribute to this prevalence.
J Formos Med Assoc 2002 Mar;101(3):223-6
High-dose steroid pulse therapy for the treatment of severe alopecia areata.
Growing evidence shows alopecia areata (AA) to be a T cell-mediated organ-specific autoimmune disease. This study aimed to evaluate the efficacy of high-dose steroid pulse therapy in Taiwanese patients with severe widespread AA exceeding 40% of the scalp. A total of 17 Taiwanese patients with severe AA lasting less than 2 years were treated once monthly at the outpatient clinic for six sessions. Children younger than 12 years of age received oral prednisolone (5 mg/kg) in three divided doses, while for adults, 500 mg methylprednisolone was infused intravenously over 2 hours. Patients with multifocal AA exhibited the most favorable response, with more than 75% hair regrowth (9/11). Relapse occurred in two patients at 4 and 8 months after the last treatment, respectively. One patient with ophiatic AA showed a transient response, but subsequently lost hair even upon continuation of therapy. Two patients of four with alopecia totalis had full hair regrowth but one lost hair again 6 months later. In the only patient with alopecia universalis, less than 10% hair regrowth occurred. No major side effects were observed. In summary, 11 of 17 patients (64.7%) had more than 75% hair regrowth after steroid pulse therapy. Our results indicated that steroid pulse therapy, given at 5-10 mg/kg once monthly for an average of 6 months, is effective and well tolerated in Taiwanese patients with severe multifocal AA lasting less than 2 years.
Made of well known Chinese traditional herbs, Hair Million is a herbal hair restoration formula that addresses hair loss problems.
Since the herbs have been in use for thousands of years, there have been numerous anecdotal cases so far that Hair Million herbs can really improves the age-related hair thinning and hair loss for a significant fraction of people who take it diligently.
It is unknown how Hair Million stops hair loss, and promotes hair growth, despite all the anecdotal observations.
Neither scientific research nor placebo controlled clinical trials has been conducted due to the cost.
Shortage or total lack of scientific/clinical research is not uncommon in herbal/nutritional arena.
It is not reasonable to stop taking daily food and herbal supplements altogether just because of scietific/clinical support: our life must go on while we stive to better understand food and herb.
There are two merits that Hair Million enjoys: Firstly, Hair Million is relatively inexpensive, and secondly, it is made only of edible herbs that are known to be safe when consumed in regular quantities. Propecia is a clinically tested prescription drug for hair loss treatment.
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