The first step to solve the alopecia is a good diagnosis, since each type has a different treatment and evolution. Some problems can be solved with medicines but in most cases, the best solution is a transplantation of the patient’s own hair.
It is very important to see a dermatologist for a diagnosis of the problem. These are the most common types of alopecia:
- Reversible alopecia: hair loss usually is due to dietary deficiencies. In this case, baldness is caused by excess hair renewal. But once we solve the problem, it is possible to recover the hair.
- Irreversible Alopecia: The most common cause of hair loss is hormonal or androgenic alopecia, which constitutes 90% of all cases. It affects 65% of men and between 15 and 25% of women.
The cause is a hereditary predisposition that determines a higher sensitivity of hair follicles to the action of the “dihydrotestosterone” male hormone. Testosterone acts reducing the hair life cycle, altering thus the fall and regeneration cycle. Sometimes it occurs due to diseases originated during the hormonal balance (ovarian, adrenal or pituitary). However, in most cases there is no pathology associated with hair loss. Androgenetic alopecia in men affects the crown and frontal and temporal region (receding hairline) of the scalp, respecting the neck and lateral regions. Alopecia in women has a different, vaguer pattern, appearing in the central area but respecting the receding hairline.
Waiting for finding the final medical solution to baldness, hair transplantation remains the best technique to treat most of the patients with androgenetic alopecia. The transplantation consists in extracting the hair follicles from the patient, from the back of the head (donor area) in order to reimplant them into the balding area. The 92.8 of the transplantations are performed in the head and the remaining 7.2 in facial areas such as eyebrows or eyelashes.
The scalp hair does not come out one by one, but in groups of 1-4 hairs known as follicular units. The transplantation technique currently used is known as “Follicular Unit Transplantation – FUT”, which indicates that all grafts that are transplanted are follicular units. This implies that the result of transplantation nowadays is completely natural and undetectable, unlike the transplantations that were made over 20 years ago in which large punches were used providing an artificial result called “dolls hair”. To extract the follicular units from the donor area, we can use two methods:
- FUSS Method: Follicular Unit Strip Surgery. The technique basically consists in removing, under local anaesthesia, a strip of skin from the occipital area of the scalp from which the hair grafts are dissected under a microscope. This technique requires team effort, usually a team composed of the doctor and 3 or 4 medical assistants who dissect the follicular units.
- FUE Method: Follicular Unit Extraction. It is another method of extracting follicular units. Units from the donor area are extracted one by one, under local anaesthesia, using a circular punch of 1 mm diameter.
Obtaining the grafts by both the FUSS and the FUE method, the insertion of each graft or follicular unit in the receiving area is carried out one by one, either with special tweezers or with special hair implanters designed specifically for this technique. The transplantations therefore are very long sessions that can last from 4-8 hours depending on the number of follicular units to be transplanted, and sometimes it is required more than one session at intervals of approximately 8-12 months.
The “new” hair begins to emerge after three – four months after transplantation and remains for life. Generally, the growth rate of transplanted grafts is 80-90%.
Since it is the patient’s own hair what is used, this one has the same characteristics of colour and brightness and it can be cut and combed normally.