In the midst of all the preparations for the big event, what are the groom’s concerns? When he pictures his wedding, whether he is striding atop an elephant or sitting under the mandap with his bride and her family, his wish is likely to be as handsome and virile as his bride is beautiful and glowing. Men may not always care about wrinkles or furrows, but what they hate more than anything is a receding hairline and scalp show at the crown.
In 2010, a team headed by Yashwanth Kamath, the former head of the Textile Research Institute in Princeton, New Jersey, tested samples of hair for four characteristics of healthy hair: thickness, tensile strength, shine, and smoothness. Caucasian, Asian and South Asian hair were put to the test for the World’s Best Hair study. Their results put an end to any splitting of hairs over the issue: of the ethnicities studied, South Asian hair was the healthiest, besting the other groups on all four counts.
Despite the health and aesthetic beauty of South Asian hair compared to other ethnicities, hereditary balding, or male-patterned androgenic alopecia (MPAA), is somewhat more common in South Asia than in the USA, although less common than in Spain and Europe. A survey of 37,000 South Asian males revealed an overall self-reported incidence of 63%, with almost half of males in their 20’s reporting some hair loss!
The Cause of Hair Loss
Male pattern hair loss is an inherited condition, caused by a genetically-determined sensitivity to the effects of dihydrotestosterone, or DHT. In some areas of the scalp. DHT is believed to shorten the growth, or anagen, phase of the hair cycle, from a usual duration of 3–6 years to just weeks or months. This occurs together with miniaturization of the follicles, and, with each complete cycle, the production of progressively fewer, shorter and finer hairs. Ultimately, the affected follicles will stop producing even these tiny hairs. The production of DHT is regulated by an enzyme called 5-alpha reductase. Several genes are involved, accounting for the differing age of onset, progression, pattern and severity of hair loss in family members. The susceptibility genes are inherited from both mother and father, so it is a myth that you can only inherit balding from your mother’s side of the family.
But other factors can contribute to its severity. The hair follicles can be damaged by oxidation from internal and external toxins: for example from pollution, chemicals, and ultraviolet light. It has recently been determined that the progenitor cells or stem cells for growing hairs in the scalp are found in the dormant, rather than active, state in larger numbers in balding individuals, which means that although the follicles are still present, they are not producing hairs.
Finding the Answer
Men are searching for answers to hair loss. They want treatment that is effective, with minimal discomfort, and with little-to-no downtime. And they want it now. Today, we are closer to being able to meet these demands than ever before.
The best results are seen with an approach that deals with many of the causes of hair loss, including blocking the effect of DHT on hair follicles, preventing and reversing the damage to follicles from toxins and free oxygen radicals, and waking up dormant stem cells as well as repopulating the scalp with new stem cells that will grow young, healthy hairs. Remarkable results are being seen with a combination of microneedling with PRP, nutritional supplements, and topical medications.
The use of PRP, or platelet-rich plasma, for hair loss was first investigated in 2007, but has been made available to patients by a limited number of trained, board-certified dermatologists, who are Hair Experts, from the US and around the world for only a few years. PRP is being investigated and has been applied to a number of health problems and skin issues, including arthritis, acute tendon and joint injuries, melasma, surgical, traumatic and acne scars, fine lines, furrows, and stretch marks. PRP is also the active ingredient of the so-called “vampire facial” made famous by Kim Kardashian. It is a preparation of platelets and their associated growth factors prepared from a patient’s own blood via a specific centrifugation, separation, concentration, and activation protocol. For hair loss, it is applied to the scalp gently by microneedle and also injected deeper into the scalp. Since PRP is prepared from the patient’s own blood, there is no possibility of an allergic reaction.
Patients rarely need any numbing, although the application of ice or cold air can be used. Rarely, a small amount of lidocaine can be mixed into the PRP or injected prior to treatment to numb the most sensitive patients.
The entire procedure including the drawing of blood from the arm, preparation of the PRP, injection into the scalp and microneedling takes about 30 minutes. The scalp can be shampooed the next day. There are no restrictions in activity or other changes in normal grooming routines, other than avoiding aspirin and NSAIDS (nonsteroidal antinflammory agents like ibuprofen), as well as smoking for several days before and after, and alcohol for several days before the procedure.
The growth factors that are introduced to the hair follicles awaken dormant follicles and call new stem cells from the circulation which differentiate into young, healthy hair follicles, resulting in the growth of new, healthy hairs.
How Much and How Often?
The procedure needs to be performed more than once, typically monthly for three to four months, to achieve significant new hair growth. And since pollution, sunshine, toxins from food and our environment are not going away anytime soon, and we cannot stop the fact that every day we are older than the day before, many men return for a treatment approximately once a year to maintain or further the results. Ideally, when preparing for a big event, you would want to start at least 3 months in advance, although 6 to 12 months is better.
Much better and more durable results are seen, with fewer PRP sessions needed for significant regrowth, if treatment is combined with a nutritional supplement for hair loss such as Nutrafol or Vivescal. In addition, Propecia (finasteride) and/or topical Rogaine (minoxidil) may be beneficial, although the best results without systemic side effects are seen with a medicated compound tailored to each patient’s needs and formulated with finasteride, minoxidil, retinoid acid, turmeric, resveratrol, lavender oil and several other ingredients to be applied directly to the affected areas of the scalp. These oral and topical FDA-approved ingredients and nutritional supplements block all of the pathways of damage to hair follicles or induced dormancy of hair growth for synergistic effects.
Effectiveness and Cost
Early studies with PRP showed that more than 50% of patients treated with PRP regrow significant amounts of hair. The protocol has since been optimized, and a much greater percentage of patients are responding. In my practice, I have not seen any treatment failures.
The cost varies by the amount of PRP that needs to be prepared and the size of the treatment area. Generally a single treatment is $600 to $1000, and discounted packages are usually offered.
And for Women
It has been gratifying to see that women with female patterned androgenic alopecia have responded just as well, with some tweaks in the nutritional supplementation and topical compound, such as the addition of spironolactone to the compound.
Patients notice renewed confidence and often more success in their work and private lives. And that’s something we all wish for, getting married or not.
By Sheryl Clark, MD
The Center for Aesthetic and Preventative Dermatology
Skin Care Medical Professional
109 E 61st St
New York, NY 10065-8101
212.750.2905
Scientist and researcher Dr. Sheryl Clark is committed to providing only the best in aesthetic and medical care. She has a special interest in wedding planning, and has helped many brides and grooms and their wedding parties get their glow on! Board-certified.
